Somatic Technique

Somatic Technique-
Technique #4 Ilium Axilliary (Chart Notes—Il-Ax)

Indications. This is a good technique for unilateral lumbosacral and sacroiliac problems. This technique can also be useful fo r bilateral tension when it is chronic. Simply do both sides.

Contraindications. Radicular leg pain is the main potential contraindication. Gently test the technique out first.

Muscles Involved. The lateral trunk, flexors—Quadratus lumborum, external and internal Obliques. (Figure 4).
Patient Position. Prone, holding head of table with both hands.

Practitioner Position. Standing at the foot of the table.

Contact. Take the patient's leg on the involved side, grasping it with both hands just above the ankle. (In this example, the patient's right side).

Figure 4

Procedure. Instruct the patient to contract the musculature on his right side by drawing his right hip (ilium) up toward his right armpit (axillary fossa). The goal is to shorten his right side, between axillary fossa and ilium, as much as possible. Instruct him to try not to lift his hip up off the table as he does this, but to keep his whole body flat on the table.

To help him make the correct movement you can, A), stand in front of him and demonstrate the movement by holding your arms up at right angles, as if holding the table, and pulling your right hip up toward your armpit, and/or B), place your hands on his hips and passively guide him through the movement.

Once he has fully contracted the ilium toward his axillary fossa, use his leg as a lever to pull in the opposite direction (toward you), so that you are providing a resistive force to his contraction. (Figure 4A).

Have him hold the contraction for a couple seconds, and then slowly and consciously release it a third of the way, before contracting again 1—2 inches.

Repeat this process several times until the patient's right side is fully lengthened (Figure 4B).

Go through the entire process one more time, then have him contract his hip all the way up for a final contraction. Apply resistance by tractioning on the leg as before, then have him release quickly on the count of three.

Note: As the patient does the quick release, do not pull down on his leg. There is an adjustive procedure that involves this movement, but if it is done with this somatic muscle release, it can cause injury to the hip or low back.

Reinforcement. Have him fully extend his right side and hold it extended (by contracting the muscles on the other side), while you attempt to push his leg and ilium toward his axillary fossa. After a few seconds, gently pump the leg and hip up toward the armpit and down again a few times, and then tap the involved muscles to further stimulate proprioceptive awareness.

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Figure 4 A

Figure 4 B