At the Hesch Institute, we are dedicated to redefining the approach to pelvic joint dysfunction, particularly focusing on the sacroiliac joint (SI joint), the pubic joint, the hips, the lumbar spine, the tailbone, and the very important role of the whole-pelvis. Traditional methods often fall short in accurately diagnosing and treating these complex issues, instead relying solely on gross motion testing and limited bony landmark palpation. However, through extensive research and practical experience, we've developed the Hesch Method—a comprehensive approach that addresses the nuanced complexities of the pelvic structure.
At Hesch Institute, with over 43 years of experience under Dr. Jerry Hesch's leadership, we specialize in helping individuals overcome the challenges of sacroiliac joint dysfunction. This blog delves into the power of the Hesch Method as a cornerstone of treatment, highlighting its diverse techniques and potential to alleviate pain, improve mobility, and restore function, not just within the sacroiliac but throughout the whole body. In 1981 Dr. Hesch started to develop the Hesch Method an advanced biomechanical model of evaluation and treatment of complex sacroiliac joint pain and dysfunction. He is an expert at treating all joints in the body which is a specialty named orthopedic manual therapy, or manual therapy. His extensive work in this area of the body is described in his curriculum vitae available through the search function of the website. He is appropriately referred to as a "Sacroiliac Guru".
Here's a breakdown of what sets this method apart:
Advanced Palpatory Skills
Our method emphasizes advanced palpatory skills, allowing for a deeper understanding of the intricate structures involved in pelvic joint dysfunction. By homing in on specific palpation techniques, we can pinpoint areas of restricted mobility and dysfunction with precision. This includes palpation of bony landmarks, ligament tone palpation, and soft tissue palpation. Comprehensive evaluation is necessary for thorough treatment. The Hesch Method evaluates more bony landmarks than the traditional osteopathic, muscle energy, chiropractic and physical therapy traditions.
Accessory Motion Tests
Unlike traditional methods, this method incorporates accessory motion tests to assess the micromotions, and force transmission through the pelvic joints. In 1981 Dr. Hesch was studying the literature on the anatomy and kinesiology of the pelvis and sacroiliac joint and he was struck by the concept that the SIJ functions as a shock absorber. He then started testing the pelvic joints in the same way that the integrity of a car shock absorber is tested. This led to a large number of shock-absorber spring tests in multiple directions throughout the pelvis. These tests are one of several significant ways in which, the Hesch model differs from the traditional model of SIJ evaluation. This comprehensive approach ensures that no aspect of dysfunction goes unnoticed, leading to more effective treatment outcomes.
Treatment Based on Neuromuscular Factors
Treatment with the Hesch Method isn't limited to addressing joint mechanics alone. We also take into account neuromuscular factors and the viscoelastic nature of the joints, providing a holistic approach to rehabilitation. There are relevant interactions between impaired joint mobility and muscle function. Ligament and muscle in addition to joint congruency enhance the stability of the pelvic joints. When there is an imbalance of ligament tone due to a micro-displacement, there will be an inhibition of normal resting tone of muscle, thus increasing hypermobility in at least one direction. Motion in the opposite direction is reduced/hypomobile. An under-appreciated fact is that by treating the direction(s) which are hypomobile, the directions which are hypermobile will return to normalcy. There are simply two sides of the hypo/hyper coin. Therefore, micromotion testing and evaluating force transmission (shock absorption and stability) is a hallmark of the Hesch Method and is a significant distinction in comparison to the traditional "alignment" model. When micromotion is normalized via the Hesch Method, ligament and muscle tone is normalized and the reflex muscle inhibition is resolved, adding to joint stability
.
Recognition of Predictable Sequences of Dysfunction
Through years of experience, we've identified several predictable sequences of dysfunction within the SI joint. In a book chapter published in 1998, Dr. Hesch described his Most Common Pattern of Sacroiliac Joint Dysfunction which consists of up to eight different components. Each is evaluated and treated sequentially, making for much more comprehensive care. In contrast, the traditional approach only names a single pattern of mobility impairment without acknowledging the true complexity of typical patterns of pelvic motion dysfunction. As Dr. Hesch states: "Correct diagnosis leads to correct treatment." By understanding these patterns, we can tailor treatment plans to address each individual's unique needs effectively.
