Principles of Manual Medicine
Right Anterior Rotated Innominate
Overview A direct action, muscle energy procedure for treating a right anterior innominant in the prone position.
Diagnosis
- Position: Right innominant anteriorly rotated.
- Motion restriction: Posterior rotation of right innominant.
Step 1 The operator grasps the patient's pelvis and slides the patient's lower trunk to the right edge of the table. The operator controls the patient's right leg by placing the patient's foot between operator's knees and grasping the patient's right knee with the operator's right hand.
Step 2 The operator's left hand stabilizes the patient's sacrum in the midline with the left index finger monitoring the right sacroiliac joint.Step 3 The operator controls the patient's right leg with abduction, external rotation, and flexion to engage the barrier to posterior rotational movement. The patient should be instructed to perform muscle effort for 3-5 seconds of extending the right leg by pushing the right foot against operator's thigh.
Step 4 The operator engages the new barrier of posterior rotation between each patient contraction, and repeats the process three to five times.
Note This dysfunction frequently accompanies a left sacrum flexed (anteriorly nutated). A combination technique can be performed as the last step of the muscle energy procedure for the left sacrum flexed. While holding the sacrum in the posteriorly nutated position with the right hand, the operator's left extends the left hip, rotating the left innominate anteriorly, and resists the muscle effort of pulling the knee to the table.