Lumbo Pelvic Hip Complex Dysfunction (LPHCD):

Predictive Model of Lumbo Pelvic Hip Complex Dysfunction

By Brent Brookbush MS, PES, CES, CSCS, ACSM H/FS

In this article we will discuss a predictive model of Lumbo Pelvic Hip Complex Dysfunction (LPHCD) as it relates to movement impairment, injury prevention, movement preparation, performance enhancement and rehabilitation. Specifically, this article will relate these concepts to the selection of exercise and corrective techniques.

For an introduction to Postural Dysfunction and Movement Impairment please refer to this article:
Introduction to Postural Dysfunction and Movement Impairment

What’s in a name?:

“Lumbo Pelvic Hip Complex Dysfunction” (LPHCD) is a purposely chosen title for the impairment discussed in this article.  Although I would prefer to use the term “Core Dysfunction,” the term core has been defined in a variety of ways by various, well-respected practitioners.  Although the core is commonly defined, as “the hip, SI joint, pelvis, lumbar spine, and all the structures that cross those joints,” the term core is also used to describe the muscles of the trunk alone and/or the muscles of the abdomen.  To mitigate any potential confusion this body segment will be referred to by its constituent parts, as above.

By using a title that refers to a body segment, rather than the specific muscle activity or joint position, the title itself will not imply a certain set of joint actions, muscle activity, or length/tension relationships.  I do not wish for the title itself to bias/limit the future evolution of this model, nor bias the debate and discussion of this model as more research becomes available.  Common compensation patterns leading to LPHCD have been previously described as an “anterior pelvic tilt,” “lower cross syndrome,” and “excessive lordosis”2-4.  However, these terms may limit the model to a particular set of joints, one variation of the dysfunction, and/or may be misleading.  For example, “lower cross syndrome” implies a set of underactive and overactive muscles, but does not consider all of the structures involved in this movement impairment.

The corrective exercise strategies discussed later in this article are used by the Brookbush Institute (http://www.brookbushinstitute.com/) and have their foundation in the corrective exercise model (CEx) developed by the  National Academy of Sports Medicine (NASM), and described in the text “NASM Essentials of Corrective Exercise Training” by Dr. Mike Clark & Scott Lucette (7).

Why do we need a better model?    

            The Search for Congruence – my revision of this model is nothing more than a search for congruence – an explanation that can find congruence between theory, research, observation, practice, and outcomes.  That is, a better model would be evidence-based, accurately describe what we see during assessment, predict exercise and techniques that will enhance performance, and contribute to our understanding of the etiology of common lower-body pathologies.  For more on my views of evidence and the development of this model click here – Search for Congruence

Note: The movement impairment model discussed and developed in this article may not describe the compensation pattern adopted immediately post acute orthopedic injury (ex. impact injuries) or accurately describe neurologic dysfunction (ex. stroke); however, they may be useful in describing

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