CLINICAL MASSAGE THERAPY A Structural Approach to Pain Management

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1 World Massage Conference Presents: Massage to support Pregnancy, Pelvic Birth Stabilization and Postnatal Including Hip for mother Replacement and baby World Massage Conference Protocols June with 2013 CLINICAL MASSAGE THERAPY A Structural Approach to Pain Management CHAPTER 2 Pelvic Stabilization The Key to Structural Integration Treating Low Back Pain, Hip Pain, SI Joint Pain and Sciatica This presentation will address the treatments of acute and chronic low back pain and sciatica. Revolutionary hip capsule adhesion release techniques, and pre and post hip replacement therapies will be highlighted. That will include incredible pre and post surgical lymphatic drainage and massage cupping benefits. The spiritual, energetic, and emotional components of healing will also be addressed. The majority of clinical conditions such as pain from spinal stenosis and bulging and ruptured discs do not require surgery, if the muscles and joints are balanced out, and normal muscle firing orders are restored. 1

2 Figure 2-1 Examples of Disc Problems. Figure 2-9A Iliopsoas. Figure 2-9B Iliacus. 2

3 Figure 2-10 Assessment for Hip Extension. Figure 2-11 Neutral Position Femur Hip Fascial and Joint Capsule Mobilization. Figure 2-12B Internal Joint Capsule Release. 3

4 Figure 2-12A External Joint Capsule Stretch. Figure 2-11 Neutral Position Femur Hip Fascial and Joint Capsule Mobilization. Figure 2-13 Traction Hip After Releasing Joint Capsule Adhesions. 4

5 Figure 2-16 Iliacus Release (Hand Placement). Figure 2-18 Psoas Release (Hand Placement). Figure 2-20 Anterior Joint Capsule Release. 5

6 Figure 2-10 Assessment for Hip Extension. Figure 2-22 Quadratus Lumborum. Figure 2-24 Palpate Iliac Crests. 6

7 Figure 2-25 Palpate PSIS. Figure 2-26 Myofascial Release, Erectors/QL. Figure 2-27 QL/Erector Cross-Fiber Gliding Strokes. 7

8 Figure 2-31A Muscle Resistance Test, Right QL. Figure 2-32 Multidirectional Friction. Figure 2-33B QL Eccentric Muscle Contraction (Finish). 8

9 Figure 2-35 Right QL Stretch. Figure 2-36 Decompress Lumbar Spine. Figure 2-43A Evaluate Internal Femoral Rotation. If there is a hard end feel do capsule work instead of stretching the deep six hip rotators. 9

10 Figure 2-39A Sciatic Nerve. Figure 2-40 Sciatic Nerve May Run Through Piriformos. Figure 2-11 Neutral Position Femur Hip Fascial and Joint Capsule Mobilization. 10

11 Figure 2-43B Evaluate External Femoral Rotation. If there is a hard or bone on bone like end feel do capsule work again instead of stretching the internal hip rotators. Figure 2-41 Internal (Medial) Hip Rotators. Figure 2-42 Adductors. 11

12 Figure 2-43B Evaluate External Femoral Rotation. Figure 2-41 Internal (Medial) Hip Rotators. Figure 2-42 Adductors. 12

13 Figure 2-44 External Joint Capsule Work. Figure 2-45 Internal Joint Capsule Work. Figure 2-43A Evaluate Internal Femoral Rotation. 13

14 Figure 2-46 Deep Six Lateral Hip Rotator Myofascial Release. Figure 2-47 Cross-Fiber Gliding Strokes and Trigger Point Work to Deep Six Lateral Hip Rotators. Figure 2-48 Internal Femur Rotation to Massage Deep Six. 14

15 Figure 2-52 Deep Six Stretch. Figure 2-54 Lower Deep Six Eccentric Contraction. Figure 2-55 Assess for Strain, Medial Hip Rotators. 15

16 Figure 2-66 Myofascial Release Up Quadriceps. Figure 2-67 Myofascial Release Up Rectus Femoris. Figure 3-31 Gluteus Maximus Compression. 16

