Pelvis somatic dysfunction

The counterstrain tender points of the lumbar spine are named for the dysfunctional lumbar vertebrae. Anterior tender points are treated with the patient supine and posterior tender points are treated with the patient prone. Many of the counterstrain techniques for lumbar somatic dysfunctions are facilitated by slight rotation of the patient s thighs and pelvis, and by resting some part of the patient s leg on the physician s thigh or knee. 

This chapter describes Still techniques for treating somatic dysfunctions of the sacrum and pelvis. There are several systems of diagnosis, but the techniques described in this chapter are related to the systems that are used in this textbook. There are also seated techniques described, albeit less effective than the supine ones described. Because of the complexity, interested students should refer to Dr. Van Buskirk s more thorough book and chapters for other techniques and diagnoses. 

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 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. 

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