The Muscle Energy Manual Evaluation and treatment of the pelvis and sacrum

VOLUME THREE INDEX 171 in observing landmarks 10 effect on passive joints xxiv longissimus 14-16 linguistic assiacotion of \"manipulation\" predictive power of xxii medial hamstring 42,45 and \"palpation\" XIX Michigan State University xvii multifidi 15 load transmission Michaelis, dimple of 4,85 obliquus abdominis 17,58 through the sacrum 30 middle and superior transverse axes obturator 18,45 localization concept xxii locating xvii intemus 20 middle transverse axis 123 pectineus 19 gluteal tubercle 85 Miller, Rolland DO xvii pectoralis major 66 PSISs/PIPs 85 Mitchell model of the pelvis xvii pelvic 14 long dorsal sacroiliac ligament 12-13 advantages xxiv peroneus 42,66 longissimus muscle 14-16 landmarks for diagnosis 3 longus 20,45 loose-packed position for sacroillic joint Mitchell, Fred L., Sr. xvii phasic xxii 130 Mitchell, Jr. and Pruzzo research phylogenesis of tighmess or low back pain, acute lwnbar adaptation to 63 sacroiliac respiratory motion 28 weakness prone 67 mobility piriformis 14-15,20,30,42-43, 45, sacroiliac lesions 128 sacral, translatory 28 46,63,66,133,139 upslipped innominate 112 tests, pelvic 115 psoas 16 lwnbar recumbent 94 pytarrUdalis 17 lateral curve and sacral torsion 112 mons pubis 103 quadratus femoris 18,45 rotoscoliosis 128 motion transmitted from vertebrae quadratus lumborum 16,42-43, sidebending, unbalanced 48 to sacrwn 21 46,62,63,66,79,90, spring test 128 motivation and compliance 115 139 lwnbodorsal fascia 20,90 multifidi quadriceps 45 lwnbosacral as lumbar postural muscles 69 reCUIS abdominis 17,29,66 dysfunction, Type II 48 muscle 15 recuts femoris 18,42,45,66 muscle(s) joint 128 rhomboid 66 junction 137 gluteus 67 sartorius 19 \"reverses what the sacrum did\" adductor brevis 19 scalene 66 91 adductors femores 29 semimembranosus 19 load, asymmetric 62 adductor longus 19 senntendinosus 19 zygapophyseal trophism with adductor magnus 19 serratus anterior 66 asymmetric hip sway 72 adductors of hip 66 short hip adductor 66 luxation 101,108 biceps femoris 19-20,42,45 spinalis 14-15 coccygeus 14-15,70,154,156, sternocleidomastoid 66,68 M 161 suboccipital 69 MacDonald, Richard C. DO xviii digastric 66 head leveling function 68 Magoun, Harold I., Sr., DO xviii erector spinae 14,15,66,79 temporalis 66 malposition, pelvic visceral 53 extensor digitorum 46 tensor fuscia lata 19,66 manipulation and palpatory diagnosis extensor hallucis 46 thoracoabdominal diaphragm 66 XIX futique causing clonic fusciculations tibialis anterior 42,45,46,66 many versions of the forward bend test 67 tibialis posterior 20,45,66 not interchangeable 72 functional classification: tonic or phasic tighmess-prone vs. weakness-prone 66 Marfan's syndrome 114,143 XXl1 tonic xxii mechanism of gastrocnemeus/soleus 42,66 transversus abdominis 17 injury 71 gemelli 18,20,45 transversus perineii 156 in flexed sacrum 61 gluteus 79 trapezius 66,68 restriction 83 maximus 4,14-15,42-43, vastus medialis 42,45 medial 63,66,92 vastus medialis and lateralis 66 Muscle Energy hamstring muscle 42,45 medius, and nnnimus 19,20, malleoli 3,9 42-43,66,92 concepts xix /lateral displacement of PSISs gracilis 19 history of xvii with nutation/counternutation hamstring 13,19,20,46,66,67,79 teclmique, predictive power of xxii 31 iliacus 18,31 treatment for pelvic joints xix median crest of the sacrwn 124,151 ilio-psoas 16,66,79 tutorial CME xxii muscle imbalance MET iliocostales 14-16 and PIR, differences imbalance 66 lower limb 74 diagnostic criteria xxvi internal obturator 154 treatment for 79 muscles and fascia, thigh application to spine, ribs and latissimus dorsi 13,16,20,63, extrennties xvii 66,79,90,139 stabilizing effi:ct on the ilium 22 muscular stability of the pubic symphysis compared with PIR xxv levator ani 14-15,70,154,156,161 concepts xvii levator scapuli 66 55

