RJR: Side of Pubic Bone

 

Releasing Joint Restrictions: Side of Pubic Bone

I call this technique Releasing Joint Restrictions (RJR) based on the system by Lawrence Jones, D.O., called Strain and Counter Strain (SCS). This is a highly specialized stretching protocol that improves skeletal alignment and reduces pain.   I have found that the best place to start treatment for pain anywhere in the body is to treat the pubic bone, specifically the side of the pubic bone.  I think the pubic bone is the key to unlocking a stuck skeleton.  The horse and thinker exercise lying down and sitting up are used to treat the side of the pubic bone.  This can be quite beneficial for most people, but for some, this stretch is not adequate.  Using a specific tender point and using the principles of the RJR technique to more precisely treat the side of the pubic bone can be more helpful.  

 

 

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Another reason I like to use the Restriction Indicator (RI) is that the stretches are slower and sloppier.  In other words, if you look for and are unable to find an RI and you have been skilled enough to find them, then you do not need to do that particular treatment position or stretch.  The RI indicates that there is an alignment problem that needs attention.  If you do not want to look for the RI, then I recommend you do either the seated horse and thinker stretch or the side of the pubic bone lying down exercise:

 

Using a Restriction Indicator

If, however, you want to learn the more precise way to use this technique, then I recommend looking for the RI on the side of the pubic bone.  First of all, work on locating the tender point or RI.  It is easiest to find this lying down on the bed.  Find the lowest bone on the front of the body.  Each side of the body has a pubic bone and they come together in the middle.  An easy way to find the side of the pubic bone is to bend your knee and put your hand in the crease at the front of the hip and slide in toward the middle of the body.  When you hit something hard this is the pubic bone and you are on the side of it.  Now straighten the leg then push down into the body and then push against the side of this bone.  This will put you toward the back end of the side of the pubic bone.  Move up and down on this surface poking very precisely until you find the spot that hurts the most when pressed.  Keep this RI marked and do not move off of it but stop putting any pressure on it.  Use the 0-10/10 scale for pain.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Finding best Movement Combination

Next, work on systematically changing positions and rechecking RI with each position change to determine if the movement was helpful or not.  Start by bringing the leg out to the side with foot moving 10".  Then recheck RI.  Now move the foot to 15" and recheck RI.  If the pain is less, bring the foot out as far as able and recheck.  Find the best position of the leg moving out to the side. If the pain worsens, you have gone too far, come back a little.  Now bend the knee and hip and find the best position of the bend.  Lastly, drop the knee in toward the other leg and find the best position of twisting the leg.  Make sure to avoid dropping the knee in if you have had a hip replacement.  Follow the precautions that your physician has put in place for you.  

Once you find the position that reduces the pain level to as close to 0/10 as possible.  Stay in this position with finger marking the tender point but do not put any pressure on this RI.  Stay in this position for 90 seconds.  

 

 

 

 

 

 

 

 

 

This movement combination can be done in sitting or standing.  You take the foot out to the side, bend the hip and knee and drop the knee in toward the other leg.  The photo in sitting does not show enough forward bend.  I recommend that you take your nose toward the knee that is not off to the side.  In standing, make sure to hold onto something solid. Do not use a rolling chair.  

 

 

 

 

 

 

 

 

 

 

 

 

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To poke or not to poke?

That is the question.  I recommend doing the poking to look for RIs.  It is the best way to know that you have found the correct movement combination for you.  Almost every joint in the body can bend forward or backward, tilt from side to side, and twist from side to side.  The positions I have recommended for the stretches for the side of the pubic bone and for the front of the pubic bone are frankly, just guesses.  They are the positions that I have found most of my patients required to resolve their RIs.  However, there have been some people who I treated the side pubic bone that required the leg to move out just a little bit to the side (abduction) while others needed a lot of abduction.  I have even found some who needed the leg to cross over the opposite leg (adduction).

