For many years I operated under the belief that a variety of pelvic torsion patterns were possible. The osteopathic literature describes many types and combinations.
I had learned about pelvic torsion in the St. John Neuromuscular Seminars in the mid-1990's and we had been taught a range of mobilization techniques to address it.
But over time in the early years of my private practice I began to see something strange: just about every client who presented in my office with intractable back pain had a torsion in their pelvis.
Not only that, but the torsion pattern I kept seeing was very similar from person to person. Over and over individuals presented with a right anterior (forward) rotation and a functionally short right leg, the typical result of such a rotation.
The muscular compensation patterns, too, were similar. This made sense because a right anterior rotation will typically result in a functionally short right leg, and that will trigger a host of muscular compensations as the body attempts to right itself when upright in gravity.
For example, I consistently found dysfunction in the primary hip flexors -- the iliacus and the psoas muscles -- collectively called the iliopsoas.
Correcting the pelvic torsion patterns of my clients (in order to relieve various symptoms) always required my treatment of the iliopsoas, especially the iliacus muscle.
After seeing the same torsion pattern in client after client, and after countless clinical hours of testing treatment protocols to correct this pattern, I slowly began to accept what the evidence was plainly insisting:
That there weren’t a variety of torsion patterns but rather a single dominant torsion pattern. You could see it in young and old, in male and female, and across ethnicities.
A single dominant pelvic torsion pattern was not only responsible for a very high percentage of the low back pain cases I saw, cases that often had been dismissed as unexplained, but it also explained other mysterious pain and symptoms in the body including hip, leg and knee pain, abdominal and groin pain, and shoulder and neck pain.
But that gets ahead of the story. First we must look at the pattern itself and then we can discuss how it can set up pain throughout the entire body.
I have settled on the acronym, RALF, to name this pattern because it describes two consistent features of it. RALF stands for Right Anterior, Left Fixed and these terms refer to the following:
This refers to the right innominate or pelvic bone, also called the ilium. In The Ralf Pattern, the right pelvic bone is found to be in an anterior, or forward-rotated, position.
This refers to the condition of the muscles and fascia of the left hip. In The Ralf Pattern, this region of the body is found to be braced, stuck, fixed in place.
But this is just the starting point for our description of this pattern.