Resurrecting the Dead Zone

This blog was written by Pelvic Rehab Report guest blogger, Richard Sabel MA, MPH, OTR, GCFP, who - along with Bill Gallagher PT, CMT, CYT - teaches the H&W course, Integrative Techniques for Pelvic Floor & Core Function: Weaving Yoga, Tai Chi, Qigong, Feldenkrais and Conventional Therapies as well as an online series of courses on the same topic.

RS: When considering the broad range of health issues that fall under the umbrella of pelvic dysfunction, we’ve observed that too many of our clients have PPA - poor pelvic awareness. Sure they’re cognizant of the pain, discomfort or distress associated with their particular issue, but in reality the pelvic region is, as Imgard Bartenieff described it, “the dead seven inches in most Americans’ bodies.” We’ve taken creative license here and call it “the dead zone.”

A lot happens “down there,” yet how many clients are attuned to the unique contribution this region has in terms of functioning? Most would identify elimination and sexual function (definitely biggies), but what about other key “happenings” such as the pelvis is home to our center of balance and femoral joints; or connect the intimate relationship of the tailbone and head in terms of mobility and flexibility; or realize that key muscles for postural alignment originate or pass through the pelvis? Not many.

How can we resurrect the dead zone? The antidote is awareness. We often think about strengthening weak muscles, stretching tight muscles and improving the coordination among muscles, however a missing component is helping our clients’ develop a better kinesthetic sense. This ingredient, added to the rehab elixir, is integral to lasting change. We live in our bodies, but most of us have major holes in our sensory awareness – what we call the “Swiss Cheese Effect.”

What about therapist? We have an excellent knowledge of anatomy and kinesiology, but how many of us embody this knowledge? It’s hard to say, but we suspect not enough. A few years ago, we observed a therapist teaching students transfers. He described the body mechanics perfectly, but when he demonstrated the transfer, his lower back was rounded. Intellectually he understood what to do, but he could not sense the awkward position of his back. Frederick Alexander would describe this as debauched kinesthesia. It’s not surprising this therapist often complained about back pain.

That’s why the intention of our touch and the cues we give clients are so important. As Deane Juhan said, “Touching hands are not like pharmaceuticals or scalpels, they are like flashlights in a dark room.” When our touch and cues are clear, we guide clients toward a new sensory experience, which may alter how they feel and in time may influence how they think and act. This last sentence is a tweaked quote from Moshe Feldenkrais. He referred to his clients as students, which changes the dynamic of the therapeutic relationship and emphasizes learning over curing.

Our webinars and on-site workshops are designed to provide participants opportunities to embody the work. Some lessons focus directly on the pelvic region and others on integrated full body movement. Once we better understand the kinematic chain or kinetic melody, we have more options: we can focus on the structure to address underlying issues contributing to dysfunction, or we can use our knowledge of integrated movement to bring about change in the structure. In other words, we go both ways.

Just for fun, try the following lesson, which we call the Ferris wheel. You’ll need a chair with a solid seat and no armrests.

Be mindful of the following rules: 1) keep the movements small, 2) move slowly, and 3) rest briefly after each movement.

Start with a body scan

Sit toward the front edge of your chair, with your feet flat on the floor, hands resting comfortably on your lap. Observe your breathing. Where do you notice the movement as you breathe in and out? Observe the way a cat watches a bird outside the window. Shift your attention to the souls of the feet. Without moving, sense how each foot makes contact with the floor. Compare both feet and notice the differences. Be as specific as possible. Now bring your attention to the buttock. Is there more weight on one side? What about the lower back, is it rounded, arched or flat? Sense the shoulders. Is one shoulder higher than the other? Finally, notice the position of the head. Is the chin pointing up or down? Is the head turned to the right or left? Keep a “sensory snap shot” of the body scan, which will help clarify changes that might occur as you progress through the lesson..

Scoot left, allowing the left sit bone to come off the chair. If you need to, place the right hand on the chair for balance. Lower the left sit bone just below the seat of the chair, then gently raise it back to the starting position. This movement will create a gentle stretch in the muscles and ligaments of pelvic floor. Repeat the movement again, this time noticing as the sit bone is lowered, how the ribs may broaden on the left side and close on the right side. Repeat the movement and this time observe the head and neck. Do they move as the sit bone is lowered? Did the right ear, tilt toward the right shoulder? If not, the next time the sit bone is lowered, in a synchronized movement, allow the head to tilt slightly to the right. As the left sit bone rises, bring the head back to midline. Did this make the movement easier? Repeat this pattern 4 more times. Keep the movement slow and small. Breathe throughout the movement. Rest.

Lower the left sit bone and begin making small circles in the sagittal plane - like a Ferris Wheel. Make 6-8 circles and rest for a moment. Observe the movement in the ribs, neck and head. Repeat this sequence going in the opposite direction. Rest.

Imagine a pen is attached to the bottom of the sit bone. Begin writing your name on an imaginary piece of paper just below the sit bone. Play. If writing your name is too hard, make any pattern that comes to mind. Just keep the movement slow and easy. Rest.

Scoot to the right allowing the left sit bone to rest on the chair. Notice how the left side of the body feels compared to the right side. What differences do you notice? Be specific. Has your breathing changed? After the body scan, repeat this sequence on the right side.

After completing the right side, repeat the body scan done prior to the lesson . How have the points of contact and position of the body changed? Is the body more symmetrical? Are there any differences in the breathing? Stand. How does the body feel in standing? What differences do you notice in this position? Take a short walk. Does your walking feel different? Be specific about any changes you observe.

There’s a second version of this lesson in which the pelvic breath is coordinated with the movements. For that experience, you’ll have to join us at an on-site workshop or view our webinar.

In a follow-up blog, we’ll discuss the rationale for the lesson. In the mean time, before we bias your thinking, it would be great to hear from you. Post a response to your experience with the lesson and how you might consider using it with a client.