Issue link: https://www.massageandbodyworkdigital.com/i/1471270
L i s te n to T h e A B M P Po d c a s t a t a b m p.co 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 33 In the Ilia Rotation Technique, we assess pelvic mobility and sensitivity from the "outside-in" via our gentle pressure, and from the "inside- out" by asking about the client's felt experience as well. Image from Advanced-Trainings. com's Ilia & SI Joints: AMT video course. 2 In the Ilia Rotation Technique (Images 2–4), we gently assess and mobilize the two large innominate (or hip bones) in relation to the sacrum. We test and address any sensitive or mobility differences by passively moving these bones in the horizontal plane, which mimics the slight twisting of the sacrum in walking or trunk rotation. We also take time to help the client feel this potential motion in their own bodies (Image 2). This subtly but tangibly shifts sacral mobility, but, perhaps even more importantly, it also changes the subjective experience of walking and turning. So, is the goal of the technique to straighten out, or de-rotate, the pelvic bones? No. Position-based descriptions such as "upslips," "torsions," "out-f lares," and the like have not been reliably correlated with pain or dysfunction, in spite of being the dominant model many manual therapy disciplines use to assess and treat pelvic issues. Thus, in this approach, we're not trying to get the pelvic bones to move into any "ideal" or symmetrical static position. "But," you might ask, "since the sacrum twists between a left and a right SIJ, what happens when the two joints aren't evenly mobile? If one side is stiffer, wouldn't that cause a slightly asymmetrical gait?" And, "Couldn't that left/right difference itself cause problems?" Again, the idea of asymmetry being the source of orthopedic issues or pain is supported by far more conventional wisdom than evidence. However, one study of SIJ pain in pregnancy did indeed show less pain in subjects who had more even left/right SIJ stiffness. 2 In other words, at least in that study, the more evenly mobile the two SIJs were, the more comfortable the subjects were likely to be. What's more, our focus in this technique is not on increasing range of motion; rather, it is on refining the evenness of the two sides' sensitivity and subtle mobility. This is based on research suggesting that the amount of movement at the SIJs doesn't correlate with pain: On average, people with less SIJ movement don't have pain any more or less often than people with a lot of SIJ movement, 3 so it's hard to say that more (or less) SIJ movement would be reliably therapeutic.