Sam Visnic - Endyourbackpainnow.com
Transcription
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