Core and Pelvic Stability
What does it mean and why is it so important?
For those of you who have had the chance to take advantage of Spectra Health and the rehabilitation services we now have on Denman and Hornby, it is very likely you’ve heard me talk about the importance of core stability and the stability through the pelvis. This is a very big topic, but given that it is such a common issue I thought it would be useful to introduce it and give some to context to it’s importance.
Walking on two legs, quite a feet
As bipeds, it’s easy to take for granted how much needs to occur for us to transfer load with every step, with every reach, with every item we carry or lift, and basically any movement we make.
Our centre of gravity will land between our feet at the midline. Our pelvis is the lever running horizontally connecting our two legs to our trunk. When transferring weight to one leg many muscles need to work in harmony to keep the horizontal lever level and parallel to the ground, to keep the plum line through the femur knee ankle and foot evenly. If you pinch one end of a pen between your fingers, add pressure downward and upward and see what happens to the free end of the pen: it drops or lifts. It requires specific pressure to keep the pen parallel to the ground when held only by one extremity. This is a very similar dynamic to our pelvis. However we don’t only need to lift one leg up, we also need to propel ourselves forward, transfer weight from foot to foot, hold the pelvis steady while reaching for objects etc… So there are muscles all the way around the head of our femur (the thigh bone) connecting to the pelvis at different angles to be able to do just that. They work with multiple abdominal muscles that can provide stability to the pelvis from above. The abdominal muscles will also stabilize the lower back as movements are occurring through the lower limbs and pelvis. And this is the simple version! There’s a lot going on! I haven’t even gotten to rotation yet. But lets keep it simple for now.
So, we’re on two feet, we have a pelvis running parallel to the ground and muscles balancing this lever to help keep our centre of gravity in the middle where it needs to be to keep the load occurring in the joints, right in the middle.
However, if you take a moment to look at yourself in the mirror you will likely notice we are rarely symmetrical. Over the years we develop a “strong side,” habits in standing and sitting, where we lean or twist to one side. Jobs that require unilateral tasks (tasks repeatedly on one side), carrying children, writing, and driving, most tasks are rarely dividing load equally in both extremities. Therefore certain muscles get strong, others get weak, some lengthen, some shorten. All of a sudden that pen you were holding parallel to the ground by one extremity, is no longer parallel. The pelvis drops, twists, hikes up, and rotates. Our amazing bodies find ways to compensate, pull a little here, push a little there by contracting certain muscles in an attempt to keep us on our feet.
But over time, what this begins to look like clinically is that weight is no longer evenly distributed landing directly between the feet at an equal distance with a nice level pelvis. If it’s not level then there is, inevitably, a portion of a joint, or many joints carrying more load, more load means prone to wear and tear, and ultimately, a more vulnerable joint altogether. Perhaps your back begins to twist, perhaps your femur roles inward which means part of your knee is carrying much more weight, perhaps your arch collapses in your foot. So you may come to me with shoulder pain and foot pain, but it turns out that for years it was a perfect storm slowly building leading to pain far away from the origin of the problem.
Before your eyes glaze over, overwhelmed by too much information, let’s go over one simple step. Look down at your body right now. How are you sitting? Are you leaning to one side? Are you crossing your legs? Are your shoulders up around your ears? Just observe, do some areas feel tight? Do some areas feel soggy, boggy and floppy?
Gently place both feet on the ground, hips and knees at 90 degrees (you may have to get onto a firm dining room chair). Sit upright without leaning on the backrest. Gently tuck your chin down ever so slightly, giving yourself a subtle double chin. Let your arms rest at your sides.
This may not feel comfortable, especially if you have some muscles on one side that have had to work hard to keep you upright. That’s ok just observe it. Don’t push through discomfort, keep it gentle.
Take a deep belly breath, that means breathing into your tummy letting your tummy fill with air like a balloon to the count of three through your nose. Now breathe out all the way, emptying your tummy bringing your belly button to your spine, getting every last drop of air out of your lungs all… the……way…… good and breathe in again into your belly. Now shake it out. Excellent. That was the very first step. It begins with the breath and awareness.
When the core and pelvis stabilizers have weakened over time our joints pay the price: hips, knees, ankles and feet, even our shoulders and necks. With years of load in the joints, this can lead to arthritis or can make existing arthritic pain much worse. You can prevent and treat this kind of discomfort by balancing and strengthening your stabilizing muscles. Figuring out exactly where the imbalance is and what combination of releasing and strengthening you need is where we can help.
