• Message from Diane:

    Jeff Rolland completed the ISM Series in 2021 and joined our two year mentorship program at the same time.  Over his 3 years with us, we witnessed Jeff integrate ISM into his programs for high level athletes and help many expedite their proficiency in their sport.  He recently completed this ISM certification (was excused from completing a full case report having answered many questions during his mentorship with us!) and is now an affiliate mentor for others wishing to follow his path.

Meaningful Complaint

Right lateral knee pain when going up/down stairs and moving in awkward positions after being tripped in hockey and falling into the boards with a flexed Right knee approximately 2 weeks prior.

Phenotype of pain - Nociceptive

Meaningful Task - Climbing stairs

Screening Task - Right One Leg Stance

Functional Unit #1 (FU#1)

Start Screen: Standing

Driver for FU#1

Primary Driver: Thorax: Priority ring is TR4

Secondary Driver: Right Hip

Functional Unit #2 (FU#2)

What information from either the story, or from the FU#2 quick screen test with FU#1 driver corrected suggest you need to even assess FU#2?

Story: Patient reported a history of concussions

Start Screen : Standing

Driver(s)  for FU#2: Cervical: Priority segment = C2

Relationship of driver(s) FU#1 & FU#2: Co Driver: Thorax (TR4) and Cervical (C2) and Secondary Driver: Right Hip

Clinical Reasoning for Driver Selection: Correcting C2 fully corrected TR4 (TR4 correction did not change C2); however, the C2 correction did not fully restore control of the right SIJ. An additional correction of TR4 was required for both neutral alignment and complete control of the right SIJ in the ROLS task.  The co-correction of C2 and TR4 only partially centred the right hip in the ROLS task.

FU #3 – Lower Extremity

What information from either the story, or from the FU#3 lower extremity quick screen test with FU#1 or #2 driver corrected, suggest you need to even assess FU#3 lower extremity?

Reason for assessing this functional unit: Due to the patient reporting Right Lateral knee pain with climbing stairs. Optimal biomechanics of the hindfoot is critical for optimal biomechanics of the knee.

Start Screen: Standing

Driver(s)  for FU #3 lower extremity:

Right foot: Talus

Driver FU#1 Thorax: TR4

Secondary Driver Hip, Right

Driver FU#2: C2    Driver FU#3: Right Foot

Relationship of all 3 unit drivers:

FU#1 Driver Corrects FU#3 Driver, but doesn’t correct FU#2 Driver

FU#2 Driver Corrects FU#1 Driver, but doesn’t correct FU#3 Driver

FU#3 Driver doesn’t correct FU#1 or FU#2

Final Driver(s)

Co Driver 2 between Thorax (Priority Ring = TR4) and Cervical (C2)
Secondary Driver: Hip, Right

Further assessment of three body regions would be required for treatment planning and management in this case: C2, TR4 and the right hip with careful observation of the impact of all treatment on pelvic alignment and control during the ROLS task.

Case Study Author

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Jeff Rolland

Physical Preparation

ISM Series Graduate

Clinical Mentorship in the Integrated Systems Model

Join Diane, and her team of highly skilled assistants, on this mentorship journey and immerse yourself in a series of education opportunities that will improve your clinical efficacy for treating the whole person using the updated Integrated Systems Model.

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  • The ISM Series 

    Clinical Mentorship in the Integrated Systems Model

    We will come together for 3 sessions of 4 (4.5) days over a period of 6-8 months with lots of practical/clinical time to focus on acquiring the skills and clinical reasoning to put the ISM model into practice. Hours of online lecture and reading material and 12 hours of in-person lecture are...

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