Manual Medicine of the Hip and Pelvis

  • Charles W. Webb
  • Jayson Cannon


Do not forget to treat sacroiliac joint and the lumbar spine. The supine direct articulatory technique for the lumbar spine is a quick, easy, and very low risk treatment. The six muscle groups of the pelvis are the adductors, abductors, external rotators, internal rotators, extensors, and flexors. Always look for a restriction of motion as a potential cause for the discomfort. Somatic dysfunction is impaired or altered the function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures; and related vascular, lymphatic, and neural elements. Somatic dysfunction is found in areas where TART exists. (TART: tissue texture changes, asymmetry, restriction in motion, and tenderness) The minor motions, not the major motions, usually become restricted when somatic dysfunction occurs.


Tender Point Manual Medicine Piriformis Muscle Posterior Superior Iliac Spine Minor Motion 
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  1. 1.
    Tettambel MA. An osteopathic approach to treating women with chronic pelvic pain. JAOA 2005; 105: S20–S22.PubMedGoogle Scholar
  2. 2.
    Pedowitz RN. Use of Osteopathic Manipulative Treatment for Iliotibial Band Friction Syndrome. JAOA 2005; 105: 563–567.PubMedGoogle Scholar
  3. 3.
    Patriquin DA. Pain in the lateral hip, inguinal, and anterior thigh regions; differential diagnosis. JAOA 1972; 71: 729.PubMedGoogle Scholar
  4. 4.
    Anderson K, Strickland SM, Warren R. Current Concepts: Hip and Groin Injuries in Athletes. Am J Sports Med 2001; 29: 521–533.PubMedGoogle Scholar
  5. 5.
    Adkins SB, Figler RA. Hip Pain in Athletes. Am Fam Physician 2000; 61: 2109–2118.PubMedGoogle Scholar
  6. 6.
    Morelli V, Smith V. Groin Injuries in Athletes. Am Fam Physician 2001; 64: 1405–1413.PubMedGoogle Scholar
  7. 7.
    O’Kane JW. Anterior Hip Pain. Am Fam Phys 1999; 60(6): 1687–1696.Google Scholar
  8. 8.
    Retzlaff EW, Berry AH, Haight AS, et al. The Piriformis Muscle Syndrome. JAOA 1974; 73: 799–807.PubMedGoogle Scholar
  9. 9.
    Ward RC, ed. Foundations for Osteopathic Medicine. Baltimore: Williams & Wilkins, 1997.Google Scholar
  10. 10.
    Beal MC. The sacroiliac problem: review of anatomy, mechanics, and diagnosis. JAOA 1982; 81: 667.PubMedGoogle Scholar
  11. 11.
    Torry MR, Schenker ML, Martin HD, et al. Neuromuscular Hip Biomechanics and Pathology in the Athlete. Clin Sports Med 2006; 25(2):177–197.CrossRefGoogle Scholar
  12. 12.
    Braly BA, Beall DP, Martin HD. Clinical Examination of the Athletic Hip. Clin Sports Med 2006; 25(2):199–210.CrossRefPubMedGoogle Scholar
  13. 13.
    TePoorten BA. The Piriformis Muscle. JAOA 1969; 69: 150.PubMedGoogle Scholar
  14. 14.
    Kuchera WA, Kuchera ML. Osteopathic Principles in Practice. Kirksville, MO: KCOM Press; 1994.Google Scholar
  15. 15.
    Greenman PE, ed. Principles of Manual Medicine 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 2003.Google Scholar
  16. 16.
    Fuller DB. Osteopathic medical component missed in treating anterior hip pain. JAOA 1997; 97: 514.PubMedGoogle Scholar
  17. 17.
    Gardner S, Mosby JS. Chiropractic Secrets. Philadelphia: Hanley & Belfus; 2000:231.Google Scholar
  18. 18.
    Shekelle, PG, Adams AH, Chassin MR, et al. The Appropriateness of Spinal Manipulation for Low Back Pain. Monograph No. R-4025/2-CCR/FCER. Santa Monica, CA: RAND/UCLA; 1991.Google Scholar
  19. 19.
    Rumney IC. Techniques for determining, and ultimately modifying, areas of restricted motion in the lumbar spine and pelvis. JAOA 1971; 70: 1203.PubMedGoogle Scholar
  20. 20.
    Kimberly PE. Outline of Osteopathic Manipulative Procedures; The Kimberly Manual, Millennium Edition. Marceline, MO: Walsworth Publishing, 2000.Google Scholar
  21. 21.
    DiGiovanna EL, Schiowitz S, ed. An Osteopathic Approach to Diagnosis and Treatment. Philadelphia: JB Lippincott; 1991.Google Scholar
  22. 22.
    Howard WH. Easy OMT. Ashville: C-4 Publishing; 1998.Google Scholar
  23. 23.
    Karageanes SJ, ed. Principles of Manual Sports Medicine. Philadelphia: Lippincott Williams & Wilkins; 2005.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Charles W. Webb
    • 1
  • Jayson Cannon
    • 2
  1. 1.Department of Family MedicineSports Medicine, Oregon Health and Science UniversityPortlandUSA
  2. 2.AtokaTennessee

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