Transverse Sacral Axes

by Tyler Cymet, DO, FACOFP

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    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.

    About the Lecture

    The lecture Transverse Sacral Axes by Tyler Cymet, DO, FACOFP is from the course Osteopathic Diagnosis of the Sacral Region.

    Included Quiz Questions

    1. Posterior
    2. Anterior
    3. Lateral
    4. Superior
    5. Inferior
    1. Superior
    2. Inferior
    3. Anterior
    4. Posterior
    5. Lateral
    1. Middle transverse axis
    2. Superior transverse axis
    3. Inferior transverse axis
    4. Left oblique axis
    5. Right oblique axis
    1. Inferior transverse axis
    2. Left oblique axis
    3. Right oblique axis
    4. Middle transverse axis
    5. Superior transverse axis

    Author of lecture Transverse Sacral Axes

     Tyler Cymet, DO, FACOFP

    Tyler Cymet, DO, FACOFP

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