RJR:  Side Pelvis

Clouds at sunset over Sequim, WA

Releasing Joint Restrictions:  Treating the side of the pelvis 

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.  Treating the pubic bone is the best place to start using the RJR technique.  Just the other day I was working on my cousin Katie who had fallen and was having back and hip pain.  We tried treating the front of the pubic bone first and the side of the pubic bone second.  We could not get the front of the pubic bone Restriction Indicator (RI) the tender point turned off. However, after treating the side of the pubic bone then we worked on the front of the pubic bone again and this time the RI did turn off.  I keep learning over and over again that it is best to start with the side of the pubic bone first even if I am treating a headache.  One would think that after 20+ years I would have learned this by now.   So, I recommend starting with the side of the pubic bone first.

Once the pubic bone is aligned then I recommend working your way up the body to the pelvis.  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.

The RI on the top of the iliac crest of the pelvis which is the large bone above your hip where a baby would ride can be difficult to hold onto while changing positions.  I tend to find the RI with the tip of my thumb and if I cannot maintain this contact, then I do the stretch anyway and check for the RI when the 90 seconds is done and I am back into a neutral position.  The handout below shows the location of the RIs and the movement combinations for treating the side of the pelvis.   This is the position for treating the top of the pelvis by sitting and tilting and twisting to the left.  This position should be held for 90 seconds and then repeat the post-test to see if any changes occurred.    

Inner core

By firing your inner core/pelvic floor muscle when moving into and out of awkward positions such as moving into and out of movement combinations using the RJR technique you can ideally keep the spine in a neutral position to prevent pain from recurring.  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.

Pubic bone

Make sure to check the pubic bone and treat these RIs if noted before working on the top of the pelvis. Check for all of the RIs you know how to treat two times a day.  If you are able to reduce pain using the RJR technique then check for RIs anytime you notice pain increasing. If you are unable to locate the RIs then perform the stretches and try to find the ones that make the biggest difference and use those two times a day and any time the pain increases.  Since the RJR technique is a passive stretch, not requiring muscles to fire or contract, this exercise protocol can be done at any time as it will not cause overuse.

Front of Spine

So far the RJR treatment positions and RIs I have provided are those treating the front of the spine.  Typically back pain that is caused by the front of the spine is felt as an aching pain that is difficult to pinpoint with your fingertip.  It is usually a larger area.  The aching might be quite intense but it is more of an aching rather than sharp, stabbing pain.  Another sign that the problem is coming from the front of the spine is that the pain or discomfort usually improves with bending forward, curling into a ball, or sitting down.  I always use the pre-test and post-test to see if this bears out.

When lying down before looking for RIs, I recommend testing the discomfort with the legs flat and again with the knees bent.  If the discomfort or pain is better with the knees bent then it is likely coming from the front of the spine.  Look for the RIs on the side of the pubic bone, the front of the pubic bone, and the side of the pelvis using the movement combination listed or finding the best movement combination for you that resolves the RI.  Repeat the post-test after doing a treatment position to see if you reduced the pain or discomfort.

Katie's knees

Katie mentioned when she was doing her post-test after her treatment that her back and hip pain were gone but now she had knee pain from arthritis.  So we went back to work and I helped her learn how to treat the inside of the pelvic bone.  Repeating her post-test after performing one side of the inside pelvis resolved the knee pain on one side.  She was shocked because she always thought her knee pain was from arthritis.  After treating the other side the knee pain on the opposite knee was turned down as well.

 

Contact:  Loraine@doctorlovejoyevans.com

 

© Dr. Loraine Lovejoy-Evans, DPT