Physical Therapist Feedback
My background as a Maitland trained physical therapist has taught me to utilize a clinical reasoning approach to patient care. The Hesch Method fit into my training in that it emphasizes testing/re-testing and utilizes spring testing. The Hesch Method utilizes what I call "springing with awareness" which allows the clinician to determine the patients dysfunctions without having to make the patient fit into pre-conceived ideas and patterns. The Hesch Method is also a very user friendly approach which allows the student to utilize the approach immediately in the clinic. This approach gives students specific patterns to follow by utilizing "the Most Common Patterns" and "the Second Most Common Patterns." The Hesch Method does not limit the clinician to these patterns but gives him/her the ability to find other less common dysfunctions as indicated. Utilizing this concept I have been able to help numerous patients who where not helped by "traditional methods." My favorite part about this method is that the techniques utilized are not labor intensive and enable the patient to self treat as appropriate. The Hesch Method has added a new dimension to my ability to treat the most complicated patients.
Robert Shapiro, MA, PT, COMT
Robert Shapiro, MA, PT, COMT
Compliment Rachel Lee McIntosh
Rachel Lee McIntosh (Australian Osteopath) Your model of evaluation, diagnosis and treatment is absolutely nothing short of genius and has completely transformed the way I treat. The results I get assessing and treating patients with your methods are mind-blowing. 04/2018
Rachel Lee McIntosh (Australian Osteopath) Your model of evaluation, diagnosis and treatment is absolutely nothing short of genius and has completely transformed the way I treat. The results I get assessing and treating patients with your methods are mind-blowing. 04/2018
From Email received from a PT Assistant treated at the weekend workshop:
Dear Mr. Hesch,
I recently attended your course and you were kind enough to use me as a demonstration according to my symptoms. In Sept of 2013 I injured my wrist as a glass cup shattered cutting my wrist and sending me to the emergency room. I received five stitches and was in a wrist brace for three weeks. Ever since then I have had deep ache pain and compression over incision on R palmar ulnar process. I also found I developed hypermobility in the R wrist causing increased pain with wrist extension. Mr. Hesch manipulated my L wrist which he explained would turn on protective receptors in the R wrist increasing stability. After the treatment I did feel more stability in the R wrist with less discomfort during wrist extension and deep ache pain was no longer present. I also found activities such as holding a glass and typing were no longer bothersome at incision point later that day.
I was a dancer for 16 yrs performing ballet, pointe, hip hop, tap, jazz and modern. I have had R hip pain located over PSIS that radiates to R groin region. I have pain in those areas when sitting or standing for more than 30min and always felt as if I was dragging R LE when walking. I also notice R sternal pain when performing UE activities and would feel a prominent press against my bra on the R. I have also suffered from late day headaches starting at the R mastoid process and shooting into occiput coupled with a long history of jaw tightness. I experienced limited jaw movements from a young age waking up with soreness in jaw and needing to cut food into small pieces due to limited ROM of jaw.
Mr. Hesch diagnosed me using his spring methods and visual observations. Mr. Hesch treated all my symptoms with his techniques using foam rolls, manual over pressure and independent standing positions. I felt immediate relief with decreased jaw pain and neck pain with greater ease with cervical ROM as well. I noticed less pressure in R PSIS location and no longer felt as if I was dragging R LE upon walking. I also no longer had tenderness or protrusion in R sternum.
I was very pleased with the treatment and relief I received. I also appreciated the independence his style of treatment gave me to maintain relief on my own. I felt the Hesch Method was very informative, made sense with previous knowledge I had and demonstrated effectiveness in myself and others that were used as demonstrations during the course. I will be using the Hesch Method to treat my patients as a Physical Therapist Assistant and feel extremely equipped to handle lumbopelvic and sacroiliac dysfunctions due to the experience at his course and with his course workbook.
Thank you again for all your help, time and knowledge. I will be looking forward to another course with you.
Feel free to quote.
