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I posted a proposal to teach a 2-day and 2 papers for CSM 2014 Women's Health Here
is one abstract. Pelvic joint mobilization for false positive late pregnancy instability A 29 year old female in the 32nd week of pregnancy had progressive pelvic pain and perceived instability feeling that her pelvis was coming apart in the front. She maintained hip adduction with all positional changes. Gait was antalgic, with a narrow base of support and shortened stride length. Pelvic instability in pregnancy is a well-established concept due to the enhancing size of the fetus, with a background of hormonal priming; particularly relaxin and estrogen. Evaluation was performed in a very cautious and limited manner with the expectation that significant pelvic instability would be encountered. Instead, micromotion testing revealed a surprising, significant hypomobility in multiple directions. Within a single intervention her posture and mobility were much improved, along with significant pain reduction. She reported significant improvement in bladder control and went on to have an easy natural delivery. In this case the subjective sense of instability was most likely a reflection of the visceral and neural tension and compression in response to the 3-dimensional non-physiological positioning of the pelvic articulations with induced spasm. This case of true hypomobility presenting as subjective “instability” underscores the utility of joint micromotion testing, AKA springing with awareness. Hypomobility and hypermobility are relevant peripartum constructs. Comments are closed.
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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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