Sacrotuberous Sacrospinous Techniques
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- Опубликовано: 27 дек 2017
- My aim is to educate the therapists on a safe, ethical and effective treatment technique by providing education congruent with current evidence informed research and by developing the therapists skill, confidence and proficiency for the treatment of injured ligaments and the surrounding tissues.
LAST is a precise, principle based, mechanoreceptor specific manual therapy technique, supported by evidence-informed research, utilized in the treatment of peripheral joint tissue injuries to improve treatment outcomes and improve the quality of life of patients.
Robert is an International Speaker and Instructor.
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Robert is an RMT with over 23yrs of practice and experience. He is a National, International Speaker and Instructor and has been featured in BCRMT Massage Matters, CMTBC Touchstone and Massage Therapy Canada Magazines.
![Massage Technique: The "Sacrum Shaker" [SI Joint Mobilization]](/img/1.gif)
The skeleton overlay is very helpful! Thank you
This is really helpful - thanks! It's also a superb example of auto-captioning :)
Excellent illustrated video!!
I think you answered my question!
Glad it was helpful!
I have been studying youtube all day to figure out what my pain is, and this is the one that resonates with me. Can Sacrotuberous ligament issues mascaraed as high hamstring tendinopathy?
Hi,
Thanks so much for watching the video and for asking your question. I greatly appreciate it.
Depending on the mechanism of injury it is possible for the ischial attachment of the ST Ligament to cause similar symptoms to a high hamstring tendinopathy. The hamstrings are an extension of the ST Ligament and both influence each other.
Thanks again so much for your questions. Please feel free to PM me anytime with more questions.
Thank you, very much appreciated, I have searched for this technique for a long time.
Good day Mr. Robert.
I have SI JOINTS problem for 20 years. I m in pain 24/7. I can’t seat, sleep, drive a car or walk a long distance...
I would like try this treatment, do you have any clinic you can refer me in Montréal?
Where’s your clinic ?
Hi,
Thanks so much for your comment.
Although I do not have anyone specifically with this training to refer you to, I have a very good friend who I think will be very competent in helping you.
Please contact Paul through his website:
pjetherapeutics.ca/?page_id=11257
Paul is honestly AWESOME!
Robert, Thanks for the video. I got injury from riding my bike and injured coccyx and ligaments in the area. I have so much pain for two years. I live in Canada Calgary city. Is there some one you know can help me? Or what doctors should I go to see? Any informations would help a lot. Thanks you so much. Kally
Hi, thanks so much for the comment, sorry for getting to you late.
If you are sill in Calgary, and wanting a Massage Therapists I would contact the MTAA
www.mtaalberta.com
You should have an assessment with a therapists, MT, PT, DC who is current with their knowledge of Pain Science and understands the multifactoral aspects of pain.
coccydinia is very discomforting and can make a long time to diminish. In some cases it can take a year or more.
Mr. Robert can we completely come out from such sacral ligaments strain issue?
Hi,
thanks so much for your comment.
Sacral ligament s are pretty strong and there are a number of layers that help with this, but as with all tissues, they are subjected to tissue challenge and can either be stretched or sensitized.
Stretching imply's that the tissue was lengthened by some mechanism of impact. When stretching occurs, there is a little rebound that does occur, but teh tissues never return to their original length. This can potentially cause a number of issues and sensations.
Sensitization, imply's that the tissue has been challenged, may or may not have been elongated, and the neurological innervation of the tissue is now sensitized. This mean that it doesn't take much stimulus to make it cranky.
There are various ways to attempt to increase the tissue sensitivity tolerance - active rehab
Unfortunately there are limited ways to attempt to re-establish tissue structural tension, but some are well documented
I would suggest researching this starting at journalofprolotherapy.com/ligamentous-articular-strain-technique/.
Thanks again for commenting here.
i have coccyx deviation to the left side, also left side pudendal neuralgia. will this help?
Hi,
Thanks so much for your questions.
Pudendal neuralgia is a difficult thing to work with and as a patient to have.
There are numerous locations along the nerve route that can compress and sensitize the nerve.
I’ve got a feeling this is what’s been causing me pain for the past 8 months. I’ve had osteo and chiropractor ask if there’s pain directly on my coccyx bone and I’ve done nothing to harm it in anyway, even though my job requires me to sit all day. It seems to be a dull ache just above the coccyx? Would sitting on a lacrosse ball on the area help to ease the tension do you think?
Hello,
Thanks so much for commenting. I greatly appreciate it.
I am always cautious when recommending treatment courses of action here as I am not completely aware of your specific situation.
I would be cautious of using a lacrosse ball in this area as there are a number of nerves and other structures that can be negatively affected and potentially decrease your quality of life.
Please remember that I recommend that you consult your most trusted medical professional for in-person advice on your specific situation.
I would recommend against sitting on the ball at this point but would recommend scheduling standing breaks from sitting.
Set your smart phone or watch for 15minutes. At the 15 minute time, you could do any of the following:
if you have a sit/stand desk, change the desk to standing for 15 minutes, than back to sitting for 15 minutes
go for a walk around the office, do a lap around your office, go get some water, do something that gets you up and walking just a little and then you can get back to work
Do 10-15 squats - stand up from your chair, do a squat so that your bum just contacts the seat of your chair and stand back up. repeat 15x.
All of these can be interchanged throughout the day, for example, it would be quite challenging to continue to only do squats every 15-30 minutes all day when you have never done squats before.
Remember, common sense is not common practice, so really be aware of your limitations and don't do anything that you feel is making your life worse. There is a difference from general muscle soreness from activity and pain/discomfort from irritating an already cranky issue.
