Workshop Highlights: Fundamentals of Osteopathic Manual Therapy – Pelvis and Sacrum Level 1

Date: November 9th-10th, 2024
Location: AL-KO Physiotherapy and Rehabilitation, Pappu Nallah, Naharlagun
Resource Person: Dr. Ujwal Bhattacharya (BPT, MPT, PhD, FOMT IHC Australia, Accredited Tutor ISABC)

The Fundamentals of Osteopathic Manual Therapy for the Pelvis and Sacrum—Level 1 workshop, held on November 9th and 10th, 2024, offered a transformative experience for physiotherapists eager to expand their expertise. 

This comprehensive two-day session, led by the esteemed Dr. Ujwal Bhattacharya, provided participants with practical tools and advanced insights to better diagnose and treat pelvic and sacral dysfunctions. 

Held at AL-KO Physiotherapy and Rehabilitation in Papunalah, Naharlagun, the event combined hands-on training with theoretical knowledge, empowering attendees to enhance patient care in their clinical practices.

Exploring the Fundamentals of Manual Therapy

Manual therapy is essential to modern physiotherapy practice, particularly for addressing joint dysfunctions. The workshop began with an overview of manipulation, a therapeutic intervention that restores mobility, alleviates pain, and addresses joint fixations.

What is Manipulation?

Manipulation involves applying a controlled force to a joint, typically in a specific direction and at a precise velocity. The goal is to create a mechanical response that enhances joint mobility. Dr. Bhattacharya explained how manipulations work by separating articular surfaces, potentially causing cavitation (a “popping” sound) while improving range of motion.

Key points covered included:

Types of Manipulation:

• Long-lever techniques: Low-velocity, high-amplitude adjustments that address broader regions such as the pelvis or scapula.

• Short-lever techniques: High-velocity, low-amplitude thrusts applied directly to specific vertebral or articular structures.

Common Terms for Manipulations: HVLA (High-Velocity Low-Amplitude), adjustments, mobilizations with impulse, and grade V mobilizations.

Day 1: Diagnosing Dysfunction

The first day focused on diagnostic assessments and understanding pelvic biomechanics. Participants learned to identify joint fixations and assess barriers to motion using tools such as the Functional Leg Length Test and Gillet Test.

Functional Leg Length Test

The Functional Leg Length Test (FLLT) is a critical diagnostic tool for evaluating mechanical dysfunctions.

Barriers to Motion

Dr. Bhattacharya explained how joint fixations are identified based on motion restrictions and abnormal end feels, such as capsular or firm adhesions. Participants practiced these techniques hands-on, better understanding how to recognize and address these issues.

Day 2: Hands-On Therapy Techniques

The second day was dedicated to manual correction techniques, emphasizing practical skill development. Participants applied manipulative therapy, including Muscle Energy Techniques (MET) and High-Velocity Thrust (HVT), to address common pelvic and sacral dysfunctions.

Addressing Posterior-Inferior Ilium (PI Ilium)

The PI ilium occurs when one side of the ilium rotates posteriorly and inferiorly, leading to issues such as:

• Functional leg shortening.
• Loss of lumbar lordosis.
• Functional scoliosis.

Correcting Anterior-Superior Ilium (AS Ilium)

An AS ilium involves anterior and superior rotation of the ilium, often causing functional leg lengthening and a shallow sacral sulcus. Participants learned to use MET to restore alignment.

Advanced Sacral Adjustments

Dr. Bhattacharya guided participants through complex sacral dysfunctions, such as sacral base anterior/posterior fixations and lateral sacral rotations (PR/PL sacrum). These conditions often cause low back pain, restricted SI joint movements, and functional asymmetry.

Sacral Base Posterior:
A sacral base stuck in a posterior position leads to:

• Flattening of lumbar lordosis.
• Positive Minor’s sign (difficulty rising from a seated position).
• Pain with trunk extension.

Sacral Base Anterior:
An anterior sacral base presents with hyper-lordosis and deep sulci bilaterally. Dr. Bhattacharya demonstrated how to correct this using HVT and MET techniques that reintroduce posterior rotation.

Participant Feedback and Key Takeaways

Participants found the workshop invaluable for improving their diagnostic and therapeutic skills. One participant noted:

“Dr. Bhattacharya’s approach made complex concepts easy to understand. The hands-on practice helped me feel more confident applying these techniques in my clinical practice.”

“Thank you so much sir for coming all the way from Guhawati. It was such a great session with so many new skills of manual Therapy.I hope all the participants had a great time learning .Thank you everyone 🙏 Sir we r thankful to you for putting so much effort in making us understand and clearing our every little doubts..we are blessed to have a mentor like you..may almighty bless you and your family..thank you sir.”

“Sir we r thankful to you for putting so much effort in making us understand and clearing our every little doubts..we are blessed to have a mentor like you..may almighty bless you and your family..thank you sir.”

Key takeaways included:

• Enhanced diagnostic skills for pelvic and sacral dysfunctions.
• Mastery of advanced manual therapy techniques, including MET and HVT.
• Practical insights into patient care, including home exercise prescriptions to maintain corrections.

Acknowledgments and Future Workshops

We extend our heartfelt thanks to Dr. Ujwal Bhattacharya for sharing his expertise and all the participants who made the event successful. This workshop represents our commitment to fostering professional growth in physiotherapy and rehabilitation.

Stay Connected:
If you missed this workshop, don’t worry! Contact us at (+91) 92339 21310 or visit our Pappu Nallah Physiotherapy Center for updates on future events.

Together, let’s continue elevating physiotherapy standards and making a lasting impact on patient care!