this is just a belief articulated a very long time ago. The orientation of the
SIJ is such that forces going superiorly through the hip joint do n
1. Downslips occur frequently but self-correct during the gait cycle. False,
this is just a belief articulated a very long time ago. The orientation of the SIJ is such that forces going superiorly through the hip joint do n
1 Comment
Amy:
I feel a little "101" here, but what is the bullet point implications here - I kinda assumed fused = no movement anywhere. The SIJ might not move much but lose that micromotion and some macromotions get effected. What is that lateral marco motion used for, is probably a better way to ask my question. Jerry Hesch Amy, just after I posted it I scrolled through my You tube videos and made the discovery some time ago, just did not recall! So there is another video on same topic with CT scan evidence. Yes fused left sij means no movement in the left SIJ. I do believe that every biomechanical expert would be very surprised to see that a one-sided SIJ fusion significantly restricts pelvic side-glide mobility. Pelvic side glide is not thought to be a pure motion in the sij, but rather very minuimal sij motion and more motion of the lumbar spine and of the hip joints. Place your hand on the sacrum and try to glide it left and right, tell me what you find. lie the person on their left side and compress the right ilium and spring test it. What do you feel? I will explain. Jerry Hesch The lateral micromotion is a functional motion during gait, lateral weight shift, etc. It of course becomes a macromotion during such movements. The test for this motion is very relevant as some clients have it restricted, yet it is treatable with Hesch Method and it is a preventive model. Side-glided pelvis' even if subtle alter weight bearing throughout the kinetic chain, especially the lower extremities, and of course as you know; will create a distal compensation such as at the occipitoatlantal joint, which in time becomes symptomatic and non responsive to "adjusting the upper cervical spine". Does that answer your question. Micromotion is such a fundamental property of joints like the SIJ, so very relevant to test if one is using terminology such as "joint". Otherwise one is talking about the bony pelvis as it moves on the hips, which is NOT sij motion, despite the popularity thereof. I believed such for many years, but could not ignore the burgeoning research. Jerry Hesch:
I define hip hiking as active and muscular driven. Upslip I define as subtle because there is remarkably little vertical mobility in the sacroiliac by design, thus, even true instability seldom manifests as Upslip. Upslip will have an absence of superior and of inferior passive joint motion testing of 10 to 40# varying client to client. The sacrotuberous ligament is lax in an Upslip, not so in hip-hiking. Posted in manual therapy blog, https://www.facebook.com/groups/288423771210717/293725407347220/ lots of interesting topics. Jonathan George started it recently. Great thinker, great clinician somewhere in New Hamshire? Where are you Jon? |
Dr. Jerry Hesch, DPT, MHS, PTMarried with 4 grown kids. Earned my Doctorate at A.T. Still University in Tempe, AZ, MHS at the University of Indianapolis and my BS PT at University of New Mexico. I enjoy working with my hands and particularly making glass objet d'art. Powered by Calendar Labs Archives
August 2016
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