The sacrotuberous ligament is a structure that is under-recognized as important to assess and treat during pregnancy. The ligament runs from the sacrum to the ischial tuberosity and has connections into the tailbone and hamstrings muscles via connective tissue. It crosses posterior to the sacrospinous ligament creating an “x” or “t” depending on orientation.When taut the sacrotuberous ligament can cause the pelvis to become posteriorly rotated, cause tension in the same side pelvic floor muscles, inhibit needed coccyx or tailbone mobility for birth, be a source low back pain, and delay or prevent symmetrical opening of the pelvic outlet. Furthermore, sacrotuberous ligament tension can cause indirect torsion of the uterus by influencing sacral alignment and be a cause of tension along the uterosacral ligaments. We assessed and determined tension in the ligament may be the culprit in this patient.
In this image we are performing an Integrative Manual Therapy technique to the sacrotuberous ligament on a pregnant patient who is past her due date. She is facedown or prone in our luxury pregnancy (belly cut out) treatment table. We had also performed direct external manual therapy such as x-friction massage and myofascial release to the sacrotuberous ligament, pelvic floor muscles, sacroiliac and ischiorectal fossa areas followed by pelvic realignment and movement patterns for optimal results. We perform many manual therapy techniques to help realign the pelvic and hip joints, release or relax pelvic and uterine ligaments, and maximize pelvic inlet and outlet opening/mobility. These techniques also enhance room so that breech positioned babies have maximal chance of changing positions. Come to us to maximize your labor and delivery!