I have spent the past two days with Peter Lelean, an Australian MT, who came to Rochester to pass along some very interesting and important information. Fresh from the 7th Interdisciplinary Congress on Low Back & Pelvic Pain Conference in Los Angeles, where he had a poster presentation on this material, Peter introduced me to the concepts of migratory fascia and its treatment implications.
Many years ago, Peter detected a previously undescribed ligament in the pelvis which, when displaced due to abnormal posterior pelvic forces, can create fascial strain patterns that will not resolve without proper treatment. You can read the abstract from his 2008 article in The Journal of Bodywork and Massage Therapy here. Clinical trials begin early next year. This ligament, hereto known as the Lelean Ligament, is intended to ride over the superior aspect of the lateral iliac crest, from ASIS to PSIS. Ind=creased fascial tightness causes a posterior migration of the ligament, contributing to iliolumbar pain.
Treatment is a multi-step endeavor, which basic principles that can be adapted to different treatment modalities. Peter’s treatment methods are quite different than mine, but through a bit if give and take, they responded well to the myofascial release that I utilize. Results were quite dramatic and easy to achieve in a single treatment session. I believe that this will be quite an important advance in the treatment of pain.
I am looking forward to bringing Peter’s findings to an audience in the United States next year, beginning with my Advanced Myofascial Release Seminar, to be held in Tucson, AZ March 18-20, 2011. I hope to be able to share it with you.
Any suggestions for self-care?
Janet,
I have sent this along to Peter Lelean for a response.
Hi Janet and Walt. Self-care is a hot topic for me, as I have a torn ext oblique that is slowly repairing. Since the LBP congress I have been wearing a sacro belt while working. and have managed to keep my pelvic alignment right after one visit to my chiro colleague. The fascial aspect is tricky to self treat, but I found it possible with regular specific stretches adapted to fascial manips. Still refining the techniques, but its driving home the message that prevention is better than fixing the damage. Knowing your limits helps, i.e. don’t do what I did and try and shift a tonne weight on your own! Coming to terms with the migratory fascia phenomena is useful for self care as well as for clients. I suggest doing a workshop, if available, to that end.
Cheers , Peter
Janet,
To follow up on Peter’s response, I have found that continuing the typical self treatment ideas of myofascial release have great value. As the primary area of restriction with the Migratory Fascia Syndrome involves the sacral/posterior pelvic region, use of a Sacrowedgy™ is helpful to keep the sacroiliacs free. Positional stretches for lengthening the gluts, piriformis, etc., are also helpful.
Walt
I have found this information very helpful. I have found unilateral migration on several of my long term chronic clients. Initial efforts to push the ligament in the right direction with interactive movement of the client have been successful.
It really is quite a simple concept, if one knows what to look for. Peter Lelean’s specific treatment protocol is one to which I’ve never been exposed. It has certainly deepened my treatment abilities and , hopefully, will do the same for other therapists.
I will be teaching these principles as a part of my Advanced Foundations in Myofascial Release seminar next month in Tucson, AZ. For more information check out the website.