The OMM Diagnostic Solver

The definitive, algorithmic calculator for sacral torsions, shears, and cranial strain patterns. Enter palpatory findings to instantly compute the somatic dysfunction diagnosis, physiologic axes, L5 mechanics, and step-by-step Muscle Energy treatment positioning.

High-Yield Board Presets:

1. Seated Flexion Test (SFT)

Identifies the dysfunctional sacroiliac joint (opposite to the oblique axis in torsions).

2. Lumbo-Sacral Spring Test

Assesses anterior motion of the sacral base (good spring = anterior/forward; poor spring = posterior/backward).

3. Sphinx Test (Prone Extension)

Comparing sacral base depth when patient props up on elbows.

4. Sacral Sulcus Depth (Palpation)

5. Inferior Lateral Angle (ILA)

Calculated Diagnosis Forward Torsion

Left-on-Left (L-on-L) Sacral Torsion

Forward (anterior) sacral torsion rotating left about a Left Oblique Axis. Sacral base moved forward on the left.

Physiologic Axis: Left Oblique Axis (LOA)

Spring Test Finding: Negative (Good Springing)

L5 Vertebral Mechanics: L5 N Sl Rr (Type I Mechanics)

Deep Sacral Sulcus: Right Sulcus Deep

Posterior/Inferior ILA: Left ILA Posterior/Inferior

Muscle Energy Treatment Setup

Patient Position: Lateral Sims (Chest flat on table / Face Down).
Axis Side: Left oblique axis side DOWN on treatment table.
Leg Position: Both knees and hips flexed to 90°, drop feet off table edge.
Contraction: Patient gently pushes feet toward ceiling against operator resistance for 3–5 seconds. Repeat 3–5 times.

NBOME / COMLEX Board Trap Rule

In forward torsions, L5 follows Type I mechanics: L5 sidebending is on the SAME side as the oblique axis, and L5 rotation is OPPOSITE to sacral rotation.

Cranial Strain Presets:

1. Vault Hold Finger Movements

Index fingers = Greater wings of sphenoid; Pinkies = Squamous occiput.

2. Etiology / Traumatic Force Vector

Classic vignette scenarios for non-physiologic cranial strains.

Calculated Cranial Strain Physiologic Strain

Right SBS Torsion

Sphenobasilar synchondrosis rotates about 1 AP axis. Sphenoid and occiput rotate in opposite directions; named for the high greater wing of the sphenoid.

Motion Axes: 1 AP Axis

Direction of Rotation: Opposite Directions

Vault Hold Sensation: Right index finger rotates superior/anterior

COMLEX Cranial High-Yield Pearl

Only Torsion and Sidebending/Rotation are physiologic cranial strains. Vertical strains, lateral strains, and compression are strictly non-physiologic (caused by traumatic impact).

The OMM Diagnostic Solver

Left-on-Left (L-on-L) Sacral Torsion

Right SBS Torsion

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