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| Spontaneous Feedback AUGUST 2009 RECEIVED AUGUST 18, 2009 That is interesting, I will definitely watch for that. I especially like some of the techniques that I learned from you that no other manual therapy course I have been to has yet addressed.....like the left side bent sacrums that remain after fixing the major problems, and your techniques of correcting that. No one else even mentions that, not the NAIOMT people, of course, not DonTigney, not Diane Lee, not Richard Jackson, not the Michigan State folks (at least the therapists I know who have taken those course don't mention it). But is the one thing that is needed in some folks to get them all the way better, and without you I would not have know to look for it. I have learned some new things though at about every course I go to, that I am adding to my bag of tricks....some muscle energy techniques and neuromuscular reeducation techniques to rid some abnormal nueromuscular patterns that lead to recurrence, of like a sacral rotation and segmental dysfunctions, that work really well. Like the protective spasm in the iliopsoas that occurs with an acute disc derangement that side bends them off the hot disc, and rotates them away. That can get imbedded as an abnormal pattern, that leads to recurrent FRS lefts, and left sacral rotation. So, there is a exercise that is done to reestablish a more normal pattern gets rid of the bad one. It is cool. It has worked on the last 6 patients that I have tried it on. Thanks for sharing. Barb C
MY REPLY AUGUST 19, 2009
Barbara, Thank you for your kind words. You always have been generous with words. I posted your email on my manual therapy web site. I believe that I have at least another one from you, posted, maybe more. When will you teach the Hesch Method? Please share your technique re the psoas. I have always been fascinated with that structure. Early in my career read Iliopsoas by Michele, I think he wrote it in the late 60's or early 70's. Then of course I busted mine up in the motorcycle wreck age 17, pelvic fracture, neuropathy including the nerves that are literally formed in the mass of the psoas, ilioinguinal, iliohypogastric and not too far away is the genitofemoral. I have always believed that due to the angle of this muscle and the iliacus that the Thomas stretch, even the modified, should be done with the hip in several positions, not just neutral. I do so at say 15 degrees abduction whioch I believe to be the approximate angle of the combined muscle fibers and then do so in neutral and then 15 degrees of adduction. I reject norms for hip extension, believing that the norms are sub optimal; so go for past neutral, say 20 degrees below horizontal. Lastly, it is sad to see several research articles in which the authors measure all hip motions, except hip extension! In some, they appear to believe that the muscle length test (Thomas/Modified Thomas) suffices. I always test iextension and rotation in prone, trust those positons, and there is some research to support that. Please check the manualtherapy.com web site every few weeks. Soon I wil post on a articular reflex connecting the talus, the knee and the hip, I stumbled on that a few months ago. Keep up the good work, and please keep in touch when you can, life is busy! Best Regards Jerry Hesch I think that spontaneous feedback is the best. Here is a nice email I received recently, and my reply. This therapist took a HESCH METHOD seminar taught by Chris Gregor-Maxwell in March 2009. The formatting is suboptimal for which I apologize. Hi Chris,
This is Shellie Parkinson writing and I first met you back in March when you brought the Hesch course to Physical Therapy Innovations in Auburn, MA. You may not remember me, but I was the PT in the course who was positive for (almost all elements of) the most common pattern and became the class example. What was also unusual about my situation was that I was about two weeks away from undergoing hip surgery for a labral tear and femoral acetabular impingment. I would like to sincerely THANK YOU for all of your knowledge and hands on treatment approaches. My surgery has come and gone and I would have never made it NWB/PWB on crutches for five weeks in the pain I was in regarding my SI and low back. Thanks to you, I am a true success as a result of the Hesch method!
Also, professionally, being able to treat those previously 'difficult' LBP/SI patients with the Hesch method has really changed my practice. Luckily, I was able to take the course with some co-workers and all of us have had great results using what we learned at your course.
Thanks again for helping me so much personally and professionally.
Hope you are having a great summer!
Shellie Parkinson
Hi Shellie, I sure do remember you! I am overjoyed to hear that your surgery and recovery went well, and also that you are using the Hesch Method so effectively.
Thank you for taking the time to contact me- I always wonder how the participants are doing once I've gone and love to hear from them.
