Category: Techniques

What the heck is a posterior sacrum ?

Published on by Robert Shapiro PTLeave a comment

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)

The Hesch Method Revisited

Published on by Robert Shapiro PTLeave a comment

I had always found the sacroiliac joint (SIJ) to be confusing and frustrating to treat. For a long time I just ignored it because I didn’t want to deal with all the crazy tests and rules. In 2006 this all changed for me.

Continue reading “The Hesch Method Revisited” →

Importance of Primal Reflexes in Rehab

Published on by Robert Shapiro PTLeave a comment

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” →

Great Home Exercise to Increase Ankle Dorsiflexion

Published on by Robert Shapiro PT1 Comment

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.

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Another great Primal Reflex Release case study

Published on by Robert Shapiro PTLeave a comment

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!

 

http://www.youtube.com/watch?v=NPuoO6VyqSY

Great Primal Reflex Release Technique case study link.

Published on by Robert Shapiro PTLeave a comment

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..