I recently had a client complaining of pain in her sacral area. When I was in massage school, almost all of our instructors skipped this area. We learned in Swedish to push the sacrum inferior as we made a long stroke down the back, and in deep tissue we learned to do a little bit of deeper work across the posterior sacrum. Nothing more than that.
In my 23 years of practice, the sacrum has become one of my favorite places to work. This particular client had swelling across the posterior aspect of the sacrum. Deeper pressure did not work for her. I gently moved the sacrum superior and inferior. Inferior pressure made her gasp and hold her breath. Neither of the things I had learned many years ago to do to the sacrum would have been comfortable for her.
Luckily I have learned much more since then. SMRT is gentle enough to use with swelling. Two SMRT positions was all it took to alleviate most of the swelling across the posterior aspect of the sacrum. This allowed me to feel the tissues and the bony position of the sacral vertebrae. The tissues were tight and ropy, and the sacral vertebrae were immobile at S2 through S4.
My anatomy brain told me that this could be due to tension in piriformis or this could be causing tension in piriformis. Either way, piriformis was next on my list of things to work with. But first, I used SMRT to mobilize the vertebrae, which decreased the tension in the tissues, and second, I used SMRT directly on the tissues, which further decreased the tension in the tissues and mobilized the vertebrae.
When I checked her piriformis muscles they were only mildly shortened and had fairly balanced tone. I still had 45 minutes left of our 60 minute session, so I worked her posterior hip flesh, flipped her over, and worked her abdomen. She came out of my office with no pain. Today she texted to thank me. She said, “I have not had pain for 5 days. Absolutely phenomenal!!”
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