Shotgun Technique

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Description

The "Shotgun Technique" is a Muscle Energy Technique (MET) used to re-align the pelvis and treat a variety of pelvic dysfunctions.

The pelvic girdle consists of the sacrum and 2 ilia meeting anteriorly at the pubic symphysis. The pubic symphysis is comprised of hyaline cartilage lining the iliac surfaces, which are connected by a fibrocartilaginous disk. This disk is reinforced by the superior pubic ligament from above and the arcuate pubic ligament from below. Muscular forces below the region—from the lower extremity, and above the region—from the abdominal muscles, affect motion and dysfunction at the pubic symphysis and may extend to the sacroiliac joint.

In a properly aligned pelvis, the pelvis is symmetrical, the sacrum is loaded, and ligamentous tension is balanced when the patient is standing.

Pain may be generated when any of the structures in the pelvic girdle become misaligned. This pain can manifest as low back pain, referred pain to the buttock, groin, or thigh, pain localized to the SI Joint and/or pain localized to the PSIS.

Indication

The "Shotgun Technique" may be indicated for the following conditions:

• Sacroiliac Joint Dysfunction
• Chronic Pelvic Pain
• Low Back Pain
• Leg Length Discrepancy
• Anterior or Posterior Innominate Rotation
  

Contraindications and Precautions

The "Shotgun Technique" should not be performed for the following conditions:

• Acute trauma
• Fracture of the pelvic girdle
• Moderate to severe joint instability
• Caution must be taken with patients with suspected infectious causes of pelvic pain, pregnancy, severe osteoporosis, or moderate to severe muscle strains in the abdominal or pelvic region.

Clinical Presentation

Use of the "Shotgun Technique" should provide immediate relief to the patient. The effectiveness of the Technique can be assessed by having the patient perform a movement or activity pre-intervention and post-intervention and noting any pain.

Note: The "Shotgun Technique" should not be painful, generate numbness or tingling in the lower extremities, or cause a loss bowel or bladder control.

Instructions

There are 2 phases to the “Shotgun Technique"

Phase I: Isometric contraction of the hip abductor muscles

The physical therapist applies resistance to either side of the patient's knees. The patient is instructed to push out against the resistance, creating an isometric contraction of the hip abductor muscles. The physical therapist performs this three times with the width between the patients knees getting progressively wider.

Phase II: Isometric contraction of the hip adductor muscles

The physical therapist applies resistance to the inside of both of the patient's knees. The patient is instructed to squeeze in against the resistance, creating an isometric contraction of the hip adductor muscles. The physical therapist performs this once with the patient's knees about hips width apart.

Note: An audible "pop" or "click" is not necessary for the Technique to be effective