Term
| what are the rules in strain counter strain (8) |
|
Definition
posterior treated in extension
midline treated with flex/extend
lateral treated with rotation and side bend
if in a row treat middle first
if multiple treat most severe first
point on extremity is usually on opposite side of pain
warn patient they may be sore
dont over treat |
|
|
Term
| absolute contradictions to strain counterstrain |
|
Definition
| trauma, fatuge, ligament rupture |
|
|
Term
| potential contradictions to strain counterstrain |
|
Definition
| positive vertebral artery test, cant voluntairly relax |
|
|
Term
|
Definition
feel pulsing when holding in strain counterstrain
probablly blood returning to area |
|
|
Term
| what are the pelvis tender points (20) |
|
Definition
| mid-pole sacrum, high flare out sacroiliac, high-ilium sacroiliac, flare in sacroiliac, piriformis, iliacus, gluteus medius LP3 and 4, low ilium sacroiliac, inguinal ligament, psoas, low ilium flare out, anterior medial trochanter, lateral trochanter, satorius / anterior lateral trochanter, sacrum 1-5 |
|
|
Term
| where is the mid-pole sacrum tender point, what is it related to |
|
Definition
medial and lateral side of sacrum
related to piriformis muscle |
|
|
Term
| where is a high flare out SI tenderpoint, how is it treated |
|
Definition
below and medial to PSIS
lateral iLA or lateral coccyx
patient pront,operator on side, hip extended and abducted |
|
|
Term
| where is the high-ilium SI tender point, how is it treated |
|
Definition
2-3 cm lateral to PSIS pressing medial to PSIS
patient prone, lift leg on side to cause hip extension, abduction, external rotation |
|
|
Term
| where is the flare in sacroiliac tender point, how is it treated |
|
Definition
3-4 in caudal to PSIS in muscle depression lateral to sacrum
patient prone, abduct thigh in slight flexion or extension to fine tune |
|
|
Term
| piriformis tenderpoint location, treatment |
|
Definition
midway in body of muscle between low lateral sacrum , ILA, and greater trochanter
patient prone, lift leg on side, fine tune with abduction and external rotation |
|
|
Term
| iliacus tenderpoint, location |
|
Definition
| abdominal lower quadrant, deep in fossa |
|
|
Term
| gluteus medius LPL3 tenderpoint location and treatment |
|
Definition
outer gluteus medius at PSIS 3/2 lateral from PSIS to tensor fasciae latae
patient prone, hip extended with fine tuning in abduction and external rotation, knee may be beneath thigh to aid in extension and external rotation |
|
|
Term
| gluteus medius LPL4 tenderpoint location and treatment |
|
Definition
outer gluteus medius at PSIS, posterior margin of tensor fasciae latae
patient prone, hip extended with fine tuning and baduction and external rotation, operator knee beneath thigh to aid in extension and external rotation |
|
|
Term
| lower ilium SI anterior tenderpoint location, treatment, association |
|
Definition
superior surface of pubic ramus, associated with attachment of psoas minor
patent supine, ipsilateral hip flexion |
|
|
Term
| inguinal ligament tenderpoint location, treatment, association |
|
Definition
on ligament at attachment to pubes, pectineus attachment
patient supine, flex thigh contralateral, cross over ipsilateral thigh and pull ipsilateral to make internal rotation of hip on affected side |
|
|
Term
| psoas tenderpoint location and treatment |
|
Definition
2/3 distance from ASIS to midline
patient supine, bilateral hip flexion, some external rotation, slight ipsilateral sidebending of lumbar |
|
|
Term
| low ilium flare out tenderpoint location and treatment |
|
Definition
inferomedial descending ramus of pubis
patient supine, flex hip, externally rotate, abduct and keep foot at midline |
|
|
Term
| anterior medial trochanter tenderpoint location and treatment |
|
Definition
1 cm lateral to ALS on lateral side of ASIS
patient supine, flex hip to 60 deg and abduct |
|
|
Term
| lateral trochanter tenderpoint location and treatment |
|
Definition
along IT band distal to greater trochanter
