Techniques 1

Techniques 1

1. FOOT

   • Medial border
     • Supine
       • HVT/Axx
         • Talo-navicular
         • navicular - medial cunieform
         • Medial cuneiform - 1st metatarsal
     • Prone
       • HVT/Axx
         • Talo-navicular
         • Navicular-medial cuneiform
         • Medial cuneiform - 1st metatarsal
   • Lateral border
     • Supine
       • patient supine -Facing away
         • Cuboid on 4th&5th MET
         • Cuboid on calcaneum
       • patient supine -Facing
         • Cuboid on 4th&5th MET
         • Cuboid on calcaneum
         • Cuboid HVT - pistol grip
     • Sidelying
       • Cuboid axx
   • Cuneiforms - supine
     • Axx
       • Figure of 8 - intermediate
     • HVT
       • knee flexed 90deg
         • Intermediate
         • Lateral
       • Cross handed tug

2. ANKLE

   • Talo-crural joint
     • 3. HVT/Axx - Shearing with leg straight
     • 4. HVT/Axx - Shearing with knee flexed and foot dorsiflexed
     • 1. Axx talus in mortise
     • 2. Txx of talus
       • straight leg can build into thrust
         • Can stabilise pt with knee on plinth and thigh against plantar aspect of other foot
       • Triangle
   • Subtalar
     • Sidelying
       • Axx (inversion/eversion/shear) lwr legs joint
       • X-handed medial aspect HVT - lwr leg joint
       • Motor bike - upper leg joint

3. KNEE

   • Improving flexion
     • Supine
       • hand behind knee and flex over it
       • Use forearm as fulcrum
     • Prone
       • hand over popliteal fossa and use leg to axx
   • improving extension
     • Supine
       • leg straight - use some traction, rotation, foot position and pillow under knee to alter forces
   • Harmonic
     • Sitting
       • can use some resistance
     • Aim is to aid proprioceptiv feedback to joint
   • Gapping
     • Add traction/int/ext rotation
     • Sidelying
       • medial joint line
   • superior tib/fib
     • HVT
       • sidelying
       • Supine

4. HIP

   • Harmonic - leg roll, supine, can use cranial hand to fix iliac crest
   • Axx - supine/sidelying
     • improving extension sidelying
       • cephalic hand can hold back at ASIS to work on RF
       • cephalic hand can reinforce at gluteals
       • cephalic hand can hold behind GT
       • Pt can hold lower leg
       • Add adb/add/int/ext rotation
       • Upper leg can have knee flexed or extended
   • Txx/Dxx
     • Sidelying - fulcrum, pillowed op thigh.
     • Supine
       • Hug and vomit
       • Pts knees bent and ops forearms used to txx

5. SIJ

   • Axx - gapping/shearing/ant/post rotation - long/short lever
     • Supine
       • Cosy
     • Sidelying
       • Shear/gap
       • Spanner
       • posterior to pt
     • Prone
       • Frog
       • Short lever
   • HVT
     • Sidelying
       • Anteriorise innominate - brace pts pelvis before roll
       • Posteriorise innominate
     • Supine
       • Chicago
       • Leg tug (also gaps LS)

6. Pubic symphysis

   • HVT/MET
     • Shotgun
   • ST
     • Adductor longus, gacilis, rectus abdominus

7. Coccyx

   • Examination
     • palpate for deviation
     • Use int/ext rotatin of hip to assess mvmt
   • ST
     • Local inhibition
       • Gluteus max
       • Levator ani
       • occygeus
       • Sacrotuberous lig
       • Sacrospinous lig
   • Axx
     • Create fulcrum with thumb on coccyx and use legs as levers
     • Place thumbs either side of coccyx and Axx/Txx
     • txx/axx into extension

8. Lumbar

   • HVT
     • Rotation thrust
       • T/L - flexion, rotation levers, with rotation thrust. Sidebeinding to lock up lumbars
       • Mid lumbars
       • LS
     • Sidebending thrust
       • upper and mid Lsp only
   • Axx/ST
     • Sidelying
     • Prone
     • Supine

9. Thorax

   • Examination
     • Sitting
     • Sidelying
   • Axx/ST
     • Sitting
       • Tsp and TES
       • Ribs
         • Upper
         • Lower
     • Supine
       • TSp
       • Ribs
       • Sternum
       • Use arm as lever for ScapThor
     • Sidelying
       • Ribs/Intercostals
         • Upper
         • Lower
       • TSp/TES
       • Scapulo-thoracic/ periscap
     • Prone
       • TSp - Short/long lever
       • Dorsal sprining
       • Rib walking
   • MET
     • Intercostals
     • Sternum
   • HVT
     • Sitting
       • Split stance perpendicular to pt
       • Split stance parallel to pt
       • Split stance at 45 deg to pt
     • Supine

10. CT

    • Axx - sitting
    • HVT
      • Sitting
        • Lift off
        • Sidebend thrust
      • Supine
        • Cradle/chin hold - rotation thrust
        • Cradle/chin hold - sidebend thrust
      • Prone
        • Sidebend thrust to SP T1
        • Rotation thrust to TP T1