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Lower Extremity Alignment: A Proximal Rehabilitation Approach

presented by Steven Dischiavi

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Utilizing the hip to influence dynamic lower extremity alignment has gained considerable attention within the physical therapy related literature. There is evidence to support a proximal control theory, but there also appears to be a limit to its effectiveness, particularly with regard to sport related tasks. This course will examine the proximal control approach to rehabilitating the hip. There will be a brief functional anatomy review as well as a review of the EMG activity of some commonly utilized hip exercises. The course concludes with the introduction of the idea of expanding from a proximal theory and adopting a more global and dynamic approach to organizing human movement.

This course is part of a three part series with Steve Dischiavi. View the courses in the following sequence:

  1. Lower Extremity Alignment: A Proximal Rehabilitation Approach
  2. Global Dynamic Functional Stability for the Hip & Pelvis
  3. Exercise Prescription for Hip & Pelvis Movement: Part 1
  4. Exercise Prescription for Hip & Pelvis Movement: Part 2

Meet Your Instructor

  • Steven Dischiavi, PT, DPT, SCS, ATC, COMT

    Dr. Steven Dischiavi is an assistant professor in the Department of Physical Therapy at High Point University (HPU), as well as the Director of Rehabilitation for the Department of Athletics at HPU. Dr. Dischiavi brings over 20 years of experience in sports medicine to MedBridge, including 10 years with a professional sports team. Dr. Dischiavi served as the team physical therapist and certified assistant athletic trainer for the Florida Panthers of the National Hockey League from 2004 to 2014, where he gained a specialized treatment approach for the hip and pelvis. He holds a relatively rare combination of credentials as a licensed physical therapist and a certified athletic trainer giving him a unique appreciation of the athlete. He also holds a manual therapy certification from the Ola Grimsby Institute. He is board certified by the American Physical Therapy Association as a Sports Clinical Specialist (SCS). Dr. Dischiavi is a faculty member at the Herman & Wallace Pelvic Rehabilitation Institute. He has developed his own course that he presents nationally titled Biomechanical Assessment & Treatment of the Hip & Pelvis. Dr. Dischiavi is currently pursuing his PhD at the University of Ulster in Ireland under the direction of Dr. Chris Bleakley. His current research focus is on optimizing therapeutic exercises for the hip to prevent lower extremity injuries and enhance physical performance. Dr. Dischiavi attended Slippery Rock University, where he earned his bachelors degree in athletic training. He earned a Master of Physical Therapy from SUNY Upstate Medical University and a Doctor of Physical Therapy from A.T. Still University.

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Chapters & Learning Objectives

Download Learning Objectives
  1. Historical Review of a Hip Focused Proximal Control Theory

    1. Historical Review of a Hip Focused Proximal Control Theory

    Hip impingement surgery rate has increased by over 600% among newly trained surgeons from 2006-2010. It will be expected that the physical therapist become an expert in the prevention and rehabilitation of the hip, particularly with the growing post-operative population. This chapter will describe local, regional, and proximal interventions and discuss the evidence for each.

  2. Dynamic Lower Extremity Alignment

    2. Dynamic Lower Extremity Alignment

    Dynamic lower extremity alignment refers to the position of the lower extremity under certain dynamic conditions. The literature has different names and ways of describing the way this dynamic alignment is quantified; these concepts are discussed in this chapter.

  3. Functional Anatomy and EMG Literature

    3. Functional Anatomy and EMG Literature

    This chapter will outline the functional anatomy related to the hip and its surrounding musculature. Particular attention is paid to the three dimensional nature of muscular control on the skeletal system, and how the pelvis is stabilized functionally in three planes. The chapter concludes with a review of EMG literature and how it impacts exercise selection.

  4. Evidence-Based Review of Hip Focused Literature

    4. Evidence-Based Review of Hip Focused Literature

    The final chapter of this course will discuss the current state of the literature for hip focused exercise interventions. The concept of strength as a non-linear progression is presented and will be a tenet of the following courses. The course concludes with the introduction of the Global Dynamic Functional Stability paradigm and the concept of Dynamic Kinetic Chain Integration.