Anterior rotation of the innominate bone: Ipsilateral or contralateral cause?

[neuromuscular]

Dear roycar:

Thank you for trying the test.

I can honestly say that in test after test, the add longus does create anterior rotation on the contralateral innominate bone such that the right ASIS is inf to the left ASIS in the majority.

Please give it a second try.

The treatment protocol is direct pressure into the add longus. You will see a difference in the level of the ASIS such that the ASIS on the right is inferior to the ASIS on the left as hip ABD increases the difference will increase.

I am not sure if you are from a country where the driver is seated on the right side of the vehicle. That could make a difference.

Best regards,

Neuromuscular.

[neuromuscular]

Dear roycar

I can think of a couple of reasons for the difference as I have looked up your location.

I believe that you are from Ireland. It is possible that like Alophysio, the driver position on the right of the vehicle may have a bearing on your not getting the same results. Further, the shorter driving distances and lessor times of travel may account for some of the other variables.

The test has had similar results in Canada and USA. However, in our countries, people do more of what we call "windshield time" as distances are greater and driving is a necessary evil.

Second, the driver position is different even though the pedal position is the same. When I was in New Zealand for three weeks, I noticed a great difference in changed driving comfort for the left side driver position. This could have a bearing on the results obtained by yourself and Alophysio.

I cannot say if it is the amount of driving and/or the driver position which contributes to the common outcome of the test here, but I would think from the patient profiles that it is. Ergonomic factors also seem to be a factor.

Therefore, just do the test and see what results you obtain. Yours may be different, but they are important. I am most interested in what you did exactly find.

I thank you for giving it a try and hope that it will add some information base to your therapy.

Thanks again for your reply.

Best regards,

Neuromuscular.

[neuromuscular]

Dear roy car:

Please try the test without any ideas of outcome.

I use a standing innominate bone position test followed by a supine ASIS to ASIS.

In the standing test, please note any variances of the ASIS to ASIS, PSIS to ASIS (R&L) and the PSIS to PSIS which increase as the width of the foot stance increases due to hip ABD.

ALso, would you be so kind as to do a PSIS to sacrum with hip ABD for every positive that you get with the "Gillett" test? I find that for every positive of the Gillett test, the PSIS moves superior and lateral to the sacrum in the results of the PSIS to sacrum with hip ABD which would be opposite to the Gillett positive. If you get the same, of what relevance do you think that this is?

My findings using the innominate bone position test with hip ABD are as follows:

When the right ASIS is inferior to the left ASIS, the add longus on the left is tender to palpation and the right psoas,iliacus or iliopsoas is tender to palpation. Do you find the same? THEORY: The left add longus and the right iliopsoas are in an imbalance or guarding response to each other.

When the right ASIS is inferior to the right PSIS the iliopsoas, psoas, or iliacus is most probably involved. THEORY: The right iliopsoas with possible interaction to a left add longus in a guarding response are in a muscular imbalance.

When the left PSIS is inferior to the left ASIS , the left add magnus and the hamstrings are most probably involved. (Mostly the left add magnus) THEORY: The left add magnus is overlooked, but has a "hamstring" type of action for part of the muscle.

THe PSIS to PSIS is less useful as differences are less noticable than the other landmarks.

If you do not get the same results. Then, please, tell me your results. I am most interested.

I build on this test by doing the tests of the muscles indicated such as active. resisted, etc. as well as passive, ROM , etc.

I have found that this leads me to less assessment time and more therapy time as I do not have to do a lot of the SIJ teting that seems to dominate much thinking.

If the supine assessment of the ASIS to ASIS reveals an inferior ASIS on the right, then what happens when you use digital pressure into the left add longus? In most cases, I find that the right ASIS moves superior to come to a position closer to the left ASIS after therapy. However, the ASIS can also do one of three things:

After treatment of the left add longus, The right ASIS will
1: Move superior and Stay at the same distance from the therapy bench or plinth as the left
THEORY: The left add longus was in a muscular imbalance with the right iliopsioas where the add longus factor was greater than the iliopsaoas factor.
2: move superior and move closer to the therapy bench or plinth than the left
THOERY: The left add longus was in a muscular imbalance with the right iliopsoas where the iliopsoas was the greater factor.
3: move superior and move away (or elevate) from the therapy bench when compared to the left
THEORY: This is the most complicated imbalance that I have found in this part of the test and therapy. There are many factors which require more assessment and palpation of the musculature involved. This is the least common result.

Again, your results may differ, and please, do not take these into the assessment settings, but use them after you have come to your own conclusions. See what you get. I am most interested in your results.

I use digital pressure into the muscle at 90 degrees to the muscle fiber. You can use whatever therapy you want to try, but please give me your results. I know what mine are and others in North America, but your situation with the driver's position on the right may impact on the outcomes found.

Thank you again for your interest in this topic.

My very best to you,

Neuromuscular