FULL PROGRAMME for Managing Movement: Solutions for the SIJ and Pelvis

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Full Programme - SIJ and Pelvis

Sacro-Iliac Complex (theoretical component)
  • Review of key concepts of movement control impairments
  • Anatomy, Function, the sacro-iliac joint as a source of pain (peri-articular and intra-articular), evidence of sacro-iliac joint movement, biomechanics, strain and stress: mechanisms.

Sacro-Iliac Movement & Control Mechanisms (practical / lab component)
  • Biomechanical Control Systems - Form Closure and Force Closure:
  • Ligamentous Support System:
    • 1: Anatomy review
    • 2: Palpation of bony landmarks of the lumbo-pelvic region
    • 3: Palpation of ligaments for asymmetry and pain sensitivity

Myofascial Control System - Form & Force Closure: (theoretical component)
  • Review of muscle function affecting the sacro-iliac complex
  • Factors optimising sacroiliac stability
  • Factors compromising sacroiliac stability

Sacro-Iliac Motion Dysfunction Tests (practical / lab component)
  • Trunk Flexion Tests:
    • Standing  (Tests for the presence of inappropriate intra-pelvic torsion)
    • Sitting  (Tests for the presence of inappropriate intra-pelvic torsion)
  • Standing Hip Flexion Tests:
    • Ipsilateral (I/S motion restriction)
    • Contralateral (S/I motion restriction)
  • Prone Extension Tests for Torsion:
    • L5 - S1 restriction causing sacro-iliac motion strain (backward sacral torsion)
    • Piriformis asymmetry causing sacral compensation (forward sacral torsion)
  • Arthro-kinematic Tests:
    • Myofascial vs. articular restriction
    • Hypo-mobile vs. hyper-mobile articular glides (Lee) (Emerson) (Fowler)
    • Articular Glide palpation

Diagnosis of Positional Compensation (theoretical component)

Identify the site and direction of uncontrolled compensation

  • Sacral
    • Torsion (forward or backward)
    • Sidebend (nutated or counternutated)
  • Innominate
    • Rotation (anterior or posterior)
    • Shear (superior or inferior)
    • Flare (out or in)
  • Pubic
    • Shear (superior or inferior) (anterior or posterior)

Management Strategies (practical / lab component)
  • Differentiate Lumbar Spine and Sacro-Iliac Joint
    • Identify which is primary and which is secondary if both regions are contribution to dysfunction and pain
  • Assess and correct different positional restrictions
    • Manual techniques to mobilise the diagnosed dysfunctions are detailed
    • Myofascial and articular techniques
    • Demonstration and practice

Mobilise Restriction Dysfunctions: (practical / lab component)
  • Assess and correct different positional restrictions (continued)
    • Manual techniques to mobilise the diagnosed dysfunctions are detailed
    • Myofascial and articular techniques
    • Demonstration and practice

Exercise to maintain normal movement (practical / lab component)
  • Develop exercise options to maintain mobility of the specific restrictions that have been mobilised
Tests of Sacro-Iliac Motion Hypermobility
  • Arthro-kinematic Tests:
    • Hypo-mobile vs. hyper-mobile articular glides
    • Articular Glide palpation
      • Short arm glides
      • Long arm glides
      • Innominate anterior rotation (coupled glide testing)
    • Pubic symphysis instability

Sacro-Iliac Complex Stability Dysfunction
  • Signs & symptoms of instability
  • The Deep Lumbo-Pelvic Core Cylinder
    • Lumbo-pelvic local muscle review

Identification of optimal recruitment for the local stability muscle system
  • Transversus Abdominis
  • Pelvic Floor
  • Posterior Fascicles Psoas Major
  • Deep Sacral fibres of Gluteus Maximus
  • Segmental Lumbar Multifidus
  • Diaphragm dissociation

Tests of Sacro-Iliac Joint Self-Locking Functional Instability
  • Open chain functional tests (non-weight-bearing)
  • Closed chain functional tests (weight-bearing)
  • Self-Locking Re-stabilisation:
  • Clinical reasoning framework
  • Matching local stabiliser recruitment to optimal self-locking re-stabilisation
  • Matching local stabiliser recruitment to optimal re-stabilisation of articular glide hypermobility

Global Control of Site & direction of uncontrolled motion Direction Dissociation
  • Flexion
  • Extension
  • Rotation
  • Lateral flexion / shift
  • Functional

Global Stabiliser Control of Specific Uncontrolled Motion
  • Retrain Global Stabiliser muscles:
    • Gluteus Maximus, Gluteus Medius, Gluteus Medius, Lateral Abdominals, Iliacus,
  • Anterior Psoas, Stabilising Adductors
  • To Stabilise Specific SIJ Uncontrolled Motion
    • Sacral, innominate and pubic compensations

Control of Mobiliser Extensibility
  • Lengthen, inhibit & regain extensibility of the short or overactive global mobility muscles:
    • Quadratus Lumborum, Tensor Fascia Latae and the Ilio-tibial band, Piriformis, Iliocostalis, Latissimus Dorsi, Rectus Femoris, Hamstrings

Integration and progression of retraining of Local and Global stability systems

Course Highlights

  • Identify uncontrolled movement at the SIJ
  • Use of palpation assessment to test for uncontrolled hypermobility
  • Identify and retrain motor control dysfunction in the local muscle system of or the pelvic joints
  • Design specific individual retraining programmes

 

Testimonials

'An excellent functional assessment..'

'The SIJ is no longer a mystery.'

Kinetic Control courses are designed for medical health professionals such as physiotherapists, osteopaths, chiropractors, podiatrists etc registered with the HPC. In exceptional circumstances experienced non medical health professionals may be allowed to attend Kinetic Control courses but these participants MUST be able demonstrate that the course material is within their scope of practice and that they have appropriate professional liability insurance to cover them for their attendance at the course and the course content.

This course has both theortical and practical elements. Please come prepared for the practical work.