Massage & Bodywork

MAY | JUNE 2022

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When a client presents with a postural dysfunctional pattern of the spine, it is natural to assume the cause of the dysfunctional pattern resides in the spine, and, therefore, the treatment of the condition should be focused on the spine. However, factors outside the spine often create altered spinal postures. So instead of focusing only on the spine, we need to expand our area of assessment to include other regions of the body as well. The spine can be likened to a statue that sits on a pedestal. In this analogy, the pedestal is the pelvis, and the entire spine from L5 upward is the statue; in effect, we think of the lumbosacral (L5–S1) joint as where the statue meets the pedestal (Image 1). If a statue stands on a pedestal that is tilted, then the statue itself would have to be commensurately tilted. In this analogy, if we see a tilted statue, we do not look at the statue as being the cause of its poor L i s te n to T h e A B M P Po d c a s t a t a b m m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 35 How Postural Dysfunctional Patterns of the Pelvis Can Impact the Posture of the Spine By Dr. Joe Muscolino KEY POINTS • A tilted pelvis that causes a tilted spine can result in a head that is not level; however, the body's righting refl ex, which keeps the head level, will compensate for the tilted pelvis by curving the spine. • If we do not address the tilted pelvis, none of our work into the spine itself has any chance of lasting because the scoliotic curve is a needed compensation for the tilted pelvis. • The root cause of pelvic dysfunction typically falls into two categories: muscular imbalance at the hip joints or dysfunctional patterns in the lower extremity. L1 L2 L3 L4 L5 Sacrum Inferior Posterior Lumbosacral (L5-S1) facet joint Spinous process (L3) Body (L2) Superior vertebral notch Inferior vertebral notch Intervertebral foramen (L4-L5) Lumbosacral (L5-S1) disc joint space Anterior Superior A right lateral view of the lumbosacral region. The lumbosacral (L5 –S1) joint is located between L5 and the base of the sacrum. Permission Dr. Joe Muscolino. Kinesiology: The Skeletal System and Muscle Function, 3rd edition (Elsevier, 2017). 1

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