Muscle Energy Techniques for the Pelvis

Muscle Energy Techniques for the Pelvis by Tom Ockler, PT
I am often asked by patients and therapists alike, why I start at the pelvis when evaluating and treating a patient, even if their chief complaint is elsewhere, like the neck or shoulder. I explain that the body is like a house and a house sits on a foundation. Structural engineers have known for centuries that if you are not on a solid and symmetrical foundation, problems…expensive problems, will eventually show up. A building or house
can adapt slightly by shifting or “settling” and if this goes on long enough, you may see cracks in the drywall, cement, doors and windows become hard to open and close, etc.
It’s pretty much the same with the body. In the human body, the same “settling” (I call it adaptation) can occur as the body attempts to compensate for an unlevel or asymmetrical foundation.  When, in the course of human locomotion, sports, slips, falls and life in general, the pelvis and or sacrum become asymmetrical, a functional leg length difference can appear and thus requires an adaptive shift to compensate. Your brain wants desperately for your eyes to level to the horizon so it will adapt to keep them so.
If this adaptation remains long enough, the body will alter its muscle firing pattern to keep us moving and going on with life. When the body can no longer tolerate that particular adaptation, it again alters the muscle firing order to allow us to continue with our daily activities and eventually again, no longer tolerate it. Over and over we adapt until no more adaptations can be made. This point is called “homeostatic brick” and just means, That’s it! I can’t tolerate this any longer..HELP! Do something. Unfortunately, this is when the patient seeks out our help, after multiple
layers have been put down in place making the therapist / body workers job much more complicated.
So back to the original question, why start at the pelvis? Most therapists are drawn to the painful area and that is where we focus our healing attention.  If a patient comes in with neck pain and I treated it appropriately with the muscle energy techniques, they would likely be pain-free in a few short visits. But, it is also very likely that the problem would re-occur. Why?  Remember I said that the body adapts to asymmetries and discrepancies that come about to help keep the eyes and head level (amongst other adaptive reasons.) And if I correct the cervical hypertonicities and hypomobilities that got a foothold as a result of the more proximal (pelvic and sacral) asymmetries without first correcting those proximal (pelvic and sacral) asymmetries, those asymmetries will just recreate the problem in the cervical spine all over again. It’s just a matter of time. This is why we have so many repeat patients filling up our already overburdened health care system. Fix the foundation first (M1 manual and DVD) and then its much easier to correct the cervical or whatever other area you are working on. Not only that, they won’t become a “frequent flyer” either. But don’t worry about losing money if you only see the patient a few times, they’ll refer multiple patients, family members, friends, strangers off the street to you. That saves you money on advertising and will fill your schedule up at the same time.
Tom Ockler P.T. has extensive teaching experience throughout the United States, Canada, England and Australia. He was a past Associate Instructor with the Upledger Foundation, teaching in their Muscle Energy and Strain Counter-Strain programs. As a teacher, Tom has earned the nickname “The Patch Adams of Physical Therapy” due to his unique style of injecting humour into complicated subjects. He has developed teaching methods that explain very complicated subjects in easily understandable formats. His DVDs Muscle Energy Technique for Lower Extremities, Pelvis, Sacrum, and Lumbar Spine and Muscle Energy Techniques for the Thoracic Spine, Ribs, Shoulder and Cervical Spine have been hailed by students as the most user-friendly and useful Muscle Energy manuals ever.