Danielle Vieira, PTA
APM Spine and Sports Physicians
Norfolk, VA
Dear Mr. Hesch,
I recently attended your course and you were kind enough to use me as a demonstration according to my symptoms. In Sept of 2013 I injured my wrist as a glass cup shattered cutting my wrist and sending me to the emergency room. I received five stitches and was in a wrist brace for three weeks. Ever since then I have had deep ache pain and compression over incision on R palmar ulnar process. I also found I developed hypermobility in the R wrist causing increased pain with wrist extension. Mr. Hesch manipulated my L wrist which he explained would turn on protective receptors in the R wrist increasing stability. After the treatment I did feel more stability in the R wrist with less discomfort during wrist extension and deep ache pain was no longer present. I also found activities such as holding a glass and typing were no longer bothersome at incision point later that day.
I was a dancer for 16 yrs performing ballet, pointe, hip hop, tap, jazz and modern. I have had R hip pain located over PSIS that radiates to R groin region. I have pain in those areas when sitting or standing for more than 30min and always felt as if I was dragging R LE when walking. I also notice R sternal pain when performing UE activities and would feel a prominent press against my bra on the R. I have also suffered from late day headaches starting at the R mastoid process and shooting into occiput coupled with a long history of jaw tightness. I experienced limited jaw movements from a young age waking up with soreness in jaw and needing to cut food into small pieces due to limited ROM of jaw.
Mr. Hesch diagnosed me using his spring methods and visual observations. Mr. Hesch treated all my symptoms with his techniques using foam rolls, manual over pressure and independent standing positions. I felt immediate relief with decreased jaw pain and neck pain with greater ease with cervical ROM as well. I noticed less pressure in R PSIS location and no longer felt as if I was dragging R LE upon walking. I also no longer had tenderness or protrusion in R sternum.
I was very pleased with the treatment and relief I received. I also appreciated the independence his style of treatment gave me to maintain relief on my own. I felt the Hesch Method was very informative, made sense with previous knowledge I had and demonstrated effectiveness in myself and others that were used as demonstrations during the course. I will be using the Hesch Method to treat my patients as a Physical Therapist Assistant and feel extremely equipped to handle lumbopelvic and sacroiliac dysfunctions due to the experience at his course and with his course workbook.
Thank you again for all your help, time and knowledge. I will be looking forward to another course with you.
Feel free to quote.
Danielle Vieira, PTA
APM Spine and Sports Physicians
Norfolk, VA
I have been to both to his basic intermediate and total body courses, and viewed his video on the advanced course for the pelvis, I can speak to the incredible insight he has shown into treatment that I have not seen or heard at any other courses I have been to. And without actually seeing these things work incredibly well on other PTs at the courses, and hearing their reactions, I never would have lent any credibility to it if I had just seen them on the printed page.
For example, a pelvic girdle misalignment pattern he called “windswept ischium”. I had never heard about this type phenomena elsewhere, certainly not in the evidence based book such as Current Concepts of for Orthopedic Physical Therapy edition 2, or Chad Cook’s evidence based Orthopedic Therapy text book (which covers up to date research up to 2012). But the therapist who happened to be at my first course who had been in an MVA 14 years previously had it, as well as a posteriorly positioned femoral head on the right. Her lab partner, who was learning to assess her, found that her subject seemed just plain bizarre, and asked Jerry to come look at her with her. After he assessed her, he stopped the class and had us gather around. He said since we had a perfect example of this, even though this was info from his advanced class, he was going to show us this. (Her symptoms were chronic back and right knee pain since the accident.)
He had her walk for us, (one of the most inexplicable gait patterns I ever saw, very different), then he showed us how her right femur bowed anteriorly, how the back of her knee didn’t touch the table like the left side, how her knee cap was far less mobile, all of these things very obvious. He then had her flip prone, and palpated her ischium, and with doing so, we could see that her right ischium was definitely more lateral, her left definitely more medial, and she had a gross asymmetry in her hip rotation prone, one leg opposite the other in ER/IR ratios.
I was clueless on what all that meant, but then he did 3 techniques to correct her, taking 6 minutes. He had her get up to walk again, and her gait was perfectly normal, and she had NO pain (1st time in 14 years). The therapist herself was totally incredulous, as were all of us in the room. Within 1 week of coming back from the course, Mindy Buck referred an 18 year old to me who had been in an MVA, had been burned, mild head injury, and pelvic girdle problems. He had been discharged from pediatric rehab. In he walks with that same bizarre gait pattern I had seen at the course. So, I looked for this “windswept” thing. And there it was. So, I got out my book to see how to treat it, and I did. His gait normalized immediately as well, and his mom came in the next visit with him, demanding to know what I did, since he has been “normal’ ever since!.
