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Sacroiliac Joint Dysfunction And Lumbopelvic Pathomechanics

The Hesch Method is an innovative approach, making the complexities of the pelvis and sacroiliac understandable with a relevant, clinical useful approach. 

SIJD is fraught with confusion and misunderstanding.  Yet 25-30% of the back pain population is reported to have a component of SIJD.  Evaluation and treatment needs to evolve with the science and research.

This method, a unique subset of Orthopedic Manual Therapy, presents a new approach to evaluation and treatment, in which spring tests are enhanced to a kinesthetic skill known as“Springing with Awareness´╗┐TM´╗┐”. The practitioner can thoroughly assess the lumbopelvic structure in all planes of the body, thus demystifying complex pathomechanics. Treatment using gentle, low-load, long-duration input goes beyond brief elastic deformation into long lasting (plastic) reorganization of dense connective tissue. This facilitates efficient neuromotor reprogramming.

Our goal is to make it easy for you to apply this material in the clinic for effective, efficient patient care. By using this approach, most simple and complex pelvic and sacroiliac joint dysfunctions are resolved in one to three visits. Clinicians are then free to address other issues such as strengthening, spinal stabilization, etc. Furthermore, this approach is very logical and very easy on the clinician and the client. We do not use long levers or grade 5 manipulation. Application of Hesch Method has been clinically proven to contribute to positive patient outcome in cases of pelvic and sacroiliac dysfunction.

Several Independent studies and a research thesis demonstrated that brief Hesch Method treatment results in significant pain relief and increased SLR. Multiple studies showed poor to fair inter-tester reliability of palpation & movement tests, whereas this approach has moderate intertester reliability. This approach is very efficient and by the third visit the pattern resolution is stable and is easily maintained such that focus can then be directed on overall rehabilitation with much greater efficiency.

Who should attend?
Physical Therapists, Manual therapists, Chiropractors, Osteopath's.

Course Outline:


8:00am            Registration

8:30am            Intro, anatomy, joint mechanics, research, outcome studies,historical perspective

10:30am          Break

10:45am          Pelvic Side Glide and Posterior Glide Fixation Hip

11:15am          Most Common Pattern, theory

12:00am          Palpation & spring testing on anatomical models

12:30pm          Lunch 

13:15pm          Palpation & spring testing on lab partners*

15:15pm          Break

15:30pm         Treatment lab*, Q & A

17:30pm          End


8:00am            Lab review Most Common Pattern

9:30am            Signs, symptoms, indications & contraindications

10:00am          Break

10:15am          Demystifying Sacral Torsion theory & lab*

11:00am          Upslip, Downslip Ilium and symphysis pubis, lab*

12:00am          Lunch 

12:45pm          Q & A, Lumbosacral mechanics: theory & lab*

13:45pm          Second Most Common Pattern: theory & lab*

14:45pm          Break

15:00pm          Integrating exercise paradigms, patient self-care and education, proper body mechanics

15:45pm           Detailed review of Most Common Pattern

16:15pm           Efficiently integrating Hesch Method in the clinic

17:00pm           End and Q&A

Upon completing this course, participants will be able to:

  • Analyze the significant limitations of the symmetrical/asymmetrical and alignment theory of SIJD
  •  Discuss studies which undergird this method
  •  Identify distal compensations within a whole-body perspective
  •  Describe joint, neuromuscular, posture and movement models
  •  Proficiently perform palpation and spring testing and treat hypomobility and hypermobility
  • Using Clinical Prediction Rules, competently evaluate and treat common patterns of symmetrical and asymmetrical  dysfunction and prescribe effective exercise, and self-care
  • Competently address pathomechanics of the entire pelvis as separate and distinct from the sacroiliac joint .


“In 8 years of practice I took 3 SI courses but never felt comfortable enough to properly assess & treat SIJD. I’m very comfortable & confident treating SIJ now!” Ridhima Wason, DPT, Indianapolis, IN

"Much less confusing than the traditional and muscle energy model. I can apply it right away in the clinic and quickly achieve lasting change.” John Bolin, San Diego, CA

“I’ve had nothing but positive feedback. All of the therapists tried it and were so excited that it actually made sense and seemed to just make everything about the patient’s problems CLICK.” Jill Irion, PT Supervisor, Norwalk, OH



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