Term
| What is muscle imbalance? |
|
Definition
An initial injury causes hypertonic muscles causing:
Lower excitability thresholds
More powerful inhibition of their antagonists
Delayed activation of the agonists in the same group (which are relatively inhibited) |
|
|
Term
| How does muscle imbalance impact muscle firing? |
|
Definition
Causes an improper firing pattern during activity proportional to the degree of hypertonicity
Due to poor coordination between the central and peripheral nervous systems |
|
|
Term
| What are the results of muscle imbalance? |
|
Definition
Abnormal movement pattern causes abnormal proprioceptive feedback
Results in adaptations to abnormal feedback that lead to uncoordinated movement, increasing the chance of further injury which then lead to further adaptations |
|
|
Term
| What process of muscle imbalance causes the pattern of dysfunction leading to clinical manifestation? |
|
Definition
| Perpetual cycle of injury-adaptation-injury-adaptation |
|
|
Term
| What lower extremity muscles are prone to hypertonicity? |
|
Definition
Iliopsoas
Quadratus lumborum
Piriformis
Hamstrings
Lumbar erector spinae
Rectus femoris
Tensor fascia lata
Is Quiet Phil Hoping Laura Reads Tolkein? |
|
|
Term
| What lower extremity muscles are prone to inhibition? |
|
Definition
Gluteus maximus, medius and minimus
Rectus abdominis
External and internal obliques.
Vastus lateralis and medius
Tibialis anterior
Fibularis longus and brevis
Glue Requires Extra Vents To Fib |
|
|
Term
| What upper extremity muscles are prone to hypertonicity? |
|
Definition
Pectorals
Latissimus dorsi
Upper trapezius
Scaleens
Sternocleidomastoid
Suboccipital group
Pete Lives Up Stairs, Still Subs |
|
|
Term
| What upper extremity muscles are prone to inhibition? |
|
Definition
Rhomboids
Lower and middle trapezius
Deltoids
Supraspinatus
Longus colli and capitus
Ron Trades Deer Soup Longingly |
|
|
Term
| Lumbar lordosis is maintained by hypertonicity of what muscle? |
|
Definition
|
|
Term
| What might cause a hypertonic iliopsoas? |
|
Definition
May be a result of habitual long term sitting
Causes a deep dull ache in the lumbar area and a difficulty in extension
Difficulty rising from a chair |
|
|
Term
| What would cause round shoulders and an increased thoracic kyphosis? |
|
Definition
| Hypertonic latissimus dorsi, and pectorals due to prolonged sitting/iliopsoas |
|
|
Term
| What allows the scapula to protract in due to rounded shoulders? |
|
Definition
| Hypertonic pectorals inhibit the lower trapezius and rhomboids |
|
|
Term
| What compensates for the instability of the scapula due to round shoulders? |
|
Definition
| Upper trapezius and levator scapula |
|
|
Term
| What moves the neck anteriorly as a result of chronic lumbar lordosis? |
|
Definition
Deep anterior cervicals are inhibited while the superficial cervicals (scalenes and SCM) become hypertonic
Hypertonic suboccipital muscles develop to keep the head forward |
|
|
Term
| What inhibits the gluteal muscles and the lower abdominal muscles during lumbar lordosis? |
|
Definition
|
|
Term
| Inhibited gluteal muscles and the lower abdominal muscles causes hypertonicity of what? |
|
Definition
|
|
Term
| What are the goals of treatment for exercise prescription? |
|
Definition
Retrain sensorimotor control
Improve the quality of muscle function
Reduce articular restriction and unequal pressure on weight bearing joints by reducing mechanoreceptor over sensitization.
Improve posture
Improve aerobic and nutritive support to the tissues |
|
|
Term
| How do you improve the quality of muscle function? |
|
Definition
Stretching the hypertonic muscles.
Retraining the inhibited muscles.
Restoring balance of muscle tone.