Since then from him, I have learned other things that work incredibly well, that I have not seen or heard of elsewhere, such as:
With this type thinking, (using only a certain type of research-backed techniques) we should ignore anything James Cyriax taught, since he did not do actual research, and we should ignore the other 2 parts of the evidence based trilogy, which is practitioner experience and patient expectations, which are considered the other 2 parts of the 3 legged stool of evidence based practice.
If we go with only what we can learn from research articles, we will be missing out on a lot of things that work well that have not just been researched yet."
Barbara Carusillo, PT, OCS, COMT
IU Health, Indianapolis, IN
For example, a pelvic girdle misalignment pattern he called “windswept ischium”. I had never heard about this type phenomena elsewhere, certainly not in the evidence based book such as Current Concepts of for Orthopedic Physical Therapy edition 2, or Chad Cook’s evidence based Orthopedic Therapy text book (which covers up to date research up to 2012). But the therapist who happened to be at my first course who had been in an MVA 14 years previously had it, as well as a posteriorly positioned femoral head on the right. Her lab partner, who was learning to assess her, found that her subject seemed just plain bizarre, and asked Jerry to come look at her with her. After he assessed her, he stopped the class and had us gather around. He said since we had a perfect example of this, even though this was info from his advanced class, he was going to show us this. (Her symptoms were chronic back and right knee pain since the accident.)
He had her walk for us, (one of the most inexplicable gait patterns I ever saw, very different), then he showed us how her right femur bowed anteriorly, how the back of her knee didn’t touch the table like the left side, how her knee cap was far less mobile, all of these things very obvious. He then had her flip prone, and palpated her ischium, and with doing so, we could see that her right ischium was definitely more lateral, her left definitely more medial, and she had a gross asymmetry in her hip rotation prone, one leg opposite the other in ER/IR ratios.
I was clueless on what all that meant, but then he did 3 techniques to correct her, taking 6 minutes. He had her get up to walk again, and her gait was perfectly normal, and she had NO pain (1st time in 14 years). The therapist herself was totally incredulous, as were all of us in the room. Within 1 week of coming back from the course, Mindy Buck referred an 18 year old to me who had been in an MVA, had been burned, mild head injury, and pelvic girdle problems. He had been discharged from pediatric rehab. In he walks with that same bizarre gait pattern I had seen at the course. So, I looked for this “windswept” thing. And there it was. So, I got out my book to see how to treat it, and I did. His gait normalized immediately as well, and his mom came in the next visit with him, demanding to know what I did, since he has been “normal’ ever since!.
Since then from him, I have learned other things that work incredibly well, that I have not seen or heard of elsewhere, such as:
- treating the posterior attachment of the 1st rib, not just the anterior.
- Use of spring tests to confirm what is going on in the pelvis
- Posteriorly displaced sacrums which make an amazing difference in folks once corrected
- How best to treat sacral torsions and what they do due to reflex neural connections to the sternum, upper cervical region
- A great sequence to treat supinatory fixated foot and ankles
- A great technique to help with forward shoulders with fixations at the joint,
- Etc etc etc.
With this type thinking, (using only a certain type of research-backed techniques) we should ignore anything James Cyriax taught, since he did not do actual research, and we should ignore the other 2 parts of the evidence based trilogy, which is practitioner experience and patient expectations, which are considered the other 2 parts of the 3 legged stool of evidence based practice.
If we go with only what we can learn from research articles, we will be missing out on a lot of things that work well that have not just been researched yet."
Barbara Carusillo, PT, OCS, COMT
IU Health, Indianapolis, IN
Read my blog about the Hesch Method here:
http://blog.newyorkorthopedicmassage.com/2012/08/12/the-hesch-method/
and here: http://blog.newyorkorthopedicmassage.com/2012/08/12/the-hesch-method-works/
Kiambu Dickerson, LMT, New York, NY
http://blog.newyorkorthopedicmassage.com/2012/08/12/the-hesch-method/
and here: http://blog.newyorkorthopedicmassage.com/2012/08/12/the-hesch-method-works/
Kiambu Dickerson, LMT, New York, NY
I just wanted to say thank you for the course last weekend and what you did for me personally. I have not had a headache since last weekend, which is amazing. I usually live on Advil. My headaches aren't disabling, but more of a sometimes near daily annoyance that I am so happy to be rid of. The rest of my body is feeling better too. I have been spending time reviewing all the coursework, and bought a used portable massage table so that I can practice on family and friends.
