“We walk with our legs.” True or False? 

True—obviously, as humans, we use our legs to walk. And false—we use more than just our legs when walking, and in fact, don’t even need legs to walk. Physicist and spine researcher Serge Gracovetsky, in his lectures about his spinal engine theory, shows a video of a man, born without legs, walking back and forth on his ischial tuberosities. The man rotates his spine and pelvis as he torsions his ilia in opposite directions, alternating one tuberosity in front of the other.¹ Gracovetsky’s point: whether we have legs or not, we also walk with our spine and pelvis.

Gracovetsky’s sophisticated theory of spinal energy uptake is not the focus of this article (though if you’re at all interested in biomechanics, gait, or spinal function, I do recommend checking out his talks or his chapter in the Dynamic Body [Freedom from Pain Institute, 2011] textbook, edited by Erik Dalton). The nuanced cycle of gait is itself complex: timing, momentum, gravity, weight shift, balance, form- and force-closing of joints, muscle sequencing, proprioceptors, and long chains of connections all play a part in the seemingly simple miracle of walking.

In this article, I’ll focus on just one key piece of the walking puzzle by describing some straightforward ways to encourage innominate bone mobility (the innominate, or hipbone, is the composite structure that includes the ilium, ischium, and pubis, Images 1 and 2). These techniques owe their inspiration to many sources, including Gracovetsky and others, and are based on the work taught in Advanced-Trainings.com’s Advanced Myofascial Techniques DVDs, online courses, and seminars.

Let’s start by making a distinction between two kinds of pelvic movement:

1.
Movements of the entire pelvic girdle (tucking, shifting, dropping, tilting, etc.).

2.
Intra-segmental movements of the innominate bones and sacrum within the pelvis itself. 

Both kinds of pelvic movement occur in walking—the entire pelvis shifts left and right over the standing foot, while each individual innominate bone also moves within the pelvic girdle (see Assess Your Own Ilia Mobility). This independent motion of the innominates is important because it:

 •
Acts as a shock absorber in walking, running, and jumping.

 •
Locks the sacroiliac (SI) joint into a stable position in weight bearing.

 •
Recycles the energy of gait by loading and releasing the SI ligaments through spring-like recoil. 

Limitations in innominate mobility indicate SI joint restriction. When this movement is absent or asymmetrical, local symptoms can include low-back pain, SI joint pain, osteitis pubis (soreness at the pubic symphysis), hip pain, sciatic pain, restricted hip mobility, and more. Loss of movement (hypomobility) here has global effects, too, and can be related to knee issues, ankle overpronation, functional scoliosis, etc. (SI joints can also cause problems when they are hypermobile. For a discussion about working with hypo- and hypermobile SI joints, see Massage & Bodywork, November/December 2012, “Working with the Sacroiliac Joints,” page 114.) 

The amount of innominate movement that should be considered normal is a subject of debate, ranging from a low of 2 degrees to a whopping 17 degrees of rotation at the SI joint.² (As a point of reference, Images 1 and 2 show 10 degrees of rotational movement, or about the median value of the different published opinions.) Other studies suggest that side-to-side evenness is more important than the absolute amount of movement, with pelvic pain more common in individuals with asymmetrical SI joint stiffness.³

Preparation: Leg Dangling

Releasing the resting tone of the musculature around the hip will help you be more specific and effective when you address the ligamentous SI joint limitations themselves. 

With a loose grip around your client’s lower leg, gently lift the leg just off the table (Image 3). Don’t lift so high that your client’s pelvis tilts and pushes the lumbars into a deeper lordosis; lifting just a half-inch off the table is usually enough. Gently swing your client’s knee from side to side, feeling for and encouraging release of any muscular holding or tension around the hip. With practice, you’ll be able to sense and relieve restrictions throughout your client’s body with this deceptively simple technique. 

Some clients will find it difficult to release a leg and let it hang. Be patient, coaxing the hip into an easier swing. If you find holding or tightness that doesn’t release on its own, you can also address it with more direct techniques such as our “Push Broom” sequence (Massage & Bodywork, March/April 2012, “Working with Hip Mobility,” page 114).

This preparatory assessment has its roots in the approach of bodywork pioneer Milton Trager, MD, and is useful before performing any hip or pelvic work.

Anterior Torsion Technique 

Once you’ve assessed and addressed the hip’s resting tone, you can release any restrictions to anterior innominate torsion (also referred to as anterior rotation).

With your client prone, lift one knee to extend the hip (Image 4). If your client is larger than you are, you can achieve the same effect by placing the leg on a firm bolster, such as a stack of towels. In passive hip extension, the pull of the quadriceps rolls the innominate into anterior torsion. Use your other hand on the center of the sacrum to stabilize it inferiorly and prevent the low back from overextending into an uncomfortable lordosis. Place this second hand on the center of the sacrum and apply firm footward (caudal) pressure (curved arrow, Image 6). This motion of the sacrum (counternutation), together with passive hip extension, focuses the movement into the same-side SI joint.

Wait here for the pelvic ligaments to adapt and release; typically, you’ll take 5–8 slow breaths before you feel the subtle drift and yielding that signals release. Mobilize both innominates in this way. Or, before doing this technique, you can compare left/right mobility using the innominate mobility assessment (see Assess Your Own Ilia Mobility, page 115) and focus on the more-restricted side. 

Posterior Torsion Technique 

After releasing restrictions to anterior innominate torsion with the prior technique, integrate and balance your work by making sure the innominates move freely in the complementary direction, into posterior torsion. 

Bring your client’s hip into flexion, either in a prone (Image 7) or supine position. Each position has advantages; with your client prone, you can use your forearm on the PSIS to gently encourage posterior innominate torsion. This position is easy on the practitioner’s body, and is probably preferred when working with clients larger than you are. In the supine position, bring your client’s knee toward her chest, with one hand under the same-side PSIS, applying caudal traction to that prominence to encourage posterior innominate torsion. As in the anterior torsion technique, wait for several breaths until you feel a slight drifting or yielding of the innominate in the desired posterior direction; then, recheck for side-to-side balance. 

In both positions, the pull of the hamstrings in passive hip flexion rolls the innominate into posterior torsion. If this important motion is restricted, the SI joint may not reach the close-packed position it needs for fully stable weight bearing. For this reason, it’s usually preferable to do this technique after freeing up anterior torsion, so as to leave clients with the stable, solid feeling the full posterior torsion can bring.

Finish your work by bringing the two sides of the body together in your client’s awareness. For example, use the bilateral SI Wedge Technique (Massage & Bodywork, November/December 2012, “Working with the Sacroiliac Joints,” page 114) to balance the left and right sides of the sacrum. Or, finish with some neck work, since its position at the other end of the spine helps complement the focused pelvic work you just performed. 

Notes 

1. For an extended version of this article, including images of Serge Gracovetsky’s ilia-walking subject, go to http://tinyurl.com/luchau-ilia.

2. H.M. Buyruk, “Measurements of Sacroiliac Joint Stiffness with Colour Doppler Imaging: A Study on Healthy Subjects,” European Journal of Radiology 21, no. 2 (1995): 117–22.

3. L. Damen et al., “The Prognostic Value of Asymmetric Laxity of the Sacroiliac Joints in Pregnancy-Related Pelvic Pain,” Spine 27, no. 24 (2002): 2,820–4.

  Til Luchau is a member of the Advanced-Trainings.com faculty, which offers distance learning and in-person seminars throughout the United States and abroad. He is also a Certified Advanced Rolfer and has taught for the Rolf Institute of Structural Integration for 22 years. Contact him via info@advanced-trainings.com and Advanced-Trainings.com’s Facebook page.