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.
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.
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