Exploring Expanded Approaches to Pelvic Blocking Procedures in Chiropractic Care

Mechanical dysfunction of the pelvis often presents a challenge in chiropractic care. Traditional methods focus on correcting pelvic torsion using padded wedges, a technique closely linked with the Sacro-Occipital Technique (SOT). This approach, popularized by Major DeJarnette, DC, has been effective but somewhat limited in scope. Recent insights suggest that these blocking procedures can be applied more broadly to address various pelvic and postural faults, offering a more versatile tool for practitioners.

Understanding Pelvic Blocking Procedures

Pelvic blocking involves placing padded wedges or blocks under specific parts of the pelvis to correct misalignments and improve posture. DeJarnette originally categorized these procedures into three main types, primarily targeting pelvic torsion. Pelvic torsion occurs when one side of the pelvis rotates forward or backward relative to the other, causing imbalances that can affect the spine and overall body mechanics.

While pelvic torsion correction remains a core use, blocking procedures can also address other mechanical dysfunctions. These include pelvic tilt, pelvic rotation, and asymmetries that contribute to lower back pain, hip discomfort, and gait abnormalities.

Expanding the Use of Blocking Procedures

The traditional three categories of blocking focus on specific pelvic distortions. However, practitioners have found that using wedges in different configurations can correct a wider range of postural faults. This expanded approach involves:

• Targeting multiple planes of pelvic misalignment: Instead of correcting only torsion, wedges can be placed to address lateral tilts and rotations.

• Incorporating blocking into full-body postural correction: Pelvic alignment affects the spine, shoulders, and even the head position. Adjusting the pelvis with blocks can improve overall posture.

• Using blocks to support rehabilitation: After adjustments or injury, wedges can help maintain pelvic alignment during healing.

  
  

For example, a patient with a lateral pelvic tilt might benefit from a wedge placed under the lower side of the pelvis to encourage leveling. Similarly, a rotated pelvis can be addressed by positioning blocks to counteract the twist, supporting the body's natural realignment.

Practical Applications in Clinical Settings

Chiropractors can integrate expanded blocking procedures into their treatment plans by:

• Assessing pelvic alignment thoroughly: Use visual inspection, palpation, and functional tests to identify the specific type of pelvic dysfunction.

• Customizing wedge placement: Based on the assessment, place wedges to target the exact misalignment rather than relying on a one-size-fits-all approach.

• Combining blocking with other therapies: Use blocking alongside spinal adjustments, soft tissue work, and exercises to enhance outcomes.

• Monitoring patient response: Adjust wedge placement and treatment frequency according to patient feedback and progress.

  
  

For instance, a patient with chronic lower back pain linked to pelvic asymmetry may experience relief when wedges are used to correct the pelvic tilt during treatment sessions. Over time, this can reduce compensatory strain on the lumbar spine.

Benefits of an Expanded Approach

Using blocking procedures beyond the original categories offers several advantages:

• Greater flexibility in treatment: Practitioners can address a wider range of mechanical issues.

• Improved patient outcomes: Tailored wedge placement can lead to more effective pain relief and functional improvement.

• Non-invasive support: Blocking provides a gentle, supportive method that complements manual adjustments.

• Enhanced postural awareness: Patients may develop better body awareness as they experience changes in alignment.

  
  

Considerations and Limitations

While expanded blocking procedures show promise, chiropractors should keep in mind:

• Individual variability: Not all patients respond the same way; careful assessment is crucial.

• Integration with comprehensive care: Blocking should be part of a broader treatment strategy, not a standalone solution.

• Ongoing research: More studies are needed to quantify the benefits and refine techniques.

  
  

Moving Forward with Pelvic Blocking

The use of padded wedges in chiropractic care has evolved from a narrow focus on pelvic torsion to a broader tool for correcting various postural faults. This expanded approach allows practitioners to customize treatments, improving patient comfort and function. By understanding the full potential of blocking procedures, chiropractors can enhance their care strategies and support better musculoskeletal health.

Patients experiencing pelvic or lower back issues may benefit from discussing blocking procedures with their chiropractor to explore if this technique fits their treatment plan.

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.