Sep 3, 2011

Adding Assetts: Advanced Hip and Pelvis

Last week I learned some new powerful and refined techniques for assessing and treating troublesome hips. Advanced Rolfing instructor and head of the certification program Advanced Myofascial Techniques, Til Luchau, demonstrated techniques to release tension in the soft tissue around the hips, as well as releasing the joints within the hip and pelvis.

Along with adding a couple dozen techniques to my repertoire, I also learned how to quickly assess and find restrictions in the hips and pelvis, allowing for more focused work where it is needed most. Even in the short time since implementing this new know-how into my work, I've enjoyed seeing my clients walk out of sessions feeling better and moving more freely.

The hip bone, also called the innominate, meaning 'nameless' in Latin, is actually 3 bones that fuse embryologically: the iliam, ischium and pubis. The two innominates join at the pubic symphsysis joint in the front and the sacrum in the back.
Some brief Anatomy:

The hip/pelvis system is marvelous and complex. It is where our upper body meets our lower body and its unique wide, bowl shape allows for our distinctly human upright nature. The hip socket is shallow and dish-shaped, allowing the femur that articulates with it great flexibility to move freely in many directions. Freedom of motion is important and a key aspect of the hips, but also has an inverse relationship to stability. Therefore strength in the soft tissues, the ligaments, tendons, muscles and enveloping fascia, is required to create stability in this vital structure, which must negotiate the functions of mobility for our legs to carry us where we want to go while also giving support to our heavy upper body. Altogether, about 20 muscles work in a harmonized symphony to create or prevent movement in our hips as we move and stabilize ourselves throughout the day, according to J. Earls and T. Myers in Fascial Release for Structural Balance (2010).

Where the hips are in space, whether we are standing, sitting or in motion, also determines the alignment of the spine and upper body. The base of the spine, the sacrum, articulates with the two hip bones creating the sacroiliac joint (SI joint). The sacrum is also the platform for the first lumbar vertebra (L5). If the hips are tilted to one side, often due to tightness around the hip socket, then the sacrum is also tilted and the spine must compensate for it by curving and counter-curving. The pelvis also tilts front to back. A little tilt is good, and creates relaxed curvature of the spine. But too much (sway back) or not enough will put tension on the body as it tries to maintain an upright posture. It's good to keep your hips relaxed, mobile and balanced, because their condition affects your whole body!

Techniques and Applications:

While at this Hip/Pelvis workshop, one of my favorite techniques I learned is actually a ligamentous release (ligaments are the dense connective tissue the link bone to bone). The sacrotuberous ligament attaches the bottom half of the sacrum, which is the fused base of the spine, to the back and bottom of the hip bone. This ligament anchors the sacrum. Working to release this ligament can help relieve tension further up in the low back, along with tension in the musculature of the hips, such as the gluteus maximus.

This technique, along with the others I learned last week, are helpful in balancing and mobilizing the hips, including in treating sciatic pain, which is a common condition, causing pain, usually on one side, starting in the glutes and down the back or side of the leg, and sometimes into the low back area.

Thanks for reading!

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