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94 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 2 0 technique THE SOMATIC EDGE I had the opportunity to speak with Canadian physiotherapist, chiropractor, and presenter Greg Lehman about several topics, including his part in a recent paper, "Changing the Narrative for Sacroiliac Pain." This excerpt of our longer conversation (available at has been lightly edited for clarity. Til Luchau: Can you say something about yourself and your interests for people who don't know you and your work? Greg Lehman: Sure. My background is in biomechanics. I got my master's in the '90s, and then went on to do my chiropractic training. I was in clinical practice for almost a decade before I went back to school for physio, like physical therapy, in Canada. And throughout that time, I was also a researcher at the Canadian Memorial Chiropractic College—primarily on the physiology of manual therapy and exercise biomechanics. I'm still in clinical practice, just not full time like I was in the past. Now, I teach a course called Reconciling Biomechanics with Pain Science. TL: That's the course I did with you. Was it four, five years ago? GL: That's right. TL: It was a colleague who said, "Hey, you should do this. It's going to rock your world." Changing the Narrative: A Conversation with Greg Lehman By Til Luchau but you challenged the biomechanical explanations I'd been trained in and was repeating in my own trainings. So, just to catch up a little bit, have there been changes in your perspective, say, in the last four or five years? GL: No, and I know that sounds super arrogant. It's just been solidified. [Five] or 10 years ago, maybe, I felt like I was the only person saying these things. I see more and more people saying these ideas now. I think the professions are changing. CHANGING THE SACROILIAC NARRATIVE TL: You and your collaborators just put out a paper titled "Changing the Narrative for Sacroiliac Pain." 1 I know you didn't necessarily write it for manual therapists, but what are a couple of things you would want them to know? GL: Actually, we were thinking of them a lot. Thorvaldur Palsson was the lead author. I think he's at Aalborg University in Denmark now, and his PhD was essentially [on the sacroiliac] (SI) joint. 2 One of [Palsson's] big studies found that people who have SI joint-related pain will often feel unsteady, unstable. There's a weakness; a sense of discomfort when they lift their leg. For so long, people thought, "Oh, the joint's unstable," meaning it's moving when it shouldn't move. This was all based on [Andry] Vleeming and the form- and force-closure of the SI joint. 3 TL: Right. GL: What [Palsson] showed was that if you just irritate the joint or irritate the tissues around the joint, without inducing Greg Lehman GL: Oh no. TL: It did. Well, maybe it was part of my world rocking at that time anyway, and you closed the deal, as it were, on the fact that I really needed to reassess how I was thinking and teaching. I'm actually a little worried talking to you today that I'm going to need another four or five years to revise what I do and get it back to a place where I feel good about presenting it. GL: OK. I bet you'll find it makes it simpler. I think often what happens is you have to go through this incredibly complicated critique of biomechanical intervention to say, "Oh, I don't have to worry about that anymore." TL: That's about right, in terms of my experience. What you were saying [then] about sensation and the brain matched what a lot of us had been thinking,

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