If you find your pelvis does not level with legs spread wide, we need to get you fixed. This article will demonstrate the ways you can fix your pelvis with structural and strength training methods.
It's quite possible that if you had one pelvis higher than the other when spreading your legs wide, you unconsciously stand like the picture below.
It's also quite possible that despite what the picture shows (which is an elevated right pelvis in standing), you have an elevated left pelvis (when trying to stand symmetrically).
How could this be?
What happens if you pound a really long nail into the ground? The more force you pound with, the deeper the nail will go, right? So, imagine you spend hours or at least everyday for 30 minutes or more standing mostly on one leg.
Whichever leg you stand on most, the deeper that hip will go into the socket (or acetabulum), which effectively makes the leg shorter. If one leg is shorter, this will lower the that same-sided hip toward the ground more. Consequently, the opposite pelvis will be higher. This is why if you stand a lot, you are more likely to have a socket-caused issue rather than a postural-caused issue.
What's the fix for a socket issue? Assume you have an elevated left pelvis issue because you stand on your right leg like the picture above. The answer is to begin to stand on the opposite leg. However, we don't necessarily need to continue to lower the right pelvis to get the benefit of mostly standing on the left leg.
In my experience, even standing with a depressed right pelvis like the picture above will still lead to positive results if you have an elevated left pelvis.
That's really about it. Here's the thing though. You will stand on your right leg unconsciously. It means you really need to pay attention as much as possible to standing on your left leg.
I tell all of my clients who've had this problem that that you will not be perfect. You will find that you find yourself standing on your right leg, and when you do, it's time to swtich, not give up . The more you practice or notice yourself - and correct yourself, the faster an effect you will get.
Let's assume you have a client who does the wide leg stance test and finds their right pelvis is still elevated. It's no wonder as this client stands a lot and happens to stand on their left side. Again, this makes left femur deeper into the socket of the left acetabulum. It results in a lower left side.
In this scenario, we want to put more pressure into the right acetabulum and distract or take away pressure from the left acetabulum. We can accomplish this with:
It's important to note that the left leg is not supported on anything. It's simply hanging. That's the goal because we want the left femur not so impacted into the left acetabulum.
As you can see, I can also focus on the likely weaker left obliques by trying to raise my left pelvis to the ceiling.
To challenge the obliques more and to get a greater distraction for the left side, you can use a DB in the crux of your left knee. (I find this is a good left hamstring warm up too as the left hamstrings are frequently weaker than the right hamstrings.)
I recommend putting this exercise before stretching and strengthening exercises. Think of it as a realignment exercise. After this, we can begin to address mobility and stability.
Before we get into the strength training, you need to make sure that all positions you are in have at least a level pelvis. Let's assume you have an elevated right pelvis. You could also position yourself with an elevated left pelvis to correct yourself in the short term. Let's assume you're normal pelvic position during the plank is:
You want to make sure that you can at least get a neutral pelvis or even an elevated left pelvis in this situation (since the right pelvis is elevated)
The bottom line is that no matter what exercise you do, always make sure you have a level pelvis (or an elevated pelvis in the opposite direction).
Let's get into how you can use strength training to correct your lateral pelvic tilt. This will apply whether you have a socket-caused or a postural-caused lateral pelvic tilt.
Whenever a lateral pelvic tilt is present, you will have abductors on the elevated side which are lengthened (and possibly weaker) and abductors on the shortened side which are shortened (and possibly stronger).
Whenever abductors on one side are lengthened, the antagonistic adductors are shortened. In our case, let's assume we have an elevated right pelvis (which is the opposite of what we just discussed above.)
In this scenario, the abductors on the left side are lengthened, the adductors on the left side are shortened, the abductors on the right side are shortened, and the adductors on the right side are shortened.
We also must contend with the abdominal musculature. With an elevated left pelvis, the left oblique muscles are shorter. The right oblique muscles are longer. Consequently, it is wise to insure that whenever we are strengthening or stretching our hip muscles, that we coordinate these efforts with stretching or strengthening the oblique muscles.
