Neutral Pelvis

If you’re interested in reading more on ideas presented in the article below, I suggest reading Diastasis Recti. If you’d like movement instruction via video, start with Nutritious Movement for a Healthy Pelvis.

Joan: OMG Becky, look at her back. It’s So Sway.

Becky: I know. Why’s she got to go around sticking that thing out?

Joan: She’s probably got low self esteem, ya know?

Becky: I know. She’s probably got a lot of back pain too, ya know? 
Yeah. She needs to tuck. that. thing. under. Ya know?

Joan: Yah. I know what you mean. Bim.bo.

So, Aligned and Well wannabees — when you look at the picture above do you see:

A. A swayback

B. An anterior tilted pelvis

C. Hyperlordosis or hyperextension of the lumbar spine

D. All of the above

If you picked “all of the above” then you’re incorrect. Actually, the only correct answer here is A: Swayback. And that’s because swayback doesn’t mean any one particular thing — it’s just how spinal curvature looks to the eye. The term swayback should never be used clinically as it doesn’t have a precise definition (read: it doesn’t tell you anything about one’s pelvis or lumbar spine.)

The person in the picture (oh wait, that’s me!) actually has a neutral pelvis. How do I know? Because 1) I know the mathematical definition of neural pelvis* and 2) I put my body in this position for the picture. My spine, however, is not curved neutrally — but this is not because my pelvis is tilted forward, it is because my ribs are sheared forward.

Here’s a quick review on vertebral motion.

Let’s say the vertebrae start from this position:

When these guys extend, it look like this:

But what I’m doing in the picture above is NOT vertebral extension, it’s vertebral shear. Chances are you didn’t get this term in your anatomy courses. And, it’s not that surprising. Today’s university-level courses are still teaching an extremely oversimplified version of anatomy that leave out about 1/2 half of the muscle and joint actions. If you really want to learn the mechanical motions of the body, my recommendation is take a few courses on mechanics first. Once you can do basic physics, you’ll see volumes in your anatomy that you never knew was there.

Anyhow. This is what vertebral shear looks like:

Rib shear, as pictured above, is caused by the anterior (forward) displacement of the ribcage. This displacement causes the lower thoracic vertebrae to forward relative to the lumbar vertebrae below, creating what looks like hyperextension. Only it’s not hyperextenion. It’s not extension at all. It’s vertebral shear. Which might sound like a simple argument in semantics, only these are two entirely different physical motions that require entirely unique corrections.

It is extremely common to misread the first picture as excessive anterior tilt, especially if 1) one has no objective, mathematical definition of neutral pelvis and 2) one has no clinical and mathematical definition for a neutral ribcage.

Because the lumbar curve is created by how the pelvis and ribcage are positioned relative to each other, it would seem pretty important to know where these bones should be in space, ya?

Neutral pelvis*

Typically, I’m not a fan of neutral. There are no Swiss Coffee walls in my house. I’ve never been to Switzerland. My car (and my mind) are perpetually in gear. I am, however, a huge fan of le neutral pelvis.

Neutral pelvis is a term that gets thrown around a lot, but through my teaching all over the US this last year — to movement and therapy professionals no less — one thing is clear. Hardly anyone knows what neutral pelvis actually is – in terms of definition and, even worse, in terms of clinical definition.

Technically (and let’s be technical, shall we?), neutral pelvis refers to the three-dimensional position of the pelvic girdle.

The first two planes of “neutral” can be determined by placing your hands on the ASIS (Anterior Superior Iliac Spine), often incorrectly called your “hip bones.”

As you’re looking at the pelvis from the front (standing in front of a mirror), these points should be level, like the artificial horizon on an airplane.

If you now look down, each ASIS should be equally out in front of you, meaning, one half of your pelvis should not enter the room before the other. This is a difficult alignment to maintain if you are a salsa dancer or are particularly fond of twisting your hips when you walk. Not so good for the spine.

The final of your three dimensional alignment check requires a third point: your pubic symphysis, and for you to turn and evaluate yourself from the side. In a nutshell, a neutral pelvis from the side should stack the ASIS vertically over the pubic symphysis, so that a plane containing all three points is vertical.

Leonardo, this is why I love you so much. Not only does he have a perfectly drawn neutral pelvis, he also figured out that a neutral pelvis is only really neutral on a neutral thigh bone.

