Recall Diagnosing the Innominate

Steps for Treatment:

Prone

1. Patient prone with the dysfunction hip flexed and off the table. The ipsilateral foot rests on the physician’s thigh
2. Physician ipsilateral, one hand on the patient’s knee and the other on the dysfunctional sacroiliac (SI) joint
3. Patient is instructed to extend the lower extremity into the physician’s thigh while the physician resists
4. Hold for 3-5 seconds then relax for 2 seconds
5. Take up slack and engage new barrier 
6. Repeat two more times
7. Finish with passive stretch
8. Reasses

Video Tutorial:

Supine

1. Patient supine
2. Physician sits/stands on dysfunction 
3. Flexes knee and hip
4. Physician with one hand (palm up) against ischium, other hand on knee/thigh (for resistance)
5. Patient attempts to straighten hip isometrically against resistance for 3 seconds
6. Patient relaxes 3 seconds, engage new barrier
7. Repeat twice more
8. Passive stretch 
9. Reassess

Video Tutorial:

Lateral Recumbent

1. Patient in the lateral recumbent with the dysfunctional side up, physician faces the patient 
2. Cephalad hand palpates the SI joint, stabilize the pelvis, caudad hand supports the knee
3. Physician flexes hip to bring innominate into posterior rotation to edge of restrictive barrier 
4. Patient pushes foot down as if taking a step up while isometrically resisted.
5. Hold for 3-5 seconds 
6. Relax 2 seconds 
7. Take up slack and engage new barrier 
8. Repeat twice more 
9. Passive stretch 
10. Reassess

Video Tutorial: