Research Corner - Q&A Upslip Downslip Hip by Anthony Carey | Date Released : 26 Apr 2005 0 comments Print Close Question: Please tell me a protocol for "upslip downslip" for the hip. It could be called the Hesch Method that deals with Sacroiliac Joint Dysfunction? It is a protocol used for hip dysplasia. Answer: There are many techniques used by physical therapists and chiropractors for upslips or downslips of the sacroiliac joint as well as the numerous other dysfunctions the S.I. joint can experience. The Hesch Method, developed by Jerry Hesch, a prominent physical therapist in Nevada, is only one of those techniques. “Protocol” implies a distinct linear process (i.e., “first this, then that…”) when addressing the S.I. joint. With the varying techniques used, there is no one protocol. All the techniques I am aware of require an extensive knowledge of the anatomy and biomechanics of the S.I. joint. Upslip refers to upward movement of one of the innominates relative to the sacrum. A downslip is just the opposite. Both can cause fixation of the S.I. joint and adversely affect the kinetic chain above and below. Hip dysplasia applies to improper articulation in the actual hip joint and involves the acetabulum, femoral head, articulating cartilage and labrum. Because this is a personal training and fitness web site, I think it is best we approach your question from what the exercise specialist can do with exercise to help stabilize a client’s S.I. joint. We always want to remain within our scope of practice. Any change in the S.I. joint will most often lead to additional changes in the pubis symphysis and the entire pelvic ring. Ideally your client is or has been treated by the appropriate professional. An appropriate corrective exercise program can help stabilize the work of the treating professional. Depending on how long the individual has experienced the upslip, it may be necessary to address secondary postural changes. If, for example, the right side has the upslip, there is a frontal plane deviation of the pelvis and the lumbar spine. The lumbar spine will move in the opposite direction from the upslip and correct itself around the thoracolumbar junction. This creates lateral flexion of the spine to the right. If the treating professional corrects the upslip manually, there still may be adaptations in length and tension of the trunk muscles. Key muscle groups that act on and help align the S.I. joint are the hip abductors. Isometric contractions of the hip adductors with the knees hip width and the client either supine hook lying or sitting with a neutral pelvis can often positively affect the S.I. joint. Key muscle groups that act on and help align the pubis symphysis are the hip adductors. Isometric contractions of the hip adductors with the knees hip width and the client either supine hook lying or sitting with a neutral pelvis can often positively affect the pubis symphysis. Back to top About the author: Anthony Carey Anthony Carey M.A., CSCS, MES is PFP Magazine’s 2009 Personal Trainer of the Year and owner of Function First in San Diego, California and an international presenter on biomechanics, corrective exercise, functional anatomy and motor control and their relationships to pain and function. Anthony has developed the Pain Free Movement Specialist certification and is the inventor of the Core-Tex®. 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