ABducted Ilium (open pubic rami) Somatic Dysfunction Muscle Energy

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ABducted Ilium (open pubic rami) Somatic Dysfunction Muscle Energy

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Recall Diagnosing the Pubic Tubercles

Place heel of hand at level of umbilicus, with your fingers pointing cephalad. Pressing down with the heel of your hand moving downward until reaching pubic symphysis. Place thumbs (or fingers) at superior aspect of pubic tubercles on top pushing caudad to ensure you have reached the appropriate landmark. When evaluating the landmarks for Abduction vs Adduction you are assessing for a “bulging” feeling, which would indicated adducted tubercles. Or looking for a gapping sensation between the pubic tubercles, which would indicated abducted tubercles.

Steps for Treatment:

The physician always adds force in direction to FIX the dysfunction

  1. Patient supine (close to one side of the table), hips and knees flexed to 90°, knees and feet pelvis-width apart. 
  2. Physician standing at the side of the table facing the patient
  3. Physician places his hands on the lateral aspect of each knee (trying to close the pubes)
  4. Patient is instructed to attempt to abduct knees and hold this contraction for 3-5 seconds (isometric contraction)
  5. After a 3 second pause, the physician adducts the knees to the new restrictive barrier 
  6. The isometric contraction is repeated 2-3 times
  7. Reassess

Video Tutorial:

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