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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 27 Consider the rectus femoris, for example (Image 1). Because of its attachments to the anterior inferior iliac spine (AIIS) and upper border of the patella, chronic hypertonicity in this powerful muscle may lead to lumbopelvic distortions. A shortened or hypertonic rectus femoris and iliopsoas can tug on the ilia, creating torsional forces that anteriorly rotate the ipsilateral pelvic bowl. Unilateral contraction of the rectus femoris and iliopsoas typically results in anterior and inferior rotation of one ilium. Bilateral contraction produces increased lumbar lordosis and lumbosacral angle. While treating the psoas is also important, releasing tension in the rectus femoris and retraining the body through deep squatting practices can help reciprocally strengthen weak inhibited muscles and will often break the cycle of lower crossed strain. In Myoskeletal Alignment Technique, the Master Myoskeletal Therapist certification teaches advanced assessment and treatment for painful lumbopelvic disorders such as torsions, iliosacral up- slips, protective muscle spasms, and nerve impingement. Here, we'll use these rectus femoris techniques more generally to balance the pelvis. 2 4 3 Technique 1 helps balance the pelvis by gently stretching the rectus femoris. Technique 2 helps balance the innominates by releasing the rectus femoris at the AIIS. Technique 3 shows a quick fix for restoring balance and alignment in those presenting with an unleveling of the hips. RECTUS FEMORIS TREATMENT FOR PELVIC BOWL ROTATIONAL PATTERNS There are many ways to address pelvic bowl rotational patterns. Today, we'll focus on three myoskeletal alignment techniques I find effective. Technique 1 With the client prone, grasp the client's left medial thigh just above the knee with your right hand and f lex the client's knee to 90 degrees (Image 2). Brace the client's body with a firm counterforce by placing your left hand on the posterior superior iliac spine. Next, slowly lift the client's leg into hip extension until you feel the first restrictive barrier or the client reports discomfort, then hold that position. Ask the client to gently push their knee toward the therapy table to a count of five and relax. Lift the client's leg until you feel the second restrictive barrier or the client reports discomfort and hold. Ask the client to gently push their knee toward the therapy table to a count of five and relax. Repeat this stretch on the right leg. Technique 2 This technique helps balance the innominates by releasing the rectus femoris at the AIIS. With the client supine, stand on the client's right side and place your right forearm softly above the client's right knee. Drop into the rectus femoris and glide your forearm slowly toward the AIIS while communicating with the client about pressure and comfort. Repeat this technique three times and pause at the AIIS attachment site (Image 3). While your right forearm pins the rectus attachments at the AIIS, your left hand internally and externally rotates the client's leg. Repeat this technique on the left side. Technique 3 Image 4 demonstrates a "shotgun" myoskeletal technique for addressing pelvic bowl rotation. A shotgun technique is a quick fix; in this case, for restoring balance and alignment in those presenting with an unleveling of the hips. To begin, ask the supine client to move to the edge of the therapy table and allow the right leg to drop off the table to extend the hip. Next, the client f lexes their left knee and grasps it with both hands. Place your right hand on the client's left knee and your left hand just above the client's right knee. Apply gentle counterforce pressure with both hands. Next, ask the client to gently raise their right knee against your resistance to a count of five and relax. Now, apply a gentle counterforce by pushing the left hip into f lexion and the right into extension and repeat 3–5 times. This is one of my favorite techniques for restoring balance and alignment to a distorted pelvic bowl.