YES! Please place the pressure on the lower part of the sacrum and not the coccyx as we don’t want to mobilize the coccyx anteriorly. Use the larger bone to offer the pressure for the release of the pelvic floor muscles. Thanks for clarifying!
Is there any change/would you work on this with someone who as SPD? Do you find that compression of the ischium and sacrum moving that way to cause increased SPD pain or do you complete an anterior rami release first before trialing the compression?
I always treat pfm’s with SPD sx. I don’t find it increased their pain as I treat the pubic bones and rami bones first before doing internal work. Get the pubic bone and rami bones softer and moveing more freely comparing side to side before going internally. Please don’t create pain so if doing the Schulte hold is painful you might want to do a bit more externally with the pelvis first then go internal. Good luck!
It’s totally up to you whether you double glove or not. I choose not to as I rarely work with vulvar symptoms so I don’t spend a lot of time examining the tissues. I like to slide my other hand under the sheet to do the Schulte hold and I find the glove gets in the way of sliding underneath someone but there is not a problem if you prefer to do so.
I thought the emphasis in the lecture was that pressure is applied to the sacrum and not the coccyx,
YES! Please place the pressure on the lower part of the sacrum and not the coccyx as we don’t want to mobilize the coccyx anteriorly. Use the larger bone to offer the pressure for the release of the pelvic floor muscles. Thanks for clarifying!
Is there any change/would you work on this with someone who as SPD? Do you find that compression of the ischium and sacrum moving that way to cause increased SPD pain or do you complete an anterior rami release first before trialing the compression?
I always treat pfm’s with SPD sx. I don’t find it increased their pain as I treat the pubic bones and rami bones first before doing internal work. Get the pubic bone and rami bones softer and moveing more freely comparing side to side before going internally. Please don’t create pain so if doing the Schulte hold is painful you might want to do a bit more externally with the pelvis first then go internal. Good luck!
Would your external hand be gloved as well as your internal hand?
It’s totally up to you whether you double glove or not. I choose not to as I rarely work with vulvar symptoms so I don’t spend a lot of time examining the tissues. I like to slide my other hand under the sheet to do the Schulte hold and I find the glove gets in the way of sliding underneath someone but there is not a problem if you prefer to do so.