Blog Archives

OMT: pelvis

This is one of the regions I was assigned to assess for my midterm practical last year. I got off to a wonderful start by handing my grading sheet to my preceptor and smashing my elbow into the corner of the table as I turned to face my patient. We had a good laugh over my misery. :O

Diagnosis:

  • Standing flexion test
  • SEAT THE PELVIS
  • ASIS
  • Pubic symphysis
  • Inflare/outflare
  • SEAT THE PELVIS
  • PSIS

Image from “The Pocket Manual of OMT” (2nd ed.).

As usual, ask for contraindications!

  • Any recent injuries? Sprains? Fractures?
  • Cancer? Infection?
  • Arthritis? Joint instability? Hypermobility?

Anterior (aka inferior) innominate ME

  • (Supine) Stand on involved side + flex/adduct the hip to its restrictive barrier.
  • Pull the buttbone (ischial tuberosity) up.
  • Ask pt to push knee into your shoulder for 3-5 seconds against your equal resistance.
  • Allow relaxation + move hip to new barrier.
  • Repeat 3-5x. Retest.

Posterior innominate ME

  • (Supine) Stand on involved side + hold opposite ASIS.
  • Move involved leg off the table + let it drop to its extension barrier. (Since it’s posterior, you want your leg to be more posterior, hence why you drop it off the table.)
  • Ask pt to push thigh upward for 3-5 seconds.
  • Allow relaxation + move hip to new barrier.
  • Repeat 3-5x. Retest.

Anterior innominate thrust, supine

  • Stand at foot of table and grasp leg above malleoli (use both hands).
  • Lift leg to ~30 degrees hip flexion + slightly abduct + internally rotate leg. (Since it’s anterior, you want your leg to be more anterior, hence the flexion.)
  • Ask pt to take deep breath. During exhalation, apply a caudad (towards the feet) tug.
  • Retest.

Posterior (aka superior) innominate thrust, supine

  • (SAME AS ANTERIOR but you don’t flex to 30 degrees.)

Pubic ME, thrust

  • Grasp outside of both (flexed) knees. Ask pt to push knees apart for 3-5 seconds. Relax. Repeat 3-5x.
  • Separate knees but holding inside of knees with hand/elbow of one arm. Ask pt to push knees together for 3-5 seconds. Relax. Repeat 3-5x.
  • Add thrust by applying a short, quick + lateral push at the end.
  • Retest.

Ilium inflare ME

  • (Supine) Stand on opposite side of inflare + flex knee + hip, putting the foot on the table close to the butt.
  • Hold opposite ASIS (the one closest to you) + laterally abduct hip to restrictive barrier.
  • Ask pt to push knee medially for 3-5 seconds. Allow for relaxation.
  • Repeat 3-5x. Retest.

Ilium outflare ME

  • (Supine) Stand on side of outflare + flex knee + hip, putting the foot on the table close to the butt.
  • Pull PSIS laterally while medially adducting the hip.
  • Ask pt to push knee into external rotation for 3-5 seconds. Allow for relaxation.
  • Repeat 3-5x. Retest.
Advertisement

apparently, numbers aren’t my thing

We had our anatomy practical on the GI system on Monday. I spent 4 hours out of my weekend tutoring my friends on it, so in theory, I should have done really well. For some unfathomable reason, however, I thought our practical was at 3:18 p.m. when in actuality, it was at 3 p.m., and our practical ended at 3:18 p.m.

Since I’d been studying with my neighbor, we basically got there at the halfway mark, and only because he asked if I wanted to race him to the lab. :[ I am a terrible person.

I think we did reasonably well though, given the circumstances? I still feel horrible though. :[ Good thing he didn’t care. :[


Part of our mini med school presentation includes a demonstration/tutorial on how to intubate using mannequins, so we were going over that yesterday. I actually got to do this about 6 years ago at a summer program I did back at the hospital my mom works at, but it’s definitely been a while. Apparently, I did retain a little somethin’ though because I was the only one who successfully intubated my patient on my first try without breaking any teeth! :D Super proud of self. I may not be such a failure after all! :D

HBLers -1. (I’m taking the picture.)

A true high five.

In other news, we had our Chapman points lab today in OPP. I’m really glad that I got paired off with one of my friends and not with someone creepy.

Courtesy “The Pocket Manual of OMT,” 2nd ed. Beatty, Li, Steele, Comeaux, Garlitz, Kribs, Lemley. Aka all my OPP professors.

If you subscribe to the belief that 2nd base is above the waist and 3rd base is below, my friend basically got to 3rd on me today. (Please note where the point for “uterus” is.) Our professor referred to it as “starting at the ischial tuberosities and moving up til the point right before where you’d get sued.” Oh, medicine. We clearly cannot have boundaries. I restate and reiterate: I’m glad my partner today was my friend.

