Pelvic Dysfunction – Flashcards
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what type of treatment is primarily offered for pelvic dysfunction?
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muscle energy techniques
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dysfunctions of the pelvis
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-upslip -downslip -superior pubic malposition -inferior pubic malposition -anterior ilial rotation -posterior ilial rotation -inflare -outflare
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how to diagnose pelvic dysfunctions
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-find evidence of malposition/dysfunction (but you don't know if its L/R that is abnormal) -do the standing flexion test -side that is hypermobile is the dysfunctional side
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why is the dysfunctional side hypermobile, hypothetically?
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the SI joint on that side is compensatorily hypermobile because individual parts are not mobilizing properly, thus moves as a whole
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upslips/downslips malposition
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-all landmarks will seem high or low -leg length discrepancy may be present according to medial malleoli
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pubic malposition
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sides of pubic symphysis will seem high/low
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ilial rotation malposition
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ASIS will be higher or or lower compared to PSIS
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flare malposition
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-ASIS/PSIS will seem closer/farther from midline -leg will often be ER/IR
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treatments for superior pubic symphysis malposition
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-shotgun technique -adduction MET
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shotgun technique for superior pubic symphysis malposition
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-supine -isometric adduction from butterfly pose with your elbow wedged between their knees -then hug their knees shut together for isometric abduction
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adduction MET for superior pubic symphysis malposition
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-supine -take them to barrier of pelvic rotation for abduction (as determined by ASIS) -then perform isometric adduction
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treatment for inferior pubic symphysis malposition
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-supine -flex knee passively until barrier of nutation (as determined by PSIS) -isometric hip extension
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treatment for upslip with anterior rotation
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-prone -grasp ankle -abduct, ER, and extend hip -apply traction can manipulate at endpoint
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treatment for upslip with posterior rotation
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-supine -grasp ankle -abduct, ER, and flex hip -apply traction can manipulate at endpoint
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treatment for downslip
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hop on one leg - typically self-correcting
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treatment for posterior rotation
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-prone -flex hip to barrier of rotation (as determined by PSIS) -isometric flexion
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treatment for anterior rotation
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-supine -flex hip to barrier of rotation (as determined by PSIS) -isometric extension
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treatment for inflare
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-supine -knee to 90, adduct to midline -isometric abduction
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treatments for outflare
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-butterfly MET -flexion+adduction MET
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butterfly MET for outflare
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-supine -butterfly position with one side -stabilize opposite hip -isometric adduction
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flexion+adduction MET for outflare
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-supine -knees and hips to 90 -IR hip -isometric flexion + adduction
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Greenman's treament order
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1) lumbar 2) pubic symphysis 3) slips 4) SI 5) IS rotation 6) IS flare 7) muscle imbalances
