Lumbar. Physician. Technique: Continue this. back pain is. bent. under the contralatera. Copyright

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Tabitha Nash
5 years ago
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problem and lumbar myofascial releasee can

side Patient position: p Supine with legs

hand under the contralateral lumbar muscles

Apply a perpendicular stretch to the lumbar

As you lean back, move the patient s knees

1 Lumbar myofascial releasee Lumbar spine Brief description: Low back pain is a common problem and lumbar myofascial releasee can be useful as part of a comprehensiv ve treatment of low back pain. By usingg the legs as a countertorque, we can further stretch the lumbar muscles. position: Stand contralateral to affected side Patient position: p Supine with legs bent Hand positioning: Place your cephalad hand under the contralateral lumbar muscles and your caudad hand on the patient s knees. 1. Place your cephalad hand under the contralatera lumbar muscles and your caudad hand on the patient s knees. 2. Apply a perpendicular stretch to the lumbar muscles by leaning back. 3. As you lean back, move the patient s knees awayy from you to cause a countertorque. Continue this technique until you have released the entire area., Respiratory Circulatory, Neurological, Metabolic Energy, Behavioral

Facilitated positional release (FPR) of sacrum Brief description: FPR of the sacrum is a

leg before applying a compression during exhalation.

Prone with a pillow under the abdomen too keep the sacrum and lumbar spine in a relatively

positioning: Place one finger in the sacral sulcus of the affected side and the heel of that

With your hand in the monitoring position on thee SI joint, move the ipsilateral leg into

Now flex the hip by gently pushing the leg towards the floor. 3.

2 Facilitated positional release (FPR) of sacrum Brief description: FPR of the sacrum is a short treatment that places the sacrum in a neutral position, then abducts and flexes the leg before applying a compression during exhalation. position: Stand on the side of the dysfunction (side of restricted ILA) Patient position: p Prone with a pillow under the abdomen too keep the sacrum and lumbar spine in a relatively neutral position and another pillow under the ipsilateral thigh to serve as a fulcrum Hand positioning: Place one finger in the sacral sulcus of the affected side and the heel of that hand on the ILA. Place your other hand on the distal leg to control thee leg. 1. With your hand in the monitoring position on thee SI joint, move the ipsilateral leg into abduction until you feel a softening under your monitoring finger. 2. Now flex the hip by gently pushing the leg towards the floor. 3. Ask the patient to take a deep breath in and apply a pressuree on the ILA superiorly towards the head as the patient exhales. (Force should be parallel to the table.) 4. Return the patient to neutral.

Sacral rock Sacrum Brief description: Sacral rocking

to improve physiological movement of the sacrum.

lateral recumbent Hand positioning: Place your hands

your hand on the apex and the other at the sacral

Place your hands over the sacrum with the patient in

Feel for the motion of the sacrum with respiration.

by applying pressure on the base with exhalation and

3 Sacral rock Sacrum Brief description: Sacral rocking encourages the natural motion of the sacrum in order to improve physiological movement of the sacrum. position: Standing Patient position: p Prone or lateral recumbent Hand positioning: Place your hands so that you cover the entire sacrum with one heel of your hand on the apex and the other at the sacral base. 1. Place your hands over the sacrum with the patient in either the prone or lateral recumbent position. 2. Feel for the motion of the sacrum with respiration. 3. Encourage the physiologic motions of the sacrum by applying pressure on the base with exhalation and on the apex with inhalation. 4. Repeat until you feel thatt the sacrum is moving better with respiration.

Muscle energy treatment (MET) of anteriorly rotated nnominate dysfunction (supine) Pelvis Brief

inferior medial malleolus and positive standing flexion test all on the same side.

patient pushes against you into their freedom.

Place your cephalad hand so that you cann monitor the PSIS and use your caudad hand to flex and resist

Have the patient bend their knee while keeping their foot flat on the table. 3.

Now ask the patient to push against you for 3 5 seconds. 5. Have the patient relax for 3 5 seconds 6.