Legs not vertical? Then your perfectly positioned pelvis still needs tweaking! I was going to make you a video to show you how to test lower body alignment but why redo perfection? Here’s one of our certified graduates, the Alignment Monkey, showing you how to check from home: http://alignmentmonkey.nurturance.net/2011/back-your-hips-up

Finding neutral leg, pelvis, and ribs is extremely important if you have a pelvic floor issue. Remember all that talk about tucking and untucking? This is what I was talking about. Most people tuck their pelvis and shear their ribs. Most people sit on their sacrum All. Day. Long. And, unfortunately, MOST people (80%) will experience a pelvic floor disorder in their lifetime. If you find neutral pelvis, you’ve got the perfect amount of tuckuntuck.

Thoracic shear

Just like neutral pelvis has an objective definition, so does a neutral ribcage. If you find that when your legs are backed up and in vertical alignment and your pelvis is in objective, measurable neutral, it’s time to get your ribs into position to allow for a neutral lumbar curve.

Aligning your ribs to your now neutral leg and pelvis is simple. You simply lower your ribs down until the front part of your lowest ribs move into the abdominal flesh — where they belong.

Now the front of your ribs are also in the vertical plane created by your neutral pelvis. And your lumbar spine is at the correct curve for your anthropometric dimensions.

Spinal curve is a tricky thing because although there is no absolute value of curvature that is appropriate for every person, there is a curve relative to one’s body parts that needs to be exact, in order to ensure proper vertebral loading. People get confused when you talk about absolute vs. relative measures because they misinterpret that anatomical variability means that there is no “one way” to be. Only there is. You just need to learn how to quantify a relative value — that is the objective points and geometrical positioning, relative to one’s own body parts.

Oh, and P.S. What you might find now is that your root issue (read: the major malalignment that you’ve been jutting and thrusting and lifting to hide) is the fact that your shoulder girdle is collapsing on itself. Can’t keep those ribs neutral because the shoulders are wrapped about the place? Now that you know what’s really going on in the body, whatcha going to do about it?

P.P.S. Does anyone else think it’s weird that my baby at one-day old looked exactly like Bobby Flay?

Right?

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41 thoughts on “Neutral Pelvis

  1. So much to learn.

    You’re going to tackle that shoulder thing next, right?

    Because what looks “right” in the mirror as far as where my shoulders should be, feels very uncomfortable. But that could be because I need to stretch something. (Most alignment issues seem to be fixed by stretching something, I’m noticing!)

    1. Have you tried the Super Supple Shoulders class? I think it’s my favorite upper body opener. It really explains (you need a full hour of talking) to get all the nuances of thoracic alignment. Believe it or not, the legs and the pelvis are the easiest to align!

      1. Thanks for the excellent blog!! Where do I find the supple shoulders class? Didn’t see it with the dvd’s. Thanks!

  2. Thank you for this post! I am 19 weeks pregnant and ordered your pregnancy package. I’ve started doing the Down There exercises and stretches, but I’ve been very confused by exactly what a neutral pelvis is. I look forward to watching the YouTube video you linked to. I hope it’s something I really will be able to identify on my body. I’ve had chronic sacro-iliac pain on the right for 3 years now, and nothing has helped other than meditation and mindfulness. Now that I’m pregnant, I suddenly have sneeze pea. *gasp* That’s when I decided to do your program NOW. I’m considering signing up for the full body course, but I wonder if I’d be better off spending that money to get a trained eye on my body. I don’t trust my ability to see what’s going on for my body. I’m in Texas, so I’d have to go out of state to see any of your graduates.

    1. First of all — congratulations! It sounds like you’re on your way. The prego kit is a great place to start. Also, you might want to do the NMKegels and the Psoas course first — they’re pretty inexpensive, but pertinent to your specific condition and about the price of seeing one “expert” for one hour, instead of the HOURS you can be correcting yourself 😉 Then, if you do decide to take the full course, you can have a refund from the first two courses! Work through the book and DVD content first, though. That’s the best place to begin. Thanks for reading and for your comment! I’m 15 weeks now, myself. Feeling better every day (I don’t do the first trimester so well 🙂 xxoo

      1. Oh, Katy, thank you for responding. That sounds like a great plan. I didn’t realize I could get a refund for the first two courses. I can’t tell you how much I appreciate the information you’re making available to us all. It is the natural extension (x10!) of what I’ve learned bit by bit over the past 3 years. I’m very excited to move to the next step in correcting and healing my body! It’s been discouraging to have so many issues so young (I’m in my mid 20s), but on the other hand, I haven’t yet had 4 decades of damage and habit-formation. I still have time to recover, at least partially–and to give our children a better chance.

        Congrats on your pregnancy too! Glad to hear you’ve stopped puking. My first trimester wasn’t any fun either. 🙁 I have SO much more compassion for pregnant women now. Who knew it could be so hard?

