TOP Education’s2018 Synergy Conference

Posture Perfect Part 1

2 CEUs

Presented By:

Anthony Gambale, DC

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class

Please scan OUT at the end of

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You must attend the entire

session to earn your credit(s) for

this class

Presented by Dr. Anthony Gambale

The History & Examination

The Postural Examination

Radiographic Examination

Spinal Manipulation for Acute Pain

Sacral/Pelvic Obliquity

a deviation of the sacral base from the

true horizontal position when observed in the anteroposterior view.

Common Conditions

Associated with

Sacral/Pelvic Obliquity

and LLI

•Low Back Pain

•Hip Pain

•Sciatica

•Weakness

•Fatigue

•Scoliosis

Botte PR: JAPA 1981;7(5):243-25

The most common causes of sacral obliquity are those clinical entities that are associated with anatomical lower extremity deficiencies of length:

*true anatomical inequalities of the lengths of the femur or tibia,

*unilateral ankle pronation secondary to collapse of the medial longitudinal arch of the foot,

*unilateral arthritic changes at the hip, knee, or ankle joints,

*congenital hip dysplasia, avascular or ischemic necrosis of the hip,

*iatrogenic causes such as total hip or knee replacement surgeries

• If the reason for the sacral/pelvic obliquity is a fallen/collapsed medial longitudinal arch of the foot, a custom molded orthotic is NECESSARY to correct this condition

• Proper assessment of the patient’s pelvis vs. feet posture must be undertaken since pelvic translations along the X-axis or rotations around the Y-axis can cause the medial longitudinal arch to collapse—conversely, a collapsed medial longitudinal arch can cause X-axis translation or Y-axis rotation malpositions (global subluxations) of the pelvis in relation to the feet

• Heel lifts alone should only be used up to 9mm in thickness. Over 9mm the foot begins to suffer from excessive plantar flexion.

• When more than 9mm are required, half may be added to the outside sole of the shoe and the other half may be added inside the shoe as a heel lift. For amounts of lift over 19mm, the entire amount should be added equally to the sole of the entire shoe.

• For patients below 16 years of age up to 9mm of lift may be added all at once. For patients 16-45 years of age, lifts should be added in increments of 5mm per month so that the patient can acclimate to the alteration in weight bearing caused by the lift. For patients greater than 45 years of age, lifts should be added in increments of 3mm per month.

• Rather than adding gradually increasing magnitudes of lift over time, an alternate method would be to add the full lift and gradually build up the time that the lift is worn each day . . . e.g. 2 hrs on day 1, 4 hrs on day 2, 6 hrs on day 3, and so on . . .

Chiropractic Technique:

Posture Perfect

Posture Evaluation: Digital Screening Results

Chiropractic Technique:

Posture Perfect

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Thank you!Mark & Paul

Some of our Synergy teachers are making their

presentations and other materials available for download

at the conclusion of the weekend.

www.toolsofpractice.com/ppts

TOP Education, the instructors teaching on behalf of TOP Education are here this weekend to educate.

They are not representatives nor speak on the behalf of any particular government entity, insurance company or TOP Education, LLC.

Any specific discussions are for example purposes only.

All specific policy or procedure questions should be directed to the entity that authors those policies