OMT Lower Extremity Somatic Dysfunction

The OMT Lower Extremity Somatic Dysfunction provides High Yield information that is needed for the COMLEX Level 1, 2, and 3, Medical School, Residency, and as a practicing Physician.

Q angle

• Angle formed by drawing a line from the center of the patella to the anterior superior iliac spine, and from the tibial tubercle through the center of the patella; men average a 10-degree angle whereas women average about 15 degrees.

Genu valgus

• distal tibia points laterally
  
• knees are medial– Knocked knees
  
• Q angle increased

Genu varum

• distal tibia points medially
  
• knee joints are lateral– bow legs
  
• Q angle decreased

Genu recurvatum

• hyperextension of the knee past 180 degrees

Short Leg Syndrome

• A discrepancy in Anatomical or Functional Leg Length
  
  
• 1) Sacral Base Unlevling
• 2) Vertebral Sidebending and Rotation
• 3) Innominate Rotation

• Anatomical Leg Length Discrepancy
  • “Actual” Anatomically Short Leg
• Functional Leg Length Discrepancy
  • “Appears” to be Short Leg

Compensated C-Shaped Scoliosis

• [Short Leg Syndrome] …short leg
• 1) Lumbar = SB Away, R Toward from
  • – Increase Ferguson Angle 2-3 Degrees
• 2) Shoulder = Higher on
• 3) Pelvis = R Away (Rotates to long leg)
• 4) Anterior Innominate Rotation
  
  • (Posterior Innominate Rotation on the long leg)
• 5) (Internally Rotate on the long leg)
• 6) (Pronation of Foot on the long leg)

Compensated S-Shaped Scoliosis

• [Short Leg Syndrome]
• 1) Compensatory C-Shaped Scoliosis
  +
• 2) 2nd Compensatory Curve Superior
• – SB Away
  =
• Shoulder = Lower on short leg

Short Leg Treatment

• Fragile or Hospitalized Patient
  • 1/16 + 1/16 (2 weeks)
• Standard “Flexible” Patient 
  • 1/8 + 1/8 (2 weeks)
• Trauma Patient
  • Full Amount of Lift Lost
• Maximum Amount of Heel Lift
  • 1/2 Inches
• A complication of Applying Heel Lift to Short Leg
  • The leg will grow faster than the unaffected leg

Anterior Fibular Head

• *Fibular Head is Anterior –> Resists Posterior Motion
  
• *Distal Fibula is Posterior –> Resists Anterior Motion
  
• *Talus –> Externally Rotated
  
• *Foot –> Everted & Dorsiflexed

Posterior Fibular Head SD

• *Fibular Head is Posterior –> Resists Anterior Motion
  
• *Distal Fibula is Anterior –> Resists Posterior Motion
  
• *Talus –> Internally Rotated
  
• *Foot –> Inverted & Plantarflexed

Ankle Sprains

• Classify the 3 types of ankle sprains:
  • Type 1 –> Anterior Talofibular
    
  • Type 2 –> Anterior Talofibular, Calcaneaofibular
    
  • Type 3 –> Anterior Talofibular, Calcaneofibular, Posterior Talofibular