Pelvis Screening PDF

THE PELVIS-Screening Elimination of severe Pathology When a client presents showing sever pain or symptoms in the previously mentioned area, you must first eliminate any pathological conditions which may alter the assessment and treatment protocol of your client. A portion of these pathologies may...

THE PELVIS-Screening Elimination of severe Pathology When a client presents showing sever pain or symptoms in the previously mentioned area, you must first eliminate any pathological conditions which may alter the assessment and treatment protocol of your client. A portion of these pathologies may be eliminated through the patient history/consultation, however, conditions such as a herniated disc, arthritis and bone degeneration must be eliminated through testing. Should a client present in acute or severe pain the following tests must be performed prior to any general assessment process. Remember you are trying to recreate the pain the client came in complaining of. Also do the non- painful side first to give client indication of what to expect. Valsalva This test is performed to assess for the possibility of disc pathology. Ask your client if they have the pain reoccur or become more severe while bearing down to have a bowel movement. A positive sign may indicate disc pathology. Slump Test Instruct client to sit on the edge of your plinth. Ask client to flex one hip and dorsi-flex their foot without bending their knee. Next, have client slump forward. A positive sign indicates a disc pathology. Repeat process on other leg. Scour Test (Joint Play for Crepitus) With the client supine, grasp the tibia of the effected leg and passively move the coxa and knee into flexion. Move hand to anterior aspect of the knee and fully flex the coxa. Compress femur into acetabulum and while continuing to hold the compression move the femur through abduction, flexion and adduction in an arch. Continue motion back and forth slowly. If pain/radiating pain is recreated or any gravelly/grinding is noted, this is indicative of Labrum tear: Capsulitis: Osteoarthritis: Femoral acetabular impingement syndrome: Snapping hip syndrome may be signs of any of the listed conditions. Utilizing further testing, palpation and client history may help to make a determination. An x-ray may be required. Patrick Test (Faber) This test can be used as a general test for coxa motion but it can also be used to differentiate between hip pain and pain referred to the hip from a pathological sacral iliac (SI) joint. The client is supine, grasp the distal aspect of the tibia and flex the knee and coxa joints into a figure 4" position by placing the sole of the foot along medial aspect of opposite knee. The component that is used to monitor for hip asymmetry is performed by monitoring distance from the knee to the plinth and comparing it bilaterally. To test for a sacroiliac pathology, place palm of one hand over opposite ASIS and one hand over flexed knee. Press down mildly on each simultaneously monitoring for pain. If clients’ pain is recreated, this is indicative of a sacroiliac pathology. After you are assured no pathology is present you may move to your general assessment protocol. Client History The first step in any assessment must be the completion of a patient history/consultation. We have discussed client histories in great detail and we will leave their format and content to your previous knowledge of that information. Once the client has completed their history, it is important to perform a consultation to further assess the clients’ complaint regarding pain. The following questions should be asked: • Do you have any history of pain in this area? • Where is the pain located? • Does the pain tend to remain localized or does the patient find the pain refers to other areas? • Did the pain result from some form of trauma? • Did the pain originally come on suddenly or did it build up gradually? • Does anything make the pain worse? • How long has it persisted? • Is the pain more severe in the morning or does it tend to be more severe later in the day? • Are there any positions which provide relief and/or is there any positions that make the pain more severe? • On a scale of 1 - 10 with ten being severe where would you rate your pain at its worst? • Using the same scale how would you rate it at this time? Once you have a good understanding of the clients concerns in regard to their condition you may then proceed to the general assessment procedures.