Manual Therapy for Lumbar, Sacroiliac, and Pelvic Dysfunctions – Shane Malecha

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Simplify the complexity of low back pain in this hands-on based seminar. Improve your evaluation and treatment skills for the most common lumbar and sacroiliac joint dysfunctions from a manual therapy perspective. Discover a streamlined approach for care of the lower back that is applicable to both acute and chronic conditions using manual techniques such as mobilization and articulation. A brief overview of stabilization exercises will also be covered to ensure long-term effectiveness of the manual corrections. Attendees will be able to immediately utilize these techniques to improve their clinical efficiency.

1. Analyze basic anatomy and the pathomechanics of low back pain
2. Identify the principles of manual therapy for the lower back and SI joints
3. Demonstrate proper manual therapy techniques for a lower back patient
4. Review the most common low back dysfunctions
5. Discuss the appropriate application of “progression of forces” concept
6. Integrate stabilization exercises for maintenance of manual corrections

PRINCIPLES OF ORTHOPEDIC EVALUATION

• Goals of the first visit
• Empathy vs sympathy
• Establishing consistency
• Avoiding clinical blindness
• Who should be referred to therapy
• Red flags
• Keys to subjective and objective evaluations

EPIDEMIOLOGY OF LOW BACK PAIN

• Predisposing factors
• Bony Anatomy of the Lumbar Spine
• Soft tissue anatomy of the Lumbar Spine
  • Ligamentous support
  • Muscular support
  • Intervertebral disc
• Biomechanics of the Lumbar Spine
• Common Diagnoses
  • Degenerative Joint Disease
  • Spondylosis
  • Spondylolysis
  • Spondylolisthesis
  • Disc protrusion
  • Herniated Nucleus Pulposis

EVALUATION OF LUMBAR SPINE DYSFUNCTION

• The key to subjective history
• Posture assessment
  • Sitting, Standing, dynamic, lordosis, lateral shift
• Movement loss
  • How much
  • Quality of the movement
  • Willingness to move
  • Lateral deviation
• Repeated Movements
  • What happens during movement
  • What happens because of the movement
• Static tests
• Neurological
  • Motor/sensory deficit
  • Reflexes
  • Dural signs
• Other considerations
  • Hip/SI joint clearing tests
  • Spondylolisthesis
  • Intermittent claudication tests

TREATMENT OF LUMBAR SPINE DYSFUNCTION

• Treatment of the acute patient
  • Modalities
  • Mid-range movement techniques
• Sub-acute/chronic patient
  • Postural syndrome
  • Dysfunction syndrome
  • Adherent Nerve Root
  • Derangement
• Treatment
  • Reduction
  • Maintain
  • Recovery of function
  • Prevention
• Manual Therapy techniques
  • Prone extension with manual overpressure
  • Prone Lumbar extension mobilization
  • Flexion Rotation mobilization