Other pelvis treatments
Balanced ligamentous tension of the pelvis is less commonly taught at osteopathic schools and / or rarely tested on the COMLEX® exams. Pelvic diaphragm release is much more frequently taught and tested.
Balanced ligamentous tension
Example: left posterior innominate rotation
- Sit facing the seated patient and grasp above both of their ankles
- Slowly push superiorly (position of ease) on the left leg while simultaneously pulling inferiorly (position of ease) on the right leg
- Instruct the patient to rotate their thoracolumbar region to the left until the left leg begins to draw upward
- Once a point of balanced tension is achieved in this left rotated position, instruct the patient to inhale deeply and hold for 5–10 seconds to further facilitate the treatment
- Hold this position until a release is palpated
Pelvic diaphragm, direct inhibition emphasis
Note: this can also be performed similarly in the supine position.
- With the patient lying prone, instruct them to flex their knees to 90º and slightly internally rotate their hips
- Palpate the ischiorectal fossa (located immediately medial and cephalad to the ischial tuberosities)
- Apply pressure into the ischiorectal fossa with both thumbs until the restrictive barrier of this pelvic diaphragm is met
- After this barrier is met, push with both thumbs toward the inferior lateral angles (ILAs) of the sacrum
- Maintain this pressure until a release is palpated. Asking the patient to cough can help facilitate release of the pelvic diaphragm soft tissue