MET: Posterior (backward) Rotation of the Innominate Bone
MET: Anterior (forward) Rotation of the Innominate Bone Purpose: To reduce posterior rotation of the innominate bone at the SI joint To increase anterior (forward) rotation of the SI joint Precautions: This position stretches the femoral nerve If the patient experiences any neurological symptoms during the procedure, discontinue Procedure:
Specific treatment for the SI joint
posterior innominate rotation Abduction/Adduction O Rotation: Posterior / functional leg length discrepancy in patients with sacroiliac joint dysfunction
The relationship between pelvic torsion and anatomical leg
Posterior innominate rotation on side of lifted leg and anterior rotation on nonlifted side; range, 3-19°; mean, 11° Baseline: right PI 1 3° Pelvic torsion did not entirely correct induced pelvic tilt Pioneering study Descriptive statistics only Only 1 lift size used, preventing determination of dose relationship
Hip & Spine Exam Pearls
Inspection & Leg Length Discrepancy 13 • Inspect from feet up • Palpation • Gait • Functional - umbilicus to medial malleoli • Up slip/Downslip • Anterior/Posterior innominate rotation • Anterior innominate appears longer • Posterior innominate appears shorter • Structural – ASIS to medial malleoli
Common presentations and diagnostic techniques
Excessive ‘bilateral anterior’ innominate rotation 120 Excessive ‘bilateral posterior’ innominate rotation 121 Sacral rotation around the coronal axis 121 ‘Bilateral sacrum anterior’ 121 ‘Bilateral sacrum posterior’ 121 The standard back examination can be misleading 122 An understanding of the ‘malalignment syn-
lumbar spine and SI eval [Read-Only]
zanterior rotation -- leg will appear to shorten zposterior rotation – leg will appear to lengthen zHave athlete supine and lift buttock off of table Passively assist athlete’s legs to a straight position Palpate medial malleoli position Have athlete sit up without using hands to a long sit position and asses relative position of medial
special tests le - Scott Sevinsky, MSPT
§ Long Sitting (Supine à Sit) Test: tests for the presence of an anterior or posterior innominate (rotation) at the SI joint Begin by having the patient positioned supine with both legs bent up so that feet are resting on the plinth You may also ask them to perform a bridge to “set” their hips (Wilson-Barstow Maneuver)
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