Focus on Intrinsic and Extrinsic Motion Restrictors
This method goes beyond only addressing the intrinsic biomechanics of the SI joint. We also examine extrinsic motion restrictors, including the biomechanics of the entire pelvic structure, and within the whole body. This comprehensive approach ensures that all aspects of dysfunction are addressed for optimal results. It is quite rare for a person in pain to only have one pattern such as "right anterior ilium motion dysfunction. Focusing on only one joint leads to inadequate treatment. The Hesch Method is a true whole-body approach, as it is based on the fact that the body functions as an integrated whole. For that reason, evaluation must include the foot and ankle, the knee, hip, pelvic joints, lumbar spine, rib cage, thoracic and cervical spine, and shoulder girdle. Here is a lucid example. The latissimis dorsi muscle has a connection between the humerus and shoulder girdle and the ilium. Therefore, balanced function of the shoulder girdle is imperative for optimal posture and optimal strength and flexibility. Body balance needs to be the goal of treatment not just "align the pelvis."
Re-balancing the Whole Body
Our method recognizes that pelvic dysfunction can impact soft tissues and movement patterns throughout the body. By re-balancing the pelvis and addressing related soft tissue issues, we can alleviate symptoms and improve overall function. This approach acknowledges the role of a very powerful neurologic reflex in the body which is named The Righting Reflex. It functions to balance blood supply to both hemispheres of the brain and help maintain the eyes horizontally. The reflex allows you walk in a straight line even if a major part of your body is twisted. Here is an example: If any part of your pelvis or lower body orients to the left, the righting reflex is mandated, and it induces a counter reflex in the upper cervical spine. Without that reflex movement would become very inefficient and you would bump into things.
The concept of the Righting Reflex and its relevance to pain, posture, and mobility impairment is illustrated: Dr. Hesch evaluated a man who had a 5-year history of severe occipital headaches. In performing a whole-body evaluation, it was found that his suboccipital muscles were like steel cable! Working directly on the neck would fail. It was discovered that he lost range of motion in the hips, ankles and the joints below the ankles. After correcting them his neck softened considerably and he was elated. Five days later he sent an email reporting no more headaches. Thus, integrating the nervous system is relevant to the work of the Hesch Institute.
At the Hesch Institute, our goal is to provide practitioners with the tools and knowledge they need to effectively diagnose and treat pelvic joint dysfunction. Through the Hesch Method for Sacroiliac Joint, we're revolutionizing the approach to SI joint issues, leading to better outcomes and improved quality of life for patients.
Visit our website today!
At Hesch Institute, with over 43 years of experience under Dr. Jerry Hesch's leadership, we specialize in helping individuals overcome the challenges of sacroiliac joint dysfunction. This blog delves into the power of the Hesch Method as a cornerstone of treatment, highlighting its diverse techniques and potential to alleviate pain, improve mobility, and restore function, not just within the sacroiliac but throughout the whole body. In 1981 Dr. Hesch started to develop the Hesch Method an advanced biomechanical model of evaluation and treatment of complex sacroiliac joint pain and dysfunction. He is an expert at treating all joints in the body which is a specialty named orthopedic manual therapy, or manual therapy. His extensive work in this area of the body is described in his curriculum vitae available through the search function of the website. He is appropriately referred to as a "Sacroiliac Guru".
Here's a breakdown of what sets this method apart:
Advanced Palpatory Skills
Our method emphasizes advanced palpatory skills, allowing for a deeper understanding of the intricate structures involved in pelvic joint dysfunction. By homing in on specific palpation techniques, we can pinpoint areas of restricted mobility and dysfunction with precision. This includes palpation of bony landmarks, ligament tone palpation, and soft tissue palpation. Comprehensive evaluation is necessary for thorough treatment. The Hesch Method evaluates more bony landmarks than the traditional osteopathic, muscle energy, chiropractic and physical therapy traditions.
Accessory Motion Tests
Unlike traditional methods, this method incorporates accessory motion tests to assess the micromotions, and force transmission through the pelvic joints. In 1981 Dr. Hesch was studying the literature on the anatomy and kinesiology of the pelvis and sacroiliac joint and he was struck by the concept that the SIJ functions as a shock absorber. He then started testing the pelvic joints in the same way that the integrity of a car shock absorber is tested. This led to a large number of shock-absorber spring tests in multiple directions throughout the pelvis. These tests are one of several significant ways in which, the Hesch model differs from the traditional model of SIJ evaluation. This comprehensive approach ensures that no aspect of dysfunction goes unnoticed, leading to more effective treatment outcomes.