moderate abduction of thigh in slight flexion |
|
|
Term
| satorius or anterior lateral trochanter tenderpoint location and treatment |
|
Definition
1 in caudal and lateral to AIIS
patient supine, flex hip, fine tune with abduction |
|
|
Term
| sacrum S1 tenderpoint location and treatment |
|
Definition
at SI junction S1
patient prone, apply posterior to anterior pressure on opposite ILA |
|
|
Term
| sacrum S2 tenderpoint location and treatment |
|
Definition
midline sacrum at S2
patient prone, extend sacrum by applying posterior to anterior pressure on coccyx |
|
|
Term
| sacrum S3 tenderpoint location and treatment |
|
Definition
midline sacrum at S3
may require flexion or extension |
|
|
Term
| sacrum S4 tenderpoint location and treatment |
|
Definition
midline sacrum at S4
flex sacrum by applying posterior to antrerior pressure on sacrum |
|
|
Term
| sacrum S5 tenderpoint location and treatment |
|
Definition
at SI junction at S5
patient prone, posterior to anterior pressure on opposite sacral base |
|
|
Term
| knee and ankle tenderpoints |
|
Definition
| medial meniscus, lateral meniscus, anterior cruciate, posterior cruciate, medial ankle, lateral ankle, flexion calcaneus, extension ankle |
|
|
Term
| lateral meniscus tenderpoint location and treatment |
|
Definition
at joint line
knee flexion, abduction of tibia, some internal or external rotation |
|
|
Term
| medial meniscus tenderpoint location and treatment |
|
Definition
on joint line
knee flexion, internal rotation, abduction of tibia |
|
|
Term
| anterior cruciate tenderpoint location and treatment |
|
Definition
superior popliteal fossa on hamstring tendons medially or laterally
pillow under distal femyr, sheering force moving proximal tibia posterior on femur |
|
|
Term
| posterior cruciate tenderpoint location and treatment |
|
Definition
in center below popliteal fossa
pillow under proximal tibia, shearing force by moving distal femur posterior on proximal tibia |
|
|
Term
| medial ankle tenderpoint location and treatment |
|
Definition
inferior to medial melleolus along deltoid ligament
pillow under medial ankle, inversion and slight sheer |
|
|
Term
| lateral ankle tenderpoint location and treatment |
|
Definition
inferior and anterior to lateral malleolus on sinus trasi (talocalcaneal sulcus)
fulcrum on lateral ankle, eversion and slight sheer |
|
|
Term
| flexion calcaneus tenderpoint location and treatment |
|
Definition
anterior calcaneus on plantar surface at attachment of plantar fascia
flexion of forefoot approximating forefoot to calcaneus |
|
|
Term
| extension ankle tenderpoint location and treatment |
|
Definition
within proximal gastrocenimeus distal to popliteal margin
plantar flexion and knee flexion |
|
|
Term
| areas of palpation of shoulder |
|
Definition
sternoclavicular, acromoclavicular, and glenohumeral joints
clavicle, spine of scapulae, greater and lesser tubercles of humerus
subacromial burase
biceps tendon: anterior lateral to bursae |
|
|
Term
| what ROM and strength testing should be done for the shoulder |
|
Definition
| flex, extend, abduct, adduct, internal and external rotation |
|
|
Term
| what is the scapulohumeral rhythm |
|
Definition
| every 15 deg shoulder abduction is 10 deg humerus abduction and 5 deg scapular rotation |
|
|
Term
| what does the drop arm test test for, how is it done |
|
Definition
rotator cuff tear
abduct shoulder to 90 deg with thumb down, patient slowly returns arm to side |
|
|
Term
| empty can (Jobe) test tests for and ow is it done |
|
Definition
supraspinatus evaluation, weakness suggests tendonopathy or tear
abduct to 90 flex to 30 internally rotate with thumb dwn provide resistance patient lifts up |
|
|
Term
| what does the apprehension test test for, how is it done |
|
Definition
sense of dislocation suggests anterior glenohumeral instability or dislocatio
patient supine, shoulder abducted, extended, externally rotated. brace shoulder and put steady pressure on wrist increasing abduction and external rotation |
