Author: Marilyn J. Nacht, M.S., P.T.

Abstract: A single subject with hypo-mobility of the hips and pelvis was treated with Biomechanical Regulators (1) for two and a half hours. Areas treated included the pelvis, sacrum and hip joints. Pre and post testing of hip range of motion showed significant changes in two out of three cardinal planes.

Key Words: Hip, Biomechanical Regulators, Motorcycle Accident

The patient was a 47-year-old male who reported multiple traumas while playing football in high school. Injuries included a fracture to the right distal tibia and fibula. He also reported a high-speed motorcycle accident impacting a tree at the age of 25 with significant injury to his trunk and pelvis. He describes "full body stiffness" for as long as he can remember which has limited walking, activities of daily living and all attempts to participate in sports.

Hip range of motion was evaluated on all planes with the patient supine using a medium international standard goniometer (Allimed, 297 High Street, Dedham, MA 02026-9135). See chart below for specific values. Pictures were taken of the right hip extension pre and post treatment. Gait deviations were evaluated visually prior to treatment. The following problems were noted: (a) circumduction of the right leg during the swing phase of gait (b) locked pelvis (c) initial contact on his mid-foot bilaterally during the heel strike phase of gait (d) short stride length and (e) minimal translation of motion up the patient’s spine during ambulation with a fulcrum around the T9-T10 spinal segment.

Hip Range of Motion Prior to Treatment:

The patient was treated for two and a half hours using Biomechanical Regulators (1) as developed by Frank Lowen, IMP,C. Bone Bruise Technique (2), Disruption of Membrane Technique (3) and Immune Deficiency Motility (3) were used periodically to clear the treated areas. Joint play motion was assessed prior to using each regulator to determine sites of hypomobility and which regulator to use. The treatment sequence was as listed below:

Regulator Problem:

Range of motion of both hips was re-assessed with the patient in supine using a medium standard international goniometer. Hip extension increased by 10 degrees on the right and 13 degrees on the left. Hip flexion improved 2 degrees on the right and 8 degrees on the left. Hip abduction increased by 9 degrees bilaterally. No significant improvement in hip adduction or rotation occurred. All post-testing range of motion values are listed in the chart below. Visual re-evaluation of gait deviations revealed the following changes a) hip flexion, instead of circumduction, occurred with the right leg during the swing phase of gait b) translation of force and motion throughout the pelvis now occurred with each step c) initial foot contact was seen at the heel instead of the midfoot with both legs and d) bilateral increase in stride length during the gait cycle.

Hip Range of Motion after Treatment:

1: A patient with chronic hypomobility of bilateral hip joints showed improvement in hip flexion, extension and abduction.

2: Visual inspection of the patient’s gait pattern after treatment revealed improvement in deviations.

3: One-week post treatment, the patient reported he was able to jog 100 yards. Prior to treatment he was unable to jog.

4: Treatment results may have been influenced by the following: a) the patient had received several hundred hours of Integrative Manual Therapy (IMT) prior to this treatment session b) the patient was a physical therapist who practices IMT and c) the patient had taken the Biomechanical Regulators course three weeks prior to this treatment session and held positive beliefs about the techniques.

Suggestions for Future Research

1: Repeat the study again with a group of subjects who have had no treatment or knowledge of IMT or Biomechanical Regulators.

2: Do follow up studies with subjects to determine how long the effects of treatment last.

3: Focus on additional areas of the body to determine what changes may occur after treatment with Biomechanical Regulators.

4: Repeat the study comparing the effects of Muscle Energy and ‘Beyond’ techniques with Biomechanical Regulators for pelvic, sacrum, hip and spine dysfunction.

1: Lowen, F. Class: "Biomechanical Regulators Level One: Foundations." Albuquerque, NM: Illuminatis; 2000.

2: Weiselfish-Giammatteo, S. Class: "The Cranial Series: Course Three." Bloomfield, CT: Dialogues in Contemporary Rehabilitation; 1998:15-16.

3: Giammatteo, T. and Weiselfish-Giammatteo, S. "Visceral Mobilization with Muscle Energy and ‘Beyond’ Technique: The Gastrointestinal Tract." Bloomfield, CT: Dialogues in Contemporary Rehabilitation: 1998: 97-98.