  3. This post is a thing of beauty. You, with the explanations. So helpful.

    My ribs won’t stop thrusting (it seems they are independent of my will) and, consequently are no longer invited to my birthday.

    I want a house with mirrors for walls. All the walls. Those ribs would have nowhere to hide!

    Got the DVD and am excited to get on it.

    So glad you’re feeling better! I puked the whole forty weeks. Incomprehensible. I think it gave me PTSD.

    Over and out.

    1. Thanks! Yes, with my first it was 5 months. This time is seems like first trimester contained a magic switch. SOOO Happy.

  4. This article is EXCELLENT! I am a chiropractor and what we were taught in school was so unhelpful in regards to really breaking down the pelvic function. I am really appreciating the way you break down this info. That being said, i am very perplexed by my own body in regards to what you are teaching for correction in spinal alignment. I have a moderate scoliosis and NOTHING is where it should be in my pelvis or anywhere else. In your method of teaching where does one start? My R ASIS is a lot more forward (and has always walked into the room before the rest of me) than my L as my R psoas is weaker than L causing a R rib hump. Is pelvic floor stabilization the place to start if I can’t find a neutral anything on my body? I am aware that with each baby (I have 2 so far but am 38 so will hopefully squeak out one more before the body says forget it) my PF is getting slightly weaker with minimal correlation to overall misalignment. Then again, my brain wouldn’t know “aligned” anyway!

    Thank you for the work you are doing!

    Jill

    P.S. I completely agree with the Bobby Flay similarity. Whoa…

    1. Thanks for your comment. If you’re new to Aligned and Well/Restorative Exercise™, then read the post STANCE and ALL ABOUT YOUR KNEES to get a better idea of aligning from the ground up. We teach in our academic certification to begin with the feet, so you’re not aligning the pelvis and shoulder girdle to a crooked bottom — also, kinetic chains are affected most from the ground reaction force, so changing how your feet interact with the ground is key. Even if you have scoliosis, etc., if you work your way up, aligning your points objectively, you’ll find that your spinal curvature is really there because one shoulder is internally rotated and displaced anteriorly when compared to the other. The scoliotic curve is how you’ve RIGHTED yourself — meaning, instead of walking around with one warped shoulder, you wing on one side and make micro-adjustments to present psuedo-forward, even though there are all these tiny mal-alignments from the ground up. Hope that makes sense! You can learn more at http://www.restorativeexercise.com — that’s our academic/practitioner site!

        1. Thank you! That makes perfect sense. I am new to your site and info and appreciate the guidance of when to begin. I will check out the link and posts you mentioned.

  5. Katy, I would look just like you in the initial photo–that’s exactly how my body is shaped too. 😉 Thanks so much for all your helpful posts!

  6. Katy, for the entire time I was dancing plus through all of the Pilates training I did the main correction I got was that my ribs were too forward….when I would lay on my back you could drive a smart car under my ribs! I tried so hard to correct that with little to no success until I started to practice your psoas class on a daily basis! Basically in a few short months I have done what I couldn’t do in about 30 years of trying!! I knew that my psoas was the problem but no other strategy I tried had worked.

    Thank you so much for the information….I am (almost) a reformed Rib Thruster!!

    1. Yay! Yes, most people learn the psoas (incorrectly) as a pelvic-tilter or as only a hip flexor. What it spends most of its time doing, however, is rib thrusting! Glad you’ve brought those ribs home!

  7. Uh, we need to ‘talk’ about this and demonstrate when you are in Columbus next month. I ‘think’ I get it, but

    going through it in real time will cement it in my mind.

    And yes, EVERYONE sits on their sacrum and tucks! I keep trying to ‘upright’ my yoga students ALL the time – get the pelvis stacked – I feel as though I’m wasting my breath. Sometimes, it seems their bones are frozen with the

    tuck.

    Martie

  8. She does look like Mr Flay!!!!…hhhhmmm. Sounds like you’re having a boy Miss Katy. Thank you for the great lesson once again AND the hearty laughs I love so much on this blog. – Hugs

    1. I had a boy the first time! Sick for FIVE MONTHS. I’ll take another boy, though. Or a girl. I don’t care — or care to find out ahead of time. It’s a little bit of Christmas 🙂

  9. Katy,

    I read all your blog posts and am really trying to wrap my mind around alignment. “What a Waist” got rid of most of my belly “pooch” left over from two pregnancies and some diastasis recti. My question: now that I’ve stopped sucking it in and am preggo with a third baby, where do I start to avoid getting worse varicose veins (that started w/ my first pregnancy)? I’ve seen you mention them and am hoping that working on my alignment will help or at least halt them. I’m 34 and live by the beach, so this problem drives me crazy! Thanks!

