Pelvis _ MET, Bony Palpation & Assessment.pdf

Pelvis : MET, Bony Palpation & Assessment Muscle Energy Techniques (MET): Integration of a client’s contraction to alter the resting tone of a muscle and/or joint position through neurological effect. MANY CLINICAL USES : • Lengthen a shortened, contracted or spastic muscle • Strengthen a physio...

Pelvis : MET, Bony Palpation & Assessment Muscle Energy Techniques (MET): Integration of a client’s contraction to alter the resting tone of a muscle and/or joint position through neurological effect. MANY CLINICAL USES : • Lengthen a shortened, contracted or spastic muscle • Strengthen a physiologically weak muscle • Relieve localized oedema (increase metabolic activity, move fluids etc) • Helps to mobilize an articulation with limited mobility (joint) • Desensitization of tissue • Helps stop a muscle spasm • Can help increase flexibility in opposing muscle pairs • Assist in realignment of an articulation thru muscle contraction Additionally: Empowering the client to take charge of his or her own rehabilitation/recovery. A client must not be a passive recipient of treatment, but rather the active participant, this begins the process of transferring responsibility to the client. Manipulation: The realignment of joint structures. Isometric: Application used to reduce muscle tone or pain. Contraction without joint motion. Isotonic/dynamic resistance: Application used to increase muscle tone. Contraction through resisted ROM Reciprocal inhibition: Contraction of the antagonist without joint motion to increase agonist length. BONY PALPATION Before assessing bony landmarks it is important to have your client square their hips. This is done by asking your client to place their feet flat on the plinth, and then “lift their hips off the plinth and set them back down.” This is done to help reduce the possibility of your client laying on the plinth in an uneven manner. Squaring the pelvis Client places feet flat on the plinth in hook lying position Client lifts pelvis off of plinth Replace pelvis on plinth. ***It is very important to inform the client before each step as to what you will be doing. This gives the client the opportunity to decline any aspect if they should feel uncomfortable at any time***. If the client is uncomfortable with any of the assessment protocol, then it is up to the therapist to use an alternate process to come to the conclusion of what the pelvic dysfunction is or what is the cause. Specific bony landmark palpation of the pelvis to determine which dysfunction(s) is present will be demonstrated and explained prior to going into specific detail of each separate dysfunction. PUBIC TUBERCLE ASSESSMENT: Therapist places heel of hand on clients’ abdomen. Slowly walk heel down until contact with pubic tubercles. Lift one side of hand and place thumb on anterior aspect of pubic tubercles. Lift opposite side of hand and repeat process with other thumb. Slide thumbs to superior aspect of tubercles. Monitor inferiorsuperior relationship of tubercles for asymmetry. Positive results would be indicated by a minimum of half a thumb difference in height. Refer finding to the side of dysfunction determined in the standing flexion test ASIS ASSESSMENT for ROTATIONS Palpate A.S.I.S with palms of hands. Lower draping below A.S.I.S. Palpate A.S.I.S with thumbs then lower thumb placement to the inferior aspect (under) of the A.S.I.S. Monitor superioposterior-inferoanterior relationship for asymmetry. Refer finding to the side of dysfunction determined in the standing flexion test. ASIS ASSESSMENT for FLARES Assessment position is described from finishing position for monitoring of innominate rotations. After monitoring for innominate rotations, flex distal phalanges to inside of crests. Monitor medial-lateral relationship of A.S.I.S in relation to midline for asymmetry. Refer finding to the side of dysfunction determined in the standing flexion test.