patient positioning
- chin 1” above the lower end of headpiece
- anterior crest of ilium 1” above upper end of pelvic piece
- 1-2 finger width b/t pelvic and lumbar pieces
Unilateral cervical syndrome
LC: 1 leg short ext; balances with head rotation to 1 side only (side of syndrome is the side they’ve rotated their head and the legs balance, body rotation is opposite side RCS=body left)
Criteria: palpate tender nodule on side opposite head rotation
Adj:
CH-superior hand, 1st PIP
SH-inferior hand, palm on zygomatic arch
LOC-L-M, P-A, I-S
Cervical Syndrome Atlas
-absence of tender nodule, adjust opposide side and
Listing: opposite side CS posterior atlas
LOC-L-M, P-A, S-I
Double Cervical lock
LC- 1 leg short in ext; balances with both sides rotation
Criteria: palpate tender nodules on 2 diff segments bilaterally
Listing: R or L CS
Adj: adjust highest seg first and recheck if lower is needed
Posterior cervical syndrome
LC: 1 leg short in extension; balances to both sides
Criteria: palpate tender nodule bilaterally on same segment
* lat xray shows loss of lordosis
Listing: P
DS-either side of patient, fencer stance
SCP-bilateral LPJs
CH-double thumb (no stabilization)
LOC-P-A, slight I-S
Overcompensated Cervical Syndrome OCCS
LC: short leg; balances with head rotation to 1 side only
Criteria: chronic C2 subluxation; tender nodules C2-C6; spinous rotation to C7; tight R trap on TN side often torticollis
DS-straight away on TN side SCP-1st rib head, side of TN CH-superior hand, thumb web SH-inferior hand, palm on zygomatic arch LOC-S-I, L-M (CH), I-S (SH) scissor action
Xception Derifield cervical syndrome
LC- legs balanced in ext; no change head rotation; short leg in flexion; legs balance on one side of head rotation
Criteria- palpate for tender nodules on side opposite of rotation
adjust as normal CS
Bilateral Cervical Syndrome
LC- legs balanced in ext; leg short on both sides of head rotation
Criteria- palpate C2 spinous tenderness
- DS-low fencer on either side of patient
- PT-prone, deflect head piece 15º, tuck chin
- SCP-inferior nuchal line
- CH-bilateral thenars
- LOC-A-P, I-S Scoop w/ a flip to ceiling
Pelvic adjustments:
Anterior iliac crest ~ 1” above pelvic piece
Drop 3-5x’s
AI Sacrum criteria
LC: short leg in ext; head rotation has no effect; flex legs and it remains short on same side or balances -Derefield
Criteria: 3 TrPs, 2 below waist
- ips: achiles, med tib, inf ischial tube, med/inf PSIS, pubic tub
- contra: T2-T6 costotransverse, 1/2 intercostal space at mid clav line
AI sacrum supine adjustment
Adjust: 2 parts *use pelvic insert
part 1
“deliver the baby”, get the elbow down LOW
-PT-supine, knee bent, leg resting laterally
-SCP-ischial tuberosity
-CH-inferior index finger, MCP joint
-SH-heel of superior hand on same ASIS
part 2 “torque”
- DS-Fencer on side of SCP
- PT-supine, opposite knee bent
- SCP-inguinal lig about 1”above pubic tube
- CH-heel of superior hand
- SH-palm on top of opposite bent knee
- LOC-slight A-P, fingers torque lateral ( CW or CCW)
AI sacrum prone
part 1-
- DS-low fencer on side of SCP
- SCP-ischial tuberosity
- CH-inferior hand, knife edge
- SH-roll in like a Toggle
- LOC-I-S, slight M-L & P-A
Pelvic tilt lever neutral
- DS-fencer on either side
- SCP-just medial to PSIS
- CH-heel of superior hand
- SH-palm sup to knee crosses & lifts leg in ext
- LOC – M-L, slight P-A
Rotated Sacrum SAR, SAL
- same leg check findings as AI sacrum but no TrPts
- neg -D
criteria- stabilze sacrum and pt lifts both legs
-leg that goes higher is side of rotated sacrum
- DS-fencer, SCP side, face cephalad or caudal
- PT-cross ↓ leg over ↑ leg, keep knee straight
- SCP-high leg side 1.sacral apex 2. medial PSIS
- CH-bilateral flesh pisiforms
- LOC-1. L-M 2. M-L, scissor thrust, slight P-A
PI iluem criteria
+D
-1 leg short in extension, head rotation no effect, goes long in flexion
criteria- leg lag, tender sartorius (med knee and inguinal lig)
PI ileum supine
Adjustment-
DS-low fencer, superior, on same side as SCP
-Use arm fossa test for exact SCP
-SCP-inguinal ligament 1” above pubic tube
-CH-superior knife edge
-SH-roll in like toggle
-LOC-A-P, S-I, L-M
PI ileum prone
- DS-fencer, opposite side as SCP
- SCP-med-inf PSIS
- CH-heel of inferior hand
- SH-fist of superior hand on ischial tuberosity
- LOC-P-A, I-S, M-L
Posterior Rocked Ishium
-D without triggers
criteria- tender gastroc
- DS-fencer, facing caudal on side of SCP
- PT-prone
- SCP-ischial tuberosity
- CH-superior fleshy pisiform
- SSP-roll in like Toggle
- LOC-P-A, S-I, with a roll
