Each side of the pelvis is made up of 3 bones – the ilium, ischium and pubis – altogether known also as the ‘innominate’ bone (from Latin meaning ‘no name’) because they do not fall within any of the common bone shape categories. For clarity, when describing each innominate or when performing a positional assessment of a patient’s pelvis and sacrum, there are a variety of bony landmarks that can be used including the anterior superior iliac spine (ASIS), the posterior superior iliac spine (PSIS), the pubic tubercle and the ischial tuberosity that describes which aspect of the innominate is concerned. Typically, one side of the pelvis or innominate is compared to the other side (e.g. left innominate compared to the right innominate) in order to determine deficiencies in ROM. Therefore, in slightly refining your question, a right PSIS which is superior to the left PSIS is characteristic of a right anteriorly rotated innominate. It could also be characteristic of a left posteriorly rotated innominate.
Muscle Energy Techniques (METs) are a broad classification of Manual Therapy techniques directed at improving musculoskeletal function and improving pain. Historically, the concept emerged as a form of osteopathic manipulative diagnosis and treatment in which the patient’s muscles are actively used on request from a precisely controlled position, in a specific direction and against a distinctly executed physician counterforce. Muscle energy techniques are used to treat somatic dysfunction especially decreased range of motion, muscular hypertonicity and pain. MET would be a suitable intervention to remedy the above patient’s presentation. However, the intervention would not be limited to tightening the stretched left hip flexors (anterior musculature of the pelvis) but may also include stretching of the tight posterior musculature e.g. Multifidus.
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