Longitudinal and x-fibre techniques.
Lumbar Erector Spinae Group
The erector spinae group runs from the sacrum to the occiput along the posterior aspect of the vertebral column. Its musculature has a dense. layered arrangement that can be visualized as branches of a tall poplar tree. The spinalis is the smallest, and lies closest to the spine in the lamina groove. The thick longissimus and lateral iliocostalis form a visible mound alongside the lumbar and thoracic spine.
Almost all low back pain will involve this muscle group. It can become extremely fibrotic due to constant hypertension and decreased circulation. The tissues often feel more like shoe leather than muscle.
In the lumbar region, the erectors are deep to the dense Thoracolumbar Fascia (TLF), and also partially covered by the latissimus dorsi and the serratus posterior inferior. The most inferior part of the erector spinae is large and strong. It’s fascial attachments are extensive and include fibers from the long dorsal sacral, sacrotuberous and iliolumbar ligaments.
- TLF wraps the erector group and spinal multifidi.
- It is often imperative to treat the fascial restrictions in this area first, before releasing the muscle.
- Fascia work will not only provide pain relief, but encourage the outer layers to slide, differentiate, and become more elastic.
Action and Referred Pain
- Extend, rotate and laterally flex the head and spine.
- Lumbar TP’s refer pain to the mid-buttock.
- Longissimus thoracis TP’s at the low thoracic and high lumbar levels, refer pain downward to the sacroiliac region and buttock.
- Pain in the back and sometimes the buttock and abdomen, that may restrict spinal motion (especially flexion), and activity.
- Subject may have difficulty rising from a chair and walking with an upright posture.
Prone Erector Spinae Release
- Strip longitudinally through the erector muscle mass.
- Your contact should be initiated with a broad surface such as the heel of the hand, flat thumb or finger pads, knuckles, or forearm.
- As you increase blood flow and feel the tissues begin to soften, you can apply more specific pressure to the adhered segments.
- To increase treatment depth, apply cross fibre friction to adhered tissues. This can be performed from the same side or opposite side of the table.
- Specific X fibre with a T-bar can also be very effective in this area.
- Finish by stripping through the entire erector group to flush out the tissues.
Side-Lying Erector and Multifidi Layers
- With the client in a side-lying position, begin with flat thumbs to feel for the lateral edge of this large group of muscles. The entire muscle group will be several inches thick, and it constitutes the bulk of the muscle mass next to the lumbar spine.
- Sink in to the thick lateral aspect of the erector group. You will need to be positioned above your client in order to use gravity, so your table will be quite low, or you may need to kneel on your table.
- Cue your client to make minute movements, as you work very slowly. Motions might include slow hip flexion or extension; reaching with arms; or pelvic tucking and rocking.
1. High Ilium Correction
A high ilium is one of the most common pelvic imbalances. It can set off a chain reaction, thus resulting in many other low back and pelvic ...
2. Quadratus Lumborum
A shortened Quadratus Lumborum(QL) is considered one of the most frequent muscular cause of low back pain.
3. Psoas Treatment Sequence
The iliopsoas complex is the most prominent of the lumbar and hip flexors, and is almost always involved in low back pain conditions.
4. Iliacus Treatment Sequence
Techniques for accessing the iliopsoas junction, iliacus, and the muscle tendon junction of the iliopsoas. The psoas and iliacus merge in t...
5. PNF Stretching Procedures
PNF or Hold/Relax Stretching is effective when ROM restrictions are due to the neuromuscular component. Muscles are most relaxed, and can be...
6. TaloFibular Mobilization & Lower Leg/Ankle stretches
Mobilization of the fibular head, is vital to improving a limited ROM of dorsi and plantar flexion of the ankle.
8. Fascial Release
Fascial work should be performed first, before the muscle work and without any lubricant. Fascia generally applies to the fibrous connective...
11. Sacral iliac Upslip
During forward bending, each sacroiliac joint should open slightly. This causes a slight delay between the movement of the sacrum and that o...
12. Pubic Symphysis Fixation
During extreme hip flexion and extension the two pubic bones rotate in opposition to one another. Misalignments can result in altered biomec...