Normalize range of motion |
|
|
Term
| How do you perform a sensorimotor evaluation? |
|
Definition
Have the patient balance in progressively less stable postures
Feet 12 inches apart, arms crossed
Feet together, arms crossed
One leg standing with arms crossed
Dynamic balance with arms crossed
Test each one with eyes open/closed and each leg |
|
|
Term
| When is OMT recommended for postural correction? |
|
Definition
| Somatic dysfunction which may be “locking in” abnormal posture by causing abnormal muscle tone |
|
|
Term
| What are the benefits of OMT used to treat postural correction? |
|
Definition
Normalizes neurologic patterns, used to improve function, and improves pain by improving function
Decreases need for medication |
|
|
Term
| What is the normal firing sequence for arm abduction? |
|
Definition
1-Deltoid and supraspinatus
2-Contralateral upper trapezius
3-Ipsilateral upper trapezius
4-contralateral quadratus lumborum
5-contralateral fibularis |
|
|
Term
| In normal abduction the shoulder will not elevate (hike up) until the arm reaches what level? |
|
Definition
|
|
Term
| An early hike of the shoulder during shoulder abduction indicates what? |
|
Definition
| Scalenes, SCM, upper trapezius, or levator scapula may be substituting for inhibited deltoid and supraspinatus |
|
|
Term
| In severe injury such as supraspinatus tendonitis or tear, the patient will use what muscles to compensate during arm abduction? |
|
Definition
| Contralateral QL to side bend the torso away and “throw” the arm up |
|
|
Term
| What are the scapular stabilizers? |
|
Definition
| Serrates anterior, rhomboids and the middle and lower trapezius |
|
|
Term
| Weakness of the scapular stabilizers during the scapular retraction test causes what deformity? |
|
Definition
|
|
Term
| What might causes scapular winging |
|
Definition
Scalene hyper tonicity as 2/3 of the long thoracic nerve passes through the scalenus medius
Glenohumeral instability or irritation can also cause this |
|
|
Term
| What is the normal firing patter of hip extension? |
|
Definition
1-hamstring
2-gluteus maximus
3- contralateral lower lumbar erector spinae
4-ipsilateral lower lumbar erector spinae
5- contralateral thoracolumbar erector spinae
6- ipsilateral thoracolumbar erector spinae |
|
|
Term
| Dysfunctional firing during hip extension is due to what? |
|
Definition
|
|
Term
| How do patients with an inhibited gluteus medius present? |
|
Definition
| Buttock pain that radiates to the back of their leg (chronic piriformis pain). Will often have lumbar aching as well |
|
|
Term
| What muscles should you observe during a hip abduction test? |
|
Definition
| Gluteus medius, TFL and quadratus lumborum muscles |
|
|
Term
| What makes up for an inhibited gluteus medius during hip abduction? |
|
Definition
| Tensor fascia lata and quadratus lumborum |
|
|
Term
| What should be observable during dysfunctional hip abduction due to an inhibited gluteus medius? |
|
Definition
No contraction of the gluteus medius
Iliac crest will move cephalad
Unopposed TFL use causes internal rotation of the femur
Use of QL cause excessive lumbar sidebending (hip “hikes up”) |
|
|
Term
| Patients that fail the hip abduction test will present with what symptoms? |
|
Definition
| Dull lumbar pain, buttock pain and often knee pain |
|
|
Term
| What should occur in the first 10 degrees of motion during a neck curl? |
|
Definition
| Chin should move toward the manubrium |
|
|
Term
| Substitution of paradoxical OA extension and accentuated cervicothoracic flexion can occur due to what muscles? |
|
Definition
| Inhibited deep cevicals and hypertonic scalenes, SCM, upper trapezius, levator scapula and pectoralis muscles |
|
|
Term
| Excessive protraction of the shoulders can cause lead to what neurological abnormality? |
|
Definition
|
|
Term
| If a neck curl induces sharp, radicular pain or numbness it may represent what? |
|
Definition
| Disk or spinal cord disease. Stop the test. Do not perform test if these already exist |
|
|
Term
| What should be observed in a normal abdominal curl? |
|
Definition
The lumbar spine will remain flat.
