Transcript Pelvic Categories

Category I, II & III
What They Are
How to Find Them
How to Correct Them
Definition of Category I
Pelvic Torsion WITHOUT “osseous”
subluxation
 Distortion of shoulder girdle common
 Distortion of cranium common

Signs & Symptoms of
Category I
Obviously Low Back Stuff
 Cervical Tension

– Pain and limited ROM on turning head
– Difficulty backing car
– Usually more marked to one side
Therapy Localization of
Category I
2 Step TL
 Step 1:

– 1 hand on each SI at the same time

Step 2:
– Then 2 hands on 1 SI at a time
- INVOLVED SIDE - for LATER
CORRECTION
Challenge for Category I
Rebound challenge
 1 contact on PSIS and,
 1 contact on opposite ischial tuberosity

Correction for Category I

ADJUST pelvic torsion
– Block Pelvis


Which is “PI side?”
Blocks face each other
– Enhancement Procedure




“Pump” on PSIS or Ischial Tuberosity
Whichever is NOT on the primary side
And NOT over a block
Correct Muscle Imbalance
Category I Muscle
Involvement




Priority List
Piriformis
Gluteus Maximus
Gluteus Medius



Quad. Lumborum
Oblique Abdominals
Sacrospinalis
Definition of Category II
“Osseous” Subluxation
 TWO TYPES of Joints in Pelvis

– SI Joints = Category Iisi
– Symphysis Pubis Joint = Category IIsp
Category IIsi

SUBLUXATION of SI joint
– Posterior Ilium
– Posterior Ischium

Same as AS Ilium
Therapy Localization for
Category IIsi
Patient SUPINE
 1 hand on 1 SI at a time
 Anything else TL this way?
 How can you know it is Cat. II?

Challenge for Category IIsi

Rebound challenge as either:
– PI Ilium
– AS Ilium (posterior ischium)
Correction for Category IIsi

ADJUST subluxation
– PI or AS Ilium
– Any technique

Correct muscle imbalance
– PI = Sartorius / Gracilis
– AS = Hamstring ( medial / lateral)
TL II before I?

1 hand on each SI at same time
– Anything else TL this way?
How can you know it is Cat. I?
 Must find & fix before checking for I

Category IIsp
SUBLUXATION of Symphysis Pubis
 TL is positive at left or right of
symphysis ONLY
 Indications can be:

– Cervical paraspinal pain
– Thoracic paraspinal pain
– Shoulder & arm pain

Correction - see Walther, p.115 if
interested
Category III
Dysfunction of the pelvis & 5th lumbar
 Related to a sacral respiratory fault
commonly
 Indications can be local OR remote

– Non responsive severe sciatica
– Cranial Nerves IX,X, and XI
TL for Category III
NO Therapy Localization
 Only CHALLENGE

Challenge for Category III

One contact is on L5 spinous
– Push lateral to medial


Toward Ischial contact
Other contact on ANTERIOR ischium
– Pull anterior to posterior
– side opposite L5 contact
Correction for Category III
First, block pelvis
 Second, evaluate for sacral respiratory
fault

– Correct if present
– Cat. III correction complete

If sacral fault NOT present,
– Maintain blocking 5-10 minutes

Correct Muscle Imbalance
Category III Sacral Analysis
Challenge P-A at sacral apex bilaterally
 Challenge A-P at sacral apex bilaterally
 Correct in direction of positive challenge

– 3 - 4 pounds of pressure
– During appropriate phase of respiration



P - A on INSPIRATION
A - P on EXPIRATION
If present, correction is complete
Pelvic Categories:
Comparison
Definition
Functional Testing
Correction
Muscle Involvement
Definitions

CATEGORY II
– SUBLUXATION of SI joint


PI or AS Ilium (Posterior Ischium)
CATEGORY I
– Pelvic Torsion WITHOUT subluxation

Category III
– Dysfunction of the pelvis & 5th lumbar
Therapy Localization
Cat. II = 1 hand on 1 SI at a time
 Cat. I = 1 hand on each SI at same
time

–

- then 2 hands on 1 SI at a time
- POSITIVE SIDE
Cat. III = NO Therapy Localization
–
- Only CHALLENGE
Challenges

Cat. II = Rebound challenge as either:
– PI or AS Ilium (posterior ischium)

Cat. I = Rebound challenge:
– Contact PSIS & opposite ischial tuberosity

Cat. III = Rebound challenge:
– Lateral to medial on L5 spinous

Toward Ischial contact
– Anterior to posterior on ANTERIOR ischium

side opposite L5 contact
Corrections

Cat. II = ADJUST subluxation
– PI or AS; any technique

Cat. I = ADJUST pelvic torsion
– Block Pelvis; blocks angled
– Enhancement Procedure

“Pump” PSIS or Ischial Tuberosity
– NOT on the primary side; NOT over a block

Cat. III = ADJUST L5/Pelvic Dysfunction
Corrections (Continued)

Cat. III = ADJUST L5/Pelvic Dysfunction
– Block pelvis; adjust blocks w/S5 tenderness
– Evaluate for sacral respiratory fault


Correct if present; Cat. III correction complete
If sacral fault NOT present, block 5-10 minutes
Correct Muscle Imbalance
Using the “5 FACTORS OF THE IVF”
 Cat. II = PI: Sartorius and/or gracilis
AS: Hamstring ( medial / lateral)

Correct Muscle Imbalance
Using the “5 FACTORS OF THE IVF”
 Cat. I = Priority List: Piriformis,
Gluteus Maximus,Gluteus Medius, Quad.
Lumborum, Oblique Abdominals,
Sacrospinalis
