IADMS Madrid 2001   [back to the Category]

The sacral complex: Normal and abnormal motion in the dancer   [read the french version]

Author :   Roger Hobden, MD

The sacral complex: Normal and abnormal motion in the dancer

Roger Hobden, MD, Dip. Sports Medicine, Dept. of Family Medicine, University of Montreal, Montreal, Canada; Suzanne Martin, MA, MPT, Smuin Ballets/SF, School of the San Francisco Ballet, St. Mary’s College; San Francisco, CA, USA

This is a one-hour interactive workshop focusing on treatment of the structure and function of the sacral complex in relation to low back pain and pelvic pain in dancers. The sacral complex is first a part of the osseous closed-system of the pelvic ring. In addition, the sacrum and its adjoining elements function as a triplanar joint complex, allowing its axes to move through the transverse, frontal and sagittal planes to create stability with the earth and so create functional dance movement. A direct biomechanical chain interacts with the functional components above the complex into the lumbar spine and then also below it into the lower extremities.

It is a common occurrence to find that the site of a dancer’s pain is not always the site of the dysfunction. The cause of the pain pattern and not merely the source of the pain generators must be determined in order for diagnosis and treatment to have both a successful and long-term outcome. Thus it is important to differentiate the problem functionally among the low back, hip joint and sacroiliac joints.

The sacroiliac joint is functionally considered two joints: 1. the iliosacral joint, i.e., the innominates moving on the sacrum, and 2. the sacroiliac joint, i.e., the sacrum moving within the ilia. A functional sacral complex is crucial to functional dance movement in terms of creating the dancer’s lumbo-pelvic rhythm, weight-bearing and weight-transference abilities, as well as gesturing leg movements.
This workshop will include theoretical content of the functional anatomy of the lumbopelvic and coxo-femoral areas. The sacral axes of motion in relation to their biomechanical chains and compensations will be explained with charts and visual images. The concepts of proximal versus distal instability will be addressed along with principles of diagnosis and treatment. Both active and passive treatment methods will be demonstrated.
Practical osteopathic manual medicine treatment will be demonstrated involving the lumbo-pelvic junction, symphysis pubis, innominate bones and sacrum. These demonstrations will be accompanied by participant applications of treatment methods. In addition, participants will be instructed in tests for the integrity and motor control of the core musculature (transverse abdominals, pelvic floor, and multifidi). Active physical rehabilitation methods will include core stability, muscle energy exercises for the pelvic bones and lumbar vertebrae, Pilates rehabilitation methods, as well as active self-mobilization of the sacroiliac joint. These demonstrations will also be accompanied by participant applications of treatment methods.