4 Muscle energy treatment (MET) of anteriorly rotated nnominate dysfunction (supine) Pelvis Brief description: Findings for an anteriorly rotated innominate include an inferior ASIS, superior PSIS, inferior medial malleolus and positive standing flexion test all on the same side. To treat this you will want to push the innominate more posteriorly by flexing the leg while the patient pushes against you into their freedom. position: Standing on the same side as the dysfunction Patient position: p Supine Hand positioning: Place your cephalad hand so that you cann monitor the PSIS and use your caudad hand to flex and resist the motion of the leg. 1. Place your monitoring hand at the PSIS. 2. Have the patient bend their knee while keeping their foot flat on the table. 3. Use your other hand to flex the patient s leg up until you are at their barrier of motion. 4. Now ask the patient to push against you for 3 5 seconds. 5. Have the patient relax for 3 5 seconds 6. Re engage the barrier by flexing further into the barrier. 7. Repeat steps 4 to 6 two more times. 8. Apply a passive stretch by flexing the leg further into its barrier without having the patient push against you. 9. Return the patient to neutral and reassess.

Muscle energy treatment (MET) of posteriorly y rotated innominate

posteriorly rotated innominate include a superior ASIS, inferior

extending the leg while the patient pushes against you into their

position: Standing on the same side as the dysfunction Patient

you cann monitor the PSIS and use your caudad hand to extend and

Place your monitoring hand at the PSIS. 2.

5 Muscle energy treatment (MET) of posteriorly y rotated innominate dysfunction (supine) Pelvis Brief description: Findings for a posteriorly rotated innominate include a superior ASIS, inferior PSIS, superior medial malleolus and positive standing flexion test all on the same side. To treat this you will want to push the innominate more anteriorly by extending the leg while the patient pushes against you into their freedom. position: Standing on the same side as the dysfunction Patient position: p Supine Hand positioning: Place your cephalad hand so that you cann monitor the PSIS and use your caudad hand to extend and resist the motion of the leg. 1. Place your monitoring hand at the PSIS. 2. Have the patient come to the edge of the table and hang their ipsilateral leg off the table. 3. Use your other hand to extend the patient s leg until you are at their barrier of motion. 4. Now ask the patient to push up against you for 3 5 seconds. 5. Have the patient relax for 3 5 seconds 6. Re engage the barrier by flexing further into the barrier. 7. Repeat steps 4 to 6 two more times. 8. Apply a passive stretch by extending the leg further into its barrier without having the patient push against you. 9. Return the patient to neutral and reassess.

6 Muscle energy treatment (MET) of superior shear of the innominate Pelvis Brief description: Findings for a superior shear of the innominate include a superior ASIS, superiorr PSIS, superior medial malleolus and positive standing flexion test all on the same side. To treat this you will want to pull the innominate inferiorly by grasping just above the ankle while the patient tries to pull their leg up. position: Standing on the same side as the dysfunction Patient position: p Supine Hand positioning: Using both hands, grasp just above the ankle. 1. Grasp just above the ankle and flex, abduct and internally rotate the leg to gap the SI joint. 2. Ask the patient to try and pull their leg up for 3 55 seconds while you apply an isometric resistance. 3. Have the patient relax for 3 5 seconds 4. Re engage the barrier by flexing, abducting and internally rotating more. 5. Repeat steps 2 to 4 two more times. 6. Now ask the patient to take a deep breath in andd out. Have them cough at the end of exhalation. When they cough pull the leg inferior. 7. Return the patient to neutral and reassess.

DIAGNOSIS ANTERIOR PELVIC ROTATION DIAGNOSIS DIAGNOSIS. Direct techniques to treat sacrum and pelvis somatic dysfunction (HVLA, MET)

DIAGNOSIS ANTERIOR PELVIC ROTATION DIAGNOSIS DIAGNOSIS. Direct techniques to treat sacrum and pelvis somatic dysfunction (HVLA, MET) American Academy of Osteopathy Convocation PHYSICIAN STUDENT Thursday, March 18, 2010 Friday, March 19, 2010 2:30 4:00 PM 8:00 9:30 AM 4:30 6:00 PM 10:00 11:30 AM Direct techniques to treat sacrum and