    1. Varicose veins are created by legs that don’t FLOW, meaning leg muscles that are 1) tight, 2) ununsed or 3) tight and unused. You should be doing all of the leg stretches (especially the calf stretch on the dome OR all the exercises in the http://www.footpainbook.com program), opening the psoas, hips, and hamstrings and then wearing minimal shoes — walking daily on that lovely beach of yours, etc!!!

  10. Pilates…..to pilate or not to pilate…that is the question? Does Pilates, Stott Pilates, jive with proper alignment? I took a sample class and the way my ribs were “positioned” and the way I was instructed to hold my pelvis concerned me….looking to you, Katy, for Wisdom! Love this post…this year I will start your comprehensive course!!

  11. I have heard you explain this several times. This is the clearest, most concise and cogent version to date. As an alignerd and anatomy teacher, I thank you.

  12. This may be an elementary question, but when putting our hands on our ASIS, do we put them on the front points (like my PT does when I see her) or on the sides?

    1. Not an elementary question at all! You put them on the front. The “A” in ASIS stands for Anterior, which means in front 🙂 Have fun! K

  13. How wonderful! I just tried to align the ribs and my stomach muscle started gently working without intention to do so. But it would be mostly kind if you would answer my lingering question.

    “But what I’m doing in the picture above is NOT vertebral extension, it’s vertebral shear. ” How can you be so sure that you are doing does not involve changing of angles between vertebrae?

    Thanks in advance.

    1. Oh, you’re absolutely changing the angles between the vertebrae with shear — it’s just that the angles created by shear are different than the angles created by extension. If you imagine a bendy straw, extension is a pure movement of one end relative to the other, so the result would be the top of the straw would be posterior to all inferior portions. In shear, the top moves relative to the middle and the middle moves relative to the bottom. So the top goes back, the middle goes forward, making the inferior portions at that point relatively posterior. Extension means a very specific thing — not just “a change in angles” but the way that angle change occurs and which tissues do it/bear the load. Extension is fine for the spine to do, where shear is not. There is no shearing musculature, only the sum total of shear displacement caused by passive muscular tension in some areas and a lack of innervation in others. The ligaments and discs will bear the load in lieu of muscles (as there are none to “put on the joint brakes” in this joint displacement — until they become hyperlax aka “hypermobile.”

      Hope that clarifies it a bit!

    1. I’m with you Carol. I so want to get it, but the other part of me thinks that may-be I don’t need to get it if I work on looking like the second picture. Here’s hoping. I am trying to fix a diastasis recti 🙂

  14. Wow! I stumbled upon your website after 2 days looking for information on sacral nutation and it answers all my questions!

    I’m a Pilates teacher and have been taught to counternutate when doing spinal extension. I’m suffering from SIJ pain and after a few fasciatherapy sessions I always get that pinching sensation back. So, as I always seek the right move and question what I’m taught as “The truth”, I started wondering if my SI issues weren’t related to my pilates pratice and looked for biomechanical explanation on the way the sacrum should move when extending or flexing the spine. Now I’ve read a few of your articles and everything falls into place!

    I realised that tucking my tailbone may actually be the reason for that SIJ pain as it counternutates the sacrum when it is more stable tilted forward (ie the tail going backwards). This relates to my tightness in the pelvic floor near the tailbone when externally rotating my hips and a weakness in the pelvic floor due to overactivating the coccygeus part of it (crazily holding my tailbone in to prevent a crunch in my lower back)!

    I’ve been working on my spine alignment for more than a year on my own trying to figure out what the problem was. I thought my pelvis was too tilted forward while it was, like you, my ribs that were thrusted forward. From my personnal experience, I ended up thinking it is coming from thight middle back muscles as well as thight psoas and reading your comments it turns out I’m not completely wrong! I’ve also worked on strenghtening my upper abs and upper back more and my natural spinal alignment starts to change. I’m super glad what I’ve questionned myself turns to be right or at leat on the right path (my Pilates trainer kept directing me towards letting my ribs free and counternuting my sacrum to tilt my pelvis backwards). It is also great that you demo of a neutral pelvis on your picture doesn’t show your very low belly vertical. You align the bones and not the flesh (wich is what I have seen on many books or websites and always seemed to me as a slight backward tilting). Anyways, thank you for all this precious information!

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