This course by Dr. Marc Heller provides an in-depth look at assessment, treatment, and rehabilitation for the Pelvis, Hip, and Sacroiliac Joint. Through this course, users will learn how to implement simple functional tests to assess various types of instability and dysfunction. Learners will identify common abnormal fixation patterns of the sacroiliac joint, sacrum, and pubic symphysis, and explain how to correct these fixations with muscle energy mobilization. Identify common conditions of the hip, and their effect on the whole of the lower back and lower extremity. Understand the various corrections for dysfunction at the hip joint; including joint, soft tissue, and rehab. Gain an understanding of how to assess the coccyx, as well as external and internal mobilizations. Learn how to integrate rehab, mobilization and soft tissue within specific patients’ patterns as well as the use of before and after functional tests to motivate exercise compliance.
Understand rotational and frontal plane instability. Explain the importance of standing on one leg, and identify which muscles affect and control this pattern. Apply simple functional tests to assess rotational and frontal plane instability. Learn basic exercises to change frontal plane instability. Identify the use of before and after functional tests to motivate exercise compliance.
Understand assessment of SI motion. Apply the concept; mobilize where the joints are stuck only. Gain knowledge of sagittal rotation, flares, and shears, and know how to correct each of these fixations within the muscle energy model. Identify the normal motions of the sacrum in gait. Identify abnormal motions. Recognize anterior and posterior torsion patterns. Utilize the 2 variations on the side bent sacrum. Know how to assess and treat these four sacral fixation patterns, using the muscle energy model. Understand pubic fixation. Identify common abnormal fixation patterns, and explain how to correct these with muscle energy mobilization.
Explain, in depth, how soft tissue work can improve stability. Understand the pro-inflammatory restart first stage healing model of using Instrument Assisted Soft Tissue Massage (IASTM). Identify the key ligaments and key tendons of the pelvis and lumbar spine to apply IASTM. Become aware of side effects and warnings around IASTM. Explain and contrast the gentler methods of soft tissue myofascial release. Review pertinent case studies. Identify how to integrate rehab, mobilization and soft tissue, within specific patients’ patterns.
Identify the common condition, hip joint dysfunction, and its effects on the whole of the lower back and lower extremity. Describe Sahrmann’s anterior femoral glide syndrome, and Lucy Whyte Ferguson’s hip dysfunction concept. Understand and know how to assess for: the hip that has excessive internal rotation; the importance of the gluteus medius and piriformis weakness, and the hip that cannot internally rotate. Learn the three key signs of the hip that cannot internally rotate. Understand the various corrections; joint, soft tissue and rehab for the hip that lacks internal rotation. Explain how to perform the wishbone maneuver. Identify how to treat the hip that lacks external rotation. Compare soft tissue release vs. IASTM approach (stimulatory pro-inflammatory approach). Know how to apply to: Psoas, Adductors, Posterior hip muscles, Gluteus medius, Obturator foramen, Anterior hip capsule, The fascia around the pubic and ischial ramus. Explain how to strengthen the psoas and the gluteus medius. Compare newer models of psoas, as weak stabilizer vs. tight short muscle.
Explain how to assess the coccyx. Explain external mobilization. Introduce internal mobilization. Discuss dynamic coccyx x-ray, used to rule out hypermobility and luxation.
A simplified version of the examination process is presented, with a focus on the key areas for assessment, and the real time flow of an exam in the office. Important exercises are also briefly reviewed.
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