What is the best way to apply deep tissue massage around the iliac crest

The ligaments are one of the most essential mechanisms to address when dealing with lower back pain. Those that run “horizontally” – from the levels of S5, 4, 3, 2, 1 and L5 to the ilium at each vertebral stage – are of special interest. In other words, the sacroiliac and iliolumbar ligaments run at 90 degrees to the erector spinae’s “vertically” organised fascia. One suggestion and one word of warning: When a person experiences a low back or sacral spasm, it is most likely that they are experiencing a ligamentous sprain. When a ligament is damaged, particularly in a weight-bearing area, nature organises us so that the muscles spasm in response, adding stability and limiting further movement. As a result, the spasm is a part of the solution. The problem is that the nervous system almost often over-reacts rather than under-reacts (“better safe than sorry”). As a result, judicious therapy will help to induce a more balanced neurological response – and therefore reduce the severity of the compensatory muscle spasm. One word of caution: if the back pain is too intense or the area feels hot and inflamed to the touch, you should probably refrain from doing the work mentioned below until the person’s body has recovered from the acute inflammation. Cross-Fiber for the Iliolumbar and Sacro-Iliac Ligaments: Applying cross-fiber (also known as “deep transverse friction”) to these ligaments is a simple and efficient technique. This necessitates a detailed “collection” of the thickened fascia bands that may be present. Shift the thumb or assisted first or middle finger up and down (inferior to superior) in the region just medial to the sacro-iliac joint, starting just lateral to the spinous process of S5. You can normally only palpate one finger’s width of ligament at this stage. You can spend up to 10 seconds moving through the grain of these fibres if you encounter a thickening or tightened band (again inferior to superior). To disperse the fibres and increase local circulation, use cross-fiber. You’re also helping to re-weave the fascia so that it’s less loosely organised – similar to how when you roll your hands over a random bunch of toothpicks, they’ll line up perpendicular to the direction you’re rolling your hand in. Continue to investigate and work with any stress or thickenings you find in this area – at each vertebral stage. The ilium’s shape and relationship to the sacrum change as you get higher. The more space between the sacral spinous processes and the ilium’s medial border, the better. So, by the time you get to the iliac crest, you might have found as many as six places to cross-fiber through the iliolumbar ligament (whereas, as we said, at the level of S5, you’ll probably only find one fingers-width amount of space). I recommend taking a “homoeopathic” approach to cross-fibering. I’ve found that if you’re anatomically correct and detailed, you don’t need to apply a lot of pressure or spend a lot of time.