The Combined Approach to the Sacroiliac Joint

Scheduled Courses
31 May - 01 Jun 2008 Royal Hallamshire Hospital, Sheffield, South Yorkshire

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14 Jun - 15 Jun 2008 Royal United Hospital, Bath

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28 Jun - 29 Jun 2008 KTB Pilates & Therapy, Dartford, Kent

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13 Sep - 14 Sep 2008 Physio4Life, Putney, London

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Tutor: Howard Turner BSc BAppSc MCSP & Hugh Jenkins BSc (Hons) MCSP
Duration: 2 day(s)

Course Description:

 

Full course outline (PDF) click here

 

The course will cover manipulative, mobilisation and muscle energy techniques and exercise prescription for pelvic motion dysfunction. The course consolidates traditional models of pelvic girdle assessment and treatment with current research and philosophies of management. It aims to provide a straightforward yet comprehensive approach to the wide variety of pelvic disorders that present to manual therapists. Clinical reasoning models that are traditionally osteopathic in nature will be modified and updated to complement contemporary physiotherapy practice. Sacroiliac instability will be discussed in detail in view of current research on the functional anatomy and mechanics of stability of the region.

 

The course has been taught in the UK since 1996 and has been completely rewritten in 2003.

 

Components of the course have been taught on the Masters’ programme at University College London and for the Manipulative Association of Chartered Physiotherapists.

 

Why the SIJ?

It would appear obvious from the anatomy of the region that the sacroiliac joints are of crucial structural importance. The sacrum has been called the keystone of the pelvis and the foundation of the spine. In saying that “…the pelvic girdle is the crossroads of the body, its architectural centre (and) the meeting place of the locomotor apparatus…” Fred Mitchell, the creator of Muscle Energy Technique, expressed the importance of their function in interposing the forces ascending through the lower limbs and descending through the trunk.

Despite these structural relationships, treatment of the pelvis is missing from most undergraduate physiotherapy courses and is considered by some to be unnecessary. This contrasts with many ‘alternative’ approaches that consider pelvic treatment to be of fundamental importance. Research has clarified the situation. It is increasingly evident that the shock absorbing torsional control provided by the sacroiliac joints is vital to the health of the spine and vital to the performance of the stabilising musculature in the surrounding area. The degree of motion may be small, but a disruption of control of that movement can have far-reaching consequences. As well as specific SIJ pain, disorders of the pelvis are clinically related to lumbar mediated pain, to disorders of lower limb rotational control such as patellofemoral pain, ITB and hip problems, tibial and foot pain, and disorders further up the kinetic chain such as shoulder and neck pain.  It may be going to far to insist, as one prominent alternative therapist does, that “…9 out of every 10 cases of back pain are due, without exception, to pelvic misalignment…” but nevertheless it is a fascinating area to understand and a rewarding one to treat. Learning to effectively manage disorders of the pelvis will be a valuable addition to the arsenal of any manual therapist.

Course Objectives

  • To enhance the delegate’s knowledge of sacroiliac biomechanics and pathomechanics in view of current management strategies and recent research findings
  • To enhance delegate’s manual skills in the effective management of sacroiliac dysfunction

 

Upon completion of the course, delegates should be able to perform the following:

  • Assess and interpret pelvic motion patterns
  • Effectively utilise muscle energy techniques, mobilisation and manipulation to optimise pelvic symmetry and motion
  • Effectively manage sacroiliac instability with manual treatment and exercise programmes
  • Integrate management of sacroiliac motion dysfunction with management of adjacent dysfunction
  • Recognise the contribution of SIJ dysfunction to lower limb and other disorders

Day 1

Day 2

 

Introduction/Applied anatomy & biomechanics of the pelvis and pelvic girdle dysfunction

 

Utilising leg length discrepancy to assess the pelvis

 

Utilising leg length discrepancy to treat the pelvis

 

Assessing myofascial disorders of the pelvis – a modified osteopathic model

 

Treatment of myofascial presentations

 

‘Piriformis syndrome’ – a demonstration of useful positional release and taping techniques to complement rehabilitation strategies

 

The biomechanics of pelvic stability and pelvic rehabilitation

 

Functional assessments of stability

 

Assessing intra-articular SIJ dysfunction

 

Passive movement assessment of the SIJ and interpretation

 

Treatment of intra-articular SIJ dysfunction

 

Specific tests of SIJ stability and accelerated rehab 

 

Conclusions and Questions

 

 

Who Can Attend:

This course is suitable for all Manual Therapists and for therapists with a basic knowledge of anatomy & biomechanics.