Your most trusted medical professional should have other suggestions for you similar to these. Please contact them.
@@robertlibbeyrmt very nice sir.
As far as I understand, the only two muscles that attach to the sacrum are the piriformis and the gluteus maximus. Can tightness of these muscles cause a pulling on (or impingement of) the sacrotuberous ligament leading to pain? In other words, is there any relationship between these three structures (piriformis, gluteus maximus, and sacrotuberous ligament)? And does the sacrotuberous ligament underlay or overlay these two muscles?
Your 1st question is the same thing that I was wondering!! I hope he answers :)
Hi, thanks so much for the comment, sorry for getting to you late.
I think of these three structures (piriformis, gluteus maximus, and sacrotuberous ligament) as innervated tissues with different densities and different functions.
The sacrotuberous ligament is innervated by DRG's L2-4 and S1-4. There is limited research documenting a ligamentomuscular reflex of the SIJ capsule and Glute Max & Min. As the ST Lig. is considered a sensory organ in research, there is a possibility of a protective/armouring effect in co-innervated tissues. But this is patient dependant and context dependant. Athletes challenge these tissues, increasing tolerance for discomfort in a context of performing activities they enjoy. A non-athlete may have gone through an activity that challenged the tissues and was not enjoyable possibly resulting in armouring, discomfort. Also a non-athlete, may have challenge these tissues in a context of performing activities they enjoy, but they did so NOT in a graded exposure application, thereby possibly resulting in armouring, discomfort.
As we know, It's really person and context dependent.
Concerning "Can tightness of these muscles cause a pulling on (or impingement of) the sacrotuberous ligament leading to pain?"
As Pain is multifactoral and specific to the individual, an in-depth assessment, with a BPS focus, of the individual with pain would be necessary.
Sir can you tear your sacrotuberous ligament by doing a sleeping knee to chest exercise ? . Because I did that stretch and then I felt a an overstretch and a small pop now I have been in pain in that area. Plz tell me sir if I have torn my sacrotuberous ligament. PLEASE HELP ME.
Hi, thanks for your comment.
Tp be honest, it would be highly unlikely that you tore your sacrotuberous ligament as it has a really high tensile strength. For example research documented that the IT Band has a tensile strength of 2000-7000lbs/sqr inch.
The "pop' that you had. Did you feel the pop or just hear it?
Pops happen in the body all the time and are neither bad or good and are caused by many things. It's interesting that you have discomfort after a pop, so I would investigate that further if I were you.
Sometimes a small strain on the tissue happens in the area of the felt pop and you can have or not have discomfort, and sometimes there can be tissue damage or irritation somewhere else that is causing the felt discomfort where you are describing.
I would suggest see your trusted physical rehab clinician for an assessment.
Please keep me up to date on what they assess and discover.
Sometimes there are little pops that occur with discomfort and then you return back to a normal life soon afterwards.
@@robertlibbeyrmt Hi sir , I just felt a pop and felt overstretch in that area as I had stretched it to much. I did not hear a pop. Now it has been 2 weeks I have been taking pain killers but it still pains when I sit or do any movement. Tell me sir if it is possible to tear anything in your butt area when you do stretch knee to chest. Due to lockdown I cant go to a doctor. PLEASE tell me if it can be a serious issue if I hold this pain for too long. I just don't want to make things worse. Can this heal at home.
@@123aayushgaikwad6 Im only a student chiropractor so take everything I say with a grain of unrefined salt. Like he said, that’d be a difficult feat to completely tear a ligament. Perhaps you might have caused injury to the soft tissue and inflammation ensued, among other things. I once had a similar situation, but I felt it after waking up one morning.
For me personally, the remedy was two ibuprofen and then biofreeze over the affected area because I, too, couldn’t see a chiro at the tine. After an hour or so, I never felt the pain again. However, you should contact a healthcare professional before trying any remedy at home. I would probably ask about inflammation in the area and maybe about strain/sprain. Any updates on your injury that you don’t mind sharing? I realize it’s been a few months.
Can both sacrotuberous and spinous be ever healed, I have persistent spasms due to the over-stretching, more then a month steady, I’m in rehab as I’m watching this video, unable to walk
Hi, thanks so much for the comment, sorry for getting to you late.
Concerning "persistent spasms due to the over-stretching" - The sacrotuberous and spinous ligaments are considered sensor organs in research rather than structural supports. Is saying this, "healing" of the tissues requires desensitizing the innervating nervous system in order to decrease discomfort and return normal ligamentomuscular reflex's of the tissues.
Sacrotuberous and spinous ligaments are both innervated by DRG's L2-4 and S1-4. The nerves from L2-4 travel through and innervate the tissues of the lower back, so these areas will need to be incorporated into the manual therapy and active rehab programs.
Once thing the clinicians and patients often forget is a very large influencing factor is "time." It's takes a lot longer to possibly modulate ADL's and qualify of life than we all think it should... if it can be modified.
Is this the logan technique?
Hi,
Great question.
No, this is not Logan Technique.
This is LASTechnique developed by AT Still, DO.
Feed that poor guy.
hard to see what he is trying to show.. it doesn't help that his demonstration skeleton is probably a small child
Hi,
Thanks so much for looking a the video.
The skeleton is actually a 5'6" model based on a 5'6" male. It is life size and anatomically correct in its representation.
In future videos. I will continue to endeavour to visually demonstrate as best as possible the intended structures to palpate and provide treatment to.
@@robertlibbeyrmt yeah I was half joking it wasn’t that bad thanks