Sacral Sag and Fascial Drag – Pelvis - PDF Document

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  1. Sacral Sag and Fascial Drag – Pelvis It is well to interpret my use of the word “drag”: To drag is to draw with difficulty against active or passive resistance. WGS Introduction Natural Agencies for Healing: ? Potency of the Tide ? Primary Respiratory Mechanism ? Secondary Respiratory Mechanism ? Ligamentous and Membranous Articular Mechanisms __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Review The concept of Sacral Sag originates in the observation that anatomic physiology peripheral to the cranium can alter the fluctuation of the CSF-Potency of the Tide, (a primary natural agent for self healing) in the posterior cranial fossa, subsequent to and/or simultaneous with altered function of: the mobility of the Reciprocal Tension Membrane; the pineal slack tension regulating, gear shifting accommodation of the motility of the neural tube; and the ligamentous and membranous components of osseous mobility (drag). __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Then again, sag rhymes with drag; and sags and fascial drags lead to chronic rags. Contributions of Thought 2nd p. 284 The cerebro-spinal fluid is the highest known element in the human body, and unless this substance is produced in abundance, a disabled condition of the body will remain. … this great River of Life must be tapped, and the withering fields irrigated or the harvest of health will be forever lost. Philosophy of Osteopathy p. 39 The Main Street Anterior and Posterior Longitudinal Spinal Ligaments Prevertebral fascia __________________________________________________________________ __________________________________________________________________ Page 1 Page 22 Pelvis and Sacrum: Where It All Comes Together 2010 AAO Convocation

  2. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ The Old Age Center __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Pelvic Diaphragm __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Suspended Sacrum Anterior convergence Respiratory Diaphragm …I prefer the sag description (to “anterior sacrum”) because the sacrum is suspended between the two ilia and relatively corresponds to another unit of the cranial-respiratory mechanism...the sphenoid bone which is suspended between and beneath two frontal bones. Sag also has my preference because there are no muscular agencies from the sacrum to the ilia to initiate articular mobility and none to be found from bone to bone in the cranial unit. Contributions of Thought 2nd p. 284 There is a movement that operates through the reciprocal tension membrane. See how the dural membrane connects up all the parts, including the sacrum, as an interosseous membrane. TSO p. 22 Page 2 2010 AAO Convocation Pelvis and Sacrum: Where It All Comes Together Page 23

  3. Manual Procedures: Sacral Sag-Anterior Sacral Alae Method COT p 286 Burruano Personal Collection ? ? Operator seated in front and below the patient (PT) Operator thumbs along iliac crest and inside working toward the posterior ilia and sacral ala PT bends forward, arms over physician’s back advancing operator’s thumbs (glove on hand) Operator uses h/h knees to bring PT’s legs together spreading PT’s ilia Augmentation/cooperation with PT breathing I/E to BLT Operator holds contact at sacrum while PT is instructed to sit up without extending lumbar spine ? ? ? ? (Another description:) The specific procedure that Dr Sutherland demonstrated ... is carried out with the patient seated across the table with his arms resting on the shoulders of the operator who is seated in front of him. The operator’s thumbs are on and parallel to the crests of the ilia, their tips just clear of the lateral borders of the quadratus lumborum muscles. Gently moving the patient form side to side, the thumbs work their way medially and downward, anterior and close to the iliacus muscles. The tissues of the body wall anterior to the sacral ala are compressed, as the patient slumps forward and the lumbar spine assumes a posterior convexity. He is instructed to exhale and hold the breath while the thenar eminences of the operator hold the crests of the ilia laterally to spread the pelvis. As the patient inhales and raises his shoulders the thumbs lift and rotate the sacrum into its respiratory flexion position assisting the natural movement that occurs in inhalation. It should be recognized that the function of the operator is not to forcibly correct the lesion but to guide and assist the inherent forces in their effort to lift the sacrum from the position of lesion into its normal relationship. (Lippincott, H 1965) Page 3 Page 24 Pelvis and Sacrum: Where It All Comes Together 2010 AAO Convocation

  4. Lumbar Pelvic-Differential Method COT p 288 Vertical Axis of the sacrum ? ? The patient is seated on the table The operator is on a chair in front of him, cupping PT’s heels with thumbs at lateral malleolus. PT’s legs are lifted to engage ischial tuberosities with table Operator pushes/pulls on PT’s legs to test ease of motion at SI Operator holds leg position – BLT - in direction of ease PT turns torso in direction of ease to point of BLT observed by operator PT assists with respiratory cooperation PT turns back to straight (turns lumbar-sacrum) while operator holds pelvis position ? ? ? ? ? ? Sacral Sag- The “simple” Sacral Method ? The patient is seated across the table, operator cupping heels, lifts PT’s legs as above- knees straight. ? Operator holds the ilia posteriorly by a backward pressure (of operator) on the leg / ankles ? PT slumps forward until the ilia start to participate in the motion ? Respiratory cooperation - exhalation until it is necessary to inhale ? PT inhales and raises shoulders ? Operator holds the ilia forward while the sacral base moves upward and back. Optional: Ischial Rectal Fossa Lift Standing SI Technique Seated Lap Technique Haltof A. Collection of Cranial Bone Photographs for Teaching. Cir 1990 Lippincott, H. AAO 1965 Yearbook Volume II, The Depressed Sacrum. American Academy of Osteopathy 2000. Sutherland, W. Contributions of Thought 2nd Ed. Rudra Press; 1998. Sutherland, W. Teachings in the Science of Osteopathy Rudra Press; 1990. Williams P, Warwick R Dyson M, Bannister L. Gray’s Anatomy 37th Edition. UK: Churchill Livingstone; 1989 Page 4 2010 AAO Convocation Pelvis and Sacrum: Where It All Comes Together Page 25