The hips will not flex
Smooth curl up involving the neck and thorax (the chin should approximate the sternum)
Flattening of the abdominals
Maintenance of pelvic tilt |
|
|
Term
| Weakness of abdominals during an abdominal curl results in overuse of what muscle? |
|
Definition
| Iliopsoas causing flexion of the hips |
|
|
Term
| Weakness of the abdominals and hypertonic iliopsoas causes what somatic dysfunction? |
|
Definition
| Unstable L4 and L5. Patients will say that if they move the wrong way they know it will “go out” |
|
|
Term
| What is the "Dirty Half Dozen"? |
|
Definition
Non-neutral lumbar somatic dysfunction
Pubic shear
Posterior sacral base or backward sacral torsion
Innominate shear
Short leg and pelvic tilt syndrome
Muscular imbalance of the trunk and lower extremity (including psoas syndrome) |
|
|
Term
| What causes lumbar instability? |
|
Definition
| Vertical line from the mid body of L3 is anterior to the anterior portion of the sacral base |
|
|
Term
| Postural imbalance is defined as what? |
|
Definition
|
|
Term
| What are the typical imbalance patterns of the lower core? |
|
Definition
Tight hip flexors and erector spinae
Weak gluteii and abdominals
Anterior pelvic tilt
Increased lumbar lordosis |
|
|
Term
| What causes increased leg lengths? |
|
Definition
| Inferior innominate shear, anterior innominate rotation, femur extension and external rotation, knee extension, foot supination |
|
|
Term
| What causes leg shortening? |
|
Definition
| Superior innominate shear, posterior innominate rotation, femur internal rotation and flexion, knee flexion, foot pronation |
|
|
Term
| What is the purpose of the “clutch-like” function of the SIJ? |
|
Definition
| Close-pack on the side of weight bearing and loose-pack on the swing side of gait |
|
|
Term
| Other than weight, what aides in the force closure of the SIJ? |
|
Definition
Surrounding muscles, ligaments, and fascia
Weakness or insufficient recruitment or timing of these muscle groups can lead to reduced force closure of the SIJ |
|
|
Term
| The lumbar transverse processes (via the iliocostalis and longissimus lumborum) and the spinous processes (via the multifidi) are functionally contiguous with what lower extremity muscle? |
|
Definition
| The biceps femoris through the sacrotuberous ligament |
|
|
Term
| The latissimus dorsi connects through the lumbodorsal fascia with attachments to the lower thoracic and lumbar vertebrae and is invested into lower extremity muscle? |
|
Definition
|
|
Term
| All movements we’ve learned (torsion, shear, etc.) are normal during the gait cycle but not in what position? |
|
Definition
|
|
Term
| SIJ restriction is associated with what muscle imbalance? |
|
Definition
| Weakness of the gluteus maximus |
|
|
Term
| What compensates for a weak gluteus maximus during gait? |
|
Definition
Piriformis
Tends to engage the oblique axis to the opposite side |
|
|
Term
| A left on left sacral torsion is commonly linked to what muscle imbalance? |
|
Definition
| Tightness in the right piriformis (contralateral side) |
|
|
Term
| A tight piriformis increases the risk of developing what neuropathy? |
|
Definition
|
|
Term
| Backward sacral torsion may be caused by what muscle imbalance? |
|
Definition
| Ipsilateral piriformis muscle hypertonicity |
|
|
Term
| Pubic shear dysfunctions may be associated with what muscle imbalances? |
|
Definition
| Adductor and abdominal muscle imbalance |
|
|
Term
| Piriformis syndrome may be caused by trauma to what areas? |
|
Definition
| Sacroiliac and gluteal region |
|
|
Term
| What are the symptoms of piriformis syndrome? |
|
Definition
| Pain in the region of the sacroiliac joint, greater sciatic notch, and piriformis muscle, extending down the leg and causing difficulty during walking |
|
|
Term
| What makes piriformis syndrome pain worse? |
|
Definition
Stooping or lifting
Prolonged sitting or on rising from a seated position, especially on hard surfaces
Pain occurs with bowel movements |
|
|
Term
| What makes piriformis syndrome pain better? |
|
Definition
| Traction (moderate relief) |
|
|
Term
| Piriformis syndrome presents with what findings? |
