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The Joint by Joint Approach Marc Heller, DC

The Joint by Joint Approach Marc Heller, DC. With thanks to Mike Boyle, who coined the term http://www.strengthcoach.com/public/1282.cfm Stability- for LB and Pelvis Mobility- for Thoracics and Hip. 1. More on the joint by joint. The thoracics are built for stability

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The Joint by Joint Approach Marc Heller, DC

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  1. The Joint by Joint ApproachMarc Heller, DC With thanks to Mike Boyle, who coined the term http://www.strengthcoach.com/public/1282.cfm Stability- for LB and Pelvis Mobility- for Thoracics and Hip 1

  2. More on the joint by joint The thoracics are built for stability Connections to rib cage Tendency to get stiff Neither chest breathers or belly breathers move the lower thoracics 2

  3. Lumbar and PelvisTendencies toward excess mobility Designed as a hinge, between trunk and legs In females, designed to open for childbirth In hypermobile people After injury, structures that do not heal 3

  4. The brilliance of the joint by joint approach See the big picture Recognize what areas, in general Need more flexibility Which need more stability 4

  5. Does this mean I should not mobilize the lower back, should not release low back muscles NO, this is not a rule It is a guide Be more selective Be aware of the general tendencies 5

  6. Why Low Force?What is Low Force? An attitude, just enough pressure Getting more information from a lighter touch A Safer way to mobilize Don’t upregulate the pain receptors Don’t startle 6

  7. Pain creates Inhibition Pain (any pain) causes profound inhibition of stabilizers transverse abs, multif, psoas, pelvic floor And Gluteus medius and Gluteus Maximus Weakness and timing delay 7

  8. What do the stabilizers do? The stabilizers are small muscles, Connecting individual joints Centrally located in the trunk (primarily) They control small motions They have precise innervation They are designed to be able to activate for longer periods. 8

  9. Pain Inhibition Instability The vicious cycle of pain 9

  10. Vicious cycle Pain- creates inhibition of stabilizers Inhibition allows excessive movement (Especially at weak links, pain sites) Excessive movement stresses weak links And creates pain 10

  11. Muscular Patterns- hypo Multifidi, psoas, (plus transverse abs, pelvic floor, deep sacral gluts) Loss of stabilizer function 11

  12. Muscular Patterns- hypo- hip Hip stabilizers that get inhibited In frontal plane, gluteus medius In saggital plane, gluteus maximus And psoas- as both a stabilizer and as a hip flexor 12

  13. Muscular patterns- Hyper What happens in dysfunction and pain Hypertonic, erector spinae Bulk at T-L junction Hypertonic- rectus femoris and TFL 13

  14. Mobility vs Stability theme Thoracics and TL need more mobility Lumbars and Pelvis need more stability In LB pain, vicious cycle Of rigidity in wrong places Loss of stability, excessive movement at the weak links (but the patient experiences stiffness) 14

  15. And on we go • The rest of the class goes into the details, • Where and how to mobilize • How to train for basic stabilization • Management of discogenic and SI pain • How to mobilize SI and the facet joints, and decompress the disc • How to assess and mobilize the hip joint

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