Principles of Manual Medicine
Left Superior Innominate Shear
Overview
The illiosacral dysfunctions are dysfunctions of the innominate on one side of the sacrum. They're dependent upon the ligamentous integrity. The mechanism of injury for this is the classic pratfall, when the patient slips and falls or some force is applied to one innominate and it drives the innominate cephalward in relationship to the sacrum on that side and it gets restricted there. Click here to join Dr. Philip E. Greenman, D.O., F.A.A.O., as he as he presents an overview of this dysfunction.
Step 1
Having made that diagnosis, Click here to join Dr. Greenman as he demonstrates how the operator stands at the end of the table with the patient's right foot against the operator's left thigh in order to position the patient before performing a combined muscle energy and respiratory technique.
Step 2
Click here to join Dr. Greenman as he demonstrates how to grasp 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
Click here to join Dr. Greenman as he demonstrates how to put long axis extension on the patient's left leg. The patient is then directed to perform 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.
Click here to view a summary of iliosacral joint dislocation.