The Anatomy of Pain
Cycle of Pelvic Floor and Low Back Pain
Pelvic and Low Back pain is caused by misalignment in the Pelvic Floor at the site of the Perineum.
Pain Free Movement is about creating balance in the pelvic floor at the site of the perineum…unraveling the distortion in the musculature at the perineal site.
Alignment…injury free, pain free, preventing injury, healthy movement, safe exercise, standing evenly on the leg bones to support the spine and entire structure, aging youthfully.
Structural ReAlignment Integration™ is a method for treating patients with Pain and Injuries; a systematic approach to achieving freedom of movement and prevention of injury.
Exercise…when exercising out of pelvic floor alignment as a result of being imbalanced for a lifetime injuries result. The very practice of yoga and other therapeutic regimes exacerbate the life-long patterns causing further trauma. There is a disconnection between the intention and the actual result. Therapists and pain management practitioners of most modalities are approaching the pain response from the outside in, instead of from the inside out.
What is the origin of the twist in the sacrum? The spiral begins in the perineal with the pulling of the musculature across the pelvic floor, in the fascia
How to change the neurology to reflect the new movement patterns…change the cellular muscle fiber memory. Rewriting the old patterns, the old muscle memory.
Create a new neurological belief system.
- Imbalance in the perineal area begins with the first steps we take as a child. Muscles are stretched across the pelvic floor. Imbalance in the superficial and deep transverse perineal muscles and fascia. The superficial perineal fascia goes around through the perineal muscle; cross fibers from the superficial and deep external sphincters (anal and vaginal) to the superficial transverse perineal muscle. This affects the anal, urethrae and vaginal sphincters and deep underneath the testicles. All lie underneath the perineal membrane. The prostate is right above the deep transverse perineal membrane. The pelvic diaphragm separates these two regions.
- Innervation of the superficial and deep external sphincters to the superficial
Transverse perineal muscle…anal and vaginal.
- The deep superficial, subcutaneous muscles connected with the perineal membrane and the levator ani muscles are shortened, constricted and spiraled. The isciocavernosus muscle and the bulbospongiosis muscle around the vaginal area connect with the deep perineal fascia at the site of the ischiopubic ramus (??) These muscles form the Urogenital and Anal Triangle, where the perineum comes in the space between the sphincters. The sacrum, the ischiopubic ramus and the coccyx and the anococcygeal ligament body with all of the above muscles form the triangles. Muscles attach to the true pelvis
- Imbalance effects the urethrae sphincters and the vaginal sphincters as they lie underneath the perineal membrane. The regions (triangles) of the perineum, urogenital and anal with all of the muscles and fascia form the pelvic diaphragm …the piriformis muscle and the obdurator internus and fascia (pubic sympysis). The extrernal anal sphincter muscle goes into the perineal body, into the transverse perineal muscle. The transverse perineal ligament (the anterior thickening of the perineal membrane) comes off of the deep perineal muscles…the tendinous arch of the levator ani muscle (illiococcygeus, pubococcygeus, and puborectalis), the annococcygeal ligaments, connects coccyx and anus and forms the backpoint of the anal triangle…Note: Perineal Raphe…Muscles connect to the true pelvis . Obdurator internus (3-4 and 9-8), prerectal muscles from levator ani muscle connect to muscles of the anal canal which is a circular muscle layer.
- Out of the triangle to the pelvic floor and connection to bone…on to the true pelvis…the pubic symphysis and the ischiopubic ramus, the gluteus maximus off the coccyx. Pelvic Misaligned Floor Along with bony structure creates TRAUMA
- Manifestation of Pelvic Pain…Elimination, Prostate, Urinary Tract, Ovarian and Uterine, Sexual Dysfunction
- Coccyx to Sacrum…to the anterior back wall of the pelvis. Annococcygeal to the coccyx. The ligaments that connect to the illium and sacrum, anterior sacroilliac ligaments (inside of sacrum to the illium)
- Sacrum to Pelvis Sacrospinous ligament, the sacrotuberous ligament form the greater and lesser foramen. The anterior longitudinal ligament starts off the sacrum. Muscles…From Inside Sacrum to Outside of the Femur
- Superior Gemellus Muscles, Obdurator internus (to Femur), inferior gemellus, quadratus femoris, piriformis, gluteus minimus, gluteus medius and gluteus maximus. Muscles from Outside of Pelvis to Femur; gluteus maximus connection to femur, tensor fasciae late to adductors, off of the illium in front form the inguinal triangle from illium to pubis
- Inside the femur…inside the illium, up illiacus to the psoas and the lumbar spine
LEG TO PELVIS TO BACK
From outside of the pelvic bone…glutes and tensor fascia late
Inside femur…behind inguinal ligament into the true pelvis to false pelvis
With illiacus, inside of illium, psoas going up the lumbar spine
Transverse abdominals, outside of the pelvis to the thoracic lumbar fascia
Transverse abdominals connect to the pubic bone affecting the abdurator sciatic nerve
When constricted and tight