|
|
Term
| what does yergasons test test for how is it done |
|
Definition
pain suggests biceps tendonitis, transverse humeral ligament instability
flex to 90 and pronate, palpate long biceps tendon, patient supines against resistance |
|
|
Term
| what is the sulcus sign testing for, how is it done |
|
Definition
inferior glenohumeral instability
patient stands with arm on side, stabilize AC and apply downward traction to humerus. >2cm movement is hypermobile |
|
|
Term
| neer impingement test: what does it test for, how, how is it graded |
|
Definition
anterior rotator cuff impingement
flex and internally rotate, stabilize glenohumeral joint
pain at 90 deg is mild impingement
pain at 60-70 is moderate
pain at 45 is severe |
|
|
Term
| apley scratch test: what does it test, how |
|
Definition
| patient tries to touch opposite scapule from superior (tests abduction and external rotation) and inferior (tests adduction and internal rotation) |
|
|
Term
| what are the rules of shoulder treatment |
|
Definition
treat passive compensations (thorax, cervical, scapular) so the injury does not become chronic
only for passive range of motion restrictions |
|
|
Term
| what are the 7 stages of spencer, how are they done |
|
Definition
patient is lateral recumbant with bad shoulder up, support AC and stabilize shoulder
extension
flexion
circumduction with rotation (increase circles)
circumduction with traction
abduction and adduction
internal rotation
abduction with traction (clasp hands around deltoid and add traction with body) |
|
|
Term
| what are the shoulder treatments in addition to seven stages of spencer |
|
Definition
scapular lift, general mobilization, general mobilizaton of AC, general mobilization of SC, shoulder wobble, pectoral traction, general mobilization of clavicle
BLT scapulothoracic serratus release |
|
|
Term
| how is a scapular lift done |
|
Definition
patient on side with arm internally rotated and forearm behind back
pull up on medial scapula |
|
|
Term
| how is general mobilization done |
|
Definition
| patient supine, grab wrist and shake arm and shoulder increasing amplitude |
|
|
Term
| how is general mobilization of the AC done |
|
Definition
| patient seater,physician beind, stabilize clavicle medial to AC articulation, grab elbow and circumduct clockwisr and counterclockwise |
|
|
Term
| how is general mobilization of the SC done |
|
Definition
| patient deated, physician behind, inxed finger above clavicle, middle finer on blavicle to monitor SC, SC is fulcrum, grab elbow, circumduct superior and posterior |
|
|
Term
| how is the shoulder wobble done |
|
Definition
| patient supine, hold elbow between knees, grab shoulder and mobilize in all planes |
|
|
Term
| how is pectoral traction done |
|
Definition
| patient supine with knees up, inxed, middle, and ring finver in armput under pecs, traction superior, patient takes in deep breath and coughs, examiner takes up slack |
|
|
Term
| how is general mobilization of the clavicle done |
|
Definition
| patient supine, grab elbow, internally rotate, abduct, fingers behind clavicle, gentile traction on clavicle while pushing shoulder superior |
|
|
Term
| how is BLT scapulothoracic serratus release done |
|
Definition
thumb on rubs and midaxillary line as superior as possible
slide thumb posterior on ribs until under scapulae (now touching ribs and scapulae)
patient leans to them so thumb slides under scapulae
other hand on top f scapulae, grasp spine of scapulae, inferior traction to get balance between thromboids, serratus anterior, and teres muscles, hold until serratus anterior relaxes |
|
|
Term
| what are the parts of a history for opp |
|
Definition
| o Onset, location, duration, character, aggravating factors, relieving factors, time/temporal, severity |
|
|
Term
Spinal column motion testing
1. if most restricted region is T1-5 screen the...
2. if most restricted region is L1-5 screen the...
3. if it is thoracic area screen the...
4. if it is over SI or innominate screen the...
