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Fantabulous

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Hi everyone.  I have a client that has been coming in for awhile on a weekly basis.  He slipped about a year ago and caught himself in a twisted way and has been having back trouble and some cramping in his legs and feet since then.  We have mostly been able to keep everything tolerable for him by having weekly appts. This last week he missed his appointment and was right back to the cramps and low back pain.  The illeum of his pelvis is out of balance.  One side "flares" out more than the other one and I see a rotation in his pelvis and low back.  If I work his Iliopsoas he feels better, but I am not having any luck in changing the balance of his pelvis.  I was wondering if anyone had any ideas about how to proceed, or other things to check.  He has a strange posture, with hyperkyphosis and all of the things that entails as well.  He's in his mid-sixties and I think that much of his posture is a long standing habit.  I don't know if Structural Integration might be the way for him to go or what.  Any ideas?  Thanks, Lisa
 

Hypocorism

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Though this is probably not the answer you were looking for, I would certainly recommend having your client see a chiropractor (if he's not already). Massage and chiropractic in conjunction could really let your client see a long term improvement in his condition.  Just a thought!
 

DANC3R

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Pelvis Problems

The SI joint is a tough one. Maybe he should see a good chiro or osteopath in addition to you?With the SI it is always good to work piriformis as it may flare or pull the sacrum. Also- The quadratus lumborum and Multifidi from posterior sacrum to mid lumbars. Biceps femoris - since it merges with posterior SI ligaments. When you say Psoas do you also mean iliacus? Some use the  - go through intestines to get the Psoas major -technique. They ignore the iliacus.... which often is the source of the problem. Its the one that attches to the ilium... not Psoas.The posterior aspect of Gluteus Medius will often spasm with SI dysfunction.And for pain work the Iliolumbar, Scarotuberous and posterior SI ligaments. The Pain from SI dysfunction arises primarily from these ligaments
 

party101

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Something that occurred to me is, what are his feet and legs doing? آ If his pelvis is unblanced, maybe it's trying to deal with his stance being uneven.  I have an old foot/ankle injury, that led to a long-standing limp that's given me an unbalanced pelvis. آ I try to work on keeping my weight evenly distributed on both feet, and through the stride, which helps a little. آ Also, I get a lot of iliac-crest and sacroiliac tension, and I find that keeping a gentle flex in the core support muscles at the front can help to release some of the tension at the back - does he have weak/underused abs?
 

iloveyou.

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I've had results from doing contract/relax with client prone.  Have him push up from the table lifting his hips off with your hands on one side of the SI joint, then the other.  The position is awkward, though.  Also, sidelying, doing contract/relax on QL.  Stand at the client's head, cradle your palms over him ilium and have him hike his hip into your hands for the 8 second count.  His top leg is bent, bottom leg straight.  After the count, push south as he straightens out his top leg.  
 

Nyx

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Pelvis Problems

He slipped about a year ago and caught himself in a twisted way and has been having back trouble and some cramping in his legs and feet since then.  We have mostly been able to keep everything tolerable for him by having weekly appts. This last week he missed his appointment and was right back to the cramps and low back pain.  The illeum of his pelvis is out of balance.  
This is definitely one I'd consider referring over to a rolfer.

You can search for one in your area on this page:

http://www.rolf.org/locate/locate.php3

:)
 

Blackhawks2

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With the kyphosis that you mentioned you may want to look into addressing some of the muscles involved with upper-crossed syndrome....For the pelvic imbalance I've had good luck with this technique:You say one side is outflared.  Have the client lie supine and bend the knee of the outflared side so the foot is resting on the table.  Then, keeping the knee bent, bring the leg out to the side laterally (which is the way that side of the pelvis wants to go) and have the client try to bring the leg back to it's original position against your resistance.  Once there, have them relax and take the leg more medially (and across the other leg) by passively stretching it that way.  Then recheck the alignment of the hips.  What you are simply doing is having the client utilize his/her own muscles to pull the pelvis back into place, and lenthening the muscles keeping it out.  This can be used for inflares, anterior and posterior rotations too.  Just remember, take it the way it wants to go, then have them push out of it.  Once everything looks like it's been normalized, you will want to do an adductor/abductor strength test just to make sure the symphysis pubis is sitting properly  :) I hope everything I said was clear, I can get off on tangents with my replies  ;)
 
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