Issue link: https://www.massageandbodyworkdigital.com/i/68013
DEEP-TISSUE SCULPTING FOR LOW-BACK PAIN 8. QUADRATUS LUMBORUM STRETCH (IMAGE 9, AT RIGHT) Intention and Imagery To release the quadratus, imagining more space between the ribs and iliac crest, and lengthen the back. Procedure Do this final procedure with the client sidelying, first on one then the other side. Use the forearm or fingertips to compress in a medial and inferior direction on the quadratus. especially the rectus and oblique abdominals. Similarly sculpt along the other side of the distal rib cage. Precautions • Melt slowly to avoid painful pressure on abdominal organs. • Do not use this procedure on pregnant or menstruating women, nor with anyone experiencing undiagnosed abdominal pain.3 • Avoid painful pressure on the floating 11th rib by ending the rib cage compressions at the end of the costal cartilages. 7. ANTERIOR FLAT OF THE ILIUM (IMAGE 8) Intention and Imagery To create skeletal awareness of the pelvis and iliopsoas myofascia and deep release and receptivity into the abdominal muscles. Procedure Position the client supine. Begin near the anterior superior iliac spine, compressing medial and toward the pubic ramus. Melt slowly and gently into the abdominals then iliacus, proceeding as the myofascia yields as if "skiing" down the slope of the iliac bowl. If release allows you to contact the psoas muscle, continue in an inferior direction releasing any stringiness, bunching, or tenderness there. Similarly sculpt the other side. This procedure may also be done with the client sidelying. Precautions • By entering at the ASIS, keeping the palmar side of your fingers against the flat of the ilium, and reducing pressure if painful, you will avoid any pointed or excessive pressure on the abdominal organs. • Be especially sensitive to wait for the client's release and to avoid working beyond his experience of the "pleasure/pain borderline." • Do not apply direct pressure in an inferior direction on the inguinal ligament as it may be weakened and would then encourage herniation. • Do not use this procedure on pregnant or menstruating women, or with any client experiencing undiagnosed abdominal pain. Delay application with postpartum women for 8–10 weeks after childbirth.4 Hints If your forearm is too wide or you can't locate the muscle belly, work using your fingertips. STROKES TO EMPHASIZE FOR INDIVIDUAL IMBALANCES Those clients with excessive lumbar curvatures (lumbar lordosis) benefit most from sculpting of the posterior fascia, erector spinae, quadriceps group, and the muscles attaching at the sacrum, iliac crest, and anterior surface of the ilium. When your client's alignment reveals a flattened lumbar curve, emphasize sculpting the gluteals and hamstring groups. To change pelvic alignment sufficiently to reduce muscle strain and spasm, encourage iliopsoas toning and stretching. Relax the quadratus lumborum on the higher side to balance uneven iliac crest heights. To release scoliosis, sculpt thoroughly and in detail on the erector spinae, especially on the sides inside the S-curve. The quadratus lumborum also will benefit from careful sculpting.5 SUPPORTIVE ACTIVITIES AND STRETCHING In addition to your table work, your client may need guidance in daily exercise, activities, and other ways to reinforce the changes experienced. If there's some residual pain, show him how to find a comfortable resting 68 massage & bodywork may/june 2009