The Pelvis: Our True Center or Core


Back Pain,  sacro-iliac problems, psoas tightness, incontinence, piriformis syndrome, ...  If you are like most people, you probably didn’t give your pelvis a second thought until you were pregnant or experienced complications. Problems that are related to poor pelvic movement are increasing and are a growing concern for health care providers.  Are the abdominals the only thing you consider when you think about the core? How do we define power, alignment and flexibility of the pelvic girdle?

Anatomy Review

The pelvis is the large bone that you touch the crest of when you touch your hips. This is the largest bone in the body that absorbs the shock from the lower body and gravity from the upper body. The pelvic structure is made of three bones: the two iliac bones and the sacrum. The weight of the head, shoulders and trunk falls directly on the sacrum and therefore the sacral bones are fused together. Since our interest is in the mechanical function rather than structural anatomy, we consider the pelvis as a whole rather than it’s parts. 

The muscles of the core are the inner and outer corset. The outer corset are the muscles that either run vertically from breast bone to pubic bone or diagonally and crisscross the abdomen (rectus and obliques/ abdominals). The inner corset is a muscular wrap that runs horizontally around the torso and is the deepest of the abdominals (transverse abdominus). One of the most important parts of the inner unit is at the bottom of your core muscles and is called the pelvic floor or the pelvic diaphragm. 

Although the outer corset contributes to generalized trunk stability, these muscles are not directly attached to the spine. Additionally, if the outer corset is too tight, the muscles may draw the chest and pelvis together and flatten the natural curve of the lumbar spine. 

When problems occur 

These structures can not only be confusing to note in anatomy references but they can also be very difficult to sense in the body. Muscle action depends on habits and if the routine way the muscles are recruited are imbalanced, the skeletal structures of the spine, pelvis and hips can alter the entire body dynamics and wear down. 

What can be done?

Physical therapists are trained to look for muscular imbalances and guide people into proper exercise and training to maintain a good balance of the muscular and skeletal system.  Differentiating what muscles should be turned on and off is all part of the core training.  

Pelvic movement is looked at and addressed in many ways, such as looking at a persons walking, upright balance, and  muscle engagement while lifting. Below is an example of an exercise to work with good muscular coordination of the pelvis and the core muscles

What time does your pelvis keep? The Pelvic Clock

Before any exercise, be aware that you are never to do exercises into pain.

Lie on the floor on your back with your knees bent. Notice where the parts of the pelvis are in your body. Think about an imaginary clock under your pelvis. The bottom of the clock points to 6 and is at your tail bone, the top of the clock is towards the small of your low back and is 12. The 3 and 6 are out to the sides. This completes your pelvic clock.

Now gently tilt your pelvis as if to flatten your low back pointing your pelvic clock to twelve, then roll the pelvis to tilt it to six pointing the pressure to move towards your tail bone. Repeat this five times making the movement slow and smooth.       

Now tilt the pelvis to your left pointing the pelvic clock to 3 and then tilt it to the right pointing towards 9. Repeat this five times slowly. 

Now start the motion at the top of the clock and tilt the pelvis to 12, then to 3, 6, 9 and back over to 12. Repeat this 5 times then reverse it 5 times. Work on touching all parts of the clock. Stand up and notice how your back feels. This is an excellent coordination exercise for pelvic control.