Sohier Concept
The „Sohier“approach to physical integrity or The Sohier concept
Sohier’s analytical treatment concept allows for restoring and harmonising the human movement system. It is based on biomechanical analysis and imaging technics which grant comprehensive diagnostics and clinical reasoning. Physiotherapeutic assessments and treatment are guided by thorough understanding of the pathomecanics of the movement system as a whole. This leads to more precise and subtle treatment procedures, which avoid unnecessary vegetative reactions. Thanks to the systematical assessment technics, effectiveness and quality of the interventions can be verified and adjusted at any time in the treatment process.
What objectives are pursued by the Sohier technics?
Sohier’s concept is based on the understanding of reharmonisation of the biological balance of injured tissues and structures like joints. It is common knowledge that joint problems are often triggered by mechanical misuse. It is crucial and therefore Sohier’s main objective to act on biomechanical harmony. That is also why Sohier’s treatment technics are called “reharmonisations”.
Reharmonisations bring unbalanced movement systems back to mechanical harmony and based on this, back to biological harmony.
Areas of use for Sohier technics
The Sohier concept is unmatched in prevention. It harmonises a slightly out of balance movement system long before any damage sets in. Many patients treated with Sohier technics do not need joint replacement or only years later than planned. If the misalignments are important, a change to more careful use of the joint can be set into place.
In sports, Sohier technics are a match winner. Only a centred joint can take the loads of accelerated movement sequences and increased muscle activity and transfer them harmonically onto the respective tissues and structures. Therefore also muscle building that centre the joints in addition are part of Sohiers concept.
In summary, the Sohier concept is most successful:
In rehabilitation: in the areas of orthopaedics, rheumatology, neurology and paediatrics.
In prevention: as prophylaxis for arthritis by harmonising the movement system
In Sports: with centring body building and in economizing the movement sequences.
Symptoms that can be treated successfully with Sohier technics
Functional, posture induced, traumatic, even microtramatically induced changes of the movement system can be treated successfully with Sohier technics. These are the diagnosis:
Arthritis
Tendopathies
Tendo synovitis
Periarthritis and Osteoarthritis
Traumas of joints or peri articular tissue (distortion, breaks, raptures of tendons)
Scoliosis
Varus and valgus knees
List of physical complaints
Headache
Neck pain
Shoulder and neck complaint
Tennis elbow, golfer’s elbow
Symptoms of overuse of the hand
Posture problem, misalignment
Spinal complaint
Upper chest problem
Hip pain or pain in the groin
Knee pain, runner's knee
Foot pain, heel spur, Achilles tendon complaint
In reference to science
There exist to date two studies directly related to the Sohier concept. 1987 scientist showed that centering of the humerus head bring better power performance (Haye, 1987). The 2021 published study of Lutz et al. has inspected 10 test of the Sohier concept for validity and reliability. They were compared to the gold standard of SPECT-CT´s. Intertester reliability as well as the validity of the test were examined, more specific, the probability to predict the location of the impact in the knee joint through Sohier testing. The inspection of the varus/valgus was found to be very valid.
The most important research for the Sohier concepts can be found in mechano-transduction. This basic research examines how sensors located in chondrocytes assist the transformation of physical stimulation into biochemical signals in the form of metabolic changes, inflammatory reactions and protein based phosphorylation that is how the cellular response to mechanical stress passes through the cellular membranes. A study of Zao et al., 2019 comes to the conclusion that chondrocytes are mechano-sensitve and that they need specific stimulation to be optimally functional. Therefore, the hypothesis of many authors of the importance of biomechanics for the creation and course of arthritis is reinforced (Felson 2013; Chang et al.,2015, Chehab et al., 2014, Sharma et al.,2013, Miyziaki et al., 2002). These insights have also been formulated in books of Sohiers in 1995 in „La dynamique du vivant“ and in 1996 in „Biologie mécanogène“ .
Even though Sohier has started to realise the importance of biomechanics for the development of arthritis and has developed assessment and treatment concept for it, he never took part in scientific studies. But he published all his findings in numerous books (Sohier, 2001, 2000, 1999, 1996, 1995, 1989, 1978, 1974, 1960).
That is why many of the scientific questions of nowadays Sohier specialists are based on related studies like those of Huwett & Bates and Huxel Bliven, & Anderson, who see that biomechanical factors can be influenced by phisotherapeutic treatments (Huwett &Bates, 2017; Huxel Bliven & Anderson, 2013).
Or more specifically on questions why “antepostion of the femoral head”, which is defined by Sohier as a ventral translation of the femoral head, reduces inward rotation in the hip joint, described also by Kapron in 2015, Shull in 2013, Barrios in 2009. Sohiers testing of “antepositon” as well as in the treatment of it takes those studies into account.
Likewise, the standardisation of the starting position for inspections defined by Seel (Zuckerman&Lutz 2020) can be put into a scientific context with the research of various authors like Krewer 2018, Azzi 2017, Chiari 2002, Uimonen 1992.
References
- Azzi, N. M., Coelho, D. B., & Teixeira, L. A. (2017). Automatic postural responses are generated according to feet orientation and perturbation magnitude. Gait & posture, 57, 172-176.
- Barrios JA, Crossley KM, Davis IS. Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment. J Biomech. 2010;43:2208–13.
