Proper biomechanics demands many things, one of which is a person’s ability to maintain proper muscle length and tension ratios. As with any joint, postural abnormality and pain can develop when a muscle is tight while its antagonist is elongated and weak. The pelvis involves a series of muscles that allow it to lean anteriorly, posteriorly, and laterally. If a significant disparity in these length-tension relationships arises, pain ranging from persistent low back pain to something more severe such as shooting or radiating pain in the buttocks and legs can occur. In this article, I will specifically explore how the pelvis can be set in a lateral tilt and what can be done to identify and correct the problem.
So what is lateral pelvic tilt and how is it best identified? The lateral pelvic tilt can best be described as simultaneously involving two movements: hip rise and hip drop. When compared to a neutral pelvic position, where the iliac crests appear level, the hip lift requires the hip on one side to rise above a neutral position, while the other iliac crest must descend below a level. neutral. By standing as evenly as possible, one should be able to determine with a mirror or another pair of eyes whether their iliac crests appear level or not. But where are these iliac crests? The iliac crest is a term used to describe the pelvic border that extends from the anterior superior iliac spine to the superior posterior iliac spine. Part of the anterior portion can be felt as the bony point of the pelvis below the oblique, while the posterior portion is laterally displaced from the base of the spine. If necessary, practice tilting your pelvis back and forth with your hands on your hips to determine their respective locations.
Another important, albeit indirect, detection method requires scrutiny of gait. If there is weakness in the gluteus medius or tensor fascia lata, then the gait is characterized by a lateral shift of the trunk as the opposite leg swings forward. A similar conclusion could be reached by standing on one leg with the opposite leg bent 90 degrees at the knee and hip and then evaluating the position of the opposite hip. If the hip drops, the abductors are likely weak. Now let’s take a closer look at some of the common dysfunctions that accompany walking and hip drops.
First of all, for a hip walk to take place, one will most likely have a tight quadratus lumbar, which is a muscle that connects the lumbar vertebrae to the iliac crest and is used primarily in lateral extension and flexion. of the lumbar spine. As a result, the side walked should create an adduction at the hip, which probably means that the adductors are tight as well. Consequently, the hip abductors, namely the gluteus medius, are likely to be in an elongated and possibly weakened position.
On the other hand, the dropped hip is likely to have an elongated quadratus lumbar and a tight gluteus medius, connecting the ilium to the top of the femur. Due to this position, the dropped hip must be abducted. This places the hip adductors in an elongated and possibly weakened position. Another potential contributor to hip drop could be a tensor fascia lata tensor muscle, which connects the iliac crest with the iliotibial band. Now that the typical dysfunctions have been clarified, what is recommended in terms of treatment?
Before proceeding any further, I recommend that all people with marked pain consult a physician before beginning any self-treatment program. That being said, the simplest solution for those with only a mild disability might require only a subtle alteration in posture and gait mechanics. In other words, practice standing with your weight evenly distributed on your feet and with your pelvis in a neutral position. This may seem painfully obvious, but too many people do not realize that they are in “postural adduction,” which is when the hips roll outward and the weight-bearing leg is positioned under the raised, displaced hip. If symptoms are a little more pronounced, other arrangements including stretching and strengthening will be necessary. When walking, a cane or cane should be used in an effort to support the weak gluteus medius. This should only be necessary in the initial stages of treatment to better control pain. If sleeping in the adduction position is painful, then a pillow between the knees might be appropriate. On the side of the dropped hip, the tensor fascia lata should be stretched by standing on one foot on a sturdy platform 2-4 inches thick with the other foot on the floor. Make sure your knees and feet are facing forward. Next, tilt your pelvis back and hold for 20-30 seconds. Corrective exercise is undoubtedly a vital component in removing any movement impairment. Those who have experienced pronounced pain would be advised to start conservatively in their corrective exercise. Hip abduction exercises in the prone or supine position are recommended initially. Progress to a side position once 20 reps can be performed painlessly with a full range of motion in the starting positions. Eventually, one should move on to standing exercises where one leg is placed on a 2-4 inch platform to practice hip drop so the foot touches the floor and then back up to a neutral position by recruiting the glute. half.
Hopefully, this article has helped clarify the ways to identify and understand lateral pelvic tilt and what can best be done to correct it. I’m sure that, with a little diligence and patience, pelvic tilt will soon become a thing of the past.