Unit2 Pelvis PP 22.pptx

Pelvis Designed and Presented by Dale Gran WC (Hon) RMT Manipulative Therapist Objectives Upon Completion of this Power Point, students should have an understanding of the following: i. ii. iii. iv. v. vi. Indications to Assess the Pelvis Different dysfunctions assessed in the Pelvis Screening T...

Pelvis Designed and Presented by Dale Gran WC (Hon) RMT Manipulative Therapist Objectives Upon Completion of this Power Point, students should have an understanding of the following: i. ii. iii. iv. v. vi. Indications to Assess the Pelvis Different dysfunctions assessed in the Pelvis Screening Tests for the Region Landmarks used for Pelvic Assessment Assessment finding and muscular involvement for Pelvic Dysfunctions Pelvis Tx Protocols Pelvis Ouch!!! Different “Packs” Innominate Rotations Seated effects on Pelvis and Lumbar Effect of Pelvic Tilt Knee Hyperextension Pelvis Dysfunction Indicators for Pelvis Assessment  Pain SI Joint (Fortens Finger Test)  Anatomical leg assessment difference in height of pelvis unilaterally  Positive standing flexion test  Coxa restrictions   Displaced tibia - Rotated tibias -Valgus/varus conditions  Longitudinal/metatarsal arch asymmetry  Bunion Screening Tests Valsalva Slump test Scour (Joint play for crepitus) Patrick's (Faber) Test Pelvis Protocol Rule out anatomical short leg. If present: • shin low side until iliac crests level. • Standing flexion test • one side travelling greater distance overall. • This determines side of dysfunction. • Seated flexion test. • eliminates hamstrings influence on Standing Flexion Test • Any finding other than: Standing flexion +, Seated flexion + on the same side • passively test hamstrings, treat if necessary • reassess standing flexion test • use these results as side of dysfunction. Bony Landmark Assessment (determining dysfunction) Squares pelvis • Superior/inferior height relationship of pubic tubercles • Pubic Subluxation • Pubic subluxation exists, treat this first. • Superioposterior and inferioanterior relationship of ASIS • Innominate Rotation • Medial/lateral relationship of ASIS to midline • Pelvic Flare. • Correlate standing flexion test findings (side of dysfunction) • This determines dysfunction present Pelvic Findings and Meanings •The following possibilities may arise (rights could be exchanged with lefts and vice versa) • •Standing flexion test Positive – side that travels greater distance • •Seated flexion testPositive – side that travels greater distance • •#1 Standing +R •Seated +R right side dysfunctional • •#2 Standing +R •Seated = right side dysfunctional (possible hamstrings tight influencing motion) • •#3 Standing +R •Seated +L may have both pelvis/sacrum dysfunction. • • • Pelvic Findings and Meanings If #2 / #3 occurs: May Indicate possible hamstring influence. Ensure no issue with hamstrings. If hamstrings are issue tx them, redo standing flexion test and go with findings. Hamstrings aren’t a problem redo standing flexion test and assume dysfunction is on side travels greater distance Pelvis Assessment Protocol 1) Determine if pelvis problem exists, what side dysfunction is on 2) Determining what pelvic dysfunction is 3) Isolate/verify cause Pelvis Treatment Protocol *****THREE STEP TREATMENT PROTOCOL***** • 1) Apply extrinsic techniques: • 2) Apply appropriate MET’s if extrinsic application is not satisfactory for dysfunctional musculature: • Completion of step 2, reassess boney landmarks to determine if treatment of condition was successful. • Reassessment of standing flexion test may also be done. Designed and Presented by: Dale Gran WC (Hon) RMT