5. if it is at the occiput screen the... |
|
Definition
if most restricted region is 1. T1-5 think about upper extremity
2. if most restricted region is L1-5 think about lower extremity
3. if it is thoracic think about ribs (if it gets harder as you palpate rib out it is an issue)
4. if it is over SI or innominate screen pelvis and sacrum
5. if it is at the occiput screen the cranium |
|
|
Term
| what should you always rule out before treatment |
|
Definition
always consider worst case scenario
rule out severe injuries
be sure there is no nerve damage with reflexes, neuro screen, and ortho tests |
|
|
Term
| how do you test the A/C and S/C joints |
|
Definition
use thumb as fulcrum at T1
Pinky on A/C
3rd finger on S/C
Posterior lateral motion
Dysfunction: cannot glide posterior |
|
|
Term
| how do you test the A/C joint |
|
Definition
| check level of spine of scapula to determine if restriction is superior or inferior |
|
|
Term
| how do you test the S/C joint |
|
Definition
Palpate medial end of clavicle
Have patient shrug shoulders
S/C should dip inferior and return superior when shoulders drop to normal
Test for anterior and posterior asymmetry |
|
|
Term
| how do you test glenohumeral joint |
|
Definition
|
|
Term
| what are the joints of the upper extremity |
|
Definition
| acromioclavicular, sternoclavicular, glenohumeral, scapulothoracic, radial head, wrist |
|
|
Term
| how do you check for proper radial head placement |
|
Definition
put thumb on distal radius
pronate and supinate arm
note restriction and end feel |
|
|
Term
|
Definition
palpate anterior and posterior
induce flexion and extension over each carpal
feel for restriction |
|
|
Term
| dysfunctions in what other areas can cause upper extremity issues |
|
Definition
cranial at occipital mastoid surface
jugular foramen
cervical dusfunction: brachial plexus
thoracic / rib dysfunction
lower body: latissimus dorsi, thoracolumbar fascia
mind, body spirit |
|
|
Term
| what indications do thoracic and rib dysfunctions give to upper extremity issues |
|
Definition
Rib 1: impede brachial plexus
Rib 1-7: effect pecs and brachial plexus
T3-T6: alter sympathetic function |
|
|
Term
| how can mind, body, and spirit causes upper extremity issues |
|
Definition
Stress causes hormone, cytokine, and autonomic nervous system stimulation
Cortisol and epinephrine: protective and damaging
Emotions take toll of musculoskeletal system (Shouldering your burdens / broken back) |
|
|
Term
| sucscapularis tenderpoint: location and position |
|
Definition
o Anterior lateral border of scapula, pressing from anterior-lateral to posterior-medial
o Shoulder extension and internal rotation |
|
|
Term
| supraspinatus tenderpoint: location, position |
|
Definition
o In belly of supraspinatus above scapular spine
o Flex shoulder, abduct, external rotation |
|
|
Term
| levator scapulae tenderpoint: location, position |
|
Definition
o Superior medial border of scapula (attachment)
o Glide scapula superior and medial |
|
|
Term
| biceps long head tenderpoint: location, position |
|
Definition
Over tendon of bicep in groove
Flex elbow, flex shoulder, abduct, internal rotation |
|
|
Term
| biceps short head / coracobrachialis tenderpoint: location, position |
|
Definition
Infero-lateral coracoid process
Flex elbow, flex shoulder, adduct and internal rotate |
|
|
Term
| radial head tenderpoint: location, position |
|
Definition
o Antero-lateral radial head at supinator attachment
o Extend elbow, supination, slight valgus |
|
|
Term
| medial epicondyle tenderpoint: location, position |
|
Definition
o On common flexor tendon at attachment of pronator teres
o Flexion, pronation, slight abduction of forearm, slight flexion of wrist |
|
|
Term
| extension of wrist dorsal tenderpoint: location, position |
|
Definition
o Dorsal 2nd and 5th metacarpal and in extensor carpi radialis and ulnaris
o Wrist extend, slight abduct / adduct |
|
|
Term
| palmar wrist tenderpoint: location, position |
|
Definition
o Palmar base of 2nd and 5th metacarpals of flexor carpi radialis and ulnaris
o Wrist flex, slight abduct / adduct |
|
|
Term
| lateral first cervical tenderpoint: location, position |
|
Definition
o Tip of C1 transverse process. Inferior anterior to mastoid
o Supine exaggerate side bend away |
|
|
Term
| anterior first cervical tenderpoint: location, position |
|
Definition
