The role of the pelvis in recurrent groin,knee and hamstring pain & injuries
General Information
This course is limited to physiotherapistsonly (for further information regarding LJ Lee and the Discover courses, please refer to www.discoverphysio.ca )
course description
Low back pain and pelvic girdle pain arecommon in all levels of recreational and elite athletes. So too are lowerextremity injuries such as groin pain, osteitis pubis, clicking hips, recurrentquadriceps and hamstring strains, and ITB syndrome. A challenge for therapistsis that often these problems are recurrent and chronic, and evidence toindicate what the most effective treatment protocol for these injuries is stilllacking. The pelvis is a key area of load transfer between the lower extremityand the spine. Poor control of the joints of the pelvis, suboptimal musclesynergies, and altered alignment have the potential to affect efficiency andlength-tension relationships of all the muscles attaching to the pelvis, andcreate excessive compression and tension loading through various structures ofthe hip and knee. These altered biomechanics can predispose the athlete toinjury in the lower extremity, and if not corrected can precipitate re-injury.Recent research has shown that patients with posterior pelvic girdle pain andfailed load transfer of the pelvis have altered timing and recruitment of thebiceps femoris. Studies have also shown that athletes with groin pain havealterations in timing of the transversus abdominis muscle, one of the keylumbopelvic stabilizer muscles. Clinically, different patterns of asymmetry anddysfunction of the hip and local trunk muscles have been observed in patientswith sacroiliac joint dysfunction and a variety of hip and knee problems.Although further research is still needed, it is apparent that treatment ofchronic, recurrent problems such as groin pain, osteitis pubis, iliotibial bandsyndrome and hamstring strains require a careful assessment of the pelvis, withparticular attention to load transfer tests.
The purpose of this 3-day evidence-basedcourse is to review the recent advances in science and discuss the role of thepelvis in common hip and knee problems. The clinical application for assessmentand treatment will be based the System-based Classification for Failed LoadTransfer (The Puzzle) and an integrated multi-modal approach will be highlighted and used extensively in this course.
Course outline/objectives
Theory to be covered:
* Current evidence on the known biomechanicsof the joints of the pelvic girdle & hip
* Current models of how the joints of thetrunk, pelvis and hips are stabilized during different loading tasks
* Common clinical patterns of altered hip andknee function which occur as a result of failed load transfer (non-optimalstrategies for function & performance) through the pelvis
Practical – Demonstrate and/or Practice:
* Functional tests for load transfer throughthe pelvic girdle, hip and knee (tests to identify non-optimal strategies)
* Joint mobility/stability tests for thesacroiliac joint, pubic symphysis, and hip (articular system tests)
*Tests which analyse recruitment patterningof the deep muscles and recognize common substitution strategies (Real-timeultrasound imaging will be demonstrated for transversus abdominis and thepelvic floor via video clips) (neural system tests)
Clinical Reasoning: Theory & DiscussionPertaining to:
* Common patterns of pelvic dysfunction andhow these patterns relate to lower extremity injuries.
* How to develop a multi-modal treatmentprogram which includes manual therapy, dry needling, education and exercise.How to use taping and external supports of the pelvis during sport to augmenttraining
Practical – Demonstrate and/or Practice:
* Specific mobilization and myofascialrelease techniques for the sacroiliac and hip joints
* Motor control training for the deep muscles– this training uses imagery and touch for facilitation. The focus will be onhow to find the optimal strategy and ensure that this strategy translates intobetter loading and function for the lower extremity
* Specific hip stabilization and exercisesfor motor control to ensure optimal balanced recruitment of the psoas, tensorfascia latae, quadriceps, adductors, and medial/lateral hamstrings duringfunctional activities
* Exercise progressions and key components totake the rehabilitation program from the acute stage to restoring full returnto sport and activity
Register on the waiting list now for your chance to attend this course, and to be the first to know about future courses scheduled.
