Mastering Movement of the Hip and Pelvis
Friday, 09 December 2022 09:00 - 17:00 (GMT)
English National Ballet
Mulryan Centre for Dance
41 Hopewell Square
Do you have a clear understanding of when, why and how to assess and address muscle dysfunction around the hip and pelvis, in order to optimise and expedite patient outcomes
Do you find yourself prescribing the same exercises for every hip & groin pain patient, regardless of their presentation?
Do your patients perform the same program for weeks or months without progressions or an understanding of what they are attempting to achieve and why?
Would you like to have a deeper understanding of muscle function and dysfunction allowing you to optimise outcomes from therapeutic exercise around the hip?
Movement patterning and muscle function around the hip and pelvis are key considerations for any lumbo-pelvic or lower limb problem and may even impact on upper limb function.
Assessment and retraining in this region require a specific and targeted approach that should consider the multifaceted requirements for optimal function and the limitations of an individual’s musculoskeletal system.
With respect to current practices around muscle testing and exercise prescription, often strength is the only consideration. While this is an important consideration, normal results on strength testing may be returned from a muscle synergy within which significant dysfunction exists. If weakness is not the primary deficit, generic strengthening may worsen rather than improve the situation by reinforcing poor recruitment strategies or imbalance in the contribution of muscles within a movement synergy e.g. TFL within the abductor synergy.
In exercise literature, often maximal EMG is the sole indicator used for exercise selection. EMG levels are not reflective of force generation and high levels of EMG may simply reflect active insufficiency where the muscle is not at an optimal range to generate force efficiently. This premise also assumes that maximal recruitment is optimal for muscle retraining and musculoskeletal health. While higher EMG levels may be required for enhancing strength or more particularly for hypertrophy, other factors should be considered.
Choosing an exercise with highest %MVC may not be in the best interests of achieving optimal or pain free function, where;
- there is a disadvantageous length-tension relationship,
- whilst encouraging poor recruitment patterning and efficiency
- with high load imposed on underlying joints or soft tissues.
This course aims to:
- Enhance clinical reasoning and skills for development of therapeutic exercise for the hip and pelvis
- Challenge participants to re-examine their own clinical practised in the light of the presented evidence base
- Stimulate new thought and provide direction for those who may be interested in contributing to the research base that is shaping contemporary clinical practice in this field.
Upon completion of this course, participants should be able to:
Perform a multifaceted assessment of muscle function for each group of synergists around the hip - hip flexors, abductors, extensors, external rotators and adductors, using standardised, objective measures
Determine the most appropriate exercise approach to target specific impairments in:
- Muscle size and strength
- Muscle endurance - global and regional
- Power, rater of force development, plyometric ability, agility
- Neuromotor function - kinematic and muscle recruitment patterns
Progress an exercise program in an appropriate and timely manner, using key markers for exercise effect and tolerance.