The trail leading to the Lower Elwah River mouth 

Place Road in Port Angeles, WA

Front of Spine

Releasing Joint Restrictions:  Treating the front of the spine

Using the Releasing Joint Restriction (RJR) technique clinically known as Strain and Counter Strain (SCS) can help you improve your skeletal alignment and reduce pain.  So far I have given instructions in using the RJR technique to improve the alignment of the pubic bone which is the front where the pelvis joins, the pelvis, ribs, and the back of the spine.  Treating the pubic bone is the best place to start using the RJR technique.

The details of using the RJR technique are listed in this handout:  RJR Explained

Handout:  Side of pubic bone using RI

Handout:  Front of pubic bone using RI

Once the pubic bone is aligned,  I recommend working your way up the body to the pelvis and then the spine.  When I taught how to treat the pelvis, I also gave information about treating the ribs.  However, it is actually better to treat the spine before treating the ribs.  The pelvis is like the turkey platter at the bottom of a stack of plates.  The dinner plates on top of this are like the lumbar spine, the salad plates on top of the dinner plates are like the thoracic spine, the dessert plates represent the cervical spine or neck.  Finally, the tea-cup sitting on top is the head.  If the turkey platter on the bottom is tilted or tipped, everything on top slides off.  The thoracic or mid-spine has to be lined up appropriately for the rib to be able to slide into the driveway on the backbones.  If the rib is not lined up correctly then the shoulder cannot fit the way it is supposed to.  So shoulder problems are best addressed, in my opinion, by starting at the bottom of the stack of plates and working your way up.

After treating the pubic bone work on the pelvis next

Handout:  RJR Pelvis with RIs

 Using the Restriction Indicator (RI) is the best way to find the most precise movement combination for your body.  After finding the RI, keep it marked but stop pushing on it.  Use the movement combination listed and check the RI after each position change to see if the tenderness is improving.  If it is getting better you are going in the right direction.  Continue checking for the RI and changing positions until the RI is as close to 0/10 pain level as possible.  Then start the clock and stay in that position for 90 seconds.  If you cannot find the RI then perform the movement combination as a stretch.

Handout for treating pelvis and ribs as a stretch:  RJR Pelvis and Ribs stretch

Treatment of the spine using RJR technique

The tender points or RIs for the front of the spine are basically on the front of the transverse processes of the spine bones.  The transverse processes are the airplane wings coming from the sides of the backbones.  To find the RIs move off to the side of the center of the body by about 1" on either side.  These RIs can be found from the belly button all the way up to the collar bones.

Handout:  RJR spine front with RIs

Handout:  RJR stretch spine front in sitting

Handout:  RJR stretch spine front lying down

Bruising with RIs

Pushing on the body may cause bruising to those who bruise easily.  If you bruise easily, you may want to use the stretches rather than poking for the RIs.  However, I learned about Strain and Counter Strain (SCS) the clinical version of Releasing Joint Restrictions (RJR) after I had a car accident in 1993.  I saw a therapist to treat my horrible back pain and was shocked that he was poking on the front of my body when it was my back that hurt.  To make matters worse, I had terrible seat belt bruises on my stomach and he was pushing on those bruises.  Well of course pushing on a bruise would hurt but what was shocking to me was that once I was in the correct treatment position when he pushed again it did not hurt, even though he was pushing on a bruise.  This was a really great lesson for me to learn both as a therapist and as a patient.  The tenderness under my finger is not the skin but something deeper inside the body.

Cause of the RI

When you push on the body and you find pain it is due to inflammation or swelling.  With the RI or tender point, the pain immediately improves when the joint is held in the proper movement combination or treatment position.  I have not been able to find an answer to this question, but  I think what may be happening is that this little ball of inflammation is trapped because the bones are not lined up as they should be which causes the tubes that carry fluid to be pinched and this leaves a little pool of fluid trapped.  When the joint gets into the proper position to line back up it opens the tube up so the fluid is allowed to move out.  I am not sure what the fluid is but I suspect it may be the lymphatic vessel that has the trapped fluid and therefore lymphatic fluid is causing the inflammation.  This is pure speculation but I think it is a really interesting question.

Inner core

I have written about the importance of the inner core.  I want to remind you to fire your inner core/pelvic floor muscle when moving into and out of awkward positions.  This includes moving into and out of movement combinations using the RJR technique.  One of the other things that can be helpful is to bend and straighten the legs one at a time when lying on the bed.  It is best to hold the inner core while moving the legs but if you forget or cannot hold the inner core while changing positions, by moving one leg at a time it will create less torque through the spine and reduce the risk of losing neutral alignment.

Handout:  Inner Core/pelvic floor

 

Contact:  Loraine@doctorlovejoyevans.com

 

© Dr. Loraine Lovejoy-Evans, DPT