Action First, the therapist asks the patient to make good contact between both feet and the
floor. Then the therapist
asks the patient to completely relax the abdominal wall and allow the pelvis to tilt slightly in the anterior direction
around the axis of the hips so that the pelvic segment moves toward the therapist’s palms. The patient should keep
the sternum in a superior–anterior position, but still remain completely relaxed on the anterior side of the body.
The therapist then modifies the contact with both hands as if to carefully support the contents of the pelvis while it
tilts forward, and then lifts it minimally in the cranial direction and gradually guides it somewhat farther inward in
the direction of the middle central line of the torso. Seen from the outside, it appears as if the therapist were trying to
push the organs from both sides toward the front of the spine.
If this technique is correctly applied, a gradual correction of the spatial relationships occurs between the fascial
layers of the abdominal wall, the anterior layer of the peritoneum, and the posterior layer of the peritoneum relative
to the renal fascia.
The effects of this technique occur gradually. In the weeks after the birth, it acts on the exterior myofascial structure
of the pelvic and abdominal cavities and the mobility of the organs. Ultimately, its objective is to move the spread-
out parts of the enlarged peritoneum more strongly together and thus allow an improved alignment of the organs of
the torso.
This technique consists of active and passive components, which must be taken into account if the technique is to be
performed successfully. The tilt of the pelvis in the anterior direction corresponds to the active part; we move our
hands only minimally in the dorsal direction. This has an effect on the patient’s body as if we were raising the entire
contents of the pelvis slightly in the cranial direction. However, this procedure has a passive component as well: in
“listening,” during the lifting process, we note any resistances that may occur in the tissue. We feel our way layer by
layer, first through the muscular fascial structure of the exterior abdominal wall until we reach the transversus
abdominis and its fascia. Only then do we intensify the quality of the touch far enough that the contact encroaches
on the peritoneum on both sides. Finally, we allow the touch to act farther in the dorsal direction through the
peritoneal cavity until we have the impression that we have arrived at the posterior layer of the peritoneum. In an
ideal case, while the patient’s pelvic cavity is leaning against our hands, we reach the retroperitoneal cavity just
below the kidneys. At this moment, it is worthwhile to change the quality of the touch again in the sense of a very
subtle “listening.” We may be able to notice a shear effect manifesting on one side in the inferior direction. We
follow this effect minimally in the inferior direction and then intensify the impulse gently in the cranial direction.
214 FASCIAL AND MEMBRANE TECHNIQUE
Figure 9.3 Treatment of the fascia of the transversus abdominis and the spatial relationship between intraperitoneal and
retroperitoneal compone