Sohier Concept
What is the Sohier concept?
Sohier is an analysis and treatment concept that can be used to restore and normalize the biological balance of the human movement system. It is based on biomechanical analysis and relies on imaging procedures. This enables comprehensive diagnostics and clinical reasoning. Examination and treatment are guided by an understanding of the pathomechanics of the musculo-skeletal system as a whole. This allows treatment techniques to be carried out more precisely and subtly, thus avoiding unnecessary vegetative reactions. The effectiveness of the measures carried out can be evaluated at any time, thanks to the systematic and standardized examination techniques and adjustments can therefore be perused.
What is the aim of Sohier's techniques?
Sohier's concept is based on the fundamental idea that a joint can only be treated effectively if the damaged or diseased tissue can be brought back into a biological balance. As the causes of joint disorders are largely mechanical in nature, the primary aim of the interventions is to restore the biomechanical balance in order to then use body awareness for centering the joints actively with strengthening exercises. This distinguishes the educational aspect of this concept.
In which areas are Sohier techniques used?
Sohier is an outstanding concept when it comes to prevention. A movement system that is easily out of balance can be reharmonized with Sohier techniques. Many patients who are treated with Sohier techniques need joint replacement less often or only years later than planned. However, even if major misalignments occur, a reversal to more joint-sensitive movement can take place.
In sports, Sohier techniques are decisive and therefore a “match-winner”. Only a centered joint can harmoniously transfer the loads of the acting forces to the respective tissues during movements and increased muscle build-up. The concept of centering joints actively with strengthening exercises is also specific to this concept.
In summary, it can be said that the Sohier concept is used successfully in the following areas:
In rehabilitation in orthopedics, rheumatology, neurology, pediatrics
In prevention osteoarthritis prophylaxis by harmonizing the musculoskeletal system
In sport with centering and strength building and therefore increasing performance with reconcile economic movements.
Which complaints can be successfully treated with Sohier techniques?
Functional, postural, traumatic and even micro-traumatic changes to the musculo-skeletal system can be successfully treated with Sohier techniques.
Arthritis (known as Arthroses in Europa)
Tendopathies
Tendo-synovitis
Arthritis, periarthritis and osteochondritis
Articular and periarticular trauma (dislocations, joint fractures, tendon ruptures)
Scoliosis
Varus or valgus of the knee
These can manifest themselves in the following symptoms:
Headaches
Neck pain
Shoulder and neck pain
Tennis/golfer's elbow pain
Overuse symptoms of the hand
Misalignments/postural problems
Spinal column complaints
Chest pain
Hip pain/groin pain
Knee pain/runner's knee
Foot pain / heel spur / Achilles tendon complaints
etc.
Reference to science
There are currently two studies that have directly examined the ABS concept. In 1987, it was shown that restoring center to the humeral head improves strength performance (Haye, 1987). The study, published by Lutz et al. in 2021, examined the reliability and validity of 10 Sohier tests. These were compared with the gold standard of the SPECT-CT. Both the intertester reliability and the validity of the Sohier tests were examined, i.e., the possibility of determining the impact in the knee joint by analyzing the tests. The inspection of the valgus/varus proved to be very valid.
The basic research that is important for the Sohier concept is currently in the field of mechano-transduction. The research investigates how the sensors and receptors localized in chondrocytes assist the transformation of physical stimulation into biochemical signals in the form of metabolic changes, inflammatory processes and protein phosphorylation, i.e., how the cellular response to mechanical stress passes through the cellular membrane. A study by Zhao et al concludes in 2019 that chondrocytes are mechanosensitive and require specific stimulation to regulate optimal function.
Thus, the importance of biomechanics, observed by various authors, for the onset and the course of joint arthrosis is reinforced. (Felson 2013; Chang et al.,2015, Chehab et al, 2014, Sharma et al. Sohier recorded these findings in 1995 in "La dynamique du vivant" and in 1996 in his work "Biologie mécanogène".
Although Raymond Sohier began to study the importance of biomechanics for the progression of joint arthrosis as early as 1945 and subsequently developed a preventive examination and treatment concept based on his ideas, he never became involved in modern studies. Instead, he published his findings in numerous books (Sohier, 2001, 2000, 1999, 1996, 1995, 1989, 1978, 1974, 1960).
For this reason, many of the scientific considerations of Sohier's specialists are based on studies with equivalent questions. For example, general questions such as those posed by Huwett & Bates and Huxel Bliven, & Anderson on which biomechanical factors can be considered to be influenced by therapeutic interventions (Huwett & Bates, 2017; Huxel Bliven & Anderson, 2013).
Or more specifically on the question why the anteposition of the hip, which represents a translation of the femur head to ventral, restricts the internal rotation (Kapron 2015, Shull 2013, Barrios 2009). Sohier uses these findings both for the design of the hip anteposition test and for the treatment approach.
The standardization of the starting position for inspections introduced by Seel (Zuckerman & Lutz 2020) can also be placed in a scientific context through research by various authors such as Krewer 2018, Azzi 2017, Chiari 2002, Uimonen 1992 or the measurement of varus/valgus at the knee joint by Sigwart 2016, Parker 2009.
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