Issue link: https://www.massageandbodyworkdigital.com/i/121374
@work be a left lateral pelvic tilt. (Lateral pelvic tilt is named for the low side of the pelvis because that's the side to which the pelvis is tilting.) Substantial challenges and detrimental effects develop from this postural distortion. Prolonged lateral lumbar flexion with weight bearing can cause irritation of the facet joints on the concave side of the lumbar curvature. The altered compressive load on intervertebral disks can also cause eventual disk degeneration. In addition, this altered pelvic position can adversely affect mechanics and cause pain in the sacroiliac joint. The pain symptoms from these complaints can be similar and sometimes difficult to discriminate. For example, symptoms of sacroiliac-joint dysfunction can often mimic radiating neurological pain down the lower extremity caused by lumbar nerve root compression. As closely as possible, identify the primary source of pain and discomfort so appropriate treatment can be used. A primary result of lateral pelvic tilt is tightness in the quadratus lumborum on the side of the hiked hip. It can be challenging to work the quadratus lumborum deeply enough to achieve the needed reduction in tightness in this muscle. A side-lying, activeengagement method is therefore a great way to get appropriate pressure on this muscle and encourage tissue lengthening. This technique is performed with the client in a side-lying position and angled on the treatment table so that the uppermost leg can be dropped off the back edge of the table (Image 4). Bring the client's leg into full abduction and ask her to hold the position. You will apply pressure with a small contact surface (fingers, thumbs, or a tool) to the lateral aspect of the quadratus lumborum. The client will slowly lower her leg as you perform a static compression or deep stripping technique along the length of the quadratus lumborum. At the end of the technique, the client's leg will be lowered off the back edge of the table. The quadratus is engaged in an eccentric muscle contraction during this motion, which increases the muscle's density and magnifies the pressure applied during the technique. Postural alterations or dysfunctional biomechanics from a lateral pelvic tilt can cause altered tension patterns in fascial connections from the lumbar region through the posterior lower extremity. Achieving postural and biomechanical balance in this area is most effectively achieved if attention is also given to the gluteal muscles, hamstring muscles, and myofascial and ligamentous connections through the lumbopelvic region. Mom's Self-Care The new mom can do much to reduce the pain and stresses on her body throughout the day by making some simple changes. A nursing pillow (Boppy) or other pillow brings the baby closer to the chest for feeding, comforting, or napping. When feeding, 4 The side-lying treatment position for the quadratus lumborum. postures that fully rest the upper back are better, like lying down or sitting in a comfortable chair and putting a pillow behind the head. A front backpack-type carrier is better than a car seat for carrying the child. New moms should be conscientious about following the usual rules about bending and lifting: lift with the legs and not the low back, which means squatting to pick the child up as much as possible, and avoid odd, twisting positions. The baby should be brought close to the body before lifting (which means dropping the crib side down or removing the tray from the high chair). A concerted effort to be conscious of posture is very important. The new mom should learn to be aware of how she is bending, holding the child, standing, etc. in order for new and healthy patterns to develop. Finally, that new mom needs a massage. There is abundant research showing the benefits of massage in reducing stress, enhancing the immune system (for her and the breastfeeding baby), and improving quality of life. And, quite frankly, I can think of no better gift for Mother's Day. Whitney Lowe is the author of Orthopedic Assessment in Massage Therapy (Daviau-Scott, 2006) and Orthopedic Massage: Theory and Technique (Mosby, 2009). He teaches advanced clinical massage in seminars, online courses, books, and DVDs. Contact him at www.omeri.com. www.abmp.com. See what benefits await you. 105