Looking at the psoas, iliacus, lumbosacral junction, and hips as one...
The other day I was holding a patient’s feet in the early part of giving a craniosacral session. I settled there listening to the expression of Health in their system. What I noticed was a presentation of the diaphragm, spine, psoas, iliacus, sacroiliac joints, pelvic bowl, and hip joints being shown as one continuous unit.
What came into my vision was that it is best to walk from the diaphragm, down through the pelvis, all the way to our feet, rather than truncating by only walking through from the lower spine.
Let me explain further... Often the lumbosacral junction is highly emphasized clinically because of all the things that can go wrong there. This is what the left brain does; it dissects, separates, and looks with a narrow perceptual field, but that is not the only important perspective. The lumbosacral junction is between L5 and S1, as we age there can be signs of compression, and degenerative changes to the disc. These changes can create joint pain, nerve pain, hip pain, and muscle tightening. This area tolerates a lot of compression when we sit in a chair, 250 pounds per square inch to be exact. Excessive sitting, and not moving much during our life can create inertia here.
The good news is that the spinal cord ends around the first Lumbar Vertebrae, which gives us more space for low back movement. Movement is more in the low back as there are no ribs. A horsetail like cluster of nerves hang down from the spinal cord at L1, and exit along the lumbar vertebrae as it descends down into the sacrum. This is called the Cauda Equina. The S1 nerve root exits between the 5th lumbar vertebrae and the first segment of the sacral bone. As little as 10 mm of pressure can activate, and inflame a sensory nerve from the dorsal root exiting the spine, causing altered sensation down the back of the leg. If there is more intense compression in the area where the nerve exits the spine from a disc, or stenosis caused by arthritis, it can influence the motor nerve of S1. The motor component of S1 nerve comes off the ventral root of the spinal cord ; and if this nerve gets really compressed it can cause your foot to not be able to point down and plantar flex. A motor nerve can tolerate a larger amount of inflammation and pressure before it begins to cause issues with muscle weakness. This is another amazing design in our systems in that our sensory sympathetic system is activated more easily than the motor sympathetic system. This is brilliant as we do not lose motor function first… so we can walk, yet we get the first warning sign of imbalance with pain from the sensory nerve first. Sensory nerve alarm signs are: pain, numbness, tingling down the back of the leg. Motor nerve impingement alarm signs are “charlie horses, weakness of muscles, and spasm.
ventral ramus (pl. rami) (Latin for branch) is the anterior division of a spinal nerve. The ventral rami supply the anterolateral parts of the trunk and the limbs. ... Shortly after a spinal nerve exits the intervertebral foramen, it branches into the dorsal ramus, ventral ramus, and ramus communicans. From Wikipedia
If we look at the lower spine and lower extremities in a fragmented way we are missing the true story. Of course we want to be able to zoom in and get a snapshot of what may be the area that is taking much of the strain of the spine as it transitions to the pelvis. L5 sits on top of the sacrum, and in the spine when structures transition is where most of the problems and symptoms arise. The lumbopelvic junction, the cervico thoracic junctions are common areas for pain.
As cranial therapists we orient to the Health. Motility is a huge part of what we do to support the Health and that is unlike most other treatments that attempt to “correct” the spine. Motility is the only way to influence how a bone is breathed by the Breath of Life. There are no other types of treatments that address motility more directly than biodynamic craniosacral therapy. Chiropractic only addresses mobility, which is movement between two bones/ joint motion.
Patient’s usually mostly care about not feeling anymore pain, although sometimes what they think should help blocks out what actually does help in terms of treatment types. As biodynamic craniosacral therapists we can address motility and mobility. The spine can get fragmented energetically, especially with so much sitting these days, and we can help that.
One of the other gifts that we offer in our work is to hold a sense of wholeness in a patient’s system. We remind them of this during sessions. This can help integrate other types of work, as well as strengthen the midtide to affect their whole system.
Now let’s take a look at the diaphragm, psoas, iliacus, and psoas minor.
These muscles support the front of the spine, deep behind all of our visceral organs. These soft tissue muscles are interconnected with the spine and each other. Yes, the diaphragm is a big muscle as well…
The organs sit on top of the spine and are massaged everytime we take in a breath, especially a big deep breath. Try taking a deep breath now. Can you feel your kidneys sitting on your psoas being massaged? Can you feel your stomach, liver, spleen, intestines, and pancreas in the front being massaged?
When we are thinking a lot and are” in our heads”, we breathe more shallowly. When we breathe more fully and orient to our breath mindfully, it helps us become more parasympathetic, relaxed, and helps lower your blood pressure.
