Principles of Manual Medicine
Left Superior Innominate Shear
Overview A direct action, muscle energy procedure for treating an innominate shear dysfunction in the supine position. Join Dr. Philip E. Greenman, D.O., F.A.A.O., as he presents an overview of this dysfunction.
Step 1 The operator stands at the end of the table with the patient's right foot against the operator's left thigh.
Step 2 The operator then grasps the patient's left leg with both hands and internally rotates the patient's extended abducted left leg to close pack the left hip joint. Using abduction/adduction, the operator moves the patient's extended left leg 10-15° to loose pack the left sacroiliac joint.
Step 3 The operator puts long axis extension on the patient's left leg and holds it there. The patient performs a series of inhalation and exhalation efforts. Three to four respiratory cycles are performed, and during the last exhalation effort the patient is instructed to cough while simultaneously the operator tugs the left leg in a caudad direction concluding the treatment sequence.
Note We would then go back and evaluate our landmarks to see if we've restored function to that restricted sacroiliac joint on the left.