Course description
Do you see patients with recurrent problems and, in the face of limited evidence, question if you are being the most effective you can be in your approach to treatment?
Do you know how to determine if the thorax, lumbar spine and/or pelvis (essentially the trunk) is playing a role in the clinical presentation and if so what to do or where to begin treatment?
Increasingly, scientific evidence suggests that function of the pelvis is essential for the performance of almost every task. However, how do we know if the loss of pelvic function is the cause of the patient’s primary complaint (the criminal) or merely the victim of an impairment elsewhere. The restoration of function and performance depends on being able to identify and treat the underlying source of the problem and it is common to find the pelvis as the criminal in some cases and the victim in others. Do you have a way of knowing when to treat the pelvis and when to look elsewhere?
This course will introduce how The Integrated Systems Model for
Pain & Disability (ISM - Lee & Lee) (Lee D 2011 The Pelvic Girdle) facilitates the understanding and interpretation of each patient’s unique clinical picture to determine:
1.
How to develop an assessment that ‘cuts to the chase’ choosing only meaningful tasks/tests that pertain to the story being told. All stories are unique; there are no protocols or recipes in the ISM approach for any impairment or pain pattern.
2.
Where the criminal is i.e. the Primary Driver. When there are multiple regions that are impaired, how do you determine which one should be the focus of your intervention? Is this a hip problem that is causing the pelvic joints to lose control and become painful (or alternately a thorax or foot problem), or is the impairment intrinsic to the pelvis itself (i.e. stiff SIJ or altered motor control of pelvic floor/transversus abdominis – a pelvic driven pelvis)?
3.
When to choose specific system tests (articular, neural, myofascial, visceral, physiological etc) to further identify the cause and effect of various impairments

within and between regions of the body so you are able to ‘do the right thing at the right time’.
Clinical reasoning of multiple findings and manual and visual assessment and treatment skills are emphasized in this course with plenty of practical time/discussion devoted to these two clinical practice tools.
At the conclusion of this course, you will have new skills to assess function of the trunk
(from the 3rd thoracic ring to the hips) and how various impairments impact function of the pelvis as well as skills to perform segmental thoracic, pelvic and hip analysis for mobility and control. You will understand how to design a multimodal treatment program (including education, manual therapy, neuromuscular release, and movement training) to restore function and performance for any patient (from postpartum moms to elite level athletes) since the principles of the ISM approach are applicable to all groups of patients.
Objectives & Learning Outcomes
1.
Illustrate how the Integrated Systems Model provides a framework to find the underlying driver for the patient's problem - whether this is pain, loss of stability, loss of performance, or other disability.
2.
Demonstrate and practice some key clinical tests for the pelvis, hip and thorax to determine whether or not a patient is using an optimal strategy for function & performance for their chosen task and when there are multiple sites of impairment, how to determine the ‘primary driver’ or impairment to be addressed first.
3.
Discuss the clinical reasoning process required to determine if the pelvis, hip or thorax is the primary driver for loss of optimal function (develop reflection skills).
4.
Demonstrate and practice key clinical tests for the articular, neural, and myofascial systems pertaining to the determined primary driver (thorax, pelvis, hip).
5.
Discuss the clinical reasoning process for the development of a prescriptive treatment program that targets interventions to various system impairments pertaining to the primary driver.
6.
Demonstrate and practice treatment techniques and movement training to release, align, connect & move the trunk/hips for restoration of better strategies for function & performance.