Tension in the sacrum can be caused by many different factors including bony misalignments, muscle imbalances, and muscle hyper- or hypo-tonicity. But it is the tightening of the connective tissue of sacrum that I want to talk about.
Several layers of connective tissue attach to the posterior sacrum. They include the latissimus dorsi aponeurosis, the erector spinae aponeurosis, and the thoracolumbar fascia. Tightening of this connective tissue can cause the sacral vertebrae to compress and even misalign in opposition to one another.
Misalignment or compression of the sacral vertebrae is at the root of several complaints that we see quite often. First, let's look at piriformis. Some of you have heard me say that releasing piriformis, achieving true, lasting softening of the muscle is impossible without addressing the alignment of the sacral vertebrae.
How often do you find yourself mashing your elbow into someone's piriformis muscle just to come back 5 minutes later and find that piriformis is as tight as before you began to work on it. While some of the tightening in piriformis has to do with femur head position and tension in the iliofemoral joint ligaments, most of held tension in this muscle is directly related to the mobility and alignment of the sacral vertebrae.
Any client coming to you with psuedo-sciatica or piriformis syndrome likely has some issue with the sacral vertebrae. Other complaints that can you may hear due to sacral vertebrae misalignment and/or compression include frontal headaches, lack of energy, depression, lower abdominal pain and weakness when bending over, and lack of bladder control.
Frontal headaches, lack of energy, and depression may all be symptoms of a shifted or compressed second sacral vertebrae. The second sacral vertebrae is intensely important to the cranial sacral system. Not only is it one of only a few bony attachment sites for the dural tube surrounding the spinal cord, but is also houses a pump that move the cerebrospinal fluid or CSF from the sacrum, through the dural tube, around the brain, and back to the sacrum.
When the second sacral vertebrae becomes immobile due to compression and/or misalignment, the CSF is unable to move through the central nervous optimally. This can cause symptoms such as lack of energy and depression, as well as diminished focus, fatique, and frontal headaches.
This same sacral vertebrae is also an attachment site for piriformis. Many times with sacral dysfunction the symptoms are varied and widespread. A client may complaint about frontal headaches and psuedo-sciatica, as well as lower abdominal pain and weakness.
Lower abdominal pain and weakness are generally a result of weakened pelvic floor muscles. Pelvic floor muscles can become weakened due to lack of tone or, just as ofter, due to chronic tension caused by misalignment and/or compression of the sacral vertebrae that these muscles attach to.
All of this is likely precipitated by a shortening of the connective tissue that attaches to the posterior sacrum. So, I am going to describe for you a broad, general Spontaneous Muscle Release Technique move to soften this connective tissue.
First, palpate the posterior sacrum. While palpating simply feel how tight the tissue of the sacrum is. Then, find the medial crest of the sacrum. The sacrum has 2 sets of bony prominences on each side of the posterior aspect. The medial crest is the set of bony prominences closest to the spinous processes of the sacrum. Use your hand closest to the feet to arc (by this I mean do not move straight superior, move lateral and superior) the sacrum up toward the floating ribs.
Next, place your hand closest to the client's head on the floating ribs. Be careful not to put undo pressure on the points of the floating ribs. Arc the floating ribs toward the hipbone and sacrum. Moving both hands together is like passively creating lateral flexion on that side of the client's body.
You do not need to move much, but you do need to have control of the bones so you are not just moving skin. Hold the position for 20 to 45 seconds. When you release the position, go back and re-palpate the posterior sacrum. You may also find softening in QL and piriformis on that side. Repeat on the other side.
This is quick, easy way to get you into the tissues of the sacrum, lower back, and hip. Enjoy!