We were working out together-ish at the gym yesterday afternoon and the following conversation ensued:
I: Hey Farrah, do you think Mike’s buff?
M: No, don’t ask her that!
F: But I didn’t even answer yet.
M: What if I don’t want to hear the answer? :[
I: I think you’re buff, Mike.
M: Stop it.
F: You don’t take compliments well, do you? :O

So today, Isaac came over.
I: While we have the chance…
F: Oh yeah! Did you want to palpate my liver? And my kidneys? (He asked about this yesterday.)
I: …Oh. Yes! But not right now. I was going to say, while you have the chance, you should feel Mike’s biceps and tell him you agree with me.
F: A most splendid idea! Will do! :D
F+I: (evil snickers)

(For the record, we’re all friends, or this probably would have been a little strange and I’d probably get Titled IX’ed.) I did this after he got through the CV/Respiratory Chapman points (what I call second base) on me.

F: I’m sorry, but Isaac put me up to this. :O Blame him if you mind. (does the Pacman kidney capture on M’s biceps)
M: Isaac!
I: What? Farrah, do you agree with me now? Look at those muscles! And whether or not you like facial hair, at least he can grow a beard if he wants to!
F: This is true.

We had fun, haha. I don’t think either of us felt a single Chapman point though.

Kroger is having a Greek yogurt sale, so I’m trying out all the brands! :P (I usually go with Fage 0% and soup it up with honey and granola, but since my honey crystallized due to the cold and I haven’t melted it back down yet, I’ve been getting the ones with actual flavor. :O

why sleeping might be a better option sometimes

I was writing up notes on GERD/peptic ulcer drugs the other night, but was extremely exhausted and trying to push through said exhaustion.

I shouldn’t have.

This is what I found after I woke up that morning:

GERD

-works like antacids except more slowly (but effects also last longer)
-can be taken prophylactically before meals to reduce likelihood of heartburn
-still needs to work on wearing safety glasses throughout lab

behold, my spine

So it appears that ever since 2005, I’ve ended up with some kind of semi-shitty injury every other year in November/December. It’s like clockwork! :[

2005
This was at my last gymnastics meet. My hands were ripped up, so I’d made some tape grips to make life a little easier on my hands (although once you stick chalk on that, it really doesn’t matter what you have over it ;_; ). The first event was bars (my worst/most hated event that I will likely always be bitter about because I worked so hard on my other routines and never got to do them), and I ended up slipping off the high bar and doing a flip, which I’ve never done before because, as mentioned before, it’s my absolute worst event. (If you want to be good at gymnastics, try not to start when you’re 14…) I was so surprised by this unplanned occurrence that I didn’t even think to fix how I was going to attempt to land it. So I landed on my neck, heard about 27 different cracks and crumpled to the floor. Shining moments. This was the one and only time my parents ever came to watch one of my meets. I make some lasting first impressions. ._.

2007
December 30th, we got sandwiched into a ginormous car accident and I spent part of the night lying on a stretcher on the side of a freeway. The plus side to this was that our insurance covered our rehab fees this time, so I got to see a chiropractor. The first one I saw in Fremont took some x-rays and I found out that my neck was bent 26 degrees in the opposite direction. :[ (That explains the shitty headaches. :[ )

2009
Deadlifting accident of sorts. After a couple days, I was coerced into seeing a doctor since the pain wasn’t going away, despite the B vitamins, self-imposed physical therapy, anti-inflammatories, heat packs and rest. I was told that it was not a herniated disc, but it eventually led to me hanging out at the emergency room I volunteered at (oh the irony) two weeks later. I was eventually released, but was told to be cautious of the possibility of a pulmonary embolism because they were worried that I might develop blood clots. After several months, the pain did actually go away, but the break from movement was really depressing.

2011
I wish I knew what happened? Clearly though, I did something completely stupid and made the 2009 goodness deprove even more. I’ve probably ruined all chances of being able to win (or even participate in) the super badass competition that I wanted to do this year. :[ I’m also really worried that I won’t get to keep dancing/doing aerial silks. The constant pain sucks major butt. :[

I finally saw a chiropractor (I figured it unlikely that the doctor would tell me anything that I didn’t already know from last time). My cervical vertebrae are apparently still pretty effed up. It is now 10 degrees in the opposite direction, which is a definite improvement from 26, but…still not good. There are already signs of degeneration that shouldn’t be there since I’m only 23. There’s basically no space left between C3-C4. :[

I was fairly sure that I’d either effed up L4 or L5. Apparently, it’s L5. :[ I’m kinda hating life right now.

sigh. :[[ must find an affordable and good chiropractor in NJ…

I also need to figure out if there are any exercises I can do in the meantime that won’t worsen my current state (i guess my favorite lifts are out of the question) and will help me retain my muscle mass. ;_;

shining moments

Guess who forgot to bring her towel into the bathroom today and had to streak across the house?