Massage & Bodywork

NOVEMBER | DECEMBER 2022

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The sacroiliac joint (SIJ) is a thing of beauty. Its strange, graceful angles and curves draw the eye, hinting at subtle and mysterious functions. Nearly hidden between the massive bones they join, the SIJ's interlocking shapes and strong surrounding ligaments balance the paradoxical demands of stability (as appropriate to its role as the vertebral column's foundational joint) and mobility (since it is the meeting place between the limb-related movement of the ilia and the spine-related movement of the sacrum). This joint does move, but just a little: Gross mobility is not its main purpose. Nor is range of motion our target in our Advanced Myofascial Techniques approach. In fact, some clients' SIJ symptoms can be worsened by overmobilizing these sensitive joints, even though pain is not, on average, more common in people with very mobile SIJs than in people with very immobile SIJs. So, instead of targeting joint mobility when clients report SIJ-related pain, sensitivity, or discomfort (experienced as low-back, hip, gluteal, or pelvic pain, as well as pain or a feeling of stiffness in the SIJs themselves), our therapeutic goal is to normalize the sensations and refine the client's proprioception related to the adaptive movement these joints can provide. We accomplish these aims with gentle, patient techniques, combined with directed client attention, all in the powerful context that receiving pleasant touch provides. After this kind of work, your clients will typically experience a sense of lightness and freedom when walking, more experientially akin to lightly f lying (Image 1) than to weight- bearing. I wrote about working with rotational (horizontal plane) SIJ adaptability in "The Twisting Sacrum: Ilia Rotation Technique" (Massage & Bodywork July/August 2022, page 32). I'll continue that theme here as we look at sagittal-plane SIJ adaptability. Adaptability at this joint includes the ability to allow and control both linear glide (like a standard SIJ squish-test assesses), and angular (rotating) motion at the SIJ surface (Image 2). 30 m a s s a g e & b o d y wo r k n ove m b e r/d e ce m b e r 2 0 2 2 TECHNIQUE By Til Luchau KEY POINTS • The sacroiliac joints (SIJs) move only slightly in the sagittal plane, but we can use this potential mobility to help with low-back, hip, gluteal, or pelvic pain, as well as pain or a feeling of stiffness in the SIJs themselves. • The aim of this approach is not to increase joint range of motion, but rather to de-threaten the small movements possible at the SIJs and normalize the sensitivity of these sometimes-painful joints. Easing the Sacroiliac Joints: Ilia Torsion Techniques THE SOMATIC EDGE When the sacroiliac joint (SIJ) is pain- and restriction-free, walking can feel like flight, rather than earth-bound and weight- bearing. This striking image was generated by the Midjourney artificial intelligence engine, using the key words sacroiliac, wings, and flight. 1

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