Practical Video for OB: Muscle Energy

00:01 muscle energy for pelvosomatic dysfunctions.

00:04 So first we have to make our diagnosis.

00:06 we assess the pelvis with the standing flexion test or with the ASIS compression test to see if there is a restricted side.

00:15 We'd check our landmarks - the ASIS and with the PSIS to see if there is a rotation or a shear.

00:21 So for here we're demonstrating muscle energy for the anterior innominate rotation.

00:26 So the innonimate is rotated anteriorly, you'd want to bring it to its barrier and have the patient activate and push towards the freedom.

00:34 So I'm gonna monitor the ASI joint, I'm gonna slowly bring the leg up and bring it to its barrier I'm gonna have the patient to gently push into my hands - 1,2,3 and relax.

00:46 Make sure you allow the patient to relax for 2 or 3 seconds before you reengage the barrier So I'm gonna kinda bring the hip more into its barrier and go ahead and push again - 1, 2, 3 and relax and then reengage the barrier and go ahead and push one more time - 1,2,3 and relax.

01:05 And so after three times of pushing, we're gonna do a passive stretch and then bring them right back and then recheck and reassess to see if it's more symetrical Muscle energy for posteriorly rotated innominate.

01:22 So in a posteriorly rotated innominate, what we're gonna do is we're gonna bring the leg off the table and extend the hip In extending the hip, we're gonna bring the innominate into more anterior position.

01:34 So we're gonna again gently bring the affected side down.

01:38 Here we're treating a left posteriorly rotated innominate.

01:42 I'm gonna support the leg and hold above the knee and with my other hand, I'm gonna hold the contralateral ASIS So this way, the patient will feel stable as they're bringing their knee up toward the ceiling So you can engage the barrier and then have the patient push to the freedom So go ahead and bring your knee up to the ceiling - 1.2,3 and relax After the patient relaxes for three seconds, we're gonna further bring the knee into extension, the hip more to extension into its barrier. Go ahead and push up again - 1,2,3 and relax.

02:14 After relaxing for three seconds, reengage the barrier and push up again - 1,2,3, free and relax.

02:20 And we're gonna do a passive stretch at the end, bring the leg back and then reassess the landmarks to make sure that the innominate is more symmetric.

02:29 This technique could also be performed with the patient lying prone and then you would just sprain the hip more into extension each time.

02:36 So that is how you could utilize muscle energy to treat a posteriorly rotated innominate.

02:43 Muscle energy to treat a superior innominate shear.

02:47 So when we have a superior innominate shear, what we want to do is to try to bring that innominate more inferiorly So here we're gonna treat a left superior innominate shear, We're gonna get good purchase on the ankle here, we're gonna internally rotate the hip and what internally rotating the hip does is it helps to close back the head of the femur into the acetabulum.

03:09 So any sort of motion or movement I put will get directed right into the innominate.

03:14 I'm gonna apply a little bit of inferior pull, I'm gonna instruct the patient to try to hike their hip up towards the head - 1,2,3 and relax I'm gonna reengage the barrier by gently tugging on the leg and go ahead and pull up again - 1,2,3, relax Reengage the barrier by pulling inferiorly again and pull up towards your head - 1,2,3, relax At the end of three isometric contractions, I'm gonna apply a little bit of increased a little bit of a tug here and then bring her back.

03:44 I'm gonna recheck to see if the innominates are more symmetric after the technique Muscle energy for pubic shear dysfunctions.

03:54 So the pubic bones sometimes undergo a lot of forces especially with pregnancy and delivery so it's a good thing to try to check for somatic dysfunctions in that area and address it.

04:05 So we could treat that area with muscle energy technique, so we wanna do is first to assess the pubic region, we're gonna explain to the patient that we're gonna place our palm on the pubic bone to diagnose any sort of somatic dysfunction or assymetry and so I'm gonna find the iliac crest, place my hand more midline and find the pubic bone and once I find the pubic bone, I'll place my thumbs there and just see if there's any sort of assymetry Now if there is assymetry, we could perform muscle energy.

04:30 The muscle energy here is going to utilize the hip AB- and ADductors and how they attach to the pubic bone to bring it more symmetric.

04:39 So I'm gonna do is have the patient bring the knees up and first I'm gonna ask the patient to bring their knees apart while I resist them with isometric contraction So patient's gonna push out - 1,2,3 and relax.

04:53 and after relaxing for three seconds, now we're gonna engage the hip adductors So I'm gonna first start with my fist in between the knees and go ahead and push together - 1,2,3 and relax.

05:04 And after relaxing for three seconds, I'm gonna put two fists here and go ahead push the knee together - 1,2,3, relax The goal is to gradually increase the distance between the knees, Now, I'm putting my forearm in between and go ahead and push together - 1,2,3, relax.

05:20 and again, each time allowing the knees to kinda fall out a little bit more to engage the hip adductors here and so go ahead, push the knee together -1,2,3 and relax.

05:34 At the end, we're doing a little bit of a passive stretch and then bring the knees back together put the legs back down and then reassess the pubic tubercles to see if they're more symmetric after the technique was performed.