Monday, December 8, 2008

The sacrum is the lower extremity scapula

What do you think of this idea? It came to mind as I was working with my hip impingement/lumbar spine pain athlete. He has iliosacral/sacroiliac issues. I'm doing MET to correct them, but knowing damn well it is only temporary.
Ben Kibler MD came up with the "scapular funnel" concept of the upper extemity. That is, the scapula transmits forces coming through the lower extremity & torso to the ipsilateral arm. But, it's reactions are only as good as the information coming in. In the computer industry they call it "garbage in/garbage out".
I think the same might be said of the sacrum. As in the scapula, dysfunctions in the IS/SI joint doesn't always manifest itself in pain directly on the joint. I've seen in the literature stress fx's of the sacrum in distance runners, which might back up my hypothesis.
The big researchers on this joint are Kaltenborn, Vleeming, and Schneiders. It's interesting stuff.


Joe Przytula said...

Responding to my own post here. Just read a piece by Marty Lambert, a manual P.T. from NY describing the innominates as the lower extremity scapulae. Along the same lines, and more food for thought.

JH said...


Think of it this way, still using the electronic analogy, the pelvis acts in more than one way. not only is it a relay of a "signal" if you will, but it also the tranformer of signals as well. Say for example that the knee/ankle/foot require more juice, however that juice may eitehr be balance, or strength or perhaps a combo of several signals which is more the case. The pelvis is the flux capacitor of the body tranferring and transforming force to and from the upper and lower body and tranlating which part needs what.

Does that make any sense to anyone but me?

PS Congrats on the 10,000...5,000 are mine (not really)

Brian said...

Hey Joe...! What are your thoughts on muscle energy techniques in managing something like this vs. traditional mobs/manipulations?

Jerimiah said...

Your absolutely right on about the power transfer, and the difference in mobility is reflective of the amount of power transfered and the stability required. The shoulder is more about mobility than stability and the hip is more about stability than mobility.