Dr. Ruch offers the Pelvic Realignment workshops periodically at his San Francisco Bay Area Clinic and will be offering the workshop online in 2018. Please visit his ‘upcoming seminars‘ page for details.

“I have a tendency for ligament laxity in general, so after two car accidents and my first pregnancy at age 40, Dr. Ruch was fundamental in healing my pelvis, and many other parts of my body, which were sore and unstable.  His gentle techniques, including The Level Pelvis Method, supported my recovery, as well as my shifting body.  He took the time to teach my partner how to measure my hip alignment, place a wedge appropriately, and pull/press on the appropriate side to encourage alignment.  This helped my pain, posture and mobility between chiropractic appointments.  Assisted by a midwife, a warm tub, a great partner, and many other helping and caring hands, and without any drugs nor emergency interventions, our little bundle was born.  Dr. Ruch’s care and techniques aided my body during gestation and played a critical role in our happy, healthy outcome.” — Amma Greenrose, LMT

A QUICK ANATOMY LESSON

Fig. 1a. Muscles and ligaments of the pelvic girdle. The ligaments hold the pelvic bones together.

In the adult, the pelvic girdle is a three-bone complex including the sacrum and the right and left hip bones. Three joints unite the bones of the pelvic girdle; the two sacroiliac joints and the pubis symphysis (see Figure 1).

The sacrum is the base of the spine and the pelvic girdle, as a whole, is the anchor for quite a substantial part of the muscular system of the spine, legs, thorax and abdomen. All of the abdominal, hip and thigh muscles originate from the pelvic girdle, as do the two large back muscles. So it is not difficult to see how misalignment of the pelvic girdle can affect any or all of these muscle groups, causing them to contract, become hypertonic (rigid), or go into spasm. In my clinical experience the key to understanding the cause of much “low back pain” is the loss of integrity, alignment of the three pelvic joints.

Fig. 1b. Side View of the Pelvis. The anterior superior iliac spine (or ASIS) are the front points of the iliac crest.

In Figures 1a and 1b some of the muscles directly involved with sacroiliac joint and pubic symphysis motion and integrity are illustrated along with the ligaments. In order for the pelvic bones to misalign, the ligaments must be failing and are injured. The muscles will then attempt to hold everything together with tightness.

Misalignment of the Pelvis Hip bone misalignment involves the sacroiliac (SI) joint and pubic symphysis, and will adversely affect all the deep and superficial muscles around the abdomen. The posterior muscles (back muscles and the deep hip muscles) are also affected. The psoas and iliacus muscles (see Figure 1) will be recruited neurologically to guard and protect the injured joints by limiting their range of motion. Misalignment can displace abdominal organs away from the origins of their nerves and arteries. Muscular distress, pain and limited range of motion will be only some of the clinical symptoms.

NOTE: photos courtesy of primalpictures.com

THE NERVOUS SYSTEM

Fig 2. Shifting of uterus with pelvic realignment

All tissues and joints in the body are embedded with various types of sensors, or nerves. When a joint is injured or misaligned, these sensors cause muscles to “guard” or go into contraction for extended periods of time. These contractions can be quite uncomfortable. Since so many important, highly used muscles attach to the pelvis, the contractions can be extremely distressing, as the sufferer can’t seem to move at all without pain. At the heart of the pelvis is the pubic symphysis. When this joint is misaligned, chaos ensues. It is extremely important to understand that the guarding (spasmed) muscles around the pubic symphysis can, like any other muscle, be relieved only by correcting the misalignment and by removing nerve distress within the joint. The nervous system may never adapt to neurological input arising from joint distress—in other words, someone who suffers from joint distress will never “get used to it” as their muscles will always fire or contract if the nerves sense a misaligned joint. The common practice is to prescribe narcotics as treatment. However drugs only mask the firing of the joint injuries. They are a temporary solution and do not treat the cause.

Fig 3. x-ray of misaligned pelvis with air injected into the uterus. Note asymetry and misalignment of bones, displacement of uterus.

Mobility and misalignment of the pelvic girdle is controversial; if it has ever happened to you, you understand how frustrating it can be to cope with the pain and confusion involved in treating such injuries. As a practicing chiropractor I encounter this type of injury every hour I am treating people. But those in the medical community, and even those in my own profession, disagree and have confusion over not only how mobility is affected by this joint but even whether misalignment of the pelvic joints occurs in the first place. The vast majority of my profession ignores the anterior joints of the body (ribs), the sternal joints (clavicle) as well as the pubic symphysis.
I am going to attempt to make this set of “realigning procedures” as easy for the helper and as comfortable for the patient as possible. We will be using an evaluation of the anterior (front) part of her pelvis (see Figure 2 A). The figure shown is the front of the pelvis and that is the only approach we will be using. There are two bony landmarks on the front of the pelvis: the left and right Anterior Superior Iliac Spine (ASIS) and the Pubic Symphysis (see Figures 1A and 1B).

Fig 4. Shift of hip bone.

A variety of complaints can result from misalignment of the pelvic joints, including infertility, urogenital and intestinal problems. In a normal female pelvis, the broad ligament stretches between the two hip bones, suspending the ovaries and the uterus (see Figure 2).

When the pelvic girdle misaligns, the broad ligament becomes skewed (see Figure 2). This changes the position of the ovaries and the uterus in the abdominal cavity and can exacerbate any problem that might exist; the pelvic examination can reveal tight and tender musculature on one side and the uterus tractioned to one side. (see Figure 3). Note the right side shift of the gynecological structures and the pelvic misalignment.

Fig 5. Forward shift of hip bone.

(The left side of this picture is the right side of the individual). Note misalignment of the pubic bones and the asymmetrical appearance in the lower pelvis. In late stage pregnancy, this shift, with a fetus in the uterus, will cause the fetus to “sit” or “press” on the Psoas. This will make walking difficult or impossible. This shift is responsible for some of the breech positions that occur. I think that a large percentage of gynecological pathology may be the result of unresolved pelvic trauma. Correcting misaligned pelvis has been shown clinically to relieve or reverse these conditions. Pregnancy and the pelvis require special attention if there has been a previous history of injury to the pelvic joints. This protocol is appropriate for late stage pregnancy when distress patterns can be significant, but can be used throughout the pregnancy. The significant displacement of the pubic bones relative to each other is a major pain producing factor. (see Figures 4 A and B). Evaluating the pattern of misalignment is critical.