Case 1 - Sacrum Dysfunction
A. Initial intake
Geraldine is a French woman of 35 years old who led an active lifestyle. She ran 3 times a week and enrolled in the local gym, where she took classes almost everyday in Ashtanga Yoga, Pilates, as well as Cycling. All this came to an abrupt halt when she was struck by pain at the sacrum area 3+ years ago.
Her doctor in Finland identified the condition as Lumbago and assured that there was no structural problem. He showed her to do Uttanasan (Forward Bend Stretch), which helped to alleviate the pain. Not long after that, the pain froze her and she had to stay in bed for 3 days. Although she recovered eventually, she continued experience pain whenever she was tired, lacked sleep, sat or stood static for a long time.
B. Goal
Geraldine’s goals for working with me was to enhance/eliminate her Sacrum Pain (short term), build a stronger hip girdle (medium) and obtain better posture and cutting down 10 pounds (long term). She was committed to the daily yoga therapy homework and was able to provide feedback on her progress.
C. Physical assessment and Body Posture Readings
| Joint Action | Mar 25 | Mar 25 | Apr 29 | Apr 29 | May 28 | May 28 |
Left | Right | Left | Right | Left | Right | |
Hip Flexion straight-leg raise(Norm 90°) | 55 | 53 | 67 | 69 | 88 | 90 |
Muscle Testing Assessments
| Joint Action | Apr 02 | Apr 02 | Apr 29 | Apr 29 | May 28 | May 28 |
Left | Right | Left | Right | Left | Right | |
Hip Flexors | 2/5 | 2.5/5 | 3/3 | 3.5/5 | 4/5 | 4/5 |
Geraldine’s shoulders and upper back were rounded and her head was little forward. She had no complains of pain on her upper back but acknowledged that she experienced stiffness. Her breathing was shallow.
• Forward head
• Round Shoulder
• Flat back
• Pelvis posterior tuck
• Hyper extended knees
D. Key Exercises
The following exercises were applied for Geraldine’s treatment:
SI sequences: to improve freedom at SI joints, stabilize and strengthen muscles that support her SI.
Joint Mobility sequences: to strengthen knee extensors, hip flexors, hips extensors and to build a stronger hip girdle and back (she has little lumbar curve) which will helps to release the pressure of body weight on these areas.
Personalized Yoga Therapy Sequences: to target specific objectives (lower back and sacrum pain, hyperextended knees, rounded back, fatigue posture)
E. Results
2nd Session
” Yesterday afternoon and today, my back pain went worse. My baby woke up nearly every hour during the night so I didn't have the rest I would have needed to heal my back. I woke up with still the same pain, but worse. After I did the exercises ,I felt much better. In fact, at the time I'm writing I'm not suffering at all. I hope this will continue like that.” ….
4th Session
…On April 16, she came with a big smile. She looked really healthy happy. She said: “ I have not been feeling good like this for a long time”. Her breathing seems deeper and she seemed to be aware of her posture. The pain has left her since last week and that she got 9 hours of sleep the day before.
6th Session
…There was improvement in her breathing and her posture as her back was not rounded like before, her trunk was straighter. She told me that she still found inhalation harder and shorter. Her weight had also reduced 3 pounds. “This is a good start for me as I find it hard to lose weight”.
10th Session (Final Assessment)
Geraldine obtained significant transformation at both physical and mental levels. She has been bringing yoga into all aspects of her life: walking, sitting, talking, studying, sleeping, thinking, feelings. She absolutely becomes more aware of her posture and the sensation of her feeling toward her body and mind. Her range of motions and strength have been improving so much with less secondary mover involvements. Her quads and hip flexors have strengthened tremendously. There was freedom and strength around her hip and shoulders girdles. She had been receiving very positive comments from her friends regarding her body tone and posture, which boosts her motivation and confidence. Most of all, she is PAIN FREE and very happy and looks forward to her yoga homework every day after her son has fallen asleep.
