I was teaching a Stabilizing the Core and SI Joint seminar recently and learned a valuable cue from a pelvic floor specialist. In the MET correction for and upslipped innominate (when the ilium slips out of the SI joint), the client is asked to perform a hip-hike for eight seconds and cough and let go of the hip-hike. Why the cough? Good question! There are a few reasons: coughing activates the pelvic floor muscles, the transverse abdominis, the anterior multifidi, the diaphragm and the attachment of the quadratus lumborum to the 12th rib. The QL stabilizes the 12th rib during forced exhalations, such as coughing and sneezing. Ever had a client with low back spasms say “I bent over and sneezed!”?
The pelvic floor specialist noticed that the model’s belly pushed out when she coughed. Allowing the belly to push out weakens the pelvic floor and abdominal group. She suggested to cue clients that when they cough the belly should go in towards the spine to properly activate all the core muscles.
This is one thing I love about teaching for PESI REHAB – the interaction with professionals from other disciplines.
Hope this is useful!