The pelvis carries the weight of the upper body and protects many organs of the human body.
For women, the pelvis plays an important role in two periods. Once an abnormality occurs, it not only affects the overall stability, but also induces pain.
"Life Times" invited experts to interpret how important it is for the pelvis to be "stable" and teach you a way to self-test for abnormalities.
Experts interviewed
Lu Min, associate professor and chief physician of the Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Gong Liyan, chief physician of the Pelvic Floor Rehabilitation Department of Hubei Provincial Maternal and Child Health Hospital
Liu Jian, Deputy Director of the Department of Rehabilitation Medicine of the Emergency General Hospital
The "pelvic girdle" has a protective effect on women
Located in the center of the body, the pelvis is responsible for connecting the spine to the lower limbs, and is a stable structure formed by the delicate interweaving of irregular bones such as the ilium, pubis, and sacrum.
The main function of the pelvis is to bear the weight of the upper body of the human body, stabilize the lower limbs and regulate walking, and at the same time protect the important organs of the urinary system, reproductive system and digestive system in the pelvis.
Although there is no large movement, the pelvis plays a supporting and immobilizing role at all times, allowing the limbs to move smoothly.
An unstable pelvic imbalance can lead to low back pain and affect physical activity. If the pelvis is displaced, it can also lead to scoliosis, neck and back pain, headaches, and even affect the alignment of internal organs, causing a series of symptoms.
In addition, a woman's pelvis also plays an important role in pregnancy and childbirth.
After giving birth, women often feel low back pain, thigh pain, especially after lying down, buttocks will also hurt, which may be a problem with the pelvic belt. Pelvic girdle pain is a common musculoskeletal disorder that affects women during pregnancy and postpartum.
The pelvis of the pelvic structure can be divided into the pelvic belt and the pelvic spine area.
The pelvic girdle is composed of the left and right sacroiliac joints, pubic symphysis, and lumbosacral joints, which enclose the pelvis like a "protective belt", and any abnormality will affect the overall stability and cause pain.
European guidelines define pelvic girdle pain as pain between the posterior iliac crest and the gluteal fold (lumbar hips), which can radiate to the back of the thigh, can occur alone, or can be accompanied by pain in the pubic symphysis (the front of the pelvis, the lower abdomen and the junction of the legs), and can be diagnosed after ruling out a lumbar spine etiology, and some patients may also have pain in the vagina, difficulty turning over or going up and down stairs, etc.
Abnormal sacroiliac joint function, or the overall relaxation, weakness, and asymmetry of the muscles and ligaments that maintain its stability, are the underlying causes of pelvic girdle pain, and a history of low back pain, pelvic trauma, and childbirth are the main risk factors, which are also more common in pregnant women.
Pregnancy can affect the stability of the pelvic girdle due to weight gain, postural changes, increased abdominal and intrauterine pressure, and relaxation of spine and pelvic structures.
Most women who have experienced pregnancy may have pelvic girdle pain in the third trimester, and a small number of them start in the first trimester, which may be mild or severe, or even require the use of crutches or a wheelchair to get around.
Most of them can basically recover in the first half of the postpartum period, and some may last for 3~4 years.
The crooked seam of the trousers may be a sign of pelvic torsion
When you lie flat, your hips feel half big and half small, when you walk with a deep foot and a shallow foot, and the seam of your pants will be crooked when you walk, which may be a reminder that your pelvis is rotating.
Ideally, the pelