Pubic dysfunction

Primary pubic dysfunctions are superior-inferior or abducted-adducted dysfunctions. 

Asymmetry of position indicates a pubic dysfunction. The diagnosis is... 

Pubic dysfunctions are iikewise named for die positive motion tests. The pubic ramus typically follows the position of the ASIS, but this is not always the case. The plasticity of bone may allow for some warping, opposite to the ASIS finding. Before drawing a conclusion, examination must be performed. A superior pubic shear and an inferior pubic shear may occur in the expected ASIS direction. They can be opposite. There are also torsions possible, as well as adducted and abducted pubes. Childbirth, wherein cartilage is softened by relaxin, is probably the greatest predisposing factor for abducted pubic dysfunction. Adducted pubes may be trauma or rebound related. Sometimes the only indications that there is a dysfunction when the pubic rami appear symmetrical are the symptoms of the patient Aseptic cystitis, pubic pain, prostatitis, pelvic paresthesias, enuresis, or other symptoms may also be betier indicators of pubic dysfunction. 

FIG. 61-5 Muscle energy technique for inferior pubic dysfunction. 

FIG. 61-6 Muscle energy technique for superior pubic dysfunction. 

The physician places his fist against the ischial tuberosity on the side of the pubic dysfunction. 

The diagnosis of pelvic dysfunction concentrates on two aspects of the innominate the ilium and the pubic components. Generally, the landmarks of the posterior superior iliac spine (PSIS), anterior superior iliac spine (ASIS), pubic rami, and their other relative structures can give some static findings as to the diagnosis. As with other regions of the body, motion testing indicates the side of the dysfunction. 

FIG. 66-3 HVLA thmsting technique for an inferior pubic somatic dysfunction. 

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 finding of somatic dysfunction at the T12-L1 region is common in the presence of prostate disease. Dysfunctions of the pubic symphysis and congestion of the ischiorectal fossa should be explored. These should be treated to relieve or prevent discomfort in this area. 

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-... 

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