Mark Philip Deal, a Chiropractor, Osteopath, Acupuncturist and Educator presented a comprehensive and edifying workshop for the Association of Remedial Masseurs on November 11, 2007 at Gladesville in Sydney. His workshop consisted of thorough explanations, a balanced mix of practical work and a number of questions from the floor. Mark complemented the workshop with a fine set of notes for participants complete with photos to illustrate the practical components.

I have extracted the information presented in this article in part from a condensed form of Marks notes along with observations and comments that were made at the workshop.

I give full respect to any intellectual rights in respect to the information given at the workshop by Mark Philip Deal and Peridor Health Schools and include portions here along with commentary purely for the benefit of those members who could not attend.

The workshop commenced with the all-important Structural Analysis. Mark emphasised the importance of performing and recording a structural analysis in a Postero-Anterior then a Lateral View before assessing the spine.

Mark covered the essentials of structural Analysis in Postero-Anterior view in particular:

• Look at the level of the ears, occiput and shoulders.

• Note the prominence and level of the scapulae.

• Are the arms closer to the body on one side?

• Is there a scoliotic curve?

• Identify and touch the PSIS.

• Mark reminded us to inform the client that you are

• about to do this - and to tell them the things that you

• are doing as you do them.

• Assess if one of the PSIS is higher than the other.

• Assess the motion of the SIJ, ask the client to raise one

• knee then the other towards the chest. Observe any

• inferior motion to the PSIS on the side of leg rising.

• Observe any positive Trendelenberg phenomenon - an

• inability to stand on one leg where the pelvis drops

• markedly on the same side as the raised leg as this may

• indicate hip pathology or Gluteus Medius failure on the

• supporting leg side.

• Is the gluteal cleft diverted to one side?

• Is the gluteal fold higher than the other?

• Is the popliteal crease higher than the other?

• Is one foot turned out more than the other?

Mark explained that measuring leg length is too arbitrary and that our palpation skills are varied and very subjective. He highlighted the fact that objective is what you can see and everyone else can see. Above all, keep your mind open to what conditions may be present. It could be a primary or secondary condition or a secondary that has become primary.