Is The Stork Test For The SIJ Useful Or Relevant?

stork testPlease note…in this article, I will give away yet another clinical “secret” that has contributed to my successful treatment of SIJ conditions…this post is mainly for therapists today but patients can get a lot out of it as well.

Ah, the stork test. It goes by a few names – the Gillet test and one leg standing test are some of them. This test has been used by therapists for many years and I have been personally using it for 15 years. in this blogpost, I will explain what the Stork test is, how I use it and still stay true to the intent of the original test and the interpretation from neuroscience.

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Why 99% of people misunderstand “Stability” – are you one of them?

Stability. It could be that you lack it. I am sure you have been told you don’t have it at some stage of your life. Maybe you don’t have a good “core”. Or maybe you need better “midline stabilization”.

I began my Physiotherapy career right when Paul Hodges et al were writing about this thin muscle called transverse abdominis. I hadn’t heard of this stability mechanism before then but there it was. Then “core stability” took off, Swiss ball training became all the rage, Pilates became popular and modified by physios and the rest is history.

I also witnessed a lot of the pelvic floor changes to exercise and have been able to watch the development of pelvic floor training and different approaches…

…and then the integration of the pelvic floor into the “core”…

…and then watching the slow train wreck that became “core stability” as different professions got a hold of the idea and basically bastardize it…along with some researchers who didn’t help.

For the past 20 years, I have been training all sorts of patients, from Olympians and Paralympians, all the way through to beginners and children. I have treated world champions in different types sports and been able to improve their performance and pain. I have trained people using gym based exercises, weights, body weight programs, Pilates, Swiss balls and all sorts of devices and gadgets. I have been around the block a few times now.

All of this introduction is to say that I have a fair idea how to improve stability in my patients…and I believe that so many people have the WRONG idea about stability – even physios, doctors, chiros, osteos etc etc.

The common belief is that “the core” is all important but really, you have local stabilization muscles at every joint. They all work to prevent shearing and excessive motion in the joints.

The local muscle system provides the firm foundation for the big force/torque producing muscles to generate their force (torque is simply force x radius).

Let’s take 3 common examples – the “core”, the shoulder and the hip.

The core is defined as the diaphragm, the pelvic floor, transversus abdominis and lumbar multifidus. It is promosies that they work together to maintain lumbopelvic stability. But now every other muscle is being included – abs (obliques and rectus abdominis), lats, glutes, erector spinae etc etc. But these other muscles don’t stabilize. They may hold position but the control of shear and segmental stabilization is the work of the 4 core muscles.

In the shoulder, we have all heard of the rotator cuff but why don’t people claim the lats, teres major, pecs and deltoids as stability muscles? We seem to understand how the shoulder stability at the glenohumeral joints work…maybe not the scapulothoracic stability though 😕

In the hips, we go back to being bipolar again. The hip “cuff muscles” get augmented with glutes but the TFL is a problem muscle even though it is similar to glute medius. We claim glute Maximus as a stabiliser but not the quads or even just rectus femoris. We claim psoas as a back AND hip stabilizer but piriformis is a problem muscle.

It is all so confusing isn’t it?

And here is why…

…stability is NOT a rating of 0-10 where 0 is no stability and 10 is the most stable it can be. This is WRONG! If you can understand how this works, you will realise how screwed up the subliminal education, the beliefs of your teachers and coaches and the whole fitness industry in general is screwed up. I call this strategy “Harder-er is better-er!” (…I deliberately want to make it sound stupid!)

You see, people (probably you), think that stability is like this. You think that if activating the glutes a bit makes me stable, then activating the glutes MORE will make me MORE stable! And I can understand this. We are used to working hard for our gains. We believe that in life, you get what you put into it. We want a good meritocracy where hard work is rewarded. We ridicule those who don’t work as hard in the hope they will work “harder”.

All of your cues that have been taught to you have been like “knees out”, “shoulders down and back”, “back straight and chest up” etc etc. The problem with these cues are that if you haven’t been coached about them, you can end up “overcooking” the cues and end up with your knees too wide out past your feet and ankles (this Diane Fu photo of squats).

