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This is Brent of the Brookbush Institute, and in
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this video we're going over the sign of
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the buttock, a very simple test but something everybody should have in their
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repertoire because this is one of those red flag issues. I'm going to have my friend
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Melissa come out she's going to help me demonstrate, and then I will explain what
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the appropriate action is if you find this sign. So the sign of the buttock
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basically goes like this, I was doing a straight leg raise,
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maybe I was doing a straight leg raise to check her hamstring flexibility,
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maybe I was doing a straight leg raise to check if she has sciatic nerve
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symptoms see if I could provoke those symptoms again, maybe checking to see if
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there's something going on with her low back, either way I get up so far and
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then I get stuck. Well me having the ability to
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do some deductive reasoning go, well we want to see if it's either sciatic nerve
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or biceps femoris, the way I could get those two structures out is I could bend
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the knee and this is where things get a little weird. I take those structures out
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which in most people gives them all sorts of hip flexion back, but this time
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I try to get them more hip flexion and nothing; and maybe even with that nothing
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they get a little pain in their backside like around their gluteal fold. This
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is one of those things where you need to take a step back and go what could
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possibly prevent somebody in their hip from getting hip flexion, and this is
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where things get a tad more serious, although you're gonna hide this from
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your client or patient initially. This is where we have to start thinking is this
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a neoplasm, is this an abscess, is this osteomyelitis.
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Is this something potentially very very serious, and you only have one recourse,
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refer out. Now keep in mind it could just be arthritis ,it could just be capsular
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tightness, it could be hip dysfunction from something like a loose
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body blocking you from getting into hip flexion, and all of those things are
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fairly benign and just orthopedic issues that we can help with.
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But because the sign of the buttock can also be related to cancer, infection of
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the bone, avascular necrosis, we have to go okay look it's a little
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weird so we're going to go through today but I want you to set up
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an appointment with your physician soon, okay and let's let's get this hip
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cleared before we start messing around with it; and that's probably about all I
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would tell my client initially. I probably wouldn't go hey that's a sign
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of cancer, don't do that. That is a terrible thing to do to somebody, you
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will have their heart drop. I don't even think I would be like hey this could be
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serious unless they started pushing back at me and saying that they don't want to
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go to their physician, or they're not going to make an appointment with their
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doctor. I'm not even going to mention it's serious, I'm just going to be like hey
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there's a couple things that could be going on with your hip in this
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particular sign that I I can't help you with, so let's make sure your physician
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gets you some imaging and we'll make sure that you're not wasting
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money with me when maybe there's something else that would treat this
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better, and I would just leave it at that. So once again the sign of the
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buttock is essentially hip flexion restriction after you do your straight
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leg raise and bend the knee, it doesn't get better. They may or may not have some
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pain in their buttock, which is why it's referred to as the sign of the buttock.
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It's more that hip flexion restriction that just makes you kind of go -that's
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not normal, and being a red flag issue you're always
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going to refer out. I hope you enjoyed this video and feel free to leave
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questions in the comment section, I know this type of test