I worked on my 10 year old son and the results have been astounding! (He) has always had a lordotic posture and has always had difficulty running correctly. He could not correct his posture with verbal cues. He has never had any pain. He would run with an excessive heel strike, almost looking like he is leaping when running and exagerrating the pumping of his arms. He could not land on his mid foot or toes or with his foot directly under his hip, and could not get a good push off no matter what strategies we tried. On the treadmill, he would have difficulty picking up his feet and they would drag/slap during swing phase. I tried strengthening his gluts and calves (glut med and max are weak, gastroc/soleus lacks endurance and poor balance going up on toes). Worked on stretching his hip flexors which were really only a little tight. Nothing really worked to improve his running or his posture, and I'm ashamed to admit I didn't really put it together till after your class.
I took another look at him and found that he fit in the 2nd most common pattern, plus lacked hip extension (only 0 degrees) and dorsiflexion in subtalar neutral. I think he had a posterior sacrum but I'm not confident enough yet to be sure. I did the manual treatments and started him on the HEP.
You can see in the attachment his posture before, and his posture on day 3- a remarkable change! His balance is much improved also-doing the nudge test to the sternum with his eyes closed, he was stumbling all over and now can hold his balance easily. His running is already much better.
I am so glad I came to your class- Thanks so much! I will keep in touch-
Stacy S., PT West Bend, WI
I worked on my 10 year old son and the results have been astounding! (He) has always had a lordotic posture and has always had difficulty running correctly. He could not correct his posture with verbal cues. He has never had any pain. He would run with an excessive heel strike, almost looking like he is leaping when running and exagerrating the pumping of his arms. He could not land on his mid foot or toes or with his foot directly under his hip, and could not get a good push off no matter what strategies we tried. On the treadmill, he would have difficulty picking up his feet and they would drag/slap during swing phase. I tried strengthening his gluts and calves (glut med and max are weak, gastroc/soleus lacks endurance and poor balance going up on toes). Worked on stretching his hip flexors which were really only a little tight. Nothing really worked to improve his running or his posture, and I'm ashamed to admit I didn't really put it together till after your class.
I took another look at him and found that he fit in the 2nd most common pattern, plus lacked hip extension (only 0 degrees) and dorsiflexion in subtalar neutral. I think he had a posterior sacrum but I'm not confident enough yet to be sure. I did the manual treatments and started him on the HEP.
You can see in the attachment his posture before, and his posture on day 3- a remarkable change! His balance is much improved also-doing the nudge test to the sternum with his eyes closed, he was stumbling all over and now can hold his balance easily. His running is already much better.
I am so glad I came to your class- Thanks so much! I will keep in touch-
Stacy S., PT West Bend, WI
The seminar *DVD that I recently purchased is a great review and learning aid for studying the Hesch Method and putting the skills into practicing.
Carla Rock, PT, Lafayette, IN
*DVD's are no longer provided; classes now online and digital.
Carla Rock, PT, Lafayette, IN
*DVD's are no longer provided; classes now online and digital.
In my quest for answers to questions that I haven’t been able to find in 40 years of athletic training, including soft tissue courses, osteopathic knowledge and manual therapy techniques, the Hesch Method is like the ‘icing on the cake’ in its ability to bring my knowledge to a new level and answers to my questions. The Hesch Method has helped me to realize that the SIJ is the key to the kinetic chain, linking the distal and the proximal.
David Craig, Head Trainer, Indiana Pacers
David Craig, Head Trainer, Indiana Pacers
My patients have always derived incredible benefits from his insightful evaluation and comprehensive treatment of these problems.
Dr. Ralph J. Luciani, D.O., M.S.,
Ph.D, M.D.(H)
Flight surgeon to the astronauts in the 1980s,
now Director of Southwest Integrative and Aesthetic Medicine
Dr. Ralph J. Luciani, D.O., M.S.,
Ph.D, M.D.(H)
Flight surgeon to the astronauts in the 1980s,
now Director of Southwest Integrative and Aesthetic Medicine
I just wanted to thank you again for the great course in Indianapolis, Indiana. You have a contagious excitement and I am now pumped to see some SIJ clients, instead of dreading them as I did before your course. I will relay my positive feedback to my director for we are still hoping to bring the course to Goshen.