o Posterior of ascending ramus of mandible at earlobe
o Rotation away, flexion, side bend away |
|
|
Term
| anterior 2-6 cervical tenderpoint: location, position |
|
Definition
o Anterior lateral transverse process
o Flex, side bend towards, rotate away |
|
|
Term
| anterior 7 cervical tenderpoint: location, position |
|
Definition
o On clavicular attachment of SCM
o Flex, side bend towards, rotate away |
|
|
Term
| anterior 8 cervical tenderpoint: location, position |
|
Definition
o At sternal attachment of SCM at mid clavicle
o Flex, side bend toward, rotate away |
|
|
Term
| posterior 1 cervical tenderpoint: location, position |
|
Definition
o Below nuchal line midway between inion and mastoid
o Extend, side bend away, rotate toward |
|
|
Term
| inion / EOP tenderpoint: location, position |
|
Definition
o On nuchal line lateral to inion
o Flex, side bend and rotate away |
|
|
Term
| posterior second cervical tenderpoint: location position |
|
Definition
o Inferior nuchal line at semispinalis capitus attachment
o Extend, side bend and rotate away |
|
|
Term
| posterior second cervical spinous process tenderpoint: location position |
|
Definition
o Superior spinous process C2
o Extend, side bend and rotate away |
|
|
Term
| posterior third cervical tenderpoint: location position |
|
Definition
o Side of inferior-lateral spinous process C2
o Extend, side bend, and rotate away |
|
|
Term
| posterior 4-6 cervical tenderpoint: location position |
|
Definition
o Inferior or inferior lateral tip of spinous process
o Extend, side bend away, rotate toward |
|
|
Term
| what are the results of ulnar abduction |
|
Definition
| Ulnar abduction causes adduction of olecranon, radius goes distal, wrist adduction --> Increased carrying angle > 12 (distal end lateral) |
|
|
Term
| what are the results of ulnar adduction |
|
Definition
| Unlar adduction causes abduction of olecranon, radius goes proximal, wrist abduction --> Decreased carrying angle < 8 (Distal end medial) |
|
|
Term
| explain radial motion in pronation and supination |
|
Definition
pronation: distal moves anterior and medial, head posterior
supination: distal moves posterior and lateral, head anterior |
|
|
Term
| how do you diagnose radial head |
|
Definition
Evaluate ease of pronation and supination with thumb on radial head
Glide radial head anterior and posterior to determine free motion |
|
|
Term
| posterior radial head: cause and treatment |
|
Definition
Fall on outstretched pronated hand
Muscle energy: Thumb on posterior radial head, elbow flexed, supination. Patient pronates against resistance |
|
|
Term
| anteior radial head: cause, treatment |
|
Definition
Fall on supinated forearm
Muscle energy: Thumb on anterior radial head, elbow flexed, protination. Patient supinates against resistance |
|
|
Term
| radial head lesion treatment |
|
Definition
Patient arm across physician thigh (fulcrum)
Thumb on anterior radial head, other fingers behind, stabilizing it
Other hand grabs patient wrist
Move forearm into flexion, abduction, rotation, extension in arch until articulation is achieved
Be careful to prevent strain of elbow |
|
|
Term
| radial head direct action treatment |
|
Definition
Patient arm protonated, extended
Stabilize wrist and grab radial head
HVLA thrust via thumb to articulate radial head (Anterior thrust is short) |
|
|
Term
|
Definition
Patient supine, arm extended, supinated, 45 deg abduction
Grab wrist and medial elbow joint
Lateral thrust produces gaping articulation of humeroradial joint |
|
|
Term
| humeroradial direct action |
|
Definition
Patient supine, supination, extension
Hold wrist and elbow
HVLA anterior lateral to elbow |
|
|
Term
|
Definition
Patient supine, abduction 45 deg, not supinated or pronated
Wrist pinned to physician side, hands on elbow
Medial and lateral motion to produce articulation |
|
|
Term
| nursemaids elbow cause and presentation |
|
Definition
Radial head dislocation from annular ligament due to longitudinal traction
Recoiling of interosseous membrane pulls radial head back to humerus pinching ligament
presents with
Flexed elbow held close to body
Pain, refuses to move it |
|
|
Term
| nursemaids elbow treatments (3) |
|
Definition
Normal Treatment
• Cup flexed elbow with index finger over radial head
• Hand in a hand shake
• Quickly extend, supinate, and distract forearm
• Immobilize elbow