Can I quote you on our website?
If you know of other sites that would be a good fit for hosting a Hesch Seminar in the future, I would appreciate that knowledge too.
Thanks again, and remember that you can always call me or Jerry Hesch with questions or comments!
Chris Gregor-Maxwell
www.heschmethod.com
I sent Shellie and email asking permission to post, here is her reply. Dear Mr. Hesch,
I just emailed Chris to let her know it would be ok to use my email for your site (but I also told her if I'd known it would be published, I would have tried my best to be a little more articulate! ha!).
You can certainly use my name, facility, city, etc. To make it easier, here is my given name (of which my PT license is under) and the other info all together:
Rachelle Parkinson, PT
Physical Therapy Innovations
Hopkinton, MA
Thank you again for helping me to become a better PT!!!
Shellie Parkinson
Spontaneous Feedback June 29, 2009 I think that spontaneous feedback is the best. Here is a nice email I received last week, and my reply. Hi Jerry...I've never met you but learned your approach from Christina Maxwell. I just wanted to let you know how many patients I've been able to help using the info I learned. It has been one of the most useful tools I've had for everything from feet to neck. Seems I always clear the pelvis first on almost everyone and so often find a problem which then translates into narrowing the pain down to one or two places. Thanks so much for taking the time to find a way to help these patients. James Phillips, PT Indianapolis Hi James, very kind of you to take the time to compliment me and the work. Chris is a great instructor and I HAVE COMPLETE FAITH IN HER. Ooops an accidental but appropriate use of caps!
If you are interested in learning the advanced work, let me know. There is an advanced DVD, but there are few patterns that have been discovered since that was developed.
Again, thank you for the kind words. It is rare and nice to hear from course participants. I think most believe I live in a cave, not the artistic ones in Southern France, but rather the boring tufa caves of the great (?) southwest!
Hmmmm....Indianapolis, I think I once got a degree from there, does it get real cold in the winter there?
Keep in touch.
Regards
Jerry Hesch, MHS, PT A VERY NICE COMPLIMENT Sent: Friday, April 03, 2009 9:45 AM Subject: RE: my video
I watched your video, and now I better get on your web site to read up some more on what you had to say about dorsally subluxed cuboids. That subject was covered in my NAIOMT classes, saying it occurs often with jumping, when a person comes down in plantar flexion and rolls inward, like when coming down on another players foot, rolling in. The manipulation they teach to restore normal position requires two people to do, and is fairly dramatic. So, it will be interesting to read more about yours. I am seeing a patient currently who found out about me through your web site, so thanks for sending her our way. She has been through a lot, and I definitely am using a lot of what I learned from you on her, along with everything else I can pull out to help her. Hope you are doing well! Barb C
this was a spontaneous email sent to Chris Gregor-maxwell who also teaches the Hesch Method From: I removed the sender's identity
Sent: Wednesday, March 25, 2009 7:21 AM
To: Christina Gregor-Maxwell
Subject: thanks
I have a renewed excitement about the hesch method and have used it many times in the past two days. It is so much easier with the new patterns and it makes so much sense. I even adjusted Stefani's second most common pattern (she said she met you at pub 99) before I discharged her. Her thoracic pain was gone but I could see her increased lordosis and just needed to do that so she could do her core exercises better. I gave her the home program and I felt so much more complete in her treatment. I even adjusted a cervical patient that i was discharging. She was older and had arthritis in her cspine so her was not 100 percent pain free all the time but she was significantly better. She had a hx of low back pain also so I keep her during my break and gave her a free pelvic allignment to see and gave her the home program. She called me back so excited she has not felt this great in years. Those patterns are fantastic. I am getting better results than ever before with the old material. Thanks again, I hope you are well. September 2, 2008
