OMM II Midterm Dx/Tx

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Right Superior Ilia Shear Dx

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Medicine

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1

Right Superior Ilia Shear Dx

+ ASIS Compression Test on the right

R iliac crest is superior

R ASIS is superior

R pubic tubercle superior

R PSIS superior

ASIS equal to midline

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2

Right Superior Ilia Shear Tx

abduct & internally rotate right leg

hold proximal to the medial malleolus

apply traction with a staggered stance

instruct patient to take a deep breath & on exhalation apply HVLA to the right leg

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3

Right Inferior Ilia Shear Dx

+ ASIS Compression Test on the right

R iliac crest is inferior

R ASIS is inferior

R pubic tubercle is inferior

R PSIS is inferior

ASIS equal to midline

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4

Right Inferior Ilia Shear Tx

patient stands & jumps on right leg while holding onto your arms

OR

patient sits right hip on table and uses left leg to stand up & down onto the right hip

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5

Right Superior Pubic Shear Dx

+ ASIS Compression Test on the right

R pubic tubercle is superior

everything else is equal

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6

Right Superior Pubic Shear Tx

patient lies supine with right leg off the table

monitor left ASIS with one hand & the other hand is on the inside & on top of the right knee

3-5 sec for 3-5 times have the patient push their knee up & in while restricting this movement (ME) reposition to the barrier each time

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7

Right Inferior Pubic Shear Dx

+ ASIS Compression Test on the right

R pubic tubercle is inferior

everything else is equal

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8

Right Inferior Pubic Shear Tx

patient lies supine on the table

flex the right leg up to the 1st barrier by pushing on the right thigh while monitoring the right ischial tuberosity

3-5 sec for 3-5 times have the patient try to push against you while restricting this movement at the thigh (ME) reposition to the barrier each time

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9

Right Anterior Ilia Rotation Dx

+ ASIS Compression Test on the right

R ASIS is inferior

R PSIS is superior

everything else is equal

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10

Right Anterior Ilia Rotation Tx

patient lies supine on the table

flex the patient’s right leg via the right knee while monitoring the iliolumbar junction to the 1st barrier

3-5 sec for 3-5 times have the patient try to push against you while resisting motion at the right knee (ME) reposition to the barrier each time

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11

Right Posterior Ilia Rotation Dx

+ ASIS Compression Test on the right

R ASIS is superior

R PSIS is inferior

everything else is equal

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12

Right Posterior Ilia Rotation Tx

patient lies supine on the table with their right leg off the table

monitor the left ASIS with the other hand on top of the right knee

3-5 sec for 3-5 times have the patient try to push their knee up while resisting this motion (ME) reposition to the barrier each time

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13

Right Ilia Outflare Dx

+ ASIS Compression Test on the right

R ASIS is lateral

everything else is equal

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14

Right Ilia Outflare Tx

patient lies supine on the table

flex & push the right leg across midline via the knee while monitoring the right PSIS

3-5 sec for 3-5 times have the patient try to push their knee out against you while applying a lateral force on the right PSIS (ME) reposition to the barrier each time

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15

Right Ilia Inflare Dx

+ ASIS Compression Test on the right

R ASIS is medial

everything else is equal

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16

Right Ilia Inflare Tx

patient lies supine on the table with their right leg making a figure 4 position

monitor the left ASIS with one hand & have the other hand on their right knee

3-5 sec for 3-5 times have the patient try to push their knee in while resisting this motion (ME) reposition to the barrier each time

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17

Right Unilateral Flexed Dx

+ Seated Flexion Test on the right

Compensated L5 (Rr)

- BBT (flexed)

R deep sacral sulcus

R ILA is posterior/caudad

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18

Right Unilateral Flexed Tx

patient lies prone on the table

abduct and slightly internally rotate the right leg

one hand goes on the R ILA with fingers pointing towards the head & the other hand monitors R sacral sulcus

5 times have the patient inhale & encourage this motion but then restrict movement during exhalation

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19

Right Unilateral Extended Dx

+ Seated Flexion Test on the right

Compensated L5 (Rl)

+ BBT (extended)

L deep sacral sulcus

L ILA is psoterior/caudad

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20

Right Unilateral Extended Tx

patient lies prone on the table

abduct & slightly internally rotate the right leg

one hand is on the sacral base with fingers pointing towards the feet & the other hand monitors the R sacral sulcus

5 times have the patient inhale while restricting this motion & encourage motion during exhalation

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21

Bilaterally Flexed Sacrum Dx

Seated Flexion Test is equal

Compensated L5 (Extended)

- BBT (flexed)

Sacral sulci are deep

ILAs are equal

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22

Bilaterally Flexed Sacrum Tx

patient lies prone on the table

abduct and slightly internally rotate both legs

one hand goes on both ILAs with fingers pointing towards the head & the other hand lies ontop of it pointing towards the feet

5 times have the patient inhale & encourage this motion but then restrict movement during exhalation

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23

Bilaterally Extended Sacrum Dx

Seated Flexion Test is equal

Compensated L5 (flexed)

+ BBT (extended)

Sacral sulci are both shallow

ILAs are equal

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24

Bilaterally Extended Sacrum Tx

patient lies prone on the table

abduct and slightly internally rotate both legs

one hand goes on the sacral base with fingers pointing towards the feet

5 times have the patient inhale & resist this motion but then encourage movement during exhalation

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25

R/R Sacral Torsion Dx

+ Seated Flexion Test on the left

Compensated L5 (N SrRl)

- BBT (flexed)

L deep sacral sulcus

R ILA is posterior/caudad

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26

R/R Sacral Torsion Tx

patient lies prone on the table

flex both legs then push their left hip & bring their legs to their chest at the same time so that they are laying on their right side

place one hand on the iliolumbar junction and the other hand on their L shoulder

3-5 sec for 3-5 times have the patient push their L shoulder up towards the ceiling while resisting this movement (ME) reposition to the barrier each time

slide both legs off the table together & support the legs on top of your knee

3-5 sec for 3-5 times push their ankles towards the ground while monitoring the illiolumbar junction while they push back towards the ceiling (ME) reposition to the barrier each time

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27

R/L Sacral Torsion Dx

+ Seated Flexion Test on the right

Compensated L5 (SlRl)

+ BBT (extended)

L deep sacral sulcus

R ILA is posterior/caudad

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28

R/L Sacral Torsion Tx

patient lies on their left side & uses their left arm to grab your elbow while monitoring the iliolumbar junction, then pull their torso to de-rotate L5 (they should have their torso mostly supine & legs still stacked on top of each other with the left hip on the table)

keep one hand on the iliolumbar junction & place the other hand on their R shoulder

3-5 secs for 3-5 times have the patient push their R shoulder up towards the ceiling while resisting this movement (ME) reposition to the barrier each time

straighten the bottom leg (L) & pull the other leg (R) off the table and rest it on your thigh

3-5 secs for 3-5 times monitor the iliolumbar junction with one hand & with the other push their R knee down while they try to push their knee up towards the ceiling (ME) reposition to the barrier each time

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