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The Anterior, Superior Ilium

By Nick Spano, DC

Pregnant moms may experience a limp or some type of pain near the site of an injury—or they might not. When it comes to the A.S. ilium, we need to think deeper than a standard chiropractic visit. The problem is we often can’t know until we’ve tried everything else, and then in one or two visits, we can become sure that we’re dealing with an A.S. ilium tension pattern. Approximately 80% of the time now I can identify it immediately, but it has taken me years to get there.

The A.S. ilium tension occurs when the ilium has moved into the anterior and superior position. Even though the pelvis is mobile, the ilium is somewhat fixed in that position, leaving the pelvis able to bend and move but slightly less.

Women are particularly vulnerable to an A.S. ilium, especially during pregnancy. It’s not that hard to imagine that the female pelvis does something completely different than the male pelvis, particularly (but not exclusively) in pregnancy. In fact, the female pelvis is affected by relaxin, a woman’s hormone, during pregnancy. When the female pelvis relaxes, it can cause the pelvis to move forward on the sacrum. This is the place for a chiropractor to check the alignment of the pelvis to make absolutely certain that it has stayed properly aligned. If it hasn’t, then the chiropractor corrects the pelvis with a minor adjustment.

The male pelvis is fairly easy to correct, whether a chiropractor is using the traditional side posture method or is using some form of a drop procedure. The female pelvis, however, is somewhat tricky, depending on the type of involvement one sees. If it is the A.S. ilium, you will use direct contact with the ischial tuberosities in either prone or side posture.

About 45 years ago, this was a mildly popular procedure. Dr. Glen Stillwagon was an expert at looking through an x-ray and determining what was happening. If there was an issue, he would simply use the drop piece to fix it. Dr. Stillwagon thought that the pelvis went into this type of misalignment 15% of the time. Since the days of Dr. Stillwagon (who was such an inspiration to me), we have reached far into the future with Advanced Muscle Palpation and found a startling number of new A.S. ilium tensions almost exclusively in women! Though it does occur in women who have not borne a child, it is more often found among pregnant women.

Just to give you some idea of how likely it is, I’ll give you two short stories. The first takes place in Canada where I was teaching a class of chiropractors and students. During the hands-on aspect of the lecture, a handful of participants pointed to a female chiropractor who was lying face down. Every chiropractor, as well as the students, kept telling me that she had an A.S. ilium, which I did not believe. But I went to the doctor playing the part of patient, and she had a striking A.S. ilium! I made a minor adjustment, and the patient felt a remarkable improvement. Fast forward to the next day when we happened to meet in the parking area of the garage, and she was noticeably better–at which time I asked her to address the class, and she agreed. She got up in front of the class to speak and became a bucket of tears!

Which brings me to my next story. To be honest, I was a lot bolder when I was younger and that’s to say that when a female chiropractor asked for help on a chiropractic message board I rarely interact on now, I was quick to answer. One of her patients was just about to deliver her baby and this chiropractor was involved, but didn’t know about the A.S. ilium. So I reached out and basically said, “I can help!” The doctor said, “We are both going to drive to the office, just tell us what to do.” When they came to the office, I simply told her what to look for and then how to correct it. That evening she said, “The baby is now in the right position to be delivered. Thank you, Dr. Spano!”