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The Pelvic Diaphragm—Self Release

This is an excerpt from The Pelvic Diaphragm by Julie Hammond.

The Pelvic Diaphragm—
Self Release

This can be used in conjunction with the manual releases in chapter 4.

Coccygeal movement is a noninvasive way to check the engagement of the pelvic diaphragm muscles, as the levator ani has an attachment site here. When the pelvic floor muscles are consciously engaged, they draw the tailbone forward and up. Stensgaard et al. (2014) evaluated the use of palpation of the coccyx as a screening tool for the assessment of pelvic floor muscle activation. The volunteers were asked to contract their pelvic floor muscles, strain, or make no movement. This simple movement test correctly identified 97% of women who did not contract their pelvic floor muscles and had 77% accuracy for those who did. The test can be easily learnt and is a cost-effective and noninvasive way to assess pelvic floor activation.

The coccyx should lift up and forward on pelvic diaphragm contraction and move down and back on relaxation. To feel this on yourself in standing, place your finger on your coccyx, inhale, and then on the exhale, close your anus and lift up, count to five out loud, and then relax. Did you feel any movement? Or did you feel the coccyx moving back? This would show that, rather than contracting and lifting the pelvic diaphragm up, you are bearing down.

1: Releasing the coccyx (rolling the ball)

Equipment needed: Prickle pod or ball
Tissues involved: Sacral fascia, thoracolumbar fascia, pelvic diaphragm
Objective: Easing tissues that may restrict coccygeal movement and help ease the tissue of the pelvic diaphragm; freeing the coccyx—this may give a sense of support for the pelvic organs as there is more adaptability in the tissue for the levator plate to lift
Indications: Hypertonicity in pelvic diaphragm, lack of sacral movement in gait, restriction in the TLF movement
Client position: Semi-supine, prickle pod or ball on the sacrum between the sacroiliac joints; ball or pod will be on the thoracolumbar fascia, covering the sacrum (figure 9.1)

Technique

Option 1: Engage your pelvic floor muscles with the visualization of tightening around your back passage. You want to draw the outer ring of the passage in and up. Notice your coccyx; you may feel it lift a little. Allow the weight of your body to create a connection with the tissue. Use your breath to relax instead of pushing.

Imagine you have a shallow dish that is like a ball maze (think of the old-fashioned puzzles where you had to move a ball around a maze) resting on the pelvis. It covers the area from the belly button to the pubic bone and reaches both sides of the pelvis. You have a marble sitting in a hole on the pubic bone. Imagine little hollows around the dish, and you need to roll the marble into each hole and back to the start before moving to the next one. To start, gently tilt your pelvis backward to roll the marble into the hole near the belly button. Relax to roll the marble back to the start. Slowly roll the marble in different directions, noticing where the ball easily wants to go and the areas that are more challenging. Recheck your coccyx by tightening around the back passage.

Option 2: This time, instead of using the motion of the pelvis to free the tissue that might be restricting the coccyx, you could engage the pelvic floor muscles as we did in the coccyx movement test. Engage the pelvic floor with the visualization of tightening around the back passage. If you cannot feel your coccyx move, or that of your client, you could refer to a pelvic health physiotherapist who will do further tests.

Cautions: Osteoporosis, pelvic pain, third trimester in pregnancy—not staying in position for too long (do just one circuit of the clock in each direction)
Contraindications: Early-stage herniated disc—the pod or ball will take the pelvis out of neutral.

More Excerpts From The Pelvic Diaphragm

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