OT level 1 unit 1

Why is the pelvis considered the foundation of general treatment?


concentrate our attention on the pelvis as the foundation of our general treatment. From this focal point we can work from cephalad to caudad, and from the axial skeleton to the periphery, otherwise known as the base-up, centre-out principle.

The pelvis, being the innominates with respect to the sacral keystone, has an influence on both the upper and lower body. Consequently, it plays a notable role in the distribution of force between these two areas. It stabilizes our legs during the walking cycle, carrying the weight of one leg while apportioning the load of the spine, thorax, upper limbs, and cranium to the other. Because of its substantial mechanical influence on the body, the pelvis (or lower T-line) should be the basis of constitutional treatment in order to have the largest mechanical effect on a patient's anatomy.

From a biomechanical point of view, the pelvis has the most influence on the superstructure of the human body; from a neurovascular point of view, the spine is a passageway from the control centre to the periphery for the delivery of information that will dictate physiological func-tions. In order for the spine to carry out its role, it must be treated as a centre of coordination rather than a centre of correction, meaning that it should be tuned as a collection of articulations that, when functioning optimally, will allow the correct physiological functions to occur.

This principle explains why the pelvic adjustment is the basis for treatment and why, after the pelvic adjustment, we work through the spine to affect the periphery. From the pelvic adjustment we can integrate the lumbar adjustment to influence the coordination of movement in the lower limbs. Coordination is further facilitated by the neurological mechanisms passing through the lumbosacral plexus. Building upon a solid lumbopelvic adjustment, the operator can then work upwards to the thoracic adjustment, and build up to the upper T-line to stimulate the parietal and visceral fields of the region (neurologically through the autonomic nervous system, and mechanically through the osseous rib cage). Once we reach the cervical spine, we are again affecting the coordination of movement to the limbs through the neurology-this time, the upper limbs through the brachial plexus— in addition to having prepared the thorax for the drainage that will be necessary in the succeeding cervical and cranial adjustment. Adjustment involves the law of balancing each part of the body with equal importance. No one part is privileged over another.

The Pelvis as the Body's Foundation

  • Base-Up, Centre-Out Principle: The pelvis acts as the mechanical starting point for treatment. Care begins at the center base (pelvis) and moves outward to the limbs and upward toward the head.

    • Example: Just like constructing a building, you must ensure the foundation is balanced before fixing a crooked frame or roof.

Weight Distribution and Balance

  • Connecting Upper and Lower Body: The pelvis holds the sacrum (keystone) between the hip bones (innominates). It receives force from the head, spine, and arms, and distributes it down into the legs.

    • Example: When walking, one leg swings while the other supports your entire body weight. The pelvis stabilizes and routes all that upper-body weight safely down through the standing leg.

The Spine as a Coordination Center

  • Communication Highway: Instead of viewing the spine as individual pieces to fix separately, it is treated as a coordinated highway of nerve signals and joints.

    • Example: Think of the spine like an orchestra; every joint must be tuned so the whole system plays in harmony, allowing nerve signals to flow smoothly from the brain to the rest of the body.

Step-by-Step Treatment Sequence

  1. Pelvis and Lower Back (Lumbopelvic) Adjustment

    • Builds a stable base.

    • Improves leg movement and nervous system signaling through the lumbosacral nerve network.

  2. Mid-Back (Thoracic) Adjustment

    • Influences the ribs, breathing, and internal organs through mechanical alignment and autonomic nerves.

  3. Neck and Head (Cervical and Cranial) Adjustment

    • Improves arm movement through the brachial nerve network.

    • Clears pathways so fluids can drain properly from the head and neck.

    • Example: Clearing a pipe from the bottom end first ensures that fluids draining from the top won't get backed up.

The Law of Balance

  • Every part of the body is equally important for overall health; no single area is given special privilege over another.