172 THE MUSCLE ENERGY MANUAL myofuscial sacral motions 122 PIP(s) (or PSISs) 81,87,126 parasympathetic nervous system 161 continuity 67 locating 85 technique xxv paravertebral motion, paradoxical 84 fullness nigger points 46 90 movement, unilateral myotatic reflex response, suppression of symmetry, observing 76 superior-inferior and/or posterior-anterior 90 XXI patient handout for sacroiliac belt 115 palpating N history with drn�ar movement (fiiL1ion) 5 National Osteopathic Foundation PIR and MET, differences importance in finding the primary XXI lesion 71 diagnostic criteria XXVI Newnann, Heinz-Dieter MD xxv instructions for upslipped innominate piriformis muscle(s) 14-15,20,30, 114 Nowland,Devota DO xvii 42-43,45,46,63,66, nutation or counternutation, sacral pectineus muscle 19 133,139 22,24-25,81 pectoralis major muscle 66 sacroiliac stabilizing fimction of 20 positive flexion test 101 delayed initiation 90 pelvic reverse, at terminal range 23 artimlar dysfimction 121 criterion tor 90 axes, history of xviii strong (++ ),weak (+),or false 87 0 bony landmark relationships 1 post isometric relaxation (PIR) xvii, xxi oblique (diagonal) axes xviii, 30, breathing movement impairment compared \\\\�th MET x:xv 33-34,43,46,128, 68 129,133,136,139 post-partmn psychosis 161 diaphragm 154 with depressed sacrum 32 naming xxiv diaphragm (in coughing) 28 posterior iliac prominence (PIP) 4 superior pole \"tipping\" of 35 dysfunctions, 22 possible 82 posterior innominate 45 for weight transmission 17,58 correlated \\vith gait abnormalities 72 dysfimction 142 obliquus abdominis muscle dysgenesis 4,81 lefi: (PIL) trea011ent 148 observing paravertebral symmetry inflare/outflare 58 lateral recumbent alternative 149 76 landmarks 4 posterior longitudinal ligament 13 obstetrics, pelvis in 161 tor diagnosis, Mitchell Model 3 posterior superior iliac spines (PSISs) 3,4,65 obturation of ischiorectal fossa ligaments 12 154-156 mobility tests 115 posteriorly rotated innominate obturator intemus muscle 18,20, 112,117 45 recumbent 94 occipito-atlantaJ lesion organ 55 postural 68 prolapsus 55 ptosis 1 balance and pelvic distortion in children 68 osteology X-rays 79 oscination,sa� 32,124,127,133 -vestibt�ar reflex 68 as indicator of cranial somatic somatic dysfimLi1 on posture control system for the head 69 dysfunction 69 as primary problem 71 pratfall (slip and fall) 108 101 osteology of the pelvis 1 subluxation, three types pregnancy 161 53,54 osteopatllic lesion XVIII subluxations 53,55 53 primary basic technique in Muscle Energy outflare/inflare pelvis 58 visceral dysfimction isometric contractions xxi outflared itmominate 53,101 visceral malposition primary respiratory walking cycle 41-46 treatment 118 mechanism(PRM) 69 overtake phenomenon 91 pelvis includes sacral nutations 32 Owens, Charles DO XVII balanced xvii motion, craniosacral 28 saves life ofFLM, Jr. XVII wlified kinematic model of XVII prolapses, visceral 156 pelvisa� prolotherapy 114 angle p 123 prone pain,acute low back palmar stereognosis 63 dysfimction ischial tuberosity 157 65,124 secondary to viscerosomatic leg length 60,64, 122-123,127 palpatory senses reflexes 71 leg length measurement 112 epicritic and stereognostic xxi joints as passive joints 23 prostatic hypertrophy 156 pants-on treatment for hemorrhoids peripheral vision xx Pruz,zo Neil Alan DO xviii 154,156 peroneus muscle 42,66 20,45 pseudo-cystitis longus paradox due to pubic subluxation 56 of the 1lA and sacral base PSIS(s) (or PIPs) 87,90 sacral base/IlA 50 34 phasic muscles xxii versus tonic muscles 67 locating 85 paradoxical physical diagnosis medial/lateral displacement countemutation eftect in Muscle Energy xx \\vith nutation/counternutation 31 of trunk hyperflexion 132 observation in x1x motion, paradoxical 84 posterior motion of the PIP 87 psychophysics of movement, unilateral PSIS or PIP motion 84 psychomotor skills of XIX superior-inferior and/or posterior-anterior 90