- Chang, A. H., Moisio, K. C., Chmiel, J. S., Eckstein, F., Guermazi, A., Prasad, P. V., Zhang, Y., Almagor, O., Belisle, L., Hayes, K., & Sharma, L. (2015). External knee adduction and flexion moments during gait and medial tibiofemoral disease progression in knee osteoarthritis. Osteoarthritis and Cartilage, 23(7), 1099–1106. https://doi.org/10.1016/j.joca.2015.02.005
- Chehab, E. F., Favre, J., Erhart-Hledik, J. C., & Andriacchi, T. P. (2014). Baseline knee adduction and flexion moments during walking are both associated with 5year cartilage changes in patients with medial knee osteoarthritis. Osteoarthritis and Cartilage, 22(11), 1833–1839. https://doi.org/10.1016/j.joca.2014.08.009
- Chiari, L., Rocchi, L., & Cappello, A. (2002). Stabilometric parameters are affected by anthropometry and foot placement. Clinical biomechanics, 17(9-10), 666-677.
- Felson. (2013). Osteoarthritis as a disease of mechanics. Osteoarthritis and Cartilage, 21(1), 10–15. https://doi.org/10.1016/j.joca.2012.09.012
- Haye. M. (1987) Effets immédiats d’une technique de recentrage articulaire sur l’épaule du joueur de hand-ball. Mémoire U.L.B. Bruxelles
- Hewett, T. E., & Bates, N. A. (2017). Preventive biomechanics: a paradigm shift with a translational approach to injury prevention. The American journal of sports medicine, 45(11), 2654-2664.
- Huxel Bliven, K. C., & Anderson, B. E. (2013). Core stability training for injury prevention. SportHelath 5(6), 514-522. https://doi.org/10.1177/1941738113481200
- Kapron AL, Aoki SK, Peters CL, Anderson AE. In-vivo hip arthrokinematics during supine clinical exams: Application to the study of femoroacetabular impingement. J Biomech. 2015;48:2879–86.
- Krewer, C., Bergmann, J., Gräfrath, P. C., & Jahn, K. (2018). Influence of foot position on static and dynamic standing balance in healthy young adults. Hearing, Balance and Communication, 16(4), 208-214.
- Lutz, N., Zuckerman, S., Seel, F., Ott-Senn, Y., Rogan, S., & Rasch, H. (2021). A clinical test examination procedure to identify knee compartment overloading: a reliability and validity study using SPECT-CT as reference. Journal of Bodywork and Movement Therapies, 27, 500-506.
- Miyazaki, T., Wada, M., Kawahara, H., Sato, M., Baba, H., & Shimada, S. (2002). Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Annals of the Rheumatic Diseases, 61(7), 617–622. https://doi.org/10.1136/ard.61.7.617
- Sharma, L., Chmiel, J. S., Almagor, O., Felson, D., Guermazi, A., Roemer, F., Lewis, C. E., Segal, N., Cooke, T. D. V., & Hietpas, J. (2013). The role of varus and valgus alignment in the initial development of knee cartilage damage by MRI: the MOST study. Annals of the Rheumatic Diseases, 72(2). https://doi.org/10.1136/annrheumdis-2011-201070.
- Shull PB, Shultz R, Silder A, Dragoo JL, Besier TF, Cutkosky MR, et al. Toe-in gait reduces the first peak knee adduction moment in patients with medial compartment knee osteoarthritis. J Biomech [Internet]. Elsevier; 2013;46:122–8.
- Sigward, S. M., Chan, M. S. M., & Lin, P. E. (2016). Characterizing knee loading asymmetry in individuals following anterior cruciate ligament reconstruction using inertial sensors. Gait & posture, 49, 114-119.
- Sohier R. (2001) Kinésithérapie analytique de la gonarthrose. Ed. Kiné-Sciences La Louvière
- Sohier R., Sohier J. (2000) Concept Sohier . Ed. Kiné-Sciences La Louvière 2000
- Sohier R. (1999) Kinésithérapie analytique de la lombalgie. Ed. Kiné-Sciences La Louvière
- Sohier R. (1996) Biologie mécanogène. Ed. Kiné-Sciences La Louvière
- Sohier R. (1995) La dynamique du vivant. Ed. Kiné-Sciences La Louvière
- Sohier R., Haye M. (1989) Deux marches pour la machine humaine. Ed. Kiné-Sciences La Louvière
- Sohier R., Heureux P. (1978) La kinésithérapie du rachis scoliotique. Ed. Kiné-Sciences La Louvière
- Sohier R. (1974) Kinésithérapie analytique de la hanche. Ed. Kiné-Sciences La Louvière
- Sohier R. (1960) Kinésithérapie analytique de la colonne vertébrale T.1 . Ed. Kiné-Sciences La Louvière
- Sohier R. (1960) Kinésithérapie analytique de la colonne vertébrale T.2 . Ed. Kiné-Sciences La Louvière 1960
- Uimonen, S., Laitakari, K., Sorri, M., Bloigu, R., & Palva, A. (1992). Effect of positioning of the feet in posturography. Journal of vestibular research: equilibrium & orientation, 2(4), 349-356.
- Zuckerman S., Lutz N.,(2020) Prozessevaluation einer Validierungsstudie von klinischen Tests - Erkenntnisse von Forschungsnovizen. Physioactive 8(28-32)
- Zhao, Z., Li, Y., Wang, M., Zhao, S., Zhao, Z., & Fang, J. (2020). Mechanotransduction pathways in the regulation of cartilage chondrocyte homoeostasis. Journal of Cellular and Molecular Medicine, 24(10), 5408-5419. https://doi.org/10.1111/jcmm.15204