Obstetrics technique practise

Below are my attendance forms to my lectures in obstetrics and osteopathy,

Applying the technique used to assess leg length discrepancy with a patient, 

 the diaphragm release/stretch technique - which can be applied to pregnant women and can be beneficial due to the poor mechanisms of the diaphragm resulting from pregnancy and pressure/restriction produced due to the foetus

 the 8 finger soft tissue technique

 modified posterior SIJ high velocity thrust - as a pregnant woman would not be able to roll on to her front to carry out this technique

 seated soft tissue of the erector spinae muscles - effective and removes the need for the patient to lie prone as the patient would be pregnant and unable to do so

 periscapular muscles soft tissue, using the patients arm to reinforce and direct treatment to specific tissues, muscles and articulation of the shoulder complex

New patient clinic

Yesterday morning I experienced new patient clinic (NPC). This involves taking a new patient and having one of your peers observe and make notes about how you were with the patient from general case history taking to treatment and professionalism.


Overall I was happy with my comments and in general agreed with what I needed to work on. I learnt about how to differentiate between a facet, disc and sacro-iliac joint.

This carried on nicely into my obstetrics elective where I further learnt how to differentiate between the three. Looking forward to applying my new knowledge on the next patient that presents with a lower back pain. Wonder how long I'll have to wait for that patient :oP

Leg Length Discrepancies...

Everyone has a leg length discrepancy (LLD) of some sort, whether it be 1 mm or 1 cm. An interesting way to check which leg is shorter was shown to us in our Obstetrics and Osteopathy technique class on Thursday. I later used this in clinic on Friday afternoon and it made life a little easier!

Firstly you have to obtain consent to lower the patients underwear so you can see the gluteal cleft. The cleft will point to the left or the right (unless it points straight up which means your patient does not have a LLD, but like I mentioned earlier, apparently we all have some sort of LLD!). The side which the cleft points to is the shorter leg, therefore if the cleft points to the right, the right leg is shorter. This can further be confirmed by asking the patient to bend their left knee, whilst keeping their heel on the ground, thereby leveling out the pelvis. If the were to bend their right knee you would see the pelvis dip significantly.

The diagram does not show much in way of which leg is shorter, but I thought it would be amusing to have a cleft on show to liven up this blog!