{"id":636,"date":"2013-11-23T19:07:52","date_gmt":"2013-11-24T00:07:52","guid":{"rendered":"http:\/\/osteopathicvision.com\/?page_id=636"},"modified":"2014-03-25T13:39:00","modified_gmt":"2014-03-25T17:39:00","slug":"the-sacrum-and-respiration","status":"publish","type":"page","link":"https:\/\/osteopathicvision.com\/staging\/articles\/the-sacrum-and-respiration\/","title":{"rendered":"The Sacrum And Respiration"},"content":{"rendered":"

At the 2005 annual IOA conference \u2013\u00a0Sequencing: the Art of Finding the Key<\/em>, Kenneth Klack, D.O. posed a question concerning the Mitchell pelvic axis system and its effect on the respiratory diaphragm.\u00a0 I am going to do my best to respond to that question here.<\/p>\n

The Mitchell pelvic axis system was proposed by Fred Mitchell, Sr. D.O. as a way to explain the motion of the sacrum around the innominates.\u00a0 The system defines six axes around which the sacrum and innominates move.\u00a0 The axes are described using surface landmarks.\u00a0 They are as follows:<\/p>\n

1)\u00a0\u00a0\u00a0\u00a0 The anterior\/posterior axis through the center of S2.\u00a0<\/sub><\/p>\n

2)\u00a0\u00a0\u00a0\u00a0 The middle transverse axis, which lies at the level of the PSIS and is the axis, which sacral flexion and extension dysfunctions occur.\u00a0 Some schools refer to these as the unilateral shears.<\/p>\n

3)\u00a0\u00a0\u00a0\u00a0 The superior transverse axis, which lays one finger width above the PSIS and is the axis about which the cranial rhythm (primary respiration) is predominantly focused.<\/p>\n

4)\u00a0\u00a0\u00a0\u00a0 The inferior transverse axis, which lays one finger width below the PSIS and is where innominate rotation primarily occurs.\u00a0 Innominate rotational dysfunctions occur on this axis.<\/p>\n

5)\u00a0\u00a0\u00a0\u00a0 The left oblique axis appears when the middle transverse axis shifts up on the left and down on the right.\u00a0 This occurs when the sacrum side-bends to the right e.g. during the walking cycle.\u00a0 Sacral torsions occurring on the left axis (ex. left on left) happen here.<\/p>\n

6)\u00a0\u00a0\u00a0\u00a0 The right oblique axis appears when the middle transverse axis shifts up on the right and down on the left.\u00a0 This occurs when the sacrum side-bends to the left e.g. during the walking cycle. \u00a0Sacral torsions occurring on the right axis (ex. left on right) happen here.<\/p>\n

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Pictures from the Glossary of Osteopathic Terminology<\/p>\n

To answer the question I began by consulting Paul Hume, N.D, and D.O. from New Zealand who was also at the course.\u00a0 Paul and I started with \u201cworking\u201d sacrum\u2019s that had no perceptible dysfunctions and proposed the following test \u2013 we would restrict the axes one at a time and observe what happened to the body.\u00a0 To restrict the axis the patient is held around that axis to restrict motion \u2013 e.g. to restrict motion around the middle transverse axis the patient would be held with circumferential compressive force between the ASIS and PSIS.\u00a0 To restrict the superior transverse axis, circumferential force is applied between the ASIS and one finger width above the PSIS, etc.<\/p>\n

Prior to the test, the patient was asked to take a deep breath and note the sensation of breathing.\u00a0 Once the operator\u2019s hands were positioned, a compressive force was applied circumferentially to the innominates and the patient was asked to take a deep breath and compare that with the original breath.<\/p>\n

The observations were:<\/p>\n

a)\u00a0\u00a0\u00a0\u00a0\u00a0 Pressure on the middle transverse did not effect respiration.\u00a0 Patients reported no change in breathing.<\/p>\n

b)\u00a0\u00a0\u00a0\u00a0 Pressure on the superior transverse gave a sensation of a weight or heaviness in the sternal area and the patient felt like they were taking a less deep breath.<\/p>\n

c)\u00a0\u00a0\u00a0\u00a0\u00a0 Pressure on the inferior transverse axis gave a sensation of weight of heaviness in the area of the respiratory diaphragm and the patient felt like they were taking a lees deep breath.<\/p>\n

d)\u00a0\u00a0\u00a0\u00a0 Pressure on the left oblique axis gave a sensation of left sided breathing restriction with no effect on the right.<\/p>\n

e)\u00a0\u00a0\u00a0\u00a0\u00a0 Pressure on the right oblique axis gave a sensation of right sided breathing restriction with no effect on the left.<\/p>\n

f)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The A\/P axis was not tested.<\/p>\n

While a dedicated scientific approach, such as the use of spirometry, may give more highly specific data, the N of 10 used in the answering of this question seems to indicate a likely correlation between the Mitchell axis system and diaphragmatic respiration.\u00a0 Participant responses to the perception of restricted breathing were similar throughout the process.\u00a0 Because of this experiment, I have been looking with new eyes at all of the pelvic dysfunctions that I treat.\u00a0 I am noticing more subtle changes in rib cage and diaphragmatic motion and correlating it with the pelvis.\u00a0 I am asking my patients to experience their breathing more, both before and after treatment.\u00a0 \u00a0\u00a0It is making me a better osteopath.\u00a0 Thank you Kenneth.<\/p>\n","protected":false},"excerpt":{"rendered":"

At the 2005 annual IOA conference \u2013\u00a0Sequencing: the Art of Finding the Key, Kenneth Klack, D.O. posed a question concerning the Mitchell pelvic axis system and its effect on the respiratory diaphragm.\u00a0 I am going to do my best to respond to that question here. The Mitchell pelvic axis system was proposed by Fred Mitchell, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":634,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","footnotes":""},"class_list":["post-636","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/pages\/636","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/comments?post=636"}],"version-history":[{"count":7,"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/pages\/636\/revisions"}],"predecessor-version":[{"id":837,"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/pages\/636\/revisions\/837"}],"up":[{"embeddable":true,"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/pages\/634"}],"wp:attachment":[{"href":"https:\/\/osteopathicvision.com\/staging\/wp-json\/wp\/v2\/media?parent=636"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}