VOLUME THREE INDEX 173 position with patient prone 157 respiratory flexion dysfi.mction 91, 123 psoas muscle 16 axis 123 resistant to treatment 129, 132 spasm 63 -circulatory model xxv flexion, mlllateral33-34, 46-47, 49, psychophysics of physical diagnosis XIX dysfi.mction, sacroiliac 51, ptosis of pelvic organs 55 testing 150 treannent for 129-131 pubic lumbosacral paradox 28 hiatus 124 axis, transverse xviii motion, sacroiliac mobility stability of 29 Mitchell, Jr. and Pruzw research 28 research evidence for 23, 27, 32 bone displacement motions of the sacrum 24 translatory 28 in rhomboid pelvis 116 restriction, sacroiliac 53-54, 68, 121 motions, movements crest(s) 3, 102, 103 treatment 152 sagittal 22 heights 157 sacroiliac torsional 36 inferior 157 dysfi.mction 127 translatory 31 dislocation motion 31, 151 voluntary vs involuntary 31 superior or inferior 9, 55 vs. trunk bending sacroiliac motion 28 with respiration 31 subluxation 6, 53, 101-102, restriction, major or minor xxii nutation or cow1ternutation 109, 119 restriction, mechanisms of delayed initiation 90 causing symptoms of cystitis 56 edema, fibrosis, joint malcongruence xxii oscillation 32, 124, 133 effi:ct on flexion tests 91 myofuscial tighmess xxii and vestibular nucleus 69 superior or inrerior 9, 55 restrictors as indicator of cranial somatic superior, treatment for 104 as unnaturalyl shortened muscles xxii dysfunction 69 recurrent 103 long xxii position, landmarks tor asies ng l 0 up or down, treatment fur 106 short xxii sulci depths 3, 11, 50-51, 60, 64, symphyseal dislocation 53-54, 101 retroversions of the uterine fundus 101 89, 122, 126, 127, symphyseal subluxation 53-54, 101 rhomboid 129-130, 133, 157 symphysis 65 muscle 66 torsion dysfunction 6, 33-35, 49, symphysis, stability of 55 pelvis (inflare/outflare) 54,101, 116 51, 91, 121 transverse axis 30, 65 pelvis and obliquus muscles 58 and lwnbar lateral curve 112 pyramidalis muscle 17 right ocpci ut anterior (ROA) obstetrical backward torsion 40, 127, 128 presentation from improper lifung 7l Q and common patterns of restriction 68 treannent for 139,140 quadratus femoris muscle 18, 45 rotated compared \\vith tmilateral flexion 47 quadratus lumbonun muscle 16, 42- coccyx 70 diagnostic criteria 64 43, 46, 62-63, 66, 79, i.tmominate dysfunction 83 efet cts of 63 90, 139 anteriorly/posteriorly 29, 54, 65, 117 forward and backward 38 quadriceps muscle 45 features of 142 forward torsion 39, 46, 127-128 effect on supine leg length 94 movements, four types of 36 R rotation spinal forces and 37 range-of-motion cranium, in the 23 sacralization of a lttmbar vertebra 78 altered xix defined 30 sacro-tuberous ligaments 3, 159 related to adaptation xx i.tmominate 83, 107 sacroiliac auricular surface tracks rapid resistive duction technique xxi anterior or posterior 29, 54, 65, 117 long arm 51 rear-end automobile collisions 71 interinnorninate 30 short arm 51 reciprocal inhibition of antagonist pelvis, in the 23 sacroiliac belt 58, 114, 159 muscles XXI -sidebending coupling 48 patient handout for 115 rectocele 101, 156 rotatory motions of the sacnun skin care with 114 rectus abdominis muscle 17, 29, 66 in the sagittal plane 21 sacroiliac rectus femoris muscle 18, 42, 45, 66 rotoscoliosis, lumbar 128 /iliosacral motion, causes of xxiv recumbent Rudy,d Thomas Jefferson DO xvii, xxi breathing movement impairment 53 dynamic leg length test 96-98 diagnosis: sine qua non of 123 interpretation of 99 s dysfi.mction 14, 53-54, 59, 87-88, pelvic mobility tests 94 S-T ligament tension and ischial 112, 121, 123, 161 relaxation tuberosity position causes positive flexion test 102 importance of balance in xxi interpretation 111 correcting 79 importance for palpation xx sacral and craniosacral adapation 68 post-contraction xvii adaptations 59 joint unstable 114 relaxin hormone 161 base asymmetry, adaptations joint, loose-packed position 130 reliability, intra- or inter-examiner 127 of trunk to 75, 78 ligaments 30 reproductive systems 161 base/HA paradox 50 motion, causes of 31 resistant flexed sacrwn, treatment 132 counter-nutation motion, respiratory 31 with flexion tests 81 respiratory dysfi.mction