17 Figure 3-32 TFL Myofascial Release. Figure 2-71 Optional TFL Stretch. 17

18 Figure 2-73 Quadriceps Stretch. Figure 2-57 Myofascial Release, Adductors. Figure 2-59 Use Muscles to Stretch the Intermuscular Septums and Deep Investing Fascia. 18

19 Figure 2-56 Assess for Strain, Adductors. Figure 2-63 Muscle Review. It is critical to do Pelvic Stabilization prior to treating compensatory knee pain. Figure 2-65 Correcting an anterior/ inferior rotated ilium to eliminate sacral torsion or SI joint pain. This also relaxes the weak inhibited gluteus max and upper hamstrings. 19

20 Figure 2-77 Myofascial Release, Hamstrings. Figure 2-75 Hamstring Strain. Figure 2-76 Hamstring Muscle Belly Strain Test. 20

21 Figure 2-87 Iliopsoas Stretch (Start). Figure 2-88 Iliopsoas Stretch (Finish). Figure 2-89 Right QL Stretch. 21

22 Figure 2-90 Lateral Hip Rotator Stretch. Figure 2-91 Quadriceps Stretch. Figure 2-92 TFL/Iliotibial Band Stretch. 22

23 Figure 2-93 Distal Hamstrings Stretch (Start). Figure 2-94 Distal Hamstrings Stretch (Finish). What happens when the hip damage is beyond repair? How do we prepare to recover fast from hip replacements? My story. 23

24 Preparation for Joint Replacement Should Include: 1. Get in the best physical condition as possibly by swimming and eating well. 2. Do your homework to get the best type of hip replacement. 3. Make sure you get tested for metal allergies; People are dying of metalosis due to the body rejecting certain metals. 4. Prepare yourself emotionally and spiritually for the journey. 5. Find a physician that does this all the time. Someone the other doctors and professional athletes go to. 6. Find a therapist that is certified in lymphatic drainage and Vacu Therapies (Massage Cupping) 7. Get lymphatic drainage and Vacu Therapy the evening before the surgery. 8. Get glut activation done the night before surgery. Critical Details Day of Surgery: 1. Move the hip slowly into lateral and medial rotation right out of surgery-micro motions to stay pain free. Scar tissue remodeling occurs as new fibroblasts are being laid down right out of surgery. Concentric and eccentric muscle contraction re-aligns scar tissue as it is being laid down. 2. Have lymphatic drainage done away from the wound site shortly after the surgery (same day) 3. Do some basic mild isometric contractions in bed of glut max to keep them activated. 4. Make sure they get you up walking the day of the surgery. 5. Use the VPULSE machine designed to prevent DVT (Venous Thrombosis) It also activates the lymphatic system through creating muscular contraction/ relaxation for faster healing. Get Vacu Therapy Post Surgically 24

25 True Healing involves putting the body into homeostasis mentally, emotionally, physically, and spiritually, to release the trauma patterns recorded in our tissues. The pain and disease in our physical body is often an outer manifestation of our emotional, energetic, psychological, and spiritual challenges. Carefully Choose the avenues of healing that you believe will heal your body, mind and spirit. Choose the thoughts you give energy to carefully. Your thoughts become your words. Your words become your actions. Your actions become your character. Your character becomes your destiny! Research proves that millions of cells will communicate throughout your body, based on the thoughts you give energy to. This can occur to the point of literally changing your DNA. DVDs, Seminars, and Product Sales All of the images in this presentation are used throughout every DVD produced by The Center for Pain Management. The DVD series take therapists looking inside of the entire body to match each technique to the underlying pathology of each clinical condition. Each one includes detailed Orthopedic Assessment, Multidisciplinary Manual Therapy Treatments and Specific Remedial Exercises for each clinical condition. For special prices on our Integrated Manual Therapy & Orthopedic Massage DVDs, Book and Client Self Care Manual visit our website or allison@orthomassage.net To order Integrated Manual Therapy & Orthopedic Massage DVDs that have all the dissection images in them, go to: or allison@orthomassage.net 25

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