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OMT Minute  |   March 2018
OMT for Patients With Sacral Somatic Dysfunction
Author Notes
  • From the Touro University College of Osteopathic Medicine–CA in Vallejo. 
  • Financial Disclosures: None reported. 
  • Support: This video was produced by the Touro University College of Osteopathic Medicine–CA. 
  •  *Address correspondence to Stacey Pierce-Talsma, DO, 1310 Club Dr, Mare Island, Vallejo, CA, 94592-1187. Email: stacey.piercetalsma@tu.edu
     
Article Information
Neuromusculoskeletal Disorders / Osteopathic Manipulative Treatment
OMT Minute   |   March 2018
OMT for Patients With Sacral Somatic Dysfunction
The Journal of the American Osteopathic Association, March 2018, Vol. 118, e15. doi:10.7556/jaoa.2018.041
The Journal of the American Osteopathic Association, March 2018, Vol. 118, e15. doi:10.7556/jaoa.2018.041
  
OMT Minute: OMT for Patients With Sacral Somatic Dysfunction
eVideo. Sacral rocking can optimize biomechanical efficiency of the pelvis.
The sacrum is an important keystone for normal gait mechanics, connecting mechanical forces from the lower extremities and providing a foundation of support for the body. Osteopathic manipulative treatment (OMT) may be used to treat somatic dysfunction of the sacrum to optimize the biomechanical efficiency of the pelvis. Additionally, treatment of the sacrum may influence parasympathetic tone to the large intestine and genitourinary systems. Parasympathetic innervation arises from the S2-S4 spinal levels and exits via the ventral rami to become the pelvic splenic nerves, which travel to their target organ. In this way, treatment of the sacrum may aid in conditions including low back pain, constipation, and dysmenorrhea. 
One technique for sacral somatic dysfunction is sacral rocking (video), which uses breathing to reduce respiratory restriction of the sacrum. Respiratory motion affects the lumbar spine via diaphragm attachments at L1 through L3. During inhalation, lumbar lordosis decreases; as a result, the sacral base moves posteriorly, also known as counternutation. During exhalation, the lumbar lordosis increases, moving the sacral base anteriorly, also known as nutation. These motions are exaggerated during the sacral rocking technique and thus can improve somatic dysfunction and restriction of the sacrum. 
Resources
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Heinking K, Kappler R. Pelvis and sacrum. In: Chila AG, executive ed. Foundations of Osteopathic Medicine. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2011:575-601.
Mnabhi A. The patient with urologic concerns. In: Nelson K. Somatic Dysfunction in Osteopathic Family Medicine. 2nd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2015:317-329.
Licciardone JC, Kearns CM, Crow WT. Changes in biomechanical dysfunction and low back pain reduction with osteopathic manual treatment: results from the OSTEOPATHIC Trial. Man Ther. 2014;19(4):324-330. doi: 10.1016/j.math.2014.03.004 [CrossRef] [PubMed]
Ruffini N, D'Alessandro G, Mariani N, Pollastrelli A, Cardinali L, Cerritelli F. Variations of high frequency parameter of heart rate variability following osteopathic manipulative treatment in healthy subjects compared to control group and sham therapy: a randomized control trial. Front Neurosci. 2015;9:272. doi: 10.3389/fnins.2015.00272 [CrossRef] [PubMed]
Brugman R, Fitzgerald K, Fryer G. The effect of osteopathic treatment on chronic constipation—a pilot study. Int J Osteopath Med. 2010;13(1):17-23. [CrossRef]
  
OMT Minute: OMT for Patients With Sacral Somatic Dysfunction
eVideo. Sacral rocking can optimize biomechanical efficiency of the pelvis.