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LP Test Strategy ANMT Chip Semplinski
Page 1 of 4
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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