ADducted Ilium (closed pubic rami) Somatic Dysfunction Muscle Energy

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ADducted Ilium (closed 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°, feet together
  2. Physician standing at the side of the table facing the patient
  3. Physician’s forearm is placed between the patient’s knees (hand on medial aspect of far knee and elbow on medial aspect of close knee, trying to open pubes)
  4. Patient is instructed to attempt to adduct knees and hold this contraction for 3-5 seconds (isometric contraction)
  5. After a 3 second pause, the physician abducts the knees to the new restrictive barrier
  6. The isometric contraction is repeated 2-3 times 
  7. Reassess

Video Tutorial:

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