Sacrum Lab Critique Flashcards
Where do you find the AL2 tender point? How do you treat it?
push medial to lateral on AIIS
Pt is supine. Stand on opposite side. Set Pt’s legs on your knee, cross Pt’s good leg over bad leg, bring thighs toward you and also lower legs toward you.
Where do you find the low ilium tender point? How do you treat it?
just lateral to pubic tubercle
Pt is supine. Stand on same side as dysfunction. Grab pt’s knee and flex hip (knee to chest) to about 100 degrees
Where do you find the piriformis tender point? How do you treat it?
midway between ILA and greater trochanter
Pt is prone. Seated on side of dysfunction. Flex hip 120 degrees and give some slight abduction/external rotation
Where do you find the high ilium flareout tender point? How do you treat it?
lateral aspect of coccyx
Pt is prone. Stand on same side as dysfunction. Slip hand underneath leg and let it sit/roll down forearm onto other leg.
Explain the Prone-direct method-respiratory force and/or LVMA technique.
Dx: left unilateral sacral flexion
- Pt is prone, stand on side of dysfunction
- Gap the joint by taking leg lateral at knee and standing 3.behind it
- Right hypothenar eminence on pt’s left ILA
- tell pt to inhale and exhale
- on exhale, spring sup. and anteriorly
note: pushing on ILA is causing sacral base to come posterior and out of flexed position
Explain the supine-direct method-HVLA tug
Dx: left unilateral sacral flexion
- pt is supine
2. grab lower leg, abduct slightly, internally rotate and tug
Explain the prone-direct method-LVMA technique
Dx: left unilateral sacral extension
- pt is prone, stand on same side as dysfunction
- heel of hand on ischial tuberosity, other hand on sacral base
- spring hands together
Explain the seated muscle energy technique for a left sacral margin posterior diagnosis
- pt is sitting
- monitor left sacral base with left hand
- take right arm and rotate pt to right
note: no side bending and make sure pt stays vertical
Explain the HVLA technique for a left sacral margin posterior
- pt is supine, stand on opposite side of dysfunction
- place right hand on ASIS of the side of the dysfunction
- take left hand and feed it behind patients left arm crossed behind head
- lift patient diagnollay back towards you and when pelvis comes off of table, thrust down onto left ASIS
Explain the technique for bilateral sacral flexion
- pt is supine
- place hands and lumbosacral junction
- have pt bend knees and lean into them
- Do muscle energy and have pt try to push you away
Explain the technique for bilateral sacral extension
- pt is prone and in sphinx
- place heel of one hand on sacral bases
- have pt inhale and exhale and spring on exhale
Explain the technique for physiologic response and LVMA for a left on left sacrum
- pt is prone, sit on opposite side (right side)
- swing pt’s legs around and place them on knee at 90 degree angle
- monitor sacral base with right hand, spring with left hand on pt’s lower leg (your knee is the fulcrum)
note: can add muscle energy to this too
Explain the physiologic response and respiratory force technique for a left on left sacrum
same set up as before
- pt instructed to inhale and exhale
- on exhale, “reach your right hand to the floor and let your feet drop to the ground”
note: can add muscle energy and springing to this
Explain the seated-direct-muscle energy and physiologic response technique for a left on left sacrum
- pt sitting
- put hand on left ILA to monitor
- tell pt to slump forward
- take right arm and side bend left and rotate left
- do ME
hint: Dx = L on L, Tx = SB L and rotate L
Explain the lateral recumbent-direct method-physiologic response, respiratory force, and LVMA technique
Dx: right on left sacrum
- pt has axis side down
- pull left arm ant. and sup., set up upper body like lumbar roll
- bring pt’s legs off table at less than 90 degrees
- tell pt to inhale and exhale, on exhale do springing