Also, thanks for treating me. We saw the difference at the course, but I also saw a difference while playing disc golf the next day. In disc, there are huge transverse plane motions. I felt better power transfer from my left hip with less effort to get the distance required. I'm looking forward to applying the techniques, and I'm sure I will have a few questions, so plan on a few more e-mails. Please extend my thanks to Jerry Hesch for developing this work.
Craig Enright PT,
Centers for Rehab, Goshen General Hospital, Goshen, Indiana
Also, thanks for treating me. We saw the difference at the course, but I also saw a difference while playing disc golf the next day. In disc, there are huge transverse plane motions. I felt better power transfer from my left hip with less effort to get the distance required. I'm looking forward to applying the techniques, and I'm sure I will have a few questions, so plan on a few more e-mails. Please extend my thanks to Jerry Hesch for developing this work.
Craig Enright PT,
Centers for Rehab, Goshen General Hospital, Goshen, Indiana
I attended your course in Jacksonville, Florida, several years ago (2002), and it changed my practice. I now employ passive accessory motion testing as my primary indicator of pelvic joint dysfunction, along with SIJ provocation testing. I also use active motion testing, load transfer test, ASLR, and palpation for alignment and pain. I share your suspicion that the mobility of the SIJs and pubic symphysis can directly affect the function of the pelvic floor.
Cynthia E. Neville, PT, BCIA-PMDB
Recent Director of Women's Health Rehabilitation at the Rehabilitation Institute of Chicago
Cynthia E. Neville, PT, BCIA-PMDB
Recent Director of Women's Health Rehabilitation at the Rehabilitation Institute of Chicago
When I was a PT student, my clinical instructor used the Hesch Method to treat a client. The client was very pleased to finally achieve pain relief, having previously sought care from several practitioners. So when I started working in outpatient Orthopedics, I took the basic/intermediate Hesch Seminar. I was pleased to achieve quick and lasting results, and I find the self-treatment very helpful. I appreciate that this work is not restrictive or dogmatic, and it is easily integrated with other PT approaches. Jerry Hesch is very available by phone and e-mail, which helped with learning the advanced material.
I completed an outcome study with 11 discharged clients, and 8 out of 11 reported benefit with the Hesch self-treatment. Most clients with pelvic girdle movement dysfunction are significantly improved within 3 visits and readily segue into strength and stabilization exercises. I have presented this approach several times to PT students at UNM, and it was enthusiastically received. It has been 5 years since I took the seminar, and I am grateful that I am very comfortable the lumbopelvic and hip girdle and easily achieving lasting change.
Bernadette Lynch, PT, Albuquerque, New Mexico
I completed an outcome study with 11 discharged clients, and 8 out of 11 reported benefit with the Hesch self-treatment. Most clients with pelvic girdle movement dysfunction are significantly improved within 3 visits and readily segue into strength and stabilization exercises. I have presented this approach several times to PT students at UNM, and it was enthusiastically received. It has been 5 years since I took the seminar, and I am grateful that I am very comfortable the lumbopelvic and hip girdle and easily achieving lasting change.
Bernadette Lynch, PT, Albuquerque, New Mexico
Having worked with the Hesch Method for more than ten years, I can honestly say that one of the best things about the technique is that you can rule out a misaligned pelvis as a source of pain within 1-2 minutes. If you rule out the pelvis, you will then need to look up and down the kinetic chain to see other sources of abnormal motion. Additionally, you can use Jerry Hesch's principals of treatment for joint movement dysfunctions anywhere in the body, besides the pelvis. If the movement dysfunction does not resolve in the usual time, then that area is probably properly aligned, and you will need to keep looking for the source of dysfunction.
Luanne Olson, DPT
Luanne Olson, DPT
Letters From Physical Therapist
I am a DPT (Doctorate in Physical Therapy). I have an interesting story to tell regarding our experience with the Hesch Method.
