00:01
We're going to talk about the transverse
sacral axes in more depth now.
00:05
Because you're going to see different things
with a transverse sacral axis
when a person takes a deep breath in
and takes a deep breath out.
00:12
If you're taking a deep breath in, the sacral
base is going to move posteriorly.
00:17
You're going to have the coccyx
come down and move anteriorly.
00:22
That's normal functioning of the thorax
along the sacral transverse axis
when you take
a deep breath in.
00:29
You're going to have the thoracic
and pelvic diaphragm go down.
00:32
You're going to have
the lumbar curve flatten.
00:36
That's normal inspiration and normal
motion of the sacrum with inspiration.
00:43
In exhalation, you're going to see
the sacral base move anteriorly.
00:48
You're going to see the coccyx come up
and the inferior lateral angle increase.
00:53
Again,
it's exhalation.
00:58
So, you can have the thoracic and
pelvic diaphragm move superiorly
and the spinal curve, the lumbar
lordosis becomes exaggerated.
01:06
Another term that's
important is nutation.
01:09
Nutation is the nodding that occurs
along the middle transverse axis.
01:15
So, in anterior nutation,
you're going to have
the sacrum move anteriorly and
the coccyx move posteriorly.
01:23
It's when the sacral base
is moving anterior,
then you're going to have
bilateral sacral flexion.
01:33
That's motion along the
middle transverse angle.
01:37
We talked about nutation
and counternutation.
01:40
It's really how does breathing affect
the sacrum and where does it go.
01:45
So, with posterior nutation or counternutation,
the sacral base moves posterior
and you're going to have
a bilateral sacral extension.
01:54
So, that's the motion along
the middle transverse angle.
01:58
You’re going to have
postural motion
and you're going to have
sacral base motion.
02:05
One thing to mention is when
I'm assessing the sacrum,
you do the seated
flexion test.
02:11
You assess the depth
of the sacral sulcus.
02:14
And you look at the
inferior lateral angle.
02:16
Why do you do the
seated flexion test?
Because if you're standing, the pelvis
is going to help change the motion.
02:23
It's going to
compensate.
02:24
When you sit, you're sitting on the pelvis
and you take the pelvis out of the equation.
02:29
So, a seated flexion test
is testing the sacrum.
02:33
When you're talking about
the inferior transverse axis,
we're pushing on the ILA
to see if both sides move,
to see whether or not
you've got a torsion,
whether it's this way or this way
amongst where the action is occurring
and the motion is occurring, or
if one side is locked or not moving.
02:52
So, in the inferior transverse axis, you're
going to see if there's motion on the pelvis.
02:58
That's a dynamic test,
the springing test.
03:01
It's seeing where the motion is
occurring and how it's occurring.
03:05
That's what's
important here.
03:06
Again, it's the oblique axis
that I focus on
because it's walking that occurs
and causes problem most often.
03:14
When you're going to
name an oblique axis,
you're going to name it by where
the motion is occurring off of.
03:20
So, if you see that you're set
in the left upper pole
and the right lower pole of the sacrum,
it's going to be a left axis,
named from the top
where the left is set
and the motion is going to
occur along that axis.
03:37
So yes, the right part
is going to be moving in
and the left lower part
will be moving in and out.
03:43
That is an oblique
sacral axis on the left.
03:47
On the right,
it's the exact opposite.
03:49
The right upper is not moving
and the left lower is not moving.
03:53
So, motion is going to be
occurring at the top
and the bottom
on the other sides.
03:58
Naming the oblique
sacral axis is important
in helping you decide
how to treat somebody
and figuring out where the motion
needs to be induced.
04:07
With gait, with walking, you're going to
have right-right, left-left.
04:13
Then when you stop walking,
you've got to stop
functioning on
an oblique axis.
04:20
You’re going to have to go back
to the anatomic motion
of the transverse
or superior axis.
04:27
So, you’re changing
axes.
04:29
If that doesn't happen, if you stop walking
and you stay in an odd position,
you're going to develop a sacral torsion
that may need to be treated
to get back to normal,
or stretched, or pulled,
or somehow allowed back
into the normal functioning.
04:45
Here's a motion example
of sacral dynamics
and sacral biomechanics
and motion.
04:54
So, hit click and
watch it move.
04:56
And understand where the
sacrum moves within the pelvis
when somebody's
walking.
05:01
Here's another example of sacral
biomechanics in a skeleton
showing you how the sacrum moves
in relation to the legs and the pelvis.
05:09
Here's a third example of sacral
motion within the pelvis
to understand the motion
and compensatory motion
you can expect
with sacral motion.