We spend most of our lives standing, walking, sitting, and lying supine on our backs. Occasionally we are prone on our stomachs. When receiving treatment, especially for low back issues, request that the practitioner evaluate how your pelvis and sacrum are aligned in standing, supine and prone. If the pelvis and sacrum are balanced in these three positions, there is a good chance your symptoms of discomfort including pain, tightness, numbness and tingling will lessen immediately after your adjustment. There is also a higher likelihood that the balancing of the pelvis and sacrum in all three positions will lead to feeling better during the activities and positions you use during the day.
There are different approaches to balancing the pelvis and sacrum. One popular technique is “Muscle Energy “ which positions the patient’s joint on three different planes of motion: coronal, sagittal and transverse, then asking the patient to contract an extremely small amount in order to get their muscles to realign the spine. Another approach is called “Biomechanical Regulators” which uses reflex points along the body to realign structure.
When realigning the pelvis in the three different positions, it is important to look for other structures, such as muscles, fascia or ligaments, which could be pulling one out of alignment. Sometimes the areas of influence are far from the pelvis such as in the shoulder or in the foot or ankle. This is caused by tissues in the body, namely fascia, which is continuous and connected throughout your body. An area of tightness in one spot may lead to tension and tightness anywhere that fascia travels. In addition, we have large muscles that can span large areas of our bodies for example the hamstring, which originates on our sitting bone of the pelvis and attaches below the knee.
After the practitioner optimizes realignment of the pelvis and sacrum, it is up to the patient to keep the changes. This means performing recommended stretches so that tight tissues will not pull one out of alignment again. A patient may also be asked to perform stabilizing exercises such as glute sets or transverse abdominals strengthening. The latter is targeted to strengthen our body’s own back corset, comprised of muscles from the transverse abdominals. The goal is to keep the gains made from realigning your pelvis and sacrum. Equally important are general body mechanics during the day. Often prolonged sitting or sleeping in awkward positions reinforces misalignment. Another important point is analyzing a patient’s daily activities. Questions to be considered are: how do you spend your day? How do you vacuum, put away dishes or dress yourself? Do you read in bed or watch television? How do you sit in your car? How long do you sit at your computer or doing weeding?
Your pelvis and sacrum will change depending on the position you’re in from standing to sitting to supine and prone because of the way the pelvis and sacrum are shaped as well as the varying degrees of tension change of ligaments, muscle, fascia and even organs which attach or traverse through your pelvis and sacrum. When working with a healing practitioner, ask your practitioner to evaluate whether your pelvis and sacrum alignment is aligned in all three positions. Optimizing alignment in various positions statistically improves success.