I learned a few of the early evolving Hesch techniques fifteen years ago from one of my PT colleagues, and found these early techniques to be an invaluable adjunct to my physical therapy practice. Hesch techniques allowed me to successfully treat many patients other therapists had not been able to satisfactorily address. My own husband, Ron, however, had been extremely difficult to treat.
Ron had surgically lost his abdominal muscles twenty years ago, and he had genetic faulty sacral issues and had two lumbar surgeries. Over a period ten years he went to the four best therapists in the area, including a national seminar presenter (teaches back pain approach). All seemed to make his complex diagnosis worse. Finally, he could barely walk. The only pain relief and function return occurred with the early Hesch techniques I used in the clinic myself. We hoped that the Hesch Institute would be able to better address his deficits, so we arranged to have him fly to Las Vegas, Nevada for 3 visits with Jerry Hesch. After several emails and phone calls and a thorough review of the medical files Jerry informed us that he simply could not determine whether or not he could help Ron. He wanted to make sure that he had
maximized local resources before committing to travel.
To our delight, Jerry Hesch treated him with significant success. Surgeries had left him with some permanent deficits, yet he is able to walk today and oftentimes enjoys complete pain relief. Jerry found an Upslip Ilium movement dysfunction, a Pelvic Side-Glide fixation and addressed these. He then identified a significant weakness of the hip abductor muscle group which is being addressed. Jerry fully acknowledges that many of these patterns involve multiple structures working in concert, hence the terminology “lumbopelvic-hip pathomechanics”. Jerry does not fully embrace the sacroiliac joint dysfunction paradigm, but rather interprets it within the complexity of the unified structure; again, the lumbopelvic-hip complex. Jerry’s treatment techniques for the pathomechanics of the pelvis are superior to any other educator I have encountered. This is an example where embracing controversy lead to effective clinical outcome in my husband, after a frustrating, long and arduous journey.
For Ron and I, the Hesch techniques are worth their weight in gold. We are very grateful for the work of the Hesch Institute, the dedicated research and development of the latest techniques. I look forward to gaining the current Hesch skills, when I am finally able to attend the actual Hesch course this Spring.
Ellen Frohriep PT, DPT
I learned a few of the early evolving Hesch techniques fifteen years ago from one of my PT colleagues, and found these early techniques to be an invaluable adjunct to my physical therapy practice. Hesch techniques allowed me to successfully treat many patients other therapists had not been able to satisfactorily address. My own husband, Ron, however, had been extremely difficult to treat.
Ron had surgically lost his abdominal muscles twenty years ago, and he had genetic faulty sacral issues and had two lumbar surgeries. Over a period ten years he went to the four best therapists in the area, including a national seminar presenter (teaches back pain approach). All seemed to make his complex diagnosis worse. Finally, he could barely walk. The only pain relief and function return occurred with the early Hesch techniques I used in the clinic myself. We hoped that the Hesch Institute would be able to better address his deficits, so we arranged to have him fly to Las Vegas, Nevada for 3 visits with Jerry Hesch. After several emails and phone calls and a thorough review of the medical files Jerry informed us that he simply could not determine whether or not he could help Ron. He wanted to make sure that he had
maximized local resources before committing to travel.
To our delight, Jerry Hesch treated him with significant success. Surgeries had left him with some permanent deficits, yet he is able to walk today and oftentimes enjoys complete pain relief. Jerry found an Upslip Ilium movement dysfunction, a Pelvic Side-Glide fixation and addressed these. He then identified a significant weakness of the hip abductor muscle group which is being addressed. Jerry fully acknowledges that many of these patterns involve multiple structures working in concert, hence the terminology “lumbopelvic-hip pathomechanics”. Jerry does not fully embrace the sacroiliac joint dysfunction paradigm, but rather interprets it within the complexity of the unified structure; again, the lumbopelvic-hip complex. Jerry’s treatment techniques for the pathomechanics of the pelvis are superior to any other educator I have encountered. This is an example where embracing controversy lead to effective clinical outcome in my husband, after a frustrating, long and arduous journey.
For Ron and I, the Hesch techniques are worth their weight in gold. We are very grateful for the work of the Hesch Institute, the dedicated research and development of the latest techniques. I look forward to gaining the current Hesch skills, when I am finally able to attend the actual Hesch course this Spring.
Ellen Frohriep PT, DPT