Exploring Expanded Applications of Pelvic Blocking Procedures in Chiropractic Care

Mechanical dysfunction of the pelvis often presents a challenge for chiropractors aiming to restore balance and reduce pain. One well-known technique involves the use of padded wedges, commonly called pelvic blocking procedures. These wedges have long been associated with the Sacro-Occipital Technique (SOT), a method popularized by Major DeJarnette, DC. While DeJarnette focused primarily on correcting pelvic torsion with these blocks, recent approaches have expanded their use to address a wider range of postural faults and clinical conditions. This post explores how pelvic blocking procedures can be applied beyond their traditional scope, offering chiropractors a versatile tool for patient care.

Understanding Pelvic Blocking Procedures

Pelvic blocking involves placing padded wedges under specific areas of the pelvis while the patient lies down. The wedges aim to correct misalignments by encouraging the pelvis to settle into a more balanced position. This technique is gentle, non-invasive, and can complement other chiropractic adjustments.

DeJarnette identified three main categories for using these blocks, primarily targeting pelvic torsion. Pelvic torsion occurs when one side of the pelvis rotates forward or backward relative to the other, causing uneven stress on the spine and surrounding muscles. By placing wedges strategically, the chiropractor can reduce this torsion and improve pelvic alignment.

Expanding Beyond Traditional Categories

While pelvic torsion remains a key focus, practitioners have found that blocking procedures can address other postural and mechanical issues. These include:

• Pelvic obliquity: When one side of the pelvis is higher than the other, causing uneven leg length and gait problems.

• Anterior or posterior pelvic tilt: Forward or backward tilting of the pelvis that affects lumbar spine curvature and posture.

• Sacral base unleveling: Unequal height of the sacral base, which can contribute to lower back pain and instability.

• Compensatory postural faults: Secondary misalignments in the spine or lower extremities that develop in response to pelvic dysfunction.

  
  

By using wedges in different configurations, chiropractors can target these faults more precisely. For example, placing a wedge under the anterior superior iliac spine (ASIS) on one side can help correct anterior pelvic tilt, while positioning a wedge under the ischial tuberosity can influence sacral base leveling.

Clinical Benefits and Practical Applications

Using pelvic blocking procedures in an expanded way offers several benefits:

• Improved patient comfort: The gentle nature of wedges allows patients to relax during treatment, which can enhance the effectiveness of adjustments.

• Enhanced postural correction: Addressing multiple pelvic faults simultaneously can lead to better overall posture and spinal alignment.

• Support for complex cases: Patients with chronic pain or multiple musculoskeletal issues may respond better when blocking is combined with other therapies.

• Facilitation of muscle relaxation: The positioning can reduce muscle guarding around the pelvis and lower back, making manual adjustments easier.

  
  

For example, a patient with chronic low back pain and a noticeable pelvic obliquity may benefit from wedges placed to level the pelvis before spinal adjustments. This approach can reduce compensatory muscle tension and improve the longevity of treatment results.

Integrating Blocking Procedures into Chiropractic Practice

To effectively use pelvic blocking beyond traditional methods, chiropractors should:

• Conduct a thorough assessment of pelvic alignment and related postural faults.

• Customize wedge placement based on individual patient needs rather than relying solely on standard categories.

• Combine blocking with other chiropractic techniques such as spinal manipulation, soft tissue therapy, and rehabilitative exercises.

• Monitor patient response closely and adjust wedge positioning as needed during treatment sessions.

  
  

Training and experience with pelvic blocking are essential to maximize its benefits. Chiropractors should stay informed about evolving techniques and consider continuing education opportunities focused on SOT and related methods.

Summary

Pelvic blocking procedures have evolved from a technique focused mainly on pelvic torsion correction to a versatile approach addressing various pelvic and postural dysfunctions. By expanding the use of padded wedges, chiropractors can improve patient outcomes through more precise alignment and enhanced comfort. This method supports a holistic view of musculoskeletal health, recognizing the pelvis as a key player in overall posture and spinal function.

Chiropractors interested in refining their practice should explore these expanded applications of pelvic blocking. Tailoring wedge placement to individual patient needs can unlock new possibilities for managing complex cases and improving quality of life.

Cooperstein R, Lisi AJ, Blocking Procedures: An expanded approach Journal of the American Chiropractic Association. 2004 Jan; 41(1): 44-6.

ABSTRACT: Using padded wedges to treat mechanical dysfunction of the pelvis is a technique procedure that is practically synonymous with Sacro-Occipital technique (SOT). Although we are not surprised at this, given that it was SOT founder Major DeJarnette, DC who popularized what he termed pelvic "blocking" procedures, there is no reason to limit how we use these wedges (or blocks). DeJarnette primarily employed blocks to correct pelvic torsion, whereas we use them to correct pelvic and other postural faults and clinical conditions. To describe these other approaches, we are going to have to go beyond the three "Categories" DeJarnette identified.