Sam Visnic - Endyourbackpainnow.com

How To Resolve Chronic Sacroiliac Joint Pain
Applying movement-based solutions for long term relief
with Sam Visnic
Neuromuscular Massage and
Corrective Exercise Therapist
Tuesday, January 7, 14
Here’s what you’ll learn...
• How to identify potential sacroiliac joint problems
• Most common SIJ tests and their usefulness
• The simple SIJ correction technique that works in MOST cases, and takes
only moments to perform
• How focusing on JUST the sacroiliac joints may cause you waste valuable
time at resolving the root cause
• A corrective program blueprint to address muscle imbalances and
instability
• Q + A at the end
Tuesday, January 7, 14
Disclaimer!
This is an educational webinar ONLY. It is not
meant to diagnose and/or treat any conditions,
nor does it substitute as medical care. Always
seek the advice of your medical doctor before
beginning any exercise or nutrition program. In
other words, make good decisions.
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Why should you listen to me?
A-List Celebrities
Weekend Warriors
Tuesday, January 7, 14
Elite Athletes
with Sam Visnic
Neuromuscular Massage Therapist
Corrective Exercise Therapist
Nutritionist
SIJ Pain?
•Tenderness directly over
the bony protrusions at
the lowest part of back
(PSIS)
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
SIJ Pain?
•Band across lower back and upper glutes
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Referred Pain?
• SIJ issues can also include a disc
component
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Medical Testing
•Difficult!
•Visual diagnosBcs
•ProvocaBon (uncommon)
•InjecBon of pain killers
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
“Less than 15% of LBP patients can be
given a precise
patho-anatomical diagnosis.”
-Craig Liebenson, DC
Tuesday, January 7, 14
Meaning that over 85% of common lower
back pain is
“non-specific!”
Tuesday, January 7, 14
Why the emphasis on visual tests?
• The false-positive rate for identifying clinically significant
herniated disc or degenerative conditions with imaging is
so high as to make the tests clinically inappropriate as
screening procedures.
• The fact that advanced imaging modalities show that a
large percent of asymptomatic individuals have herniated
discs means that their presence in symptomatic
individuals is often coincidental.
Craig Leibenson
Tuesday, January 7, 14
Why the emphasis on visual tests?
• In my opinion, disc involvement is over-exaggerated, and most lower
back pain involves functional imbalances in the locomotor system.
Karel Lewit
Tuesday, January 7, 14
Why the emphasis on visual tests?
• Diagnosis of sacroiliac joint problems is just as much, if not greater a
problem!
• It appears that a combination of tests helps determine where the
problem may be
Tuesday, January 7, 14
Joint Tests: Best of 5?
• Gaenslen
• FABER test
• ASIS distraction
• Side-lying sacral compression
• Femoral shear test
• TIME is an issue!!
Can find these on Youtube!
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Movement Testing
• Backward bending
• Forward bending
• Sometimes side-bending and/or rotation
• Sitting/standing for long periods of time brings on pain
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Postural Illusions
Elevated RotaBon
ShiNing of the soN Bssues can be tricky! Are the bones really moving?
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Summing Up Joint Testing
• Manual approaches suffer same problems
• Everything is a clue
• Correction confirms diagnosis?
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Richard DonTigny
• Tremendous amount of research
• 650 slides leading to:
• S3 subluxation
www.TheLowBack.com
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Anterior Pelvic Tilt
• Correlated with forward head posture
• Correlated with flat feet or no arches
when standing
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Simple Correction
Generally 10 repe::ons performed for 3 sets each side, in alterna:ng fashion. hQp://endyourbackpainnow.com/blog/cool-­‐gif-­‐image-­‐for-­‐sacroiliac-­‐joint-­‐mobilizaBon-­‐2/
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
Over-Reliance on Manual Therapy
• Magical adjustment or mobilization?
• Instead, use the correction as a “quick fix” to break the pattern, but stop thinking it
is supposed to last!
• Combination with focus on movement as SOON as possible
Copyright Sam Visnic. 2013
Tuesday, January 7, 14
The movement toward movement!
• More and more people are becoming aware of the
correlation between movement and pain
• Lewit calls problem “Functional Pathology Of The
Locomotor System”
Tuesday, January 7, 14
Movement is a complex task...
• Involves multiple muscles working
together as a chain, not in isolated parts
• Efficiency is the name of the game
• Reduce, produce, and distribute forces to
minimize stress
Tuesday, January 7, 14
Muscle Chains = Stability!
Your body works as ONE big funcBonal system! Copyright Sam Visnic. 2013
Tuesday, January 7, 14
When things go wrong...
• Some muscles work more
• Some muscles work less
• = “faults” in the movement chain
• Fatigue, trigger points, tissue overload...
Pain!
Tuesday, January 7, 14
Ever feel pain when...
• Sitting for long period of time
• Standing for long period of time
• As you get into a run, bike ride or physical event
• Key element: TIME
• Correlates with “dull ache”
Tuesday, January 7, 14
Focusing on the wrong area!
If you are constantly focusing on the painful area, you may be
missing the kink in the hose!
Tuesday, January 7, 14
How do we know which kink to fix?
Since we never know HOW important any given kink is, we must
keep peeling away the layers of them until the work “sticks”!
Example: The big toe shoulder problem...
Tuesday, January 7, 14
Kink Tests
Faulty Movement Patterns
• Hip Abduction
• Hip Extension
• Trunk Curl
• Shoulder Abduction
• Cervical Flexion
• Respiration
Tuesday, January 7, 14
How to fix faulty patterns:
The Corrective Blueprint
• Relax the tight and overworked
• Strengthen the weakened and under-active
Tuesday, January 7, 14
Example: Faulty Hip Extension
Tight
• Hip flexors (Hip Flexors and
Quadriceps)
• Calves
• Groin
Tuesday, January 7, 14
Weak
• Glutes
• Hamstrings
• Abdominals
Example: Faulty Hip Extension
Weak
• Glutes
• Hamstrings
• Abdominals
Tuesday, January 7, 14
Example: Faulty Hip Extension
Tight
• Hip flexors (Hip Flexors and
Quadriceps)
• Calves
• Groin
Tuesday, January 7, 14
A pattern is essentially a Habit!
How do you break a habit?
• Interrupt
• Choose new pattern
• Repeat over and over again until it becomes subconscious
Tuesday, January 7, 14
How long does it take
The thing we hate...Patience
• Creating a pattern can take as little as a few hundreds repetitions
• Re-patterning can take THOUSANDS of repetitions!
• Not necessarily the SAME exercise, but same pattern of activation
Tuesday, January 7, 14
Junk in = Junk out
You must do your corrective work with super high degree
of precision or it may not produce an ideal outcome.
Tuesday, January 7, 14
What happens
• Coordination occurs rather quickly and produces MOST of the
initial results
• Metabolic changes occur over weeks and weeks
• Pain relief, however, can occur quite rapidly
Tuesday, January 7, 14
Blocking factors to success
• Lifestyle; ergonomics, bending and lifting, sleeping postures
• Diet; don’t discount the influence of biochemistry
Tuesday, January 7, 14
Do you see how powerful the process of
addressing SIJ pain with a movementbased approach can be?
Tuesday, January 7, 14
Visit:
http://www.endyourbackpainnow.com
to learn more about the Back
To Stability Program
Tuesday, January 7, 14