I have in my back pocket is Joe Abbott and Joe is a researcher in the UK who has spent the last five years of her PhD investigating all things manual manual methods and obviously the reliability studies for the sake really I joined come up and there are a lot of problems with the methods in the reliability studies and there are in the last systematic review that was published by clerks and you know some really good people were involved were involved in this study they come up with the same conclusion that we don't have reliability but again the letter to the editor following that publication in 2019 it was just full of things that I don't even understand which is neither well I can't speak for Adam but for myself I'm not a researcher in the way that I can actually critique the methods and how things are done you trust that the methods are accurate they've been peer reviewed you trust that they've been reviewed well and so we look at the inclusion criteria the subjects and we jump to the conclusions because man when I look at statistics they just go right over my head and the track we fall into is that we trust that they're telling us the truth and in fact what Joe is discovering the course of her PhD is that there are a lot of problems with how the methods of the research being being done for a number of different reasons and that's not a podcast for Anthony is to have someone on like Joe who's a researcher that can actually tear apart not tear apart but break down the literature and help us more to understand it so my whole take on on the pelvis is that the pelvis needs to function like a platform whether stable is the right word or not it needs to be able to mitigate and manage and disperse the forces that reach it in all tasks and activities that we do and I think the form and force closure theories and motor control theories of the integrated model of function that Andre Vlaming and I put together in the late 90s still holds true for me today because pain does not guide me in terms of how I assess and treat the pelvis in fact those tests of laziness and also when you combine it with the active straight legrees test for which there's reliability sensitivity and specificity for pregnancy related polypertal pain and you still have to use your hands on that test there's manual methods involved in that test as well they very rarely do you do I find in my practice two out of four of those tests positive and even if they were there's there's no indication that it's truly the joint that is is causing the proficiency section and if it was so what what do I do about it I don't have a needle that I can inject inside the joint florisz socket guidance that has to be done expertly according to Ben Sterson that's not a tool in my toolbox what do I do about this painful SI jump it doesn't answer the why question for me so the load transfer test as Ben Sterson is now calling it and in 2002 and Barb Hulkerford proposed this test which she called the Stork test and basically it's just load the pelvis stand on one leg and see what happens at the SI joint and from the hundreds of studies before it by Vlinning and Damon and Schneider's and the route and we go on forever in the mid-90s all the work that was done looking at what should happen at the joint what should happen at that joint when you load it is nothing it should close pack it should force close it should stay stable so that forces can go through it and the problem is when that doesn't happen so if you have had damage to the ligaments from trauma or birth which is not common if you have changes in your motor control particularly changes in pelvic floor multifidous relationship that is from my perspective the the one of the critical patterns and imbalance of that that prevents control of the SI joint that when this happens and you can't effectively transfer load we get movement at the joint and it's not about how much it's not about this we're not judging is it too much is it too little is it any and can we feel it so in Antwerp in 2019 at the World Congress a low back in pelvic pain I was so surprised to see that Ben Sturrs and it changed his mind about this low transfer test and that he's using it now pre surgically to determine who needs surgery who doesn't who needs an injection who doesn't and I asked him I went up to him and said wow you're actually using the low transfer test are you telling me now that you can feel when the SI joint is controlled and when it's not when it gives way and he says no I can't feel it Dan but my physiotherapist can and I trust them and I went and I test them as what he said I said how do