When there is a structural collapse of the core distortion, the leg on the side of the anteriorly rotated ilium is longer, and the leg on the side of the posteriorly rotated ilium is shorter. This creates an imbalance in the distribution of body weight down through the legs, and a distortion within the hinge of the knee due to the relationship of the knee and lower leg caused by the rotation of the iliums – i.e. to compensate for the leg length discrepancy the knee and lower leg tend to be rotated in opposite directions.

My first goal is to release the structural collapse of the core distortion by moving the iliums into balance to take the pressure off the stressed areas of the knees. The quickest and most direct way to accomplish this was to apply Cranial/Structural releases that release the iliums into alignment and give weight bearing support to the sacrum. This also initiates an unwinding of the myofascial holding patterns affecting the entire leg and the structural imbalances of the knees. Once these changes were initiated it was time to apply effective soft tissue treatment.

The challenge was to apply a soft tissue protocol that would maximize the release of structural imbalance and allow the knee and leg to support the body in balance. This required knowing which leg was long due to the anteriorly rotated ilium, and which was short due to the posteriorly rotated ilium. This was accomplished by structural assessment while the person was standing. Locating the ASIS of each ilium showed me which was rotated anteriorly as it was lower than the one that was rotated posteriorly. Also, viewing the client from behind it was easy to see that the PSIS on the ilium that was rotated posteriorly was lower. The gluteus maximus was more defined on the side of the posteriorly rotated ilium, and there was a shortness between the crest of the posteriorly rotated ilium and the floating rib. This gave me the information necessary to effectively address and release the myofascial holding patterns causing the distortions affecting the knees.

Using the 3-step approach - (1. release the ischemia, inflammation, and swelling, 2. release the myofascial holding pattern working with deep, broad, slow strokes that only move with the release of the tissue, 3. release individual fibers, adhesions and scar tissue with deep very specific strokes also moving only with the release of the tissue) - I was able to work effectively and deeply from the first session with clients.

- Don McCann, MA, LMT, LMHC – founder Structural Energetic Therapy, Inc.