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Clinical Reasoning in the Examination of the Pelvic Girdle: The “Load Transfer” Test

Posted by Michael Lucido, PT, DPT, OCS, COMT, FAAOMPT on Jan 8, 2019 7:39:54 PM

Low back pain continues to be one of the most difficult maladies of the musculoskeletal system in the modern world. The scientific literature tells us LBP is a heterogeneous entity best treated by recognizing the characteristics of this group as subsets. One of these subsets are people who have pain specifically located at or close to the posterior superior iliac spine (PSIS). This location is also known as “pelvic girdle pain” or “sacroiliac joint pain.”

In NAIOMT's Lumbopelvic Spine II course we teach that the examination of this subset of patients is best performed in weight bearing and non-weight bearing. This assessment is supported by sound biomechanical research suggesting load transfer through the pelvic joints is a dynamic process involving joint reaction forces, joint position, proprioceptive muscle activation, muscle contractions and ligament tension (1).

As musculoskeletal/manual therapist this pattern recognition of “pelvic girdle” pain alters load transfer through the spine, hip and pelvis when asked to perform one legged standing, both on the symptomatic and non-symptomatic side. The effects of over recruitment of the external oblique and the contralateral biceps femoris may “over brace” the pelvic girdle, which may lead to the erroneous assumptions of hypomobility of the pelvic girdle--which is why we teach the biomechanical assessment in non-weight bearing as well. Non weight bearing test gives us a different look at movement while minimizing the compensatory muscle activation patterns.

To learn more, join me in Dallas for our next Lumbopelvic Spine II course on February 22 at Texas Woman’s University. Follow the link below for additional course details and to register. Courses happening in other regions are listed below the video.

Watch the video below where I demonstrate a biomechanical assessment of the Sacroiliac Joint. This technique is taught in the upcoming Lumbopelvic Spine II course.

 

 

 Other Upcoming Lumbopelvic Spine I and II Courses Across the Country

 

Topics: treating lumbar spine

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