|
Definition
Tenderness in the piriformis muscle and/or tendon at counterstrain tender points or myofascial trigger point
External rotation of the hip
Positive Lasegue test sign (straight leg test)
Possible gluteal atrophy |
|
|
Term
| What causes psoas syndrome? |
|
Definition
| Prolonged shortening of the psoas followed by its sudden lengthening, may occur while working at a desk or crawlspace, road trips, or due to trauma (strain) |
|
|
Term
| What are the signs/symptoms of psoas syndrome? |
|
Definition
Stooped posture
Back pain, buttock, anterior and posterior thigh pain |
|
|
Term
| What are the findings for psoas syndrome? |
|
Definition
Positive Thomas test
Anterior and posterior lumbar and iliacus counterstrain points
Non-neutral upper lumbar somatic dysfunction
Can be caused by pathology of ureters, colon, or appendix, tumors |
|
|
Term
|
Definition
| Just medial from the ASIS palpating on the inner aspect of the ilium |
|
|
Term
|
Definition
| The inferior and medial aspect of the AIIS |
|
|
Term
|
Definition
| The lateral portion of the AIIS |
|
|
Term
|
Definition
| The inferior portion of the AIIS |
|
|
Term
|
Definition
| Anterior, superior aspect of the pubic rami just lateral from the symphysis |
|
|
Term
| How do you treat AL counterstrain points? |
|
Definition
| Flexion to lumbar level, pelvic rotation away from tender point |
|
|
Term
|
Definition
| Inferolateral side of the deviated spinous process |
|
|
Term
| How are the PL counterstrain points treated? |
|
Definition
| Extend lower trunk on ipsilateral side by lifting the pelvis |
|
|
Term
|
Definition
| Superior medial aspect of the PSIS of the ilium |
|
|
Term
|
Definition
| Found 2 cm below the PSIS of the ilium |
|
|
Term
| How is the LPL5 counterstrain point treated? |
|
Definition
| Flexion of the hip to approximately 90 with adduction and internal rotation |
|
|
Term
| With any physical examination, you should always auscultate what areas? |
|
Definition
|
|
Term
| The lower ureter corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| The bladder corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| The kidneys and upper ureter corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| The uterus and cervix corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| The prostate corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| What are possible causes of inflammation of the patella and bursa that can lead to suprapatellar edema? |
|
Definition
| Chondromalacia, infection, fibular head somatic dysfunction, muscle imbalance, tight hamstring, tight rectus femoris, or ITB |
|
|
Term
| What are the OMT treatments that can be used to help relieve suprapatellar edema? |
|
Definition
MFR to knee (direct to engage fascia in all three planes)
ME to the posterior fibular head dysfunction
Mobilize lymphatics and venous drainage
CS to the rectus femoris, hamstring, ITB |
|
|
Term
| An ankle sprain usually presents with what visual findings? |
|
Definition
| Swelling around lateral malleolus, just below pant edge, bruising |
|
|
Term
| What are possible causes of an ankle sprain? |
|
Definition
Sprained ankle, grade I or first degree
Possible avulsion fracture of the distal fibula
Somatic dysfunction of the left fibular head, tensor fascia lata and possibly the gluteus medius, anterior talus
Somatic dysfunction of the L5-S1 vertebral level |
|
|
Term
| 80% of all ankle sprains are of what type? |
|
Definition
|
|
Term
| What ligaments are involved in an inversion sprain of the ankle? |
|
Definition
Anterior talofibular ligament
Calcaneofibular ligament
Posterior talofibular ligament |
|
|
Term
| What are the different grades of ankle sprains? |
|
Definition
Grade I: Ankle sprains cause stretching of the ligament
Grade II : Ankle sprain is more severe partial tearing of the ligament
Grade III : Ankle sprains are complete tears of the ligaments |
|
|
Term
| Which OMT techniques are useful in the treatment of sprained ankles? |
|
Definition
Counterstrain to the ankle (where), ITB/TFL
ME to Gluteus medius, MFR to pelvis
CS or ME to the lower spine/sacrum.