Hi Jerry, Two things, first, I was wondering how __________________did after you saw her again? Second, I was wondering if you had any thoughts about another patient of mine............She was able to ride and swim most of the time since then but had to give up running and she just dealt with the pain and muscle spasms as no one to this point has helped her for any length of time. During the past 2 months she has been able to work on a walk jog progression and has progressed to jogging 25 minutes. She has a lot of confidence in your techniques and is pretty happy with how much better she has felt- even going a few days without spasms was huge for her. I have done a lot of manual therapy including postional release and augmented STM (Graston tools)....... Sharon O, PT Indianapolis Jerry's comments: Again, I am grateful that this is an unsolicited compliment. This very brief case shows that the Hesch Method is not a closed system, it encourages any and all other approaches after the Hesch Method has been utilized to balance the pelvic structure. Within my clinical practice I do treat whole-body. The term "Hesch Method" applies to my system of treating the sacroiliac, symphysis pubis, pelvis, lumbar spine and hip, which then segues into any of several appropriate techniques such as Grafton for scar release, myofascial release, movement with awareness, lumbar stabilization, etc. This email came on August 28, 2008 and the compliment was completely unsolicited. I removed her name, per her request "I have been a ___________ for over 20 years. I now have a two year old daughter. When she was born, the first check in hospital, thought they heard a click in her hip joint. An ultrasound revealed nothing. Now, she walks with definite "pigeon toes" and her ambulation is therefore challenged. I have taken her to a naturopath who advised "wait and see", which is generally good advice. A friend of mine had her teenage daughter's subluxing kneecap corrected by the Hesch Method after a Dr. had recommended surgery. I am writing to ask, after reviewing your website, does your work/research extend to feet and ankles? If so, is it "Wait and see?" or "Why did you wait so long?" Understanding the pelvis as I do, it seems reasonable to ask you if Hesch Method can help my daughter. If so, at what age? Thank you for any info you can give me. J P, Black Canyon City, AZ This email came to me today. It is a very nice thoughtful compliment. Sometimes it is very challenging to provide a consultation. However, I am pleased that I was able to be helpful to Elaine and very pleasantly surprised to recieve this via email.
----- Original Message -----
From: Elaine Parker
To: jerryhesch
Sent: Tuesday, October 02, 2007 7:07 AM
Subject: thank you!!!
October, 2007
Dear Mr Hesch,
It has been about a year since I last spoke with you. I am writing to let you know how I am doing and to thank you for your guidance and help. Without your interventions, I truly feel that I would be in a totally different physical (and mental) state.
I had a total hip replacement to treat advanced osteoarthritis in March, 2006. My surgeon assured me that the surgery had gone well and by measurement, my legs were the same length. However, I was experiencing a leg length discrepancy which created other issues: lower back pain and increased pain in the “other” hip joint. I went through ten weeks of physical therapy aimed at strengthening and rehabilitating my hips. The therapy indeed improved my reconstructed hip but I began experiencing increased pain in the “other” hip which was significantly affected with osteoarthritis as well. An assessment before leaving physical therapy determined a “slight twist’ in my pelvis-probably caused pre-surgery as I compensated for the hip immobility and pain from the osteoarthritis. My therapy plan was to continue strengthening exercises and use a heel lift to lengthen the “shorter” leg. Although my hip strength improved, the pain in the “other” hip increased, and the “shorter” leg was still shorter!
A friend had heard of your physical therapy methods and encouraged me to search for more information. Through this process I ended up contacting you directly. Your help made a huge and significant difference in the level of pain that I was experiencing. After my first “telephone assessment” and instructions for exercise, I began exercising daily. I was amazed that very simple maneuvers led to such relief. I continued strengthening exercises along with your pelvic exercises. My pain level was decreased to a tolerable level so that I could participate in daily activities without the intense pain.
In January 2007, I underwent the second total hip replacement. After this surgery I was able to locate a physical therapy department that utilized your techniques and was treated there post-surgery. My pelvic issues were identified, assessed, and treated. I am no longer under their care but feel that I have learned a great deal. Your initial instructions were continued and expanded in my therapy sessions. I was able to see a huge and significant difference in two treatment plans, physical therapy departments, and in my results and rehabilitation. My experience confirms the power and necessity of addressing pelvic issues!
I still use many of the exercises on a daily basis and some only when the need arises.
I am a true believer in your methods and share my experience with anyone who will listen!! Thank you for taking the time and your patience in teaching me about your techniques.
