Lynn,
Is there a recommended timeframe (post-delivery) in which this technique is most effective?
What would be the opening of that window? 4 weeks post-partum?
What about the other end? I have a patient who has a three-year-old, complaining about what could be an open sacral flexion pattern. Can you make changes after years?
YES!!! Midwives I”ve trained are doing these mobilizations day after birth. There is no most effective. Anytime works, the sooner the better. We can always make changes, the longer it is in the body the more sessions it may need to remain in the original position.
No I don’t. Try a softer object to push the sacrum forward. Does it hurt if you do it by hand? If it does then I wonder if there is something stuck in the tissues? Trauma from the birth?
These videos are so hopeful! My question is.. Do you find those with sacral flexion patterns tend to sit in a anterior pelvic tilt? This is what I noticed in a few patients I tested for.
Absolutely, sacral flexion does promote that. However I have also found them in posterior rotation to try and help them feel more stable because this open birthing pattern feels unstable for them.
What about during pregnancy/with pregnant clients? I remember when I was in the last 2 months of my pregnancy, I could not lie supine on a flat surface without excruciating, shooting pain in my lower back/bilateral SIJ areas that would even make me catch my breath. I went on to have a tremendous amount of back labor both during both early and active labor (not to mention debilitating SPD). I digress…haha!
Laura there wouldn’t be a home program for them then. If you are a clinician. you’d treat them in hands and knees and do your best to mobilize the lower sacrum. If this pain was in a subsequent pregnancy then your pelvis was in an open birthing pattern that needed to be addressed during your pregnancy if you didn’t have it in the first pregnancy. If this was a first pregnancy then the pelvic bones were definitely not happy! We have to address what we can with how our clients are feeling. Thanks for your question.
Client tried this at home, they said they almost immediately felt like their illiac crest scifted on one side, that it felt like one side was higher that the other. No pain – she said it felt really good when she came off and back to the ground and when standing after. Could that be the shift in their sacrum feeling different in the front?
If we are treating patients with these techniques and the goal is not to feel pain, what should the patient be feeling then? I ask patients all the time that if somethings becomes painful let me know. And they will say “well it’s not pain, but it is unpleasant.” I would like to be able to tell my patients what they can expect to feel with these techniques, versus only telling them what they shouldn’t feel.
Thanks Lynn!
The patients should feel pressure from your mobilizations but that pressure should not cause pain. Some clients will say that hurts but it feels so good, that is ok to continue. But if you get them jumping or reacting then I”d move on to another technique. IF they say it’s unpleasant then try reducing your pressure and see if that still allows you to get a release or better motion in the joint. I’d also try a different technique if it doesn’t change the “unpleasant feeling”.
How long they will stay in this position ? Do you encourage working with breathing or only to relax and let the tissue become soft?
I’d have them lay there for 5-10 mins if tolerable. Breathing is fine or whatever helps them to relax.
Lynn,
Is there a recommended timeframe (post-delivery) in which this technique is most effective?
What would be the opening of that window? 4 weeks post-partum?
What about the other end? I have a patient who has a three-year-old, complaining about what could be an open sacral flexion pattern. Can you make changes after years?
YES!!! Midwives I”ve trained are doing these mobilizations day after birth. There is no most effective. Anytime works, the sooner the better. We can always make changes, the longer it is in the body the more sessions it may need to remain in the original position.
Hi Lynn,
Do you have recommendations for other home treatments if the one shown causes pain? TY!
No I don’t. Try a softer object to push the sacrum forward. Does it hurt if you do it by hand? If it does then I wonder if there is something stuck in the tissues? Trauma from the birth?
These videos are so hopeful! My question is.. Do you find those with sacral flexion patterns tend to sit in a anterior pelvic tilt? This is what I noticed in a few patients I tested for.
Absolutely, sacral flexion does promote that. However I have also found them in posterior rotation to try and help them feel more stable because this open birthing pattern feels unstable for them.
What about during pregnancy/with pregnant clients? I remember when I was in the last 2 months of my pregnancy, I could not lie supine on a flat surface without excruciating, shooting pain in my lower back/bilateral SIJ areas that would even make me catch my breath. I went on to have a tremendous amount of back labor both during both early and active labor (not to mention debilitating SPD). I digress…haha!
Laura there wouldn’t be a home program for them then. If you are a clinician. you’d treat them in hands and knees and do your best to mobilize the lower sacrum. If this pain was in a subsequent pregnancy then your pelvis was in an open birthing pattern that needed to be addressed during your pregnancy if you didn’t have it in the first pregnancy. If this was a first pregnancy then the pelvic bones were definitely not happy! We have to address what we can with how our clients are feeling. Thanks for your question.
Client tried this at home, they said they almost immediately felt like their illiac crest scifted on one side, that it felt like one side was higher that the other. No pain – she said it felt really good when she came off and back to the ground and when standing after. Could that be the shift in their sacrum feeling different in the front?
Hard to tell. When the sacrum shifts it can effect the ilium too so it is possible. Glad it wasn’t painful and sounds like she felt better?
If we are treating patients with these techniques and the goal is not to feel pain, what should the patient be feeling then? I ask patients all the time that if somethings becomes painful let me know. And they will say “well it’s not pain, but it is unpleasant.” I would like to be able to tell my patients what they can expect to feel with these techniques, versus only telling them what they shouldn’t feel.
Thanks Lynn!
The patients should feel pressure from your mobilizations but that pressure should not cause pain. Some clients will say that hurts but it feels so good, that is ok to continue. But if you get them jumping or reacting then I”d move on to another technique. IF they say it’s unpleasant then try reducing your pressure and see if that still allows you to get a release or better motion in the joint. I’d also try a different technique if it doesn’t change the “unpleasant feeling”.