Neutral Pelvis 2

Here ye, here ye: Movement is food. Exercises are vitamins. Just as you can’t live on a diet of supplements, your body cannot get what it needs from isolated exercises.

In the beginning…or, at some point 40 years ago, it was commonly accepted that the human pelvis was neutral when the ASIS (Anterior Superior Iliac Spine) and the PSIS (Posterior Superior Iliac Spine) lined up on a horizontal plane like this:

 

Which, if you notice, places the pubic symphysis a skosh in front of the rest of the pelvis.

Later, a neutral pelvis was redefined (by people who research and write therapy textbooks and stuff) as the ASIS lining up with the Pubic Symphysis in a vertical plane, like this:


Subtle difference. I, like many, use the latter, although there are still a ton of people using the former. And really, who knows which is correct? It’s not like there’s a book out there that came with the body saying which was what and how to use it. The reason the Institute uses this marker, though, is because the PSIS is not prominent, which makes is invisible even to the well-trained eye. And, studies on measurement show that in women or anyone with a bit of extra padding, this point is misinterpreted, making the PSIS really unusable unless you’re extremely thin and you’ve got a master body-worker to prod, feel, and alert you to the point each time you need to check your own alignment.

But that that all aside, a good question is WHY do we need a neutral pelvis?

And it’s such a good question, I’m glad someone asked:

Katy, if it isn’t too much trouble, could you please quickly explain why you need a neutral pelvis to prevent organ prolapse. I want to understand! Thank you! ♥

Dear Ends-Your-Request-With-a-Heart,

In a nutshell: You get the greatest amount of loaded hip extension while walking with the ASIS and PS in a vertical plane.

Now before I explain more, it helps to see it in pictures and to try this out for yourself.

Try out my neutral (ASIS/PS) first. And I call it my neutral because I invented it and it’s mine so I own it. You can just borrow it.

Lie face down and get your ASIS and PS on the ground. WITHOUT moving the pelvis (which is tricky because the pelvis will tend to rock forward, pressing the ASIS more into the ground and lifting the PS away) lift your leg to it’s maximal height — no straining.

Make sure you’re not bending your knee (use a mirror), which is common when your muscles are so tight.

If you measure the angle between the thigh bone and the pelvis, it’s ideal if you can come up to about 30°. This is an indication that your glutes and hamstrings work through this range of motion while walking.

Note: you must also be pelvic-listing on the standing leg, and keep your heel connected as long as possible, which — it’s coming all together now — requires nice, long calf muscles.

(And do I need to mention my drawings are never to scale?)

That crappy picture up there is trying to explain something that is critical to understand. But, I don’t have enough time to write more on that if it’s unclear as well as crappy.

Want to know why I’m short on time?

Moving on, give yourself a slightly tucked pelvis by propping up the ASIS by lying on a rolled towel or yoga mat and keep your PS on the ground. How does this affect your hip motion when you try to extend?

Try to lift your leg WITHOUT increasing pressure in the ASIS or moving the PS.

What’d ya come up with? (And, P.S. That last picture was me trying to extend my hip. With all of my might but little avail.)

Most people can’t budge their hips at all with their pelvis posteriorly tilted. Which means they can’t do it while walking either. Which means no loaded hip extension while walking, which means very little work performed by the glutes.

A neutral pelvis gives our hips the much-need range of motion while walking. Yes, a neutral pelvis is also great while standing and sitting, but it’s what the glutes do while walking that gives the pelvic floor, always contracting under the load of the abdominal and pelvic floor organs,  the constant resistance to generate an eccentric force that it needs to keep from shortening.

Does that make sense, Ms. Cupid?

And can I stress the walking-with-neutral pelvis part of this post? Because a few days ago someone sent me the 1 Billion Squat Challenge, or something like that, and said, Isn’t This Awesome? How Strong is Everyone’s Pelvic Floor Going To BE???

Squats are the new black, apparently. And while I love me some squatting, you’re missing my *big point on natural movement.* Biology is not a fan of using exercises in lieu of movement. Exercises to improve movement is one thing — eating exercises like M&Ms is another.

(Is anyone else craving M&Ms now?)

What I can totally see happening twenty years from now is people doing as many squats a day as they were kegel exercises. Magazines will be touting the squat as the go-to exercise for pelvic floor disorder. Every physical therapist and every birth educator and every personal trainer will be handing out the squat ExRx like it’s a dollar bill. And we’ll have the exact same problem: the sarcomeres of the pelvic floor being positioned away from neutral. And guess who’s going to look like a jackass in 2033? I am.

Only thanks to the internet, I’ve got it on digital record that I told you so, repeatedly, if you’ve really read all my blog posts. Poor Dr. Arnold Kegel wasn’t so lucky. I never said you should be squatting as an exercise. I’m saying you should be squatting in a manner similar to how you would were there no modern conveniences. Squat when you go to the bathroom. Squat when you pick up stuff.