174 THE MUSCLE ENERGY MANUAL evaluation 150 and scoliotic adaptation 8I depth 123 respiratory motion, movements 23 shim 79 palpation tor joint motion 131 Mitchell, Jr. and Pruzw research 28 with patient prone 157 superficial dorsal sacroiliac ligament 13 respiratory restriction 54,68,121 with patient supine 157 superior and middle transverse axes xviii testing 151 sidebending superior innominate dislocation, treatment I52 balanced 48 treatment for ll3 strain 108 -rotation coupling 48 superior pubic ligament I3 subluxation 159 unbalanced lumbar 48 supine leg length 142 Sl�CUS 128 sight, line of afiected by rotated innominate 94 versus iliosacral motion 21 in observing landmarks 10 Sutherland, Wilmlia Gamer, DO 161 unstable 108 skin care with sacroiliac belt 114 Sutton, Sarah DO xvii sacrospinous ligament 12 slip and fall (pratfall) 108 sympathetic nervous system I6l sacrotuberous (S-T) ligaments 8, injuries 28 symphysis pubis 2I,65 I2,I09 somatic dysfunction tension Ill,I57 vs. subluxation 56 T sacnun correction of by isometric contraL1ion tarsal arch 45 depressed primary basic technique in technique anterior innominate 144-147 post-partum psychosis with 32 Muscle Energy xxi pelvic Aexed, unilaterally 90,I28,157 backward torsioned sacrum 139-I41 mechanism of injury in 61 as primary problem 71 coccyx 70,156 spastic or hypertonic muscles XXI median crest of 124 sphinx cranial xx nutates with flexion of the trunk 81 tonvard torsioned s.1cmm 133-I38 torsioned 62,83,157 position 63-64,123,125,133,139,157 fi.mctional xix test 122,127-129,xviii backward 62,122 iliac inflare II7 iliac outflare II8 left-on-right 64 for IIA position 124 torward 62,122 spinal indireL1: styles of xix self-treatment tor 138 curves, adaptive 68 inferior pubic subluxation I05,I06 treatment tor 137 dura 13 ischiorectal fossa 70,156 torsioned or unilaterally flexed 59 spinalis muscle I4-15 Muscle Energy xix unilaterally flexed 60,83,107,II2 springing articulatorytests 76 myofu.scial xxv sartorius muscle 19 stability of the pubic symphysis 55 posterior innominate I48,I49 scalene muscle 66 stages of compensation 79 rapid resistive duL1ion xxi sciatic entrapment 46 standing flexion test 5,64-65,75-76, sacroiliac respiratory I52 sclerotherapy 114 84,115-116,I23,157 strain-counterstrain xxv scoliosis I12 new variation 86 superior pubic subluxation 104,I06 scoliotic adaptation 78 standing iliac crest heights I57 thrust (HVI.A) xxi, xxv screening examinations 72 static bony landmark relationships unilaterally flexed sacnm1 129-132 screne ing test 75 step breathing 130 upslipped innominate 113 seated flexion test 5,60,64,75,76, sequence in treating unilaterally temporalis muscle 66 84,88,122-123,I57 flexed &1LTUm 129 teusor fascia Ll' ta muscle 19,66 seated iliac crest heights 76 stereognostic, stereognosis, palmar 5, test pelvic mobility 115 test 81 6,8,9,10,65,llO, testing sacroiliac respiratory motion 151 self-treatment technique for I24, 155 thoracoabdominal diaphragm muscle 66 forward sacral torsion 138 palpatory sense xxi, 109 thoracolumbar fascia 13 semimembranosus muscle I9 sternocleidomastoid muscle 66, 68 thrust (high vdocity-low amplitude) semitendinosus muscle 19 Stiles, Edward DO xvii techniques xviii thrust technique xxv sequence stork tests 5,65,92 tibialis of examination and treatment 73,121 Strachan, Frasier DO xviii of treaonent 79 stretching treatment for tight muscles 67 