Great case study this weekend at the Hesch Method seminar in Las Vegas where I had the opportunity to assist Jerry teach. I’m just hoping what gets taught in Vegas does not stay in Vegas. :). One of the students presented with what Jerry Hesch calls a “posterior sacrum”. A posterior sacrum is defined as a dysfunction in which the entire sacrum is stuck in a posterior glide between the ilia and bilateral sacral sulci are shallow. When trying to spring the sacrum and ilium all motions are blocked and both sacrospinous and sacrotuberous ligaments are taut to palpation. This dysfunction can cause havoc up the kinetic chain up to the occiput. The mostly likely cause of this non-physiological dysfunction is some sort of trauma such as landing on the buttocks. A common complaint by the patient is increased fatigue, headaches and increased urinary frequency. This weekend one of the students had this seemingly rare dysfunction with these same complaints. She was used as a case study using the Hesch Method which consisted of gentle mobilizations which were performed both manually and with the use of props to enhance soft tissue mobility based on the the principle of viscoelastic creep. The treatment took a total of about 15 minutes and consisted of 5 different mobilizations to correct the dysfunction and associated mobility restrictions and the student got off the table and stated how loose and mobile she felt. She was given a home exercise program to follow and will report back to us on her progress.
The main purpose of this short article is to share with you another tool that can help you with those hard to figure out and often frustrating cases. For more information go http://www.heschinstitute.com or check out Jerry’s many videos on YouTube (search JerryHesch)
I am honored to be one of four physical therapists to be interviewed by Dr. Perry Nickelston on the use of David Weinstock’s approach called Neurokinetic Therapy and what it has meant to me as a clinician . Please check it out at http://painlasercenter.com/Downloads.html.
I thought you might appreciate this paraphrased statement by Sally Goddard in “Reflexes Learning and Behavior” and whyI think PRRT (Primal Reflex Release Technique) is such an important part of the entire picture and complements the NKT (Neurokinetic Therapy) and SFMA (Selective Functional Movement Assessment ) approaches,… Continue reading “Importance of Primal Reflexes in Rehab” →
Loss of ankle dorsiflexion (DF) is seen in the clinic on a daily basis. Lack of proper ankle DF can lead to compensations all the way up the kinetic chain. A good article to read on the importance of normal ankle mobility can be found on Eric Cressey’s web site. The primary motion of DF comes for the talocrural joint (TCJ) (the joint between the talus and the tibia). DF can become limited by decreased muscle length of the plantar flexors of the ankle and/or due to the lack mobility of the ankle joint itself (also called joint play). In order to regain normal range of motion, both of these must be addressed. The joint play that is most needed for full ankle DF at the TCJ is posterior glide of the talus on the tibia. After being mobilized in the clinic the patients need to be able to follow up at home to maintain the gains made. The following exercise addresses the muscle stretching and joint play components necessary to regain full ankle DF. It will help the patient mobilize their talus posteriorly as they are dorsiflexing, simulating the mobilization performed in the clinic.
Step1 : Tie a piece of theraband around a non-movebale object
step 2: Face away from the object and place the band around the front surface of the talus.
step 3: step away from the object until there is a moderate amount of tension pulling on the talus
step 4: with a majority of your weight on the leg to be mobilized, perform a forward movement of your knee while keeping your entire involved foot on the ground.
Step 5: Hold for 3 seconds and repeat this 30 times.
This is another great video by John Iams performing PRRT on a patient. I integrate this work with NKT (Neurokinetic Therapy ) SFMA (Selective Functional Movement Assessment) and manual therapy. The combination of these techniques/approaches allows me to be thorough and address all components of the pain puzzle. Enjoy!
Check out this great video showing a case study where John Iams (the developer of PRRT) shows how he uses this technique with a patient who presents with a very common presentation. The main thing to remember is PRRT is just one tool you can use to solve the pain puzzle and is easily integrated into other systems. Check back shortly for more info. I hope you enjoy the video..
I can still remember seeing a YouTube video done by John Iams on Primal Reflex Release Technique (PRRT) and saying to myself “this stuff is weird and I could never imagine doing that to my patients”…… Continue reading “Primal Reflex Release Technique?” →
This is a great video of David teaching NKT. I had the opportunity to assist him while he taught in NYC a few months ago and utilize his work on a daily basis in the clinic. Enjoy.. check out this video..