LP Test Strategy ANMT Chip Semplinski

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Step Muscle/Test Description Travell Ref0-5 Positive for R SI joint dysfunction

5-20 Prone

20-35 Side Lying Vol 2: p. 151, fig 8.1

35-37 Stretch Supine Assisted Hold-Relax technique Vol 2: p.146, fig 7.7A

37-50 Supine Vol 1: p. 944, fig 49.2A2

50-55 Retest

55-60 Education

ApproxTime

Greet & Ortho Tests

Modified Thomas / KendallSacral Compression / Gapping (+)Straight Leg Test (+ > 70 degrees?)Slump Test

Gluteus MaximusTrP1 along sacral attachment

Attaches to sacrum, TrP1 refers to sacrum/SIStraight leg or figure four, warm, palpate edge of sacrum with hidden thumbs, DTF w/ elbow and come lateral in corncob fashion.

Vol 2: p. 133, fig 7.1Ap. 138 SI dysfunction

Gluteus Medius TrP1 and/or TrP3

TrP1 refers along sacrum/SI, TrP3 onto sacrum over SIBolster knee above hip (level), insure sholders stacked w/ head support. DNM greater trochanter, warm, palpate using second thumb, DTF w/ elbow from below illiac crest, corncob to greater trochanter

Gluteus Maximus – Single Leg to Chest

Rectus Abdominis TrP2 at pubis attachment

Attaches to innominate, TrP2 at pubis refers across sacrum & SI. Flat palpation of pubis, DTF w/ forearm/elbow

Sacral Compression / GappingStraight Leg Test

Explain what we did in the session and why, show self hold-relax stretch, show ball self massage

LP Test Strategy ANMT Chip Semplinski

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Test Testing Mechanics PositiveIliopsoas / RF

ASIS Gapping

ASIS Compression

Straight Leg Test

Slump Test P: Nerve impingement

Modified Thomas / Kendall

Client leans on table side, bring knee to chest, aid client to supine.

Thigh horizontal or above: T iliospoasLower leg not vertical: T RF

SI JointASIL

CL supine, legs straight, hands on ASIS push posterior and lateral.

P: SI joint compression or ligament stress

SI Joint PSIL

CL supine, legs straight, hands on ASIS push posterior and medial.CL sidelying, knees flexed & stacked, press medially.

P: SI joint compression or ligament stress

Hip, Nerve, Nerve Root / HNP, SI

CL supine, legs straight, raise testing leg slowly. P between 30-70, lower & dorsiflex ankle.

P <30: hip30 < P < 70: nerve30 < P < 70 dorsiflex: nerve root / HNPP > 70: SI joint

Nerve Root / HNP

CL seated, hands clasped behind LB, slump forward head/trunk, raise foot, dorsiflex.

LP Test Strategy ANMT Chip Semplinski

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Muscle Why? Attachments TrPs Location ReferralGluteus Maximus TrP1 Lateral to mid sacrum

TrP2

TrP3 Coccyx

Gluteus Medius TrP1

TrP2 Central below iliac crest

TrP3

Rectus Abdominis TrP1 High costal margin

TrP2

TrP3

TrP4

Attachment to sacrum / ilium & referral of TrP1

Medially and proximally it attaches to the posterior border of the ilium to the posterior iliac crest, the posterolateral side of the sacrum, the side of the coccyx, aponeurosis of the ESG, the length of the sacrotuberous ligament and fascia of G. medius.

Crescent of pain around gluteal cleft

Laterally and distally about ¾ of the muscle (all upper fibers and superficial lower) attaches to the thick aponeurotic tissue that becomes the ITB of the fascia lata. The remaining lower tissues attach to the gluteal tuberosity of the femur.

Just superior to ischial tuberosity

Entire buttock and deep

Most medial & inferior fibers

Referral of TrP1 & TrP3

Proximally to the external surface of the ilium along the anterior ¾ of the ilic crest between the anterior and posterior gluteal lines, and to the gluteal aponeurosis that covers 2/3 of the muscle.

Near SI joint below iliac crest

Along posterior iliac crest, SI joint and sacrum

Distally, to both sides of a broad tendon anchored to the poseterosuperior angle and the external surface of the greater trochanter.

Lateral and to the mid gluteal region

Near ASIS below iliac crest

Along iliac crest, across LB & bilaterally to sacrum

Referral of TrP1 & attachment to pubis

Above, it attaches to the cartilages of the 5th, 6th and 7th ribs. Fibers are interrupted by 3 or 4 transverse tendinous inscriptions.

Across mid back

Fibers attach below to the crest of the pubic bone, with fibers from each side interlacing across the symphysis.

Lowest part @ pubis attachment

Bilaterally across the low back and SI

McBurney's point, along arcuate line at lateral border

Pseudo-appendicitis

Below arcuate line, medially.

Dysmenorrhea, P around TrP

LP Test Strategy ANMT Chip Semplinski

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