Joint Mobilization: Lumbar Spine and Sacroiliac Joint

Introduction

This course describes joint mobilizations for the lumbar spine and sacroiliac joints (SIJ). Several terms and definitions have been used to describe the "mobilizations" (e.g. mobilisations) that are taught in this course. The Brookbush Institute uses a conventional definition of "mobilization" that includes low amplitude, low-velocity, oscillatory techniques intended to reduce the stiffness of joints exhibiting a decrease in passive accessory range of motion (a.k.a. arthrokinematic motion and specifically glide or slide). Note, the term "manipulation" is reserved for high-velocity techniques taught in a separate set of courses. Further, the types of mobilizations taught in this course are posterior to anterior (PA) and include both unilateral posterior to anterior (UPA) mobilizations directing force over facet joints, and central posterior to anterior (CPA) mobilizations directing force over the spinous process. These mobilization techniques likely represent the most commonly recommended techniques due in part to their relatively high reliability and efficacy.

This course includes mobilization techniques that intend to improve excessive stiffness of the lumbar spine and SI joint, improve restrictions in spine range of motion (ROM), and reduce pelvic asymmetry. For example, research has demonstrated that the SIJ may be the origin of approximately 15% of low back pain cases, asymmetrical stiffness the most common sacroiliac joint dysfunction, and mobilization of the stiff side an effective method for improving pain, function, and symmetry. These techniques may also be used in an integrated approach for lower extremity dysfunctions (LED) and lumbopelvic hip complex dysfunctions (LPHCD) including chronic low back pain, acute low back pain, hamstring tendinopathy, groin pain, hip impingement syndrome, patellofemoral pain syndrome (PFPS), and postural dysfunctions including knee valgus, knee varus, excessive forward lean, anterior pelvic tilt, and/or asymmetrical weight shift. Some research and clinical outcomes even suggest that addressing lumbo pelvic hip complex dysfunctions (LPHCD) may reduce the risk of future lower extremity injury.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) with the intent of developing an evidence-based, systematic, integrated, patient-centered, and outcome-driven approach.

Techniques Covered in this Course:

• Lumbar Mobilization
• Sacroiliac Joint Mobilization

Sample Intervention (Example, Anterior Pelvic Tilt )

• Manual Release
  • Tensor Fascia Latae (TFL) and Gluteus Minimus Static Manual Release
  • Rectus Femoris Static Manual Release
  • Psoas and Iliacus Static Manual Release
  • Erector Spinae and Multifidus Static Manual Release
• Mobilization or Manipulation
  • Lumbar Mobilization
  • Sacroiliac Joint Mobilization
• Manual Lengthening
  • Thomas Test Hip Flexor Stretch
• Activation
  • Gluteus Maximus Activation
  • Gluteus Medius Activation
  • Transverse Abdominis Activation
• Integration
  • Static Lunge to Unilateral Row

Related Courses

Additional Joint Mobilization Courses

• Joint Mobilizations: Ankle and Tibiofibular Joints
• Joint Mobilizations: Knee and Hip Joints
• Joint Mobilizations: Lumbar Spine and Sacroiliac Joints
• Joint Mobilizations: Cervical and Thoracic Spine
• Joint Mobilizations: Shoulder, Sternoclavicular, and Acromioclavicular Joints
• Joint Mobilizations: Elbow and Proximal Radioulnar Joints

For an introduction to joint mobilizations and manipulations:

• Joint Mobilization and Manipulation: Introduction
• Joint Mobilization and Manipulation: Reliability
• Joint Mobilizations and Manipulations: Effects
• Joint Mobilization and Manipulation: Risk of Adverse Effects
• Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning