SOT Quick Notes (Category III)
Card Set Information
SOT Quick Notes (Category III)
I do what I want. NO.
REFER OUT, IF....
1) Treatment causes radicular SX to periphralize.
2) DTR's, dermatomes & muscle function decrease.
3) Pain decreases but numbness increases &/or signs of atrophy worsening.
4) SX's of visceral or organic relationships.
5) Response to SOT treatment & SOT indicators are not congruent.
Category III SX
1) No rib head movement.
2) Generalized muscle ridgity.
3) Muscle guarding.
5) Sciatica -> leg.
6) L/S pain.
7) Post thigh pain, lead weakness, paresthesia, atrophy.
8) Calf pain w/ palpation.
9) Pain w/ palpation of greater sciatic notch (near performs).
10) Pain moves to the spine as things start to get better.
: towards side of pain.
*NO SIDE POSTURE!
: away from side of pain.
*SIDE POSTURE OK, PAIN SIDE DOWN.
: anterior antalgic position.
*Have pt bend leg & push into your hand to find the psoas.
1) Short arm leg side.
2) Supine w/ leg flexes... Dr on opposite side.
3) Pull knee medially.
4) If after correction the other arm goes short, correct the contralateral psoas until both sides are equal.
5) Work the psoas fibers laterally.
LEG LENGTH ASSESSMENT
1) Have them grab the head of the table, while apply traction.
2) Traction caudally for 30 seconds.
3) Maintain traction while observing leg length discrepancy.
INITIAL BLOCKING POSITION
*Use adjusting board under the pelvis!
1) Palpate the musculature in the center of the calf & gluteal region for tenderness.
Long leg block
: under the ASIS, towards opposite hip.
Short leg block
: obliquely under the greater trochanter, 45 degrees caudally.
**Leg lengths should begin to equalize after blocks are positioned**
BLOCK ANGULATION FOR PAIN CONTROL
If the original blocking position does NOT diminish the pain, angulate the blocks in 10 degree intervals both caudally & cephaldly.
*If no position reduces the pain, try SB- or SB+ placements.
1) After legs are even, traction the affected leg to release pressure at the disc.
2) As long as the original short leg length discrepancy does not increase it's all good.
3) THE DOCTOR LIFTS THE PELVIS TO REPOSITION THE BLOCKS, NOT THE PATIENT.
rocess pain on the side of the
*Check inferior TP of L5 with Styloid process near same side C1.
ransverse provess pain on the side of
*Check superior TP & same side C1 TP.
1) Spread thumbs apart to open up suture, while finger tips pull the parietal bones upward.
2) Repeat until all painful areas have resolved.
3) Have the patient try to lift the sciatic leg on an inhale.
*If midline discopathy is present have them lift both legs.
*If it is too painful, have them tighten the muscles, or think about attempting to lift the leg.
Check the piriformis!
1) Is it contracted &/or pain with palpation of the mm's surrounding the greater troachanter?
2) Is there restriction in internal rotation of the hip?
3) Flex the leg, but not to the point of pain.
4) Press your thumb into the tissue (inferior to the acetabulum). Apply pressure to all surrounding painful areas, particularly around the greater trochanter.
5) Circle the leg while rolling the thumb over the tissue for easier access.
*Stand on the same side that you are working on.