Stability is much more like a target. A range to hit. It requires the Goldilocks principle – not too little and not too much…just the right amount of stability at just the right time and with just the right amount of force.

Rather than stability being a scale of 0-10, think of it as being a scale from -5 to +5. You are trying to get the right amount of force happening. Too little and it won’t stabilize you. Too much and you will be overly compressed and unable to adapt to changes in loading requirements at all your joints.

Touch your nose. Your brain sorted it all out. You don’t have to think about contracting ANYTHING because your brain has got all that figured out for you! You don’t think of every muscle, every joint, how many degrees each joint has to move nor the ability to change the angles and adapt to load differences…you just think “touch your nose” and it happens!

Try this one. Get a dumbbell that is 5-10kg. Front raise it (straight arm forward flexion to 90deg). Now context your glutes as hard as you can, or tense your core, or put your shoulders down and back, or turn on your pelvic floor, or do whatever thing you want to test as a stability cue and front raise that dumbbell. If the cue is helpful, it will feel lighter. If it feels heavier, your AUTOMATIC strategy is BETTER than contracting the muscles. If it feels the same, it isn’t helping…you don’t necessarily need to do it!

I genuinely feel that this misconception about stability is rife. I know you are sitting there reading this going “duh, that’s pretty bloody obvious”…but then why do I have to retrain coaches, elite athletes, amateur athletes and basically everyone every day about this? Why is it that people tell me they understand stability the way I talk about it and want it but then when I watch them do the exercises, I have to sort out all the erroneous stability strategies they have.

This is part of the reason why I have been talking about matching the tension to the task (#tensiontotask) and relaxing before movement…I test to see if the brain can sort this out BEFORE I give you a cue to do!

If you disagree with me, let discuss it. I am keen to learn more and love a good debate!

Summary: Harder-er is NOT better-er!” Stability is a target to achieve with the Goldilocks principle – not too little and not too much…it has to be JUST RIGHT!

Seminars – Mobility, Stability and Flexibility

Perhaps you didn’t know that I run seminars. I have run 1 and 2-day seminars for the Sacroiliac Joint (for educating health professionals), as well as short talks through to half day seminars for the general public, coaches, athletes, as well as health professionals.

My Passions:

My passion has always been to help people. I do that by being a physiotherapist (Physical Therapist) every day.

But I also understand that the world AND the internet is full of misleading and inaccurate information…

…so I thought that I could help more people by educating. That is why this blog exists. That is why I run seminars. That is why I plan to have e-books and e-courses.

Some topics that I get passionate about:

  1. “Core Stability” – what it is and what it isn’t
  2. Correct Technique – people are often told lots of different things…but what is “correct”?
  3. People doing what they are told instead of testing what someone tells them
  4. The pelvis and the thorax – 2 of the most poorly understood and taught areas in Physiotherapy
  5. Strengthening from a very low level all the way up to extremely heavy weights
  6. Time efficiency – it would be nice to have all day to work on your flexibility, mobility and stability – you don’t though…so I love to teach people how to maximise the time that they have

My Education Website

www.mypteducation.com is my education website. I would be more than happy to consider visiting your location to deliver a seminar topic/s of your choice.

I am currently hoping to organise some seminars in Hong Kong, Singapore, Queensland, NSW and Victoria. I already have a couple of seminars running in Sydney and Canberra.

In the future, I hope to have free and paid slideshows, e-books and courses available on the website.

 

Follow My PT Education on Facebook

www.facebook.com/mypteducation is where notifications pop up – like the link and follow what is going on.

 

Contact Me or Comment Below For More Information

What is “Stability” and “Core Stability”? Busting the myths!

"Core Stability" - why do so many people get it WRONG!?

“Core Stability” – why do so many people get it WRONG!?

One of my pet peeves is how health and fitness professionals and the general public throw around terms like “stability”, “core stability” and “unstable joints”. This blog post hopes to address some of these issues and shed light on why there are so many well-meaning but simply incorrect education out there about how to develop good “core stability”.

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