An appropriate go-to methodology is simply to strengthen the lengthened muscle in a shortened position and to stretch the shortened muscle in a lengthened position. Here's how we can do that. Again, we must be very careful to pay attention to how we place the hip depending on which side we are working on.
Again, if I have an elevated right pelvis, I will want to work on my right side hip abductors. I will have clients hold this position above (if it's sustainable). Some clients you will find have cramps, so you may need to gradually increase the time you hold this position.
Eventually, you should try to get your way up to holding it as high as they can. I will have my clients work their way up to 30 seconds with ankle weights for at least 3 sets per day.
However, you must make sure to not hike up your right pelvis because then, we are giving into the direction of our elevated pelvis. At least, try to keep your pelvis level like I'm trying to do below.
The next part we can focus on is the left adductors.
I'm not doing a great job of keeping my pelvis level, but I should be more level. Basically, my pelvis line in this position should be vertical.
For the adductors, you should be able to hold this position for along time. You can build your way up to putting a 10 to 30 pound dumbbell on your mid thigh. Hold for 30 seconds in the top position for multiple sets.
You may need to mobilize your adductors and abductors and to be honest, it usually never hurts to do this. Even if you are hypermobile, stretching the shortened abductors and adductors can help turn these muscles off.
In our case (as we are still working with the elevated right pelvis), I'm going to put my right leg on a wall as shown in the picture below to feel a good stretch in my adductors. If you cannot make it to at least 45 degrees, then you definitely need to try to get to 45 degrees. Hold for 30-40 seconds.
I don't do a great job keeping my pelvis level, but you should try to keep it level or even have the left pelvis elevated.
Next, it's time to stretch out the left hip abductors. To do this, we are going to make sure we have a level pelvis, then get into the stance like the picture below.
With an elevated right pelvis, it means the left obliques may be weak. To correct this, you can do a left side plank, but again, make sure the pelvic line is neutral or you actually have an elevated left pelvis (which is a wise correction in the short term).
With clients in the position below, I'll even try to pull their left pelvis low so they have to keep it elevated. This challenges the obliques the way we want them to adapt which is to elevate the left pelvis.
As you can see, there are many different ways we can attack a lateral pelvic tilt. Make sure that you at least test the wide leg stance first to know which direction you should go with either a postural-caused or socket-caused lateral pelvic tilt.
Regardless which you have, you should do appropriate strength training and always make sure your pelvis is level before beginning any exercise. I'm confident that you will get out of your lateral pelvic tilt fairly quickly if you are diligent in watching your posture and using stretching and strength training together.
This woman obviously looks like she is in shape, and she may or may not have a lateral pelvic tilt.
Lateral pelvic tilt simply means that one of your pelvis is higher than the other. (This is different than a leg-length discrepancy because how far up the femur is in the socket can influence this.)
In this article, we’ll explore some postural corrections if you have a lateral pelvic tilt due to your posture. There is another possibility which we will explore in my next article. We'll also cover the strength training corrections in the next article as well.
Our corrections here will entail checking your alignment and correcting all the postural positions which could be contributing or causing it.
Our first test is going to directly assess the pelvic rim using our hands. Make sure both feet are together and that one foot is not in front of the other.
Using your palms, make sure that you don’t tickle the hell out of your client because if you go with fingers digging into the sides, it’s not comfortable. If you use your palms at first, they will be a lot less likely to be tickled.
You can either use your palms or fingers to go into the sides of the pelvis. From here, you can use your middle fingers (or palms if they can’t tolerate the middle fingers), to see how your fingers line up. If you find they are equal, great! You’re done, and can move onto another assessment.
If you find there is a half inch difference or greater, you need to correct it.
The second assessment you need to perform is simply standing with your legs wide. If you find that your pelvis becomes completely level or significantly improves, you should continue with the postural recommendations below. If however you find there is no change, check out the next article.
The corrections are simple. The first is standing. Let’s assume you have an elevated left pelvis. To correct this, we are simply going to try to stand like this as often as we can.
As you can imagine, if you had an elevated right pelvis, you are going to stand like this as often as possible.
