Massage & Bodywork

November/December 2012

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technique ClASSrooM To ClienT | @worK | enerGy worK | MYOFASCIAL TECHNIQUES working with the Sacroiliac Joints By Til Luchau The sacroiliac joints (SIJs) are the body's structural meeting place. Here, the spine meets the pelvis, the upper body meets the lower body, the axial meets the appendicular skeleton, and the left and right sides meet the center. These deep, complex, and large articulations play a key role in bending, sitting, stepping, walking, and many other daily activities. What is more, when there is SIJ pain, it can seem to affect the very core of our subjective experience, giving a sense of instability and disruption that, for many people, is reflected in their mood and outlook, as well as in their objective physical functioning (Image 1). Work with the SIJs is indicated when clients experience: • Low-back pain, especially when unilateral (discussed below). • Sciatic pain, both axial and appendicular (see Massage & Bodywork, July/August 2011, "Assessing Sciatic Pain," page 110). • Pain or sensitivity in the SIJs themselves, such as in sacroiliitis (inflamed joints) or sacroiliac dysfunction syndrome (too much or too little movement, also discussed below). Sacroiliac (SI) mobility and balance are also important to address whenever working with issues such as scoliosis, leg-length differences, asymmetrical activities and habits (such as throwing sports or crossing one's legs), and other The sacroiliac joints are the articulation of the sacrum (opaque) with the hip bones (transparent). These important joints can be painful when they are either too loose or too tight. Hip, groin, sciatic, buttock, or low-back pain can result. Image courtesy Primal Pictures. Used by permission. 1 114 massage & bodywork november/december 2012 structural or functional patterns that demand extra accommodation at the sacral meeting place. In this article, I'll describe two gentle but effective SIJ techniques from's Advanced Myofascial Techniques seminars. In addition to being useful in addressing the symptoms listed above, these two examples of SIJ techniques are also effective ways to: • Begin a session, since they tend to evoke a palliative parasympathetic response (the sacrum is one of the body's two locations for parasympathetic nerves). • End a session, both because of their calming and quieting effect, and because ensuring sacral adaptability after working elsewhere is thought to aid in integration and help prevent postsession discomfort. (Ida Rolf, the originator of Rolfing Structural Integration, used sacral work as part of the closing ritual in most, if not all, of her sessions.) SI ANTERIOR/POSTERIOR RELEASE When SI motion is excessive, such as after an injury, the joints can become irritated. However, in walking and bending, there is a surprising amount of movement in healthy SIJs—they twist, glide, shear, and gap to a palpable degree. These motions are crucial for shock absorption, structural adaptability, and kinetic loading. Since the planes of the SIJs are oblique, anterior to posterior movement of the sacrum in relationship to the ilia will slightly distract (open) the SIJ (Image 2). We can use this principle to assess and release mobility restrictions at the SIJs.

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