anterior muscle 42,45-46,66 posterior muscle 20,45,66 importance of 59 subluxation(s) xviii, IOl,I07 serratus anterior muscle 66 pelvic 21,53,55 tightness prone muscles Sherrington, Sir Charles xxi causes positive flexion test I02 phylogenesis of 67 shim for short leg 79 three types I0I tightness-prone vs. weakness-prone shim, leveling the pelvis with pubic symphyseal 53 phylogenetic history 66 for the standing flexion test 84 superior or inferior 55 tonic muscles XXII shims, heel or shoe vs. somatic dysfunL1ion 56 tonic versus phasic muscles 67 inside or outside the shoe 80 with or without dislocation torsion and flexion dysfunction shoe lift therapy 78 or aVl�sion 108 discriminating between 123 short axial ligament 13 suboccipital muscles 69 torsion dysfunction, most common 122 short hip adductor muscle 66 head leveling fimction 68 torsion, backward sacral 40 short leg sulcus (sulci), sacral 50,51,128,129 torsion, forward sacral 39 anatomic 157

VOLUME THREE INDEX 175 torsion, sacral 33-35,49,51 unilaterally flexed sacrum 33-34, Zink, J. Gordon, DO 122 46-47,49,51,59,60, torsioned sacrum 59,62,83,90, zygapophyseal trophism 1 121,122 71,83,90,107,112, zygapophyseal trophism, lumbosacral diagnostic criteria for 64, 133 121-122,127 with asymmetric hip sway 72 four possible variations 133 compared with sacral torsion 47 treatment for 129,130 compared with flexed sacrum 64 unstable sacroiliac joint 108,114 backward 40,124 backward !eft-on-right 64 upslipped innominate 8,53-54, forward 39,124 56-57,61,71,94, translatory 101,107,110,119, mobility of the sacrum 28 157,159,161 motions of the sacrum diagnostic criteria tor 108 112 in the sagittal plane 21 incidence of 107 114 sacral movements 31 lumbar adaptation to mobility tests for 109 transverse axes, middle and superior xvili transverse axis patient instructions inferior 29,30 syndrome ll5 pubic 30,65 treatment for stability of reduction stability of 29 113 unsuspected (bilateral) 115 transversus urogenital diaphragm 161 abdominis muscle 17 perineii muscle 156 uterine malpositions and fibroids 161 trapeziu.� muscle 66,68 uterine prolapse 101 treating anterior innominate 143 treatment sequence for pelvic dysfunction v 122 vastus treatment (self-) for lateralis muscle 66 anterior innominate right (AIR) 147 medialis muscle 42,45,66 sacrum torsioned fOrward 138 flexed sacrum 132 ventral treatment and evaluation sequence 73 treatment concepts of MET xxi sacrococcygeal ligament 12 sacroiliac ligament 12 vestibular postural reflex 68 treatment for visceral anterior innominate (AIR) 145,146 dysfimctions, pelvic 53,54 lateral recumbent, fur 144 malpositions in the pelvis 101 backward sacral torsion 139-140 prolapses 156 coccygeal dysfi.mction 156 vision, peripheral xx forward torsioned sacrum 134,136 visual perception, special characteristics of inflared innominate 117 in physical diagnosis xx ischiorectal fussa 156 tangent view xx Vleeming, Andre 20 outflared innominate 118 posterior innominate left (PIL) 148 resistant flexed sacrum 132 w sacroiliac respiratory restriction 152 walking sacroiliac respiratory restriction 153 and sacral forward torsion 62 cyde, kinesiology 42 sacrum torsioned forward 137 41 cyde, original unilaterally flexed sacrum 129,130 weakness prone muscles Trendelenburg one leg stand 92 trigger points, myofascial 46 phylogenesis of 67 trunk adaptations to sacral base 66 phylogenetic history 66-67 asymmetr y 75,78 vs. tightness-prone 161 trunk flexion, coordination of 90 whiplash 61 Type II lumbosacral dysfimction 48 Wolf, A Hollis, DO u X X-rny technique utiliring umbilicus 3,6 anode heel efef ct unbalanced lumbar sidebending 48 X-rnys, posturnl 79 79 unified kinematic model of the pelvis xvii unilateral PIP or PSIS movement superior-inferior and/or z Zaglas, ligament of posterior-anterior 90 13

1 7 6 THE MUSCLE ENERGY MANUAL