I think you get the idea. Let's assume you had an elevated left pelvis. You can use a small folded up towel to put under your left ischial tuberosity.
You wouldn't even be able to tell that you are sitting on the pad. Here is something you need to be careful of however.
Since we sit so much, I've found myself and clients can ruin or efforts if we tend to lean to one side or the other. Sometimes, having a pad under our right side can cue us to lean to the left like this:
Avoid this position and make sure to sit straight up. You can literally ruin your efforts, because this position effectively puts us back in an elevated left pelvic position which we do not want.
The last position we are concerned with is our lying posture.
For those with wide hips and a small torso, this can be a real problem. It can be even more of a problem if you only sleep on one side or the other. One of the best ways to stay neutral is to sleep on both sides. If you can't however, one thing you can do is to use a pillow under your torso like this:
Lastly, some people simply like to lean to one side or the other when they are lying down. This can lead to a lateral pelvic tilt. It simply feels more comfortable to them. If you can get a picture of yourself, you might look like this:
To correct this, you need to try to get into the opposite posture. It will feel weird. In fact, all of your new postures should feel strange and unfamiliar at first. It's because you don't do them. By making sure that you address all of your main postures, you will get out of lateral pelvic tilt.
When I get clients in the gym and I tell them to simply stand up straight, here is often what I see:
The weird thing is that we can’t really know if we are rotated because it’s simply normal to us. In other words, your neutral is not neutral.
The problem is pelvic alignment is a big deal. The pelvis can of course effect the pelvis, but it can also affect the low back, the hip, the knee, thoracic spine, neck, all the way down to the ankles.
For individuals suffering from back pain or hip pain, I highly recommend taking the 10 seconds required to merely check for pelvic rotational asymmetry at every session.
What is pelvic rotational alignment? It’s simply this:
Put your fingers on the ASIS and make sure your thumbs are of equal distance to you. If you find that one thumb is farther away from you like this picture below, you have a pelvic rotation. (It's difficult to really tell in the picture, if you try it out, you'll quickly be able to tell.)
You can also do a self-assessment by putting your own thumbs on your ASIS and see if any of them are more forward than the other.
It might not seem like a big deal, but if you find one thumb is more forward than the other, this automatically entails:
·The lumbar spine is automatically rotated because of the close proximity to the pelvis.
·The thoracic supine and upper thorax are automatically rotated (or have a torque) because of the rotation going on in the lumbar spine. The upper thorax may compensate or not.
·One of the femur’s will internally rotate while the other will automatically externally rotate.
·The knee joint may be internally or externally rotated.
·The ankle joint may be affected either in internal/external rotation or pronation/supination.
Typically, the low back and the hip joint will experience the most discomfort or pain when there is a pelvic rotational malalignment.
Luckily, our corrections are fairly simple. While there are some specific muscles we could chase like the TFL, lumbar erectors, or even lats, we need to correct the posture which gave rise to our malalignment. (Releasing tight muscles can definitely help too, but let’s start with the posture.)
Addressing posture becomes fairly simple. Since our malalignment likely arose from either a sitting, sleeping, or standing position, we need to focus on correcting all of these.
Stand up, and reverse your pelvic position like this:
I will even try to rotate my clients pelvis towards the right and ask them to resist me. This will strengthen the muscles which have become weakened to the pelvis being rotated towards the right.
You need to hold this and then observe if your pelvis gets neutral.
If you are training, make sure that you always start neutral. Be careful for lifts like squats and deadlifts because it is very difficult to control your pelvis with these type of lifts, especially if you are lifting heavier weight. If you’ve had pain with these type of lifts and you have a pelvic rotation, it’s very possible the rotation has contributed to your pain.
This isn’t the end of the story. You need to make sure that your pelvis is corrected when sitting. Chances are that you got a pelvic rotation from sitting like this:
To correct, you need to have your clients sit in an eutral posture.
When lying down,
You need to make sure that you aren’t lying on a groove. Make sure your bed is flat. You can even check your ASIS while laying down to make sure they are level. If not, you should put something under the glute which is lower or sleep in a different part of your bed.
