OMT: sacrum

I’m pretty sure I’m not the only one, but the day(s) that I know OPP/OMT best tend to be the night before/morning of my practical. We had our midterm practical yesterday, so I figured…what better time to write up my notes on it (while it’s still fresh in my mind and I still remember it!!!) than now?

The sacrum is probably one of my worst sections, so I actually drew something out for it. (What is this sudden dedication!?)

If the answer to the light blue question in #1 is “no,” then you’d best be sure to lower the table until they are. :O

Images from “The Pocket Manual of OMT” (2nd edition).

(The actual diagnostic terminology.)

Sweet! Now that we’ve gotten those out of the way and we have a diagnosis, what next?

Ask about contraindications!

  • Have they had any recent injuries to the area?
  • Broken bones, fractures, sprains, cancer, infection?
  • Arthritis? Blood clots? Possibility of going into premature labor!?

No? Alright, proceed!

But what are you gonna do to make it better? Give me a treatment!

For our midterm, we were responsible for 5 treatments in this section. (I have 5 more sections to write about. It’s gonna be fun.)

Forward sacral torsion ME

  • (Lateral Sims) Have pt lie with their problem side (“axis side”) down.
  • Since it’s forward, have the pt’s front (their chest) on the table.
  • Put one hand on their lumbosacral jxn and flex their hips until you feel motion at the jxn.
  • Ask pt to push their feet toward the ceiling for 3-5 seconds against your equal resistance.
  • Tell them to relax, then move their legs to the new restrictive barrier.
  • Repeat 3-5x. Retest motion/symmetry!

Backward sacral torsion ME

  • (Lateral recumbent) Have pt lie with their problem side down.
  • Since it’s backward, have the pt’s back on the table.
  • Put on hand on their lumbosacral jxn + extend the bottom leg until motion is felt. Bend the top leg + place it behind the other knee.
  • Hold shoulder w/ other hand to prevent pt from falling off the table.
  • Ask pt to push their flexed knee toward the ceiling for 3-5 seconds against your equal resistance.
  • Tell them to relax, then move their legs to the new restrictive barrier.
  • Repeat 3-5x. Retest motion/symmetry!

Unilateral sacral flexion ME

  • (Prone) Stand facing the pt’s head on side of flexion.
  • Place thenar or hypothenar eminence on ILA + push anteriorly/superiorly.
  • Use other hand to slightly abduct + internally rotate the leg.
  • Ask pt to take a deep breath. Push ILA during inhalation + resist sacral flexion during exhalation.
  • Repeat 3-5x. Retest!

Unilateral sacral extension ME

  • (Prone) Stand facing pt’s feet on side of extension.
  • Place thenar or hypothenar eminence on sacral base + push anteriorly/superiorly.
  • Use other hand to slightly abduct + internally rotate the leg.
  • Ask pt to take a deep breath. Resist during inhalation + push sacrum into flexion during exhalation.
  • Repeat 3-5x. Retest!

Sacroiliac articulatory

  • (Lateral Sims) Have pt lie on uninvolved side w/ chest down.
  • Stand behind pt + put thenar eminence on sacral base of restricted SI joint + grasp knee w/ other hand.
  • Lean in to stabilize, then ask pt to take deep breath + hold it as you flex it to its barrier.
  • Slowly abduct + externally rotate hip to barrier + maintain abduction barrier as you extend hip (tell pt to exhale here!).
  • Repeat 3-5x. Retest!
Advertisements

About Farrah

A frugal, selectively antisocial Family Medicine resident physician with too many interests. Loves...God, family, friends, volunteering and helping others, making others happy, music (especially piano and singing), Tahitian/hula/salsa/pole dancing, aerial silks, learning, writing, cooking, eating, sleeping, lifting weights, playing SNES and DS, photography, editing, window-shopping, gymnastics, kickboxing, BJJ, finding great deals, pyrography, horseback riding, archery, frolicking in the great outdoors...making every moment count.

Posted on December 12, 2013, in School and tagged , , . Bookmark the permalink. Leave a comment.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: