Comprehensive Stabilization Strategies for the Low Back

Comprehensive Stabilization Strategies for the
Low Back, Pelvis & Hips

Teaching Postural Control & Optimal Movement Skills

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Course Description

In this fun and interactive movement lab course we will observe, analyze and participate in movement based exercises while learning new treatment strategies designed for immediate clinical application. This approach goes beyond strengthening the muscles to teaching integrated movement patterns that simultaneously elicit core muscle activation, stretch and strengthen relevant hip muscles, facilitate proprioceptive self-awareness, postural control and body mechanics optimization. Since recent Regional Interdependence research has shown a clear correlation between hip limitation and low back pain, we know the hips need to be mobilized in one or more directions to reduce lumbar hypermobility stresses. But sometimes the hips themselves are unstable; people with trochanteric pain syndrome, femuro-acetabular impingements, hip replacements and damaged labrums need to learn stabilization. Considering the complex regional inter-relationships in this area and the repetitive and unconscious nature of human movement, muscle strengthening alone does not guarantee stability. Nor does it force a change in the habitual and suboptimal movement and postural patterns that created the instability in the first place. Carrying forward aspects of current stabilization principles but progressing to something both more informative and functional, we can borrow from selected aspects of dynamically integrated movement systems to improve patient compliance, outcomes and extrapolation to daily activities. Connecting the dots between exercise and ADLs is imperative for long lasting results. Come experience a refreshing new perspective, you will never see movement and exercise the same way again!

Course Objectives

By the completion of this course, the participant will be able to:

• Define Regional Interdependence & Specificity Principle
• List three primary differences between Static Integration & Dynamic Integration based exercise
• Define the difference between Global & Differentiated movement or postural patterns and list two examples of each in the low back/hip region
• List three principles of Optimal Movement and give examples of common hip/lumbar injuries resulting from sub-optimal movement
• Define a Pelvic Force Couple and list the relevant pairs of muscle synergists
• Explain how teaching techniques make exercise more “informational”; reciprocating movements, use of constraints, change of venue, goldilocks principle and link to functional context

Course Outline

Lab sessions include experiential movement, partner observation, facilitation techniques, modifications & discussion of clinical relevance.

Day 1

7:45-8:00—Registration & Snacks

8:00-9:30—Introduction to Integrated Movement Principles

• Exercise Paradigms: Isolate or Integrate?
• Types of Integrated Movement/Exercise: Static & Dynamic
• Principles of Optimal Movement/Posture

9:30-9:45—Morning Break

9:45-12:00—Lab I: Lumbo-Pelvic AP Relationships (1st Approximation)

• Determining Habitual & Non-Habitual Differentiation Patterns
• Hip Extensor/Abdominal & Hip Flexor/Back Extensor Synergies
• Facilitating Patient Perception: Find & Maintain AP Neutral Spine

12:00-1:00—Lunch on your own

1:00-3:00—Lab II: Lumbo-Pelvic Rotational Relationships (1st Approximation)

• Mobilizing Hip IR/ER: Stabilizing Pelvis & Low Back Rotationally
• Functional Training of Hip Rotators, Adductors & Gluteus Medius
• Reciprocating Movements: Balancing Antagonists & Re-Calibrating Neutral

3:00-3:15—Afternoon Break

3:15-5:30—Lab III: Lumbo-Pelvic AP Relationships (2nd Approximation)

• Mobilize Thoracic/Stabilize Lumbar: Funneling Movement Where We Want It
• Applying Constraints & Changing Venues: Targeted Thoracic Activation
• Facilitating Even Distribution of Movement & Proportional Use of Synergists

Day 2

8:00-9:45—Lab IV: Lumbo-Pelvic Rotational Relationships (2nd Approximation)

• Adding Resistance: Facilitating Core Awareness & Control
• Coordinating 3 Layers of Stability: Intersegmental, Waist & Pelvis
• Patient Pattern Recognition & Problem Solving: Creating Progressions

9:45-10:00—Morning Break

10:00-12:00—Lab V: Lumbo-Pelvic AP Relationships (3rd Approximation)

• Functionalizing Exercise: Sit, Stand, Bend, WIFS
• Making Better Movement Choices: Introducing Deliberate Mistakes

12:00-1:00—Lunch on your own

1:00-3:15—Lab VI: Multi-Planar Hips (Diagonals, Force Couples & 3D Hips)

• Defining & Training Pelvic Force Couples
• Unilateral Hip Flexor & Hip Extensor Use: Balancing L/R
• Stabilizing the Hips: Trochanteric Pain, FAI, Labral Issues & Piriformis

3:15-3:30—Afternoon Break

3:30-5:30—Lab VII: Gait Considerations & Wrap UP

• Common Gait Types: Rotational, Lateral Shear & Heavy-Footed
• Pelvic Force Couple Gait Pattern: Advantages & Drills
• Research, Review & Questions

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