Let's assume you are correcting a pelvic rotation towards the right. This means, we need to make sure the pelvis is neutral or temporarily goes towards the left.
When sleeping on your side, you should discourage right sidelying because it promotes a rotated pelvis towards the right.
You could use a cushion under your top knee in the picture above if you really liked laying on your right side.
I would say more emphasis should be placed on sleeping on your left side because this promotes your pelvis rotating towards the left.
I'll find some individuals who only sleep on their right side, and sleeping could be the sole culprit.
Still, you should examine everything to help them get neutral.
Pelvic rotation is often a culprit in hip and low back pain. Once you correct it, you may not alleviate all of your pain, but it is definitely a step in the right direction.
I'll be the first to admit, I usually don't use planks with new clients.
If you simply put a stick on people's back and ask them to do a plank, you'll likely see a few problems. Here are 7 of them.
1. You don't know whether you should protract your shoulders (or push your shoulders forward).
As a basic test to know whether you should protract your shoulders or not, you should first check the alignment of your scapulae or shoulder blades. Measure the distance from the middle of the scapula to the middle of your spine. It should be about 2.5 inches to 3 inches.
If you are beyond 3 inches, avoid protracting your shoulders. You will only create an abducted scapula position. If you are from 2.5 to 3 inches, you can protract your shoulders, but you should balance it out with some form of scapula retraction. If you are at 2.5 inches or below, you definitely need to protract.
The problem is that many individuals don't really know what their scapula alignment is.
2. Many individuals will have pain in the elbow, shoulder, or neck area simply being in a plank position.
Some individuals who have had recent trauma, are overweight, had chronic injuries, or simply have pain in these areas should be careful with planks.
If you are not overweight, and you loaded up 50 pounds for a one minute plank, think how that would feel. You might be able to do it without pain, but that is a lot of stress on the elbow and shoulders.
3. They can't achieve a neutral lumbar spine.
Their is likely a greater than one inch space between the lower back and the stick. If this is the case, the person cannot maintain a basic neutral pelvis.
The only way you will get out of anterior pelvic tilt is by maintaining and reinforcing a neutral pelvic position.
A regular floor plank for many individuals is too intense. A proper progression is to begin with a plank with forearms on a bench. It already places the hips in hip flexion and helps to flatten out the lumbar spine.
A person can then progress down to the floor, and eventually have a weight on their back, use an ab wheel, or use a long plank with the arms more overhead. Before you use these exercises however, I usually see problem number 4 rear it's ugly head.
4. Individuals quickly lose neutral pelvic posture (or don't have sufficient core endurance).
Have you ever seen plank contests for time? Have you noticed by the end of the contest that individuals look like they finished with an invisible person sitting on their low back?
You need to use a stick and monitor the space under the low back from beginning until the end. If you think you can hold a plank for two minutes, you need to be able to maintain a neutral pelvis for that long.
5. The head is not neutral.
With a stick on the back, most individual's heads look like this:
When you try to have them correct it, it then looks like this:
The reality is that the ground is too advanced for them. What you will need to do is to start off higher like putting your forearms on a bench like this.
6. Thoracic kyphosis prevents a neutral thoracic or head position.
All this means is that the upper back may be so rounded that the head and the upper back can't be neutral.
I'm a big fan of eliminating flat thoracic spines, but they often accompany thoracic kyphosis, so it is wise to address both of them.
Although we haven't dealt yet with thoracic spine corrections, it can seriously help to perform some thoracic extensions or side lying thoracic rotations before you get into your plank. This may allow your upper back and head position to be neutral or at least be closer to neutral.
7. You can't breathe with the stick on your back.
You need to breathe into your back. Because of this, the stick should rise slightly above your head on your inhale, and fall back onto your head on the exhale. If you see someone who keeps the stick stationary on their head, it means their not expanding their back which they should.
The floor plank is an intense exercise. It includes a lot of components like proper head and thoracic posture, and proper breathing. Make sure you get all these components under control before you advance.