Hyperpronation method of treatment
• Same set up
• Quickly hyperpronate forearm
• Immobilize elbow
Supination / flexion method of treatment
• Elbow slightly flexed, moderate pressure of proximal radius
• Hold distal forearm and cause traction
• Supinate and fully flex |
|
|
Term
| lateral epicondylitis (tennis elbow) treatment |
|
Definition
Stretch wrist extensors
Strap to make new proximal attachment
NSAIDS, steroid injections, prolotherapy
Fascial plane milking
• Stretch myofacial tissue, use after treatment of axial skeleton
• Flexion isolytic / isometric: Cup elbow grab wrist. Patient flexes elbow and tenses biceps. Physician counterforce at wrist. Quick isolytic extension to arm
• Twisting of the forearm |
|
|
Term
| what is the normal ROM of the wrist |
|
Definition
Flex 90, extend 70
Adduct 50, abduct 20
By means of carpal gliding
Flexion: dorsal glide
Extension: palmar glide |
|
|
Term
|
Definition
Asymmetric presentation and joint space
Hips, knees, spine, DIP, PIP
Worse after activity, in morning
Heberden’s (DIP) and bouchard’s deformities |
|
|
Term
| signs of theumatoid arthritis |
|
Definition
Symmetric presentation and joint narrowing
MCP, PIP, hips, elbows, spine
Worst after inactivity
Swan neck deformity
boutonniere (PIP) deformities |
|
|
Term
| symptoms of carpal tunnel and exam |
|
Definition
• paraestheisa of digits 1-3 and half of 4
•later: weakne ss and atrophy
Tinel, phalen, prayer tests |
|
|
Term
| ulnar compression symptoms |
|
Definition
5th and half of 4th finger loss of sensation
compressed between carpals |
|
|
Term
| colle's fracture: cause, orientation |
|
Definition
• fall forward on pronated hand
• radial fracture proximal to wrist: distal end goes posterior and proximal anterior |
|
|
Term
| smith's fracture: cause, orientation |
|
Definition
• fall backward on supinated hand or fall onto dorsum of flexed hand
• redial fracture to proximal wrist: distal end goes anterior, proximal posterior |
|
|
Term
| carpal seperation technique: the longer one |
|
Definition
fingers on thenar and hypothenar eminence, thumb on distal radius and ulna
wrist in passive flexion, lateral gliding to sides if needed
bring into extension with distraction to articulate carpals
if a carpal fails to mobilize put fingers on each side of it and hold it while flexing and extending wrist |
|
|
Term
| capal seperation technique: the easier one |
|
Definition
patient supine
compression across carpal bones with thenar eminences while patient opens and closes their hand |
|
|
Term
| transverse carpal ligament release |
|
Definition
physician fingers lateral to the 1st and 5th fingers
thumbs between thenar and hypothenar
stretch ligament holding 15-30 sec for 2-3 min |
|
|
Term
| facial plane milking in the hand: process |
|
Definition
| stabilize wrist with one hand and interlock fingers, move wrist into passive extension and have patient flex wrist. Resist force then overcome with isolytic force |
|
|
Term
| artiulation of the radioulnar joint |
|
Definition
related to interosseous membrane rension
isometric or isolytic
hold distal radius and ulna and resist supination and protination |
|
|
Term
| indirect myofacial release on hand |
|
Definition
| stabilize elbow as wrist and elbow are balanced in pronation, supination, radial , and ulnar deviation and compression and distraction |
|
|
Term
|
Definition
Traction at metacarpophalangeal then at proximal and distal interphalangeal joints
With joint extended and flexed side bend
Physician hand used as counterforce |
|
|
Term
|
Definition
Physician holds wrist as counter force
Grab thenar eminence just distal to carpometacarpal
Downward pressure makes articulation |
|
|
Term
| interdigital tissue release |
|
Definition
Finger in mild traction
Test for rotation
Treat in indirect way |
|
|
Term
| what do the ASIS compressions mean |
|
Definition
• Inferior ITA: innominate
• Down MTA: sacrum
• Superior STA: cranial |
|
|
Term
| explain how to name a sacral dysfunction |
|
Definition
o Find side of positive test
o Find anterior / posterior on positive side
o If sacral base is not same level as ILA it is unilateral flexion or extension
o If sacral base is the same level as the ILA there is a torsion
If base and ILA on the side of the positive test are going anterior it is a forward torsion (left on left, right on right)