Lymph and venous drainage techniques |
|
|
Term
| How is internal/external rotation of the tibia assessed? |
|
Definition
Physician holds the feet and dorsiflexes the ankles to close pack the ankle joint
Rotation movement is tested on both sides to determine the permitted range, quality of range, and the end feel |
|
|
Term
| How do you treat an internally rotated tibia with muscle energy? |
|
Definition
Ankle is dorsiflexed and the leg is externally rotated to engage the barrier
Patient internally rotates the leg against resistance for 3 to 5 seconds followed with a few seconds of relaxation
Reengage barrier, repeat |
|
|
Term
| How do you treat an externally rotated tibia with muscle energy? |
|
Definition
Ankle is dorsiflexed and leg is internally rotated to engage the barrier
Patient externally rotates the leg against resistance for 3 to 5 seconds followed with a few seconds of relaxation
Reengage barrier, repeat |
|
|
Term
| How do you treat an anterior fibular head with muscle energy? |
|
Definition
Physician contacts the fibular head and applies a posteromedial force
The other hand inverts the foot (to free-up the fibula) and externally rotates the tibia while the foot is dorsiflexed
Patient is instructed to evert and plantar flex the foot against physician’s counterforce for 3-5 seconds, relax, reengage barrier, repeat |
|
|
Term
| How do you treat an posterior fibular head with muscle energy? |
|
Definition
Physician contacts the fibular head and applies a anterolateral force
The other hand everts the foot (to free-up the fibula) and internally rotates the tibia while the foot is plantarflexed
Patient is instructed to invert and dorsiflex the foot against physician’s counterforce for 3-5 seconds, relax, reengage barrier, repeat |
|
|
Term
| If foot dorsiflexion is restricted, talus is in what position? |
|
Definition
|
|
Term
| If foot plantarflexion is restricted, talus is in what position? |
|
Definition
|
|
Term
| What is the position for muscle energy treatment of an anterior talus? |
|
Definition
Physician places one hand under the plantar surface of the patient’s foot and the web of the other hand over the neck of the talus
The foot is dorsiflexed to the barrier with encouragement of posterior talar glide |
|
|
Term
| What planes of motion should be assessed for the talocalcaneonavicular joint? |
|
Definition
Anterior/posterior motion at the talus
Plantar/dorsiflexion through talus and forefoot
Inversion/eversion of calcaneus and forefoot |
|
|
Term
| What is the direction of the thrusts for the plantar hiss whip? |
|
Definition
Straight down for the navicular and cuneiforms
Down and laterally for the Cuboid |
|
|
Term
| What causes somatic dysfunction in normal pregnancies? |
|
Definition
Changes in maternal structure and biomechanics as a result of the developing fetus
Changes in body fluid circulation
Hormonal changes |
|
|
Term
| During pregnancy, the mother's center of gravity moves forward causing what biomechanical changes? |
|
Definition
Increased lumbar lordosis
Paraspinal muscles shorten posteriorly overstretched abdominal muscles weaken anteriorly
Increased pelvic tilt, lumbar lordosis and thoracic kyphosis |
|
|
Term
| What hormonal changes occur during pregnancy that effect the biomechanics of the body? |
|
Definition
| Relaxin- secreted by corpus luteum, relaxes ligaments (SI & pubic symphysis) |
|
|
Term
| Distortion of the thoraco-abdomino-pelvic cylinder during pregnancy has what respiratory/circulatory effect? |
|
Definition
Decreased diaphragmatic amplitude altering the thoracoabdominal pressure gradient
Allows passive congestion of the low pressure venous and lymphatic systems |
|
|
Term
| What are the consequences of the passive lymph and venous congestion seen in pregnancy? |
|
Definition
| Build-up of the waste products of cellular respiration and sub-optimal functioning of the body’s self-healing and self-regulating properties |
|
|
Term
| How much do fluids increase over the course of pregnancy? |
|
Definition
|
|
Term
| Postpartum patients will have compromised motion in which diaphragm? |
|
Definition
|
|
Term
| The tentorium cerebelli & falx cerebri are connected to the sacrum via what connection? |
|
Definition
|
|
Term
| The tests corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| The penis and anterior vaginal wall corresponds to sympathetic reflexes at which level? |
|
Definition
|
|
Term
| How are pregnant mothers positioned for examination and treatment during the first trimester? |
|
Definition
| Positions as usual, encourage moderate exercise |
|
|
Term