The squat isn’t for the “exercise” of it, but for the movement. And movement, like food, offers way more than just minerals and vitamins.

Thanks. I love ya, peeps.

Are you still interested in learning more on this?

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23 thoughts on “Neutral Pelvis 2

  1. “Only thanks to the internet, I’ve got it on digital record that I told you so, repeatedly,…” Yes! Are you backing up routinely?

    PS: that chesty pic was too much, nearly fell off my C – – – R … laughing!
    PSS: still working on my old man re: squatting over the pot. He doesn’t drink kool-aid evidently.

  2. Love the leaky boob. I get that all the time. However, it only seems to leak through my bra, nursing pad and down half my shirt when I’m out in public, go figure. Of course, I have bent over plenty of times while wearing a milksaver and dumped it on myself plenty of times at home and had the same effect. :/

  3. That is an awesome demonstration of why pelvic position is necessary for hip extension! But you knew that. Glad to see the babes aren’t starving, too. 🙂

  4. Love the leaky boob! I feel like I need to reread this 10 more times to apply it. Loved the “I own it.” Go nurse your babe!
    speaking of nursing what is the best position to nurse in for proper alignment?

  5. And here I was feeling guilty cos I’ve only been working on using my glutes when standing up/sitting down etc. instead of an exercise. I am definitely thinking more about my alignment because of finding your blog & I can see massive improvements in my *postural* kyphosis already (guess who listened to the lecture last night!). Thanks for being a brilliant educator & a hilariously honest woman to boot!

  6. How did you manage to only leak on 1 side? Mine was always both sides…& in public! LOL Thabks for all the wonderful help you give to all of us. Merry Christmas too!

  7. It does make a lot of sense and I am very grateful you helped me understand, thank you so much Katy! <3 This means it's just very logical that women with tilted pelvis often have literally no buttocks, since they fail to "excercise" them while walking.

  8. I love the fact I don’t have to exercise. Just natural body movement is enough. And since I stopped exercising I look and feel better than I ever have. Thanks Katy.

  9. Oh yes, much to love here – the new clinical term “a skosh,” the leaky boob shot (BTDT, just not on my blog you brave woman, you) and the best part … a place for me to direct clients to continue to drive home the importance of natural movement and just using your body. Shifting the paradigm, shifting the paradigm.

    And on that whole squat when you should bit … Interestingly, my mom was telling me the other day that in her “etiquette” classes as a young “society” woman, she was told to never squat to get into a chair. A “lady” was to stand in front of the chair and use her arms to lower herself into it. It saddens me to think of her generation being trained for dysfunction.

  10. Very nice post, thanks. Just last week one of my clients ask me how many squats I do every day, after we did a half-squat challenge at class. I explained that I do at least 30 – 50 a day, as I squat everytime I sit down (on a chair or floor) and get up without using my arms but no squat exercises as such. Easy and no extra time used but for some reason not as catchy as a 100 squat a day challenge.

    My motto for the week: Walk with neutral pelvis. I always try and do, but one forgets.

  11. I’m thinking that not being able to get my ASIS to touch the ground is a sign that my psoas are way too tight? Also I must not be able to drop my ribs as much as I think while standing, if they’re that much in the way while I’m on the floor?

  12. Another great posting!!! To all those ‘but mine only leaked in public’ folks: ummm, does it REALLY get more public than here?!!

    @naturalgirl: when I work with pregnant women I always have them begin to add pillows/cushions/rolled towels during their pregnancy: pillows on their laps to support books while reading so that when baby’s on-the-outside they’re already familiar with what Me ‘n’ My ‘Body’ need in order to be supported. Slurpin babies + weighty breasts +fatigue + gazing into your babe’s Very Being can all contribute to thoracic & cervical collapsing [which goes along with posterior sacral collapsing]. Can’t do much about the slurpin/weighty/fatigue/gazing bits but CAN get support from those cushions that bring baby UP to the source rather than you leaning down to that hungry mouth.

    The following link is from UK Childbirth Educator, Doula & Alexander Technique teacher Ilana Machover. Pix of pillow-supported nursing are in her fantastic book. Also check out her Eutokia page [from the Greek meaning happy childbirth]. http://homepage.ntlworld.com/ilana.m/eutok.htm

  13. Can you recommend anything for pelvic pain in pregnancy? I have been to a physio but it’s not improving and I’m heading into the final weeks, I expect it’s only going to get worse.

  14. I´ll come back to Emily L´s comment not being able to get ASIS to touch the floor. I had to press the ASIS down in order to feel them. So it means my psoas are tight? I have noticed some women have very strong PS which is really like a hill. Do they have the ASIS developed in the same way – coming out very clearly and being level with the PS? If not how they are able to get their ASIS down? They are sure to have anterior tilt. How to create the neutral pelvis when prone?

  15. Thanks!! Only with this inquiry I realized I am tucking – not much – but anyway.
    So better not just force the ASIS down but start to lengthen the psoas.

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