Issue link: https://www.massageandbodyworkdigital.com/i/68008
ESSENTIAL SKILLS That area is often very tense, holding many locked emotions. It is sometimes better to leave it alone, especially if you have not had supervised training working in that part of the body. CRANIOSACRAL THERAPY This treatment does not specifically treat a back problem, but it is useful in restoring a healthy balance in the body to allow the ligaments to heal and stay well. It is a very gentle treatment that requires time and patience to be effective, and it is only effective when performed by a skilled practitioner. MANIPULATION Osteopathic and chiropractic manipulation often succeed in eliminating pain from overstressed ligaments in the sacral area, at least temporarily. One to five manipulations should be all that is necessary. If a client does not see results after five sessions, that person probably needs to try a different treatment. There are various theories about why manipulation may be helpful with these conditions. It may help by allowing the sacrum to go back into place, thereby relieving the stress, or by causing the strained fibers to tear and then become stronger as they heal. INJECTIONS Proliferant injections into the affected ligaments (performed by a physician who is trained in orthopedic medicine) can be very effective. They often provide a good long- term solution for people who have loose ligaments in the low back and sacrum that are causing instability and repeated trauma. I know from personal experience — this treatment once played a critical role in my own healing from back pain, and I have seen it help many of my clients as well. Proliferant injections help to break up adhesive scar tissue, to align the bones of the sacrum and low back, and to tighten, thicken, and strengthen the stretched and weakened ligament fibers. After each injection treatment, the visit massageandbodywork.com to access your digital magazine 105 REFERRED PAIN PATTERNS: SUPRASPINOUS LIGAMENT L5–S1 area of pain is somewhat diminished. The patient then guides the physician to the remaining areas of pain so that they can be injected. Typically, about eight injections are needed to fully relieve the pain. Note that this treatment requires a very high level of skill on the part of the physician. LASTING RELIEF Low-back pain is probably the most common musculoskeletal problem treated by massage and bodywork therapists. Depending on the severity of the pain, this condition can range from being a nuisance to being a debilitating, life-altering experience. In many cases, the underlying cause of low-back pain is injury to the ligaments of the sacrum. Often a combined treatment approach—using massage to increase circulation, friction therapy to eliminate adhesive scar tissue, and exercise to prevent future adhesions from forming—is highly effective in providing clients with lasting relief. education and sports medicine. He is founder of the Muscular Therapy Institute. Benjamin has been in private practice for more than 45 years and has taught communication skills as a trainer and coach for more than 25 years. He teaches extensively across the country on topics including SAVI communications, ethics, and orthopedic massage, and is the author of Listen to Your Pain, Are You Tense? and Exercise Without Injury and coauthor of The Ethics of Touch. He can be contacted at bbby@mtti.com. REFERRED PAIN PATTERNS: SUPRASPINOUS LIGAMENT L5–S1 OR SACROILIAC LIGAMENTS ON ONE SIDE Editor's Note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. Essential Skills is based on author Ben Benjamin's years of experience and education. The column is meant to add to readers' knowledge, not to dictate their treatment protocols. Ben E. Benjamin, PhD, holds a doctorate in