The Pelvis
The pelvis provides a foundation for the trunk and upper body and a fulcrum point for the legs and movement. It is crucial for body structure. It is closely connected to the body’s core, both physiologically and metaphysically. Many muscles attach to the pelvis. Each of these muscles pulls the pelvis in a specific direction. Good pelvic posture requires good coordination of these muscles so that the pelvis is neutrally positioned.
The pelvis is also closely linked to the walking gait. Deficits in the walking gait can create imbalances in the pelvis. A twisted pelvis can create a short leg and gait problems.
Pelvic Categories
In Applied Kinesiology three pelvic dysfunctions are generally recognised, as first described by DeJarnette. The first two involve dysfunction within the pelvis, while the third involves the interaction of the pelvis in relation to the lumbar vertebra.
- Category 1 is usually related to a subluxation of the sacroiliac joint. It can also result from a fault in the pubic symphysis. This results in a twisting or rotation of one side of the pelvis. A typical complaint with a category 1 is leg pain that develops during the night but is not present during the day. Mid-thoracic, lumbar, or abdominal pain often develops after heavy
- Category 2 occurs when the hips have torqued (ie. out of shape so that one half is twisted forward and the other half is twisted backwards) and usually involves the sacroiliac joint. Category 2 is often associated with neck tension, pain and limited motion on turning the head. This is usually more marked on one There is also often torsion of the shoulder girdle and that may result in pain in the thoracic region of the back.
- In Category 3 the pelvis is intact but the fault is in the lumbar vertebra. It can be associated with sciatica, lumbar disc dysfunction, displaced lumbar vertebra, and facet This should be corrected before Category 1 or 2 imbalances are addressed.
More than one type of pelvic category may be present at the same time. Sometimes when one is corrected another will show.
Cranial-Pelvic Connections
The pelvis is closely connected with the jaw and the cranium. Pelvic faults create dural tension because the dura (the tough lining of the spine) has a firm attachment to the sacrum and the coccyx. When the pelvis is twisted or pushed forward or backwards the dura tightens and creates disturbances at its other end (it has firm attachments to C2/3 and the occiput). Thus it is common for pelvic conditions to be associated with limited range of neck movement, neck pain or stiffness.
Another factor that links the jaw and the pelvis is the link between chewing and the digestive system. The sensation of chewing is neurologically linked to digestion. The stomach, small and large intestine meridians all cross the jaw. Often excessive stress, a clenched jaw, “butterflies in the stomach”, and poor digestion occur together.
The Basic Pelvis Checklist
When balancing the pelvis it is also best to activate or challenge:
- Cranial-Pelvic reflexes
- Neck muscles & neck righting reflexes
- Vestibular & oculomotor systems
- Pitch, Roll, Yaw, Tilt
- TMJ (Temporomandibular joint)
- Cranial bones.
The key factor to address when correcting the pelvis is the proper coordination of the muscles that affect the pelvis. Thus in pelvic balancing, activation and assessment of the muscles attaching to the pelvis is of primary importance in releasing stress patterns associated with this area.
The table below summarises the primary muscles that are likely to be O/F or shortened in cases of pelvic imbalance. The antagonists of these are likely to be U/F or lengthened.
| Effect on Pelvis | Group | Muscles (O/F or too short) |
|---|---|---|
Hip flexors | Psoas, iliacus, quadriceps Sartorius, tensor fascia lata | |
Back extensors (posterior pelvis pulled superior) | Erector spinae, quadratus lumborum, multifidous, intertransversii | |
Abdominals (anterior pelvis pulled superior) | Rectus abdominals, internal obliques, external obliques | |
Leg extensors (posterior pelvis pulled inferior) | Glut max, hamstrings | |
Leg abductors (pull inferior on one side of pelvis) | Glut minimus and medius, tensor fascia lata | |
Lateral trunk muscles (pull superior on other side of pelvis) | Quadratus lumborum, external obliques, internal oblique, assisted by hip adductors |
Orthopedic Assessment of the Pelvis
In order to investigate the alignment of the pelvis and allow evaluation of the efficacy of treatment, an orthopaedic assessment should be carried out in any postural session, prior to correction.
- Anterior tilt: lateral view of pelvis shows ASIS more than 5° inferior to PSIS
- associated with exaggerated kyphosis or lordosis and enlarged or flaccid abdomen, Category 3
- Posterior tilt: lateral view of pelvis shows ASIS superior to PSIS
- associated with flat back or sway back, Category 3
- Lateral tilt: posterior view of pelvis shows one iliac crest superior to the other
- associated with scoliosis, short leg, differing shoulder height, Category 1 or 2
- Ilium flared in/out: anterior view shows ASIS closer to umbilicus on one side than the other
- associated with Category 1 or 2
- Sacroiliac joint jammed: client sitting or standing, posterior view - SI jammed on side where PSIS moves with forward trunk flexion. - associated with Category 1 or 2