Sincerely,
Elaine Parker
Elaine Parker, Director
Adult Secondary Education
John A. Logan College
700 Logan College Road
Carterville, IL 62918
(618) 985-3741 Ext 8349
Fax: (618) 985-4825
When I was a PT student my clinical instructor used the Hesch Method to treat a client. The client was very pleased to finally achieve pain relief, having previously sought care from several practitioners. So when I started working in outpatient Orthopedics, I took the basic/intermediate Hesch Seminar.
I was pleased to achieve quick and lasting results, and find the self-treatment very helpful. I appreciate that this work is not restrictive or dogmatic, and it is easily integrated with other PT approaches. Jerry Hesch is very available by phone and e-mail, which helped with learning the advanced material.
I completed an outcome study with 11 discharged clients and 8/11 reported benefit with the Hesch self-treatment. Most clients who present with pelvic girdle movement dysfunction are significantly improved within 3 visits and readily segue into strength and stabilization exercises. I have presented this approach several times to PT students at UNM and it was enthusiastically received. It has been 5 years since I took the seminar and I am grateful that I am very comfortable the lumbopelvic and hip girdle and easily achieving lasting change.Bernadette Lynch, PT Albuquerque, NM
Hi Chris
Just wanted to thank you again for the great course in Indianapolis, IN
on 9/8-9/07. You have a contagious excitement and I am now pumped to
see some SIJ clients (instead of dreading them as I did before your
course).
My previous SI coursework consisted of muscle energy techniques and I
did not feel competent in treating SIJD because it relied too heavily on
palpation findings. I now understand the importance of incorporating
sping mobility testing to help determine where to mobilize.
I will relay my positive feedback to my director for we are still
hoping to bring the course to Goshen.
Also, thanks for treating me. We saw the difference at the course, but
I also saw a difference while playing disc golf the next day. In disc
golf there are huge transverse plane motions. I felt better power
transfer from my left hip with less effort to get the distance
required.
I'm looking forward to applying the techniques and I'm sure I will have
a few questions, so plan on a few more emails.
Thanks to Jerry Hesch for developing this work.
Craig Enright PT
Centers for Rehab
Goshen General Hospital
Goshen, IN
My background as a Maitland trained physical therapist has taught me to utilize a clinical reasoning approach to patient care. The Hesch Method fit into my training in that it emphasizes testing/re-testing and utilizes spring testing. The Hesch Method utilizes what I call "springing with awareness" which allows the clinician to determine the patients dysfunctions without having to make the patient fit into pre-conceived ideas and patterns. The Hesch Method is also a very user friendly approach which allows the student to utilize the approach immediately in the clinic. This approach gives students specific patterns to follow by utilizing "the Most Common Patterns" and "the Second Most Common Patterns" . The Hesch Method does not limit the clinician to these patterns but gives him/her the ability to find other less common dysfunctions as indicated. Utilizing this concept I have been able to help numerous patients who where not helped by "traditional methods" . My favorite part about this method is that the techniques utilized are not labor intensive and enable the patient to self treat as appropriate. The Hesch Method has added a new dimension to my ability to treat the most complicated patients.
Robert Shapiro MA PT COMT
Again, I will say that I am enjoying this training and am quite impressed so far! Do you know how many courses I have taken trying to understand the sacrum!? Several! Your method is so simple and effective....This (distance learning with phone consults) seems like the bargain of the century! C.B. Distance Learning Student-When we complete the training I will ask for a longer endorsement!
Jerry Hesch is not only committed to assisting Physical Therapists enhance their manual skills, but is passionate about his work and studies of the pelvis. He is able to explain and describe the complexities of the pelvis in such a manner that it is easier to comprehend and learn the mechanics of his Hesch methodology. It has been a fabulous learning experience to have Jerry as a mentor giving feedback with some of my patients even though he lives in a different state. He is quick to respond to both phone calls and emails, and gives the experienced Physical Therapist a chance to be challenged and to experiment with new and creative treatment approaches. As a Physical Therapist who specializes in pelvic pain and dysfunctions and has over 17 years of experience, I highly recommend Jerry Hesch as teacher, mentor, and educator.
Deena Goodman, PT
Los Angeles, CA
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