| How are pregnant mothers positioned for examination and treatment during the second trimester? |
|
Definition
| Position as tolerated, can be direct or indirect |
|
|
Term
| How are pregnant mothers positioned for examination and treatment during the third trimester? |
|
Definition
| Lateral recumbent, seated, or all fours |
|
|
Term
| What are potential somatic dysfunctions that may arise in the second trimester? |
|
Definition
| Carpal Tunnel Syndrome and Round Ligament Syndrome |
|
|
Term
| What are potential somatic dysfunctions that may arise in the third trimester? |
|
Definition
| LBP, edema, reflux, hemorrhoids, varicose veins, constipation |
|
|
Term
| How might you use OMT to aid a mother who is failing to progress during delivery? |
|
Definition
| Balance autonomics, CV4 to start or augment contractions, sacral mobilization |
|
|
Term
| Postpartum treatment using OMT focuses on restoration of what structures to normal? |
|
Definition
Pelvic diaphragm especially if episiotomy was done
Pubic symphysis
Sacrum
Diaphragms including tentorium cerebelli (think postpartum depression)
Baby-carrying/breastfeeding strains to posture and breast care/mastitis treatment |
|
|
Term
| What are contraindications to the use of OMT in pregnancy? |
|
Definition
Undiagnosed vaginal bleeding
Threatened or incomplete abortion
Ectopic pregnancy
Placenta previa
Placental abruption
Prolapsed umbilical cord
Preterm rupture of membranes
Pre- term labor (relative)
Eclampsia and unstable pre-eclampsia
Other surgical or medical emergencies |
|
|
Term
| Where are potential sites of passive congestion? |
|
Definition
Achilles tendons
Popliteal spaces
Lateral thighs
Inguinal regions
Axillary folds
Supraclavicular areas
Suboccipital areas
Epitrochlear spaces |
|
|
Term
| Standing flexion tests are used to determine what? |
|
Definition
| Lateralize an ilio-sacral (innominate) dysfunction |
|
|
Term
| Seated flexion tests are used to determine what? |
|
Definition
| Lateralize a sacro-iliac (sacral) dysfunction |
|
|
Term
| How do you treat a posterior innominate rotation with ME? |
|
Definition
Patient is supine, physician is standing on the same side as the dysfunction
The patient’s lateral sacrum is brought to the edge to the table
Patient’s leg is placed between the physician’s knees while the pelvis is supported with a hand placed on the contralateral ASIS
Patient attempts to flex the hip against resistance for 3-5 seconds |
|
|
Term
| How do you treat a anterior innominate rotation with ME? |
|
Definition
Patient is supine with physician standing on opposite side of dysfunction with the hip and knee flexed
Place heel of hand on ischial tuberosity with fingers monitoring at the SI join
Dysfunctional innominate is taken to the barrier in flexion, external rotation, and abduction |
|
|
Term
| How do you treat a inflare innominate rotation with ME? |
|
Definition
Patient supine and physician on same side as dysfunction
Patient’s hip and knee are flexed with foot placed on the contralateral knee, inferior to the patella
Place one hand over the contralateral innominate to stabilize the pelvis and places the other hand on the medial aspect of the knee of the dysfunctional side, externally rotating the hip engaging the restrictive barrier |
|
|
Term
| How do you treat a unilateral sacral flexion? |
|
Definition
Monitor sacrum at the middle transverse axis, abduct left leg to about 15 degrees to disengage SIJ
Internally rotate the hip to further gap the posterior sacroiliac joint
Heel of hand is on the ILA of the dysfunctional side, pressing anteriorly |
|
|
Term
| How do you treat a unilateral sacral extension? |
|
Definition
Monitor sacrum at the middle transverse axis, abduct left leg to about 15 degrees to disengage SIJ
Externally rotate hip to further gap the anterior SIJ
Heel of hand is at the dysfunctional side of sacral base, pressing anteriorly |
|
|
Term
| How do you treat a bilateral sacral flexion? |
|
Definition
Abduct both legs to about 15 degrees to disengage the SIJ
Internally rotate both hips to further gap the posterior SIJ
Heel of hand is on the central portion of the apex of the sacrum, pressing anteriorly |
|
|
Term
| How do you treat a forward sacral torsion? |
|
Definition
Patient prone, bend the patient’s knees and hips to approx 90° and turn them onto the hip- axis down
One hand monitors the lumbosacral junction while other hand rotates upper trunk to get L5 rotation
Physician seated with legs over knee, patient attempts to lift legs towards ceiling 3-5s |
|
|
Term
| How do you treat a backward sacral torsion? |
|
Definition
Patient right lateral recumbent with axis down, facing physician.
Extend both legs until the sacral base begins to move anteriorly. Leg contralateral to side of dysfunction is placed in front of the other's knee
Maintain L5 rotation with one hand, patient lifts toward ceiling while you resist 3-5s |
|
|
Term
| Where is the high ilium CS point? |
|
Definition
| 2 to 3 cm lateral from the PSIS of the ilium pressing medial toward the PSIS |
|
|
Term
| How do you treat the high ilium CS point? |
|
Definition
| Extension of the hip with fine tuning in abduction and external rotation. |
|
|
Term
| Where is the gluteus medius CS point? |
|
Definition
| Two points at the upper outer portion of the gluteus medius muscle at the level of the PSIS. PL3 is 2/3 lateral from PSIS to tensor fasciae latae and PL4 is at the posterior margin of tensor fasciae latae |
|
|
Term
| How is the gluteus medius CS point treated? |
|
Definition
| The hip is extended with fine tuning in abduction and external rotation |
|
|
Term
| Where is the piriformis CS point? |
|
Definition
| Found half way along a line between the top of the greater trochanter and a point between the PSIS and the coccyx |
|
|
Term
| How do you treat the piriformis CS point? |
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Definition
| Marked flexion of the hip with abduction and fine-tuning with either internal or external rotation |
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Term
| Where is the coccygeus CS point? |
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Definition
| Found at the region of the inferior lateral angle of the sacrum on the coccygeus muscle |
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Term
| How do you treat the coccygeus CS point? |
|
Definition
| Extend and adduct the hip over the contralateral leg |
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Term
| If the ILA and deep sulcus findings are on the opposite side, it is ALWAYS what? |
|
Definition
|
|
Term
| If the ILA and deep sulcus findings are on the same side, it is ALWAYS what? |
|
Definition
| A unilateral sacral dysfunction (flexion vs extension depends on seated flexion test) |
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Term
If the ILA and deep sulcus do not follow the line of the axis (ILA is on same side as axis, opposite side of seated flexion test), it is ALWAYS what?
Right on Right
Left on Left |
|
Definition
|
|
Term
If the ILA and deep sulcus follow the line of the axis (ILA is on opposite side as axis, same side of seated flexion test), it is ALWAYS what?
Right on Left
Left on Right |
|
Definition
|
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Term
| A positive seated flexion test on the right, right posterior/inferior ILA, and right deep sulcus would be what? |
|
Definition
| Right unilateral sacral flexion |
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Term
| A positive seated flexion test on the right, right posterior/inferior ILA, and left deep sulcus would be what? |
|
Definition
| Right on Left backward torsion |
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|
Term
| A positive seated flexion test on the right, left posterior/inferior ILA, and right deep sulcus would be what? |
|
Definition
| Left on Left forward torsion |
|
|
Term
| A positive seated flexion test on the right, left posterior/inferior ILA, and left deep sulcus would be what? |
|
Definition
| Right unilateral sacral extension |
|
|
Term
| A positive seated flexion test on the left, left posterior/inferior ILA, and left deep sulcus would be what? |
|
Definition
|
|
Term
| A positive seated flexion test on the left, right posterior/inferior ILA, and left deep sulcus would be what? |
|
Definition
| Right on right forward torsion |
|
|
Term
| How do you name a sacral dysfunction? |
|
Definition
| Posterior/Inferior ILA then Axis |
|
|
Term
| A positive seated flexion test on the left, right posterior/inferior ILA, and right deep sulcus would be what? |
|
Definition
| Left unilateral extension |
|
|
Term
| A positive seated flexion test on the left, left posterior/inferior ILA, and right deep sulcus would be what? |
|
Definition
| Left on Right backwards sacral torsion |
|
|
Term
| Backwards bending tests should be positive (improve, become more even) with what types of sacral dysfunction? |
|
Definition
Backwards torsions
Right on Left
Left on Right |
|
|
Term
| Spring should be better when backwards bending tests are what? |
|
Definition
Negative
Right on right
Left on left |
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