The relationship between pelvic block placement and radiographic pelvic analysis

Klingensmith RD, Blum CL10th Annual Vertebral Subluxation Research Conference Hayward, CADec 7-8, 2002

Introduction: From a study by Lisi, Cooperstein and Morschhauser entitled “A Pilot Study of Provacation Testing with Pelvic Wedges: Can Prone Blocking Demonstrate a Directional Preference?”[1] a relationship between block placement and pain was determined. The study found, “It appears that low back tenderness can change in response to various position of pelvic wedges, and that a preferred blocking pattern can be determined. ” Preliminary results of the study suggest that tenderness decreases on increases in response to various blocking positions. Also, the blocking positions that increase or decrease tenderness are typically diametrically opposed, that is, directional preference can be shown.”[1] In another study, Cooperstein found that padded wedges or SOT pelvic blocks could be used for lumbopelvic mechanical analysis. [2] Unger noted that pelvic block placement could be shown to affect muscle strength. [3]

In the Lisi et al study [1] they determined a pain pressure threshold of patients in a neutral position, and then with a pair of padded wedges placed under the subject in each of four different positions: (Right Short Leg – Category One) left iliac crest, right greater trochanter; (Left short Leg – Category One) right iliac crest, left greater trochanter; (SB+) left and right iliac crests; and (SB-) left and right greater trochanters.

Methods: In this current study, radiographs were taken to determine whether pelvic distortions could be demonstrated on x-ray when pelvic blocks were placed under the patient in the prone position. One patient was placed prone in a neutral position and radiographs were taken in a neutral position, and then with a pair of pelvic blocks placed under the subject in each of four different positions: (Right Short Leg – Category One) left iliac crest, right greater trochanter; (Left short Leg – Category One) right iliac crest, left greater trochanter; (SB+) left and right iliac crests; and (SB-) left and right greater trochanters.

Results: Findings indicated that pelvic block placement could create or affect distortions of the pelvis.

Conclusion: Further studies are indicated correlating radiographic analysis, pain provocation, and muscle strength to determine if a clear pelvic block preference can be determined definitively.

References

Lisi AJ, Coopertein R, “A pilot study of provocation testing with pelvic wedges: Can prone blocking demonstrate a directional preference?” Proceedings of the ACC Conference IX, Journal of Chiropractic Education Spr 2002; 16(1): 30-1
Coopertein R, “Padded Wedges for Lumbopelvic Mechanical Analysis” Journal of the American Chiropractic Association, Oct 2000: 24-6.
Unger JF, Jr, The Effects of a Pelvic Blocking Procedure upon Muscle Strength: a Pilot Study Chiropractic Technique Nov 1998; 10(4): 50-5

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