Innominate, Sacrum, and lumbar spine HVLA Flashcards Preview

OS2 Final > Innominate, Sacrum, and lumbar spine HVLA > Flashcards

Flashcards in Innominate, Sacrum, and lumbar spine HVLA Deck (12)
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HVLA inferior innominate shear (with forearm)


bend legs

straighten the bottom one and take the top leg and put it in the popliteal fossa

place caudal hand on their rotated shoulder, place inferior forearm on the PSIS

engage the barrier with your forearm, breathe in and out and on exhale give a superior thrust through your forearm


HVLA Bilateral Sacral Flexion


Abduct the leg and internally rotate it on BOTH LEGS –> opening up the posterior side

palpate to the apex of the sacrum

encourage inhalation (extension) and resist exhalation (flexion). inhale, and at the top of inhalation, push anteriorly and superiorly and pop the sacrum backwards.


L1-L5 extension/neutral dysfunction: long lever rotational emphasis –> “Walk around”


YOU’RE STANDING OPPOSITE THE PTP (so L4 NSLRR you’re on their left side)

clasp hands together, behind their head

Make a C shape away!!

caudal hand on the contralateral ASIS

cephalad hand on the underside of the contralateral bicep

rotate them around towards you with your cephalad hand

on exhalation, exert a rotational thrust down towards the floor while stabilizing the ASIS

return to neutral


Right on a left axis sacral torsion HVLA


be on the axis side (so on their left side)

have them put their hands behind their head

put them in a C shape away from you

take your caudal hand on the contralateral ASIS, and cephalad hand on the contralateral underneath bicep

inhale, exhale, and rotate them over towards you into the barrier

inhale, and on exhalation you do a posterior thrust through the ASIS hand and go back to neutral


HVLA Pubic Restriction


bend legs like you would for the pubic muscle energy

start with muscle energy at this location

have them put their knees about 6 inches away and then have them squeeze in and breathe in and out, and you thrust away (quick and small) (abduction motion from you)


HVLA Type 1 lumbar, lateral recumbent?


Lateral recumbent, PTP SIDE UP

you grab their lower arm (elbows grabbing, and you rotate them down to the dysfunctional segment that you’re monitoring with the caudal hand

flex both legs up until you have movement with your bottom hand at the segment

straighten the bottom leg, top leg foot goes in popliteal fossa

to engage the side bending barrier you pull that lower arm UP the head

stabilize the shoulder, caudal forearm on the greater trochanter

breathes out you are doing a rotational thrust

return to neutral slowly


HVLA Inferior Innominate Shear (lateral recumbent with both hands)


Lateral recumbent, affected side UP, have them grab your elbow and you grab their elbow and rotate them a big to get the torso out of the way.

cephalad hand on the PSIS, caudal hand on the ASIS

push in and lift up (technically lateral) to distract the SI Joint

take a deep breath in and out, and on exhalation thrust towards head


HVLA Bilateral Sacral Extension


You have them come up on their elbows in sphinx position (encouraging flexion)

ABDUCTthe legs and EXTERNALLY rotate, opening up the anterior side

on inhalation you RESIST the INHALATION , and follow exhalation you move into flexion.

on final exhale you are giving an anterior and inferior thrust at the BASE of the sacrum


HVLA Posterior Innominate Rotation


1) lateral recumbent, rotate the trunk away using the elbows (same thing)
2) flex the legs up to the SI joint, STRAIGHTEN the bottom leg and hook the top leg in the popliteal fossa
3) the caudal forearm is on the PSIS and iliac crest
4) you’re going to be thrusting towards the umbilicus!


HVLA Anterior Innominate Rotation


affected side up, lateral recumbent, same thing, rotate the torso away through having them grab your elbow

bend the legs to localize to lumbosacral junction. take the top leg and drop it off. (DO NOT STRAIGHTEN LOWER LEG)

cephalad hand is on the shoulder holding it in place

caudal forearm is placed BETWEEN THE PSIS AND TROCHANTER

simultaneously push shoulder posterior and roll pelvis anterior to induce the rotation until SI joint is palpated

HVLA directed with caudal forearm DOWN THE SHAFT of the femur, parallel to the leg that’s off the table.


HVLA Superior Innominate Shear


1) patient is supine, you’re at the foot of the table
2) abduct leg, internally rotate, dorsiflex foot
3) take deep breath in and out
4) exhales, give a short thrust


HVLA: Type 2 Lumbar, Lateral Recumbent

what about if they’re flexed or extended?


PTP up, grab elbow and rotate down to the segment

take their arm and pull it DOWN!!

take their knees and flex them both up till you feel motion

straighten bottom leg COMPLETELY with the top leg’s foot in the popliteal fossa for FLEXION

bend the bottom leg a little bit with the top leg crossed over the bottom and off the table for EXTENDED

deep breath in, as they exhale you apply a ROTATIONAL thrust

return to neutral