The psoas is an oblique long muscle that attaches with the back of the spine and diaphragm supporting as a continuous structure. The psoas goes down the front and sides of the spine from the lower thoracics and courses through the front of the ilium attaching into the front of the femur/ hip socket. This muscle has been called the parade marching muscle when it contracts. When the psoas is shortened it puts us in the flexed fetal position. It helps us feel safe and regulates our nervous system. Think of child’s pose in Yoga, which shortens this muscle and helps us feel calm and soothed.
The psoas can hold sympathetic nervous system activation quite easily. The kidneys sit right on top of it, and they make stress hormones norepinephrine and epinephrine. There is a relationship here that I have often felt while giving sessions. This muscle can also hold fear, and is a major mover for flight to get us away from a dangerous situation. It is intertwined with our diaphragm and our breathing.
Our diaphragm is sympathetically controlled by the spinal nerves C3, C4, and C5. This is another transition area of the spine. The vertebra change from cervical to thoracics. Think of the implications here. We sit at a computer as I am now… my psoas is shortened, and my neck is flexed forward looking at the keyboard as I type. My posture in essence is mimicking a self protection modus operandus.
Try walking with this orientation as an experiment...
What if we started walking from a higher place of orientation? Try walking from your diaphragm and top of your psoas all the way down through your spine to your feet. As you do that take some deep belly breaths. Notice how that feels. Now try just orienting to walking from your hips and L5-S1 area, and breathe shallowly. When you only include the lower psoas, lower spine, and hips, flexion happens and we lose some of our lumbar lordosis. The lumbar lordosis is the natural curve that protects us against degenerative spinal changes and absorbs shock (not trauma, just gravity shock absorber) as we walk.
Now go back to walking again and include your diaphragm, psoas, iliacus, entire spine, hips, and lower legs. Notice the front and back of your body and how they help you improve your posture. This is a good mindful practice for people to do as they walk. The psoas lengthens, the trapezius, and latissimus fire up in our upper back, our gluteus maximus fires up and that is a very powerful muscle; our posture improves. To enhance this remember your abdominal muscles supporting the front of your trunk, holding your spine up to create a barrel effect of support all around your spine. Then add in the rib cage in your awareness for some more stability to the upper body/torso. Feel its cylindrical support.
For cranial therapists hold the feet and look at the spine and its muscular relationships holistically. Supporting titration can help discharge activation, and create more motility, and fluidity in the fluid tissue field. Especially when the safety of the relational field is well established. Bringing awareness in this area supports balancing the flow throughout a person’s day between sympathetic and parasympathetics. That can support healthy digestion, menstrual cycle, genitourinary tract function, detoxification, hypothalamus pituitary adrenal axis, immune system, detoxification system, and emotional regulation.
How can we work with this?
Start a session with the ritual of contact. As you move to the feet take a peek into their system as you hold a wide perceptual field including their whole body and biosphere. See if you can connect with the legs, pelvis, and spine and look at the lower extremities as continuous extension of the psoas and diaphragm. As a unified field of action. I know this is not the inherent treatment plan, you can do that after you take a peek.
Can you now see the relationships here? How is the mobility and motility on this level of awareness? Now hold the sacrum, do you notice some inertia in the lower spine and extremities? Hold the whole system, while noticing the legs, pelvis, psoas, spine, and diaphragm as one continuous unit, then add in the whole spine, rib cage, heart, lungs, and sternum. Is there some titration happening in any of bones, soft tissue, organs? Let things go deep and settle and orient to the Midline Health, then all the way out to the biosphere.
What happens? The patient’s system becomes more holistic. You may even notice the chakra system coming off of the midline experienced a spinning funnels. The hip sockets and ilia, may titrate, the sacrum becomes more motile, as do the lumbars. The kidneys soften, as does the diaphragm. The heart softens as the pericardium is continuous with the diaphragm.
Maybe there is some titration here in the chest cavity. When this releases the lungs and heart soften as does the mid back and neck.
Then the continuous fascia into the neck especially anteriorly that comes up and hangs off the cranial base can release….
Just think of what happens emotionally when a person’s system becomes more fluid. The heart opens, and the mind lets go…
This is a great picture from Michael Kern’s book: Wisdom in The Body.
It shows the interconnectivity of the fascia in the neck and chest cavity…
The take home here is that our body in one big continuous, connected system. When we start perceiving the body that way things can change, and people can heal on many levels. The body holds all experiences be they emotional, physical, spiritual, or mental. It is helpful to be able to be specific to “hear” what the tissue is presenting, then hold the large field as you work. It is also helpful to orient to what supports good posture while walking, standing, and sitting.
You can then take this understanding into the realm of walking and moving about as a daily practice to prevent and slow down inertial and degenerative changes of your spine and body.
Dr Kate has been in practice since 1989. She utilizes Chiropractic, Nutrition, and Biodynamic Craniosacral Therapy to help her patients.