Treatment Based on Neuromuscular Factors
Treatment with the Hesch Method isn't limited to addressing joint mechanics alone. We also take into account neuromuscular factors and the viscoelastic nature of the joints, providing a holistic approach to rehabilitation. There are relevant interactions between impaired joint mobility and muscle function. Ligament and muscle in addition to joint congruency enhance the stability of the pelvic joints. When there is an imbalance of ligament tone due to a micro-displacement, there will be an inhibition of normal resting tone of muscle, thus increasing hypermobility in at least one direction. Motion in the opposite direction is reduced/hypomobile. An under-appreciated fact is that by treating the direction(s) which are hypomobile, the directions which are hypermobile will return to normalcy. There are simply two sides of the hypo/hyper coin. Therefore, micromotion testing and evaluating force transmission (shock absorption and stability) is a hallmark of the Hesch Method and is a significant distinction in comparison to the traditional "alignment" model. When micromotion is normalized via the Hesch Method, ligament and muscle tone is normalized and the reflex muscle inhibition is resolved, adding to joint stability
.
Recognition of Predictable Sequences of Dysfunction
Through years of experience, we've identified several predictable sequences of dysfunction within the SI joint. In a book chapter published in 1998, Dr. Hesch described his Most Common Pattern of Sacroiliac Joint Dysfunction which consists of up to eight different components. Each is evaluated and treated sequentially, making for much more comprehensive care. In contrast, the traditional approach only names a single pattern of mobility impairment without acknowledging the true complexity of typical patterns of pelvic motion dysfunction. As Dr. Hesch states: "Correct diagnosis leads to correct treatment." By understanding these patterns, we can tailor treatment plans to address each individual's unique needs effectively.
Focus on Intrinsic and Extrinsic Motion Restrictors
This method goes beyond only addressing the intrinsic biomechanics of the SI joint. We also examine extrinsic motion restrictors, including the biomechanics of the entire pelvic structure, and within the whole body. This comprehensive approach ensures that all aspects of dysfunction are addressed for optimal results. It is quite rare for a person in pain to only have one pattern such as "right anterior ilium motion dysfunction. Focusing on only one joint leads to inadequate treatment. The Hesch Method is a true whole-body approach, as it is based on the fact that the body functions as an integrated whole. For that reason, evaluation must include the foot and ankle, the knee, hip, pelvic joints, lumbar spine, rib cage, thoracic and cervical spine, and shoulder girdle. Here is a lucid example. The latissimis dorsi muscle has a connection between the humerus and shoulder girdle and the ilium. Therefore, balanced function of the shoulder girdle is imperative for optimal posture and optimal strength and flexibility. Body balance needs to be the goal of treatment not just "align the pelvis."
Re-balancing the Whole Body
Our method recognizes that pelvic dysfunction can impact soft tissues and movement patterns throughout the body. By re-balancing the pelvis and addressing related soft tissue issues, we can alleviate symptoms and improve overall function. This approach acknowledges the role of a very powerful neurologic reflex in the body which is named The Righting Reflex. It functions to balance blood supply to both hemispheres of the brain and help maintain the eyes horizontally. The reflex allows you walk in a straight line even if a major part of your body is twisted. Here is an example: If any part of your pelvis or lower body orients to the left, the righting reflex is mandated, and it induces a counter reflex in the upper cervical spine. Without that reflex movement would become very inefficient and you would bump into things.
The concept of the Righting Reflex and its relevance to pain, posture, and mobility impairment is illustrated: Dr. Hesch evaluated a man who had a 5-year history of severe occipital headaches. In performing a whole-body evaluation, it was found that his suboccipital muscles were like steel cable! Working directly on the neck would fail. It was discovered that he lost range of motion in the hips, ankles and the joints below the ankles. After correcting them his neck softened considerably and he was elated. Five days later he sent an email reporting no more headaches. Thus, integrating the nervous system is relevant to the work of the Hesch Institute.
At the Hesch Institute, our goal is to provide practitioners with the tools and knowledge they need to effectively diagnose and treat pelvic joint dysfunction. Through the Hesch Method for Sacroiliac Joint, we're revolutionizing the approach to SI joint issues, leading to better outcomes and improved quality of life for patients.
Visit our website today!
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