Pelvic somatic dysfunctions

This section describes muscle energy techniques for sacrum and pelvic somatic dysfunctions. 

There are a number of causes for the creation of psoas dysfunction. Among these are trauma to the lumbar spine, lesser trochanter or pubes, myosistis or psoatic bursitis, or visceral dysfunction in relationship to the psoas muscle, such as an acute appendicitis, renal or urethral dysfunctions, fallopian tube inflammation, and iliac or femoral arteiy phlebitis. Any musculoskeletal condition that causes a low back imbalance and lumbar and pelvic somatic dysfunctions must be evaluated. It is important lhat any and all of the findings be actively treated. 

Somatic dysfunctions in the lower thoracic and upper lumbar regions are often found in association with renal and urological conditions. Pubic and other pelvic somatic dysfunctions may occur due to regional inflammation or as viscero-... 

Somatic dysfunctions of the sacrum and pelvis are common and are among the most common causes of low back and pelvic pain. The articulation of L5 -S1, the sacroiliac joints, and the pubic articulation are all sources of pain resulting from dysfunctions. These are described in detail In previous chapters. 

The gluteus maximus follows the law oj muscle detorsion. Therefore, to increase hip extension, as in ballet movement, the ilium must be rotated. Somatic dysfunction of the lumbar spine will limit lumbar regional motion, pelvic rotation, and hip extension... 

The question that must be answered when this diagnosis is made is, what was the underlying condition that caused this condition The function of the bursa is in relationship to muscle function. The muscle(s) involved include those used for hip motion as well as knee motion. Pelvic function and balance is involved as well. Somatic dysfunctions are a common finding and must be addressed. The finding of an anatomical short leg should be sought. Simply treating the local symptoms will not "cure" the condition. 

The bursitis has as its cause trauma to the area, acute or chronic, as well as any dysfunction affecting the ischium or the structurai integrity of the knee joint. The patient reports pain at the medial aspect of the knee, but careful palpation will elicit point tenderness below the knee joint that is very specific and localized in its nature. The pain will be made worse with contraction of the semitendinous, sartorius, and gracilis muscles. An evaluation for somatic dysfunctions of the pelvis, sacrum, and lumbar region, as well as the postural balance of the lower extremity, must be performed. Treatment can be a local injection of a steroid, a prescription for a NS AID, ice, exercises, and osteopathic manipulative treatment (OMT) of all somatic dysfunctions, including knee, hip. and pelvic region. 

Osteopathic treatment can begin with the initial physical examination and should include treatment of the primary somatic dysfunctions. Treatment of the uterus and pelvic floor during bimanual examination is most appropriate. 

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