 

With each movement possible there can be a whole range of positions available. Abduction moving the leg away from the body such as making a snow angel has about 45 degrees available normally.  Ths means that you will need 0 to 45 degrees of hip abduction motion.  Without poking for the RI, I have no idea how much movement you need into hip abduction.   Flexion is the movement bringing the knee toward the front of the chest has up to 120 degrees available typically.  Rotation internally is turning the toes in toward the other leg and external rotation turns the toes away from the other foot.  Internal rotation usually has around 30 degrees and external rotation around 40 degrees available.  So you can see, the possible combinations of these movements are truly overwhelming.   By poking for the RIs you will be able to precisely find the position that should resolve your joint restrictions.

 

By getting familiar with the locations of the RIs and the movement combinations or treatment positions required to resolve them, you can get really fast at improving your alignment.  Once you are skilled at locating RIs, then you will scan for potential RIs to release them.  When you are scanning and do not find an RI, you do not have to treat that joint, as the lack of an RI indicates the joint is in neutral alignment.  Using the RIs makes you much faster eventually.  When you are first starting out and locating several RIs it will take you awhile to get them resolved.  Eventually, however, you can ideally get rid of all of your RIs and will be left with scanning for them and not finding them. You decide if you want to poke or not poke, but if you can take the time to learn the RJR system, it can be very rewarding.

 

Most important concept to learn from me

If you learn nothing else from me, please learn about the importance of strengthening and using the inner core.  When the pelvic floor muscle is really weak it is so thin, it is like a piece of shaved ham.  When the pelvic floor muscle is very strong, it is like a thick steak.  With a strong pelvic floor muscle, it is much more difficult for the pelvis and spine to slide out of alignment.  Bodybuilders at rest have really strong, thick muscles.  So their bones tend to stay in neutral alignment easier than those with weak muscles.  Using the Releasing Joint Restriction protocol helps to improve the alignment of the skeleton to reduce pain, and having a strong pelvic floor/inner core helps maintain the improved alignment.

 

Canary in the coal mine

My personal “canary in the coal mine” or sign of a big problem coming, is using the bathroom more frequently, especially waking up at night to use the bathroom. Typically, I can go for 8 hours before I have to use the bathroom.  At the age of 53, I find people my age have to go much more frequently, probably every 2-3 hours.  Even more frequently for those who have had children.  Having children wrecks havoc on the pelvic floor muscles.  Despite this, unless there is nerve damage or a rupture (tearing) of the muscle, the pelvic floor muscle can be strengthened.  I just had a patient last week who is in her 80’s that told me she is now getting up one time a night to use the bathroom rather than every two hours.  She is the kind of patient I point to when people tell me they are old and it is normal to have more difficulty holding back urine because of age.  If this were the only factor, this patient should not be getting better at holding her urine, she should be getting worse.  Age is a lousy excuse in my book.

 

I can tell you from personal preference it is not age but rather laziness that causes most problems with weakness.  The lazier I get, the weaker I get.  When I recognize that I am failing to fire my pelvic floor often enough to keep it strong, such as waking at night to use the bathroom, then I chastise myself and get back on the bandwagon of firing my pelvic floor.  As long as I keep my pelvic floor strong, I do not get RIs or pain. When I get weaker, then I find RIs.  I do not want the pain to return, so the weak pelvic floor, going to the bathroom more than every 9 hours is my sign that I better do something to stop the regression.   If I do have pain, then it is entirely due to laziness. The good news is that if I do have pain, I typically know how to resolve it by using the RJR technique.

 

When your skills have sharpened, you can find your canary in the coal mine may initially be locating RIs.  I have found people with RIs that do not have pain.  But once they have enough of the RIs, the pain returns.  It is best to find the RIs and turn them off to prevent the pain.   Perhaps you will get to the point I am where you will find your canary in the coal mine to be a weakness in the pelvic floor by having to wake up at night to use the bathroom or go more often during the day.

 

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Contact:  Loraine@doctorlovejoyevans.com

 

© Dr. Loraine Lovejoy-Evans, DPT