If base and ILA on the side of the positive test are going posterior it is a backward torsion (left on right, right on left)
**remember axis is opposite to the positive seated flexion test |
|
|
Term
| explain how L5 and the sacrum are integrated |
|
Definition
o L5 rotation is opposite sacral rotation
o If sacral base is posterior L5 is usually extended
o If sacral base is posterior L5 is usually flexed |
|
|
Term
| explain muscle energy for sacrum for forward torsion, backward torsion, and unilateral flexion |
|
Definition
forward sacral torsion: use both legs patient pushes down, patient supine deep sulci down with hips sideways and shoulders toward ceiling
backward sacral torsion: patient supine deep sulci down with hips sideways and shoulders toward ceiling, lift one leg, localize motion of the lumbosacral junction
unilateral sacral flexion : Abduct and internally rotate ipsilateral lag to gap the SI joint, pressure on posterior ILA |
|
|
Term
| explain how to do HVLA on the sacrum |
|
Definition
| SI articulation: Patient hugs table with dysfunctional hip up. Bend knee, bring forward and around to straight |
|
|
Term
| explain how to to BLT on the sacrum |
|
Definition
Patient supine, physician hand on sacrum other on L5
Ease sacrum into nutation and counternutation for ease of motion
Patient breathes with motion
Hold in position of ease and feel for shifting of sacrum
Adjust to new positions of ease until it stops moving |
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Term
| explain how to fix a flare with muscle energy |
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Definition
| • Leg and hip bent and in external rotation, patient pushes knee up |
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Term
| explain how to do HVLA on an anterior innominate |
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Definition
• Patient on side, Flex hip and knee on affected side
• Physician facing patient, forearm on ischial tuberosity
• Roll patient towards you
• Thrust directed anteriorly and towards the floor |
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Term
| explain how to do HVLA on a posterior innominate |
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Definition
• affected hip up, knee flex with foot in popliteal fossa
• physician facing patients, forearm on ischial tuberosity
• roll patient towards you
• thrust anterior and toward floor |
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Term
| explain how to do BLT on an innominate |
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Definition
One hand under pelvis fingers on SI joint other on ASIS
Rotate anterior and posterior to find position of ease
Decompress and hold until strain is corrected
Augment with respiration
If standing cross effected leg over |
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Term
| what are some common dysfunction patterns in the lumbar spine |
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Definition
o Prone to type 1 movement
o Treat at base L5: Usually in type 2 mechanics
o Treat at top T12: Usually in type 2 mechanics |
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Term
| explain how to do muscle energy on a type 2 flexed at T12, type 2 flexed at L5, and a type 1 lumbar issue |
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Definition
Two step technique for T12 flexed: Translate to put T12 into barrier, extend at T12
Flexed dysfunction type: Patient lays on side to flatten side bend, lower leg straight. Flex knee until motion is felt at restricted segment. Rotate shoulders back towards table to induce rotation
Type 1: Patient lays on side to flatten curve. Use knees as fulcrum to monitor apex of curve for movement |
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Term
| explain two ways to to HVLA on a type 1 lumbar dysfunction |
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Definition
• Lumbosacral junction technique. Brings lower sacral base cephalid. Lay on side to flatter curve
• Thoracolumbar junction technique: Brings upper sacral base caudad. Lay on side to not flatten curve |
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Term
| explain how to do function for L5 |
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Definition
Translate to localize segment
Apply compression towards segment and wait for unwinding |
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