So the somatic dysfunction of the pelvis affects the entire body; the spine, the thoracoabdominal
diaphragm, the pelvic diaphragm, the primary respiratory mechanism and the lower extremities.
So, any sort of restriction of the motion at the pelvis will affect a lot of the different structures
outside of it. There might be a lot of different causes that cause these pelvic somatic dysfunctions.
It could be secondary to muscle restrictions, it could be due to a wide variety of different issues
and what happens is you might have a lot of different patient complaints. So, somatic dysfunctions
of the lumbar spine could affect the lumbar plexus and cause symptoms in the pelvis and the lower
extremity. So if we have dysfunctions of the quadratus lumborum or the psoas muscle, that could
create symptoms similar to a groin pull or a hernia. Dysfunctions of the piriformis or the sacrum
could affect the sciatic nerve as it radiates down the leg mimicking a herniated disc. So if that
irritation is caused by the tightness of the piriformis muscle, this is called piriformis syndrome.
Viscera complaints could be related to imbalance of autonomic control of the pelvic viscera. So
remember the parasympathetics innervate the pelvic organs and the distal colon and so the sacral
nerves S2, S3, S4 will innervate and provide parasympathetic innervation. If you have restrictions
of the pelvis, that could potentially irritate those nerves and cause issues if you have problems
with the pelvic diaphragm as we discussed before. If the pelvic diaphragm is stiff, that is
going to decrease the excursion and motion and movement of the diaphragm and decrease circulation
and lymphatic distribution throughout the pelvis. Somatic dysfunctions of the pelvis could also
cause issues with the gut and the repro system. So visceral complaints could be related to an
imbalance of autonomic control of the pelvic viscera. For example irritable bowel syndrome, which
tends to be parasympathetic dominant could have symptoms such as headache, nausea, diarrhea and
cramps and if we treat the pelvis and we help balance the autonomic tone between the sacrum and the
parasympathetic innervation from S2 to S4 that could potentially help with some of the symptoms
with GI issues, constipation or irritable bowel syndrome. Another example is looking at primary
dysmenorrhea. If we normalize parasympathetic tone and help to encourage venous and lymphatic return
by helping to improve motion of the pelvis and improve motion of the pelvic diaphragm, this could
potentially help to decrease some of the symptoms associated with primary dysmenorrhea.