OPP Block 4 Quick Review

8/7/2019 OPP Block 4 Quick Review

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8/7/2019 OPP Block 4 Quick Review

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-  Anterior glide posterior movement of distal fibula and ext. rotation of the ankle

-  Posterior glide anterior movement of distal fibula and int. rotation of the ankle

Tibiotalar joint

-  People with inflexible joint are 5x more at risk for sprains

o  Usually plantar flexion (anterior talus)

Navicular

-  External rotation = inversion

Cuboid

-  Internal rotation = eversion

o  Usually the cause of an inversion ankle sprain

LumbarMuscle Energy

-  Lateral Recumbent

-  Type I

o  Posterior TP up

-  Type II

o  Posterior TP down

InnominateMotion

-  Physiologic (normal when in motion)

o  Rotation and flare-  Non-physiologic (caused by some trauma)

o  Innominate shear and pubic shear

-  Innominate Shear

o  Superior shear both ASIS and PSIS superior

o  Inferior shear both ASIS and PSIS inferior

o  Determine which side by flexion test

-  Pubic Rami Shear

o  Superior superior pubic tubercle and tender inguinal ligament

o  Inferior inferior pubic tubercle and tender inguinal ligament

-  Pubic Compressiono  Standing flexion test +/-

o  ASIS and PSIS equal

o  Tender pubic rami and tender pubic symphysis

-  Innominate Rotations

o  Anterior rotation

  Inferior ASIS, superior PSIS

8/7/2019 OPP Block 4 Quick Review

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o  Posterior Rotation

  Superior ASIS, inferior PSIS

-  Innominate Flares

o  Outflare

  Lateral ASIS, medial PSIS

o  Inflare

  Medial ASIS, lateral PSIS

HIPLSIT (order we treat dysfunction)

-  Hip

-  Innominate Shears

-  Pubic

-  Lumbar

-  Sacroiliac

-  Innominate Rotations

-  Thoracic

Lumbar HVLA 

-  Posterior TP down

-  Lateral recumbent

-  Localize to joint space below

PubicMuscle Energy (types of ME used; he always likes to ask this)

-  Superior Innominate Shear

o  Respiratory cooperation

-  Inferior innominate Shear

o  Post-isometric and respiratory cooperation

-  Superior Pubic Shear

o  Joint mobilization using muscle force

-  Inferior Pubic Shear

o  Post-isometric

-  Pubic Symphysis Reset

o  Joint mobilization using muscle force

-  Anterior Innominate Rotation

o  Post- isometric

-  Posterior Innominate Rotation

o  Joint mobilization using muscle force

-  Outflared Innominate

o  Post-isometric

-  Inflared Innominate

o  Post-isometric

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SacralMuscle Energy

-  Remember Fred Mitchell came up with this stuff 

-  3 tests

o  Seated flexion

o  Spring testo  Backwards bending

-  2 landmarks

o  Sacral sulcus

o  ILA 

-  2 problems

o  Sacral shears

o  Sacral torsions

-  3 horizontal axes on sacrum

o  All on S2 (top, middle, bottom)

-  Shearso  Non-physiologic

o  Involves slippage of the sacrum around the backward C-shaped SI joint

o  Occurs around middle axis

o  True SI joint problem

-  Torsions

o  Physiologic

o  L5/S1 joint problem

o  Occurs around oblique axis

o  Imbalance in the muscles that affect sacral motion in relation to L5 motion

-  * L5 rotates to same side as deep sulcus *-  Respiratory Motion

o  Inhalation

  Curves flatten; sacrum conternutates

o  Exhalation

  Sacrum nutates

HVLA Review

-  Long lever and short lever

-  Goal is to move 1/8 inch

-  For thoracic somatic dysfunction

o  Flexion

  Isolate to segment below

  Force is 90 posterior

o  Extension

  Isolate to segment below

  Force is directed 45cephalad and posterior