Thigh adductor length test This tests for hypertonicity of the adductor group of muscles. The client should be lying in the supine position. On the thigh that is being tested, the client will place the plantar (bottom) surface of their foot on the medial portion of the opposite knee. (The client should be in a “figure 4” position.) From this position, the therapist will push down on the knee on the side of the adductors that are being tested. (The therapist may want to place a hand on the Hip range of motion test This tests for hypertonic muscles or a dysfunction of the hip joint. The client should be in the supine position, and their knees may be bolstered for comfort. The client’s thigh is brought into approximately 45 degrees of flexion at the hip while keeping the knee flexed. The therapist will perform circumduction of the hip joint. Limited ROM or pain around the femur’s greater trochanter may indicate hypotonic muscles depending upon where ROM is limited. Pain deep Ober’s test Tests for hypertonicity of the iliotibial band, (IT band), and the tensor fasciae latae, aka the TFL muscle. The client should be placed in the side-lying position. Their bottom leg, the leg not being tested, is flexed to 90 degrees at the hip and knee. The leg being tested is kept straight. The client is then asked to abduct their entire leg while attempting extension to 45 degrees. Then the client is Piriformis length test Tests for hypertonicity of piriformis. The client should be in the prone position on the table. Their legs should be straight with knees together before the therapist passively flexes the knees to 90 degrees. Holding the client’s ankles, the therapist medially rotates both hips (feet outward) to test the length of piriformis. A hypertonic piriformis is indicated if there is less than 45 degrees lateral rotation of the feet away from the midline. Any signs of sciatica such Posterior sacroiliac joint test This tests for a posterior SI joint dysfunction. The client should be in the side-lying position. Both their hips and knees should be flexed to 90 degrees. Standing behind the client, the therapist places the fingers of one hand on the ASIS and their other palm on the ischial tuberosity of the side being tested. The therapist attempts to passively rotate Anterior sacroiliac joint test This tests for an anterior SI joint dysfunction. The client should be in the supine position on the table. The therapist places crisscrossed hands (fingers facing away from the body) across the client’s ASIS and pushes them laterally away from each other. Deep pain in the inferior abdomen, SI joint motion test/Stork-Gillet test This procedure tests for ROM at the SI joint. The client should be standing with the therapist behind them, a thumb on each side of the client’s PSIS. The client flexes the hip of the side being tested while standing on the unaffected side. Then the other hip will be tested. This should be repeated several times so the therapist has a good sense of the client’s hip movement. An anterior tilt to the pelvis, Gaenslen’s test This tests for an SI joint dysfunction. The client should be in the side-lying position on their unaffected side and will flex their hip and the knee toward their chest. The therapist will stand behind the client and passively extend the affected hip’s thigh as far as possible. A positive result is indicated by pain at the SI joint when the affected side’s thigh is moved
opposite thigh’s quadricep muscles just above the knee for stabilization purposes.) Hypertonic adductor muscles are indicated if the knee is unable to touch the table top. Note that hypertonic adductor muscles may be involved in dysfunctions of the pelvic floor. Directional massage, PNF stretches, and trigger point therapy may relieve the hypertonicity of this group (Manske & Magee, 2018). in the joint or crepitus (crackling) at any point through the ROM may indicate a dysfunction between the acetabulum and the head of the femur. The head of the femur can be pressed into the acetabulum to elicit pain to confirm the result. PNF stretches may lengthen hypertensive muscles that may be limiting ROM, though the therapist should avoid performing ROM movements and stretches if crepitus is present (Manske & Magee, 2018). asked to slowly lower their leg toward the therapy table. If the client is unable to lower their leg smoothly, this indicates hypertonicity of the IT band or TFL. Myofascial release along the IT band from knee toward the hip may by beneficial. Directional massage, PNF stretches, and trigger point therapy are indicated for the TFL muscle itself (Manske & Magee, 2018). as numbness, tingling, burning, and/or pain in the lower back, gluteal region, and/or down the legs are further confirmations of a hypertonic piriformis. Cross-fiber friction at the edge of the sacrum and the superior-posterior aspect of the greater trochanter may be helpful. PNF stretches are also an effective noninvasive treatment (Manske & Magee, 2018). the hip posteriorly. Pain at the posterior SI joint indicates an SI joint dysfunction. Since a positive result would indicate a dysfunction of the SI joint’s ligaments, manual therapy will be of limited value unless hypertonic muscles such as the psoas or inferior aspect of the erector muscles is the cause (Manske & Magee, 2018). at the anterior SI joint, indicates a dysfunction. As in the previous test, manual techniques will most likely be of limited value in directly addressing any SI joint dysfunction (Manske & Magee, 2018). commonly attributed to hypertonic iliopsoas, may be indicated by a lack of movement of the PSIS on the side of the raised knee or if the PSIS moves superiorly instead of inferiorly during flexion of the hip. PNF stretches and trigger point therapy may relieve the hypertonicity of the iliopsoas (Manske & Magee, 2018). beyond 20 degrees of extension. Note that the pain may be due to either injured ligaments or a hypertonic gluteus maximus at its origin along the superior aspect of the border of the sacrum. Cross-fiber friction between the sacrum and ilium and PNF stretches are indicated for gluteus maximus (Manske & Magee, 2018).
Page 85
Book Code: MPA0825
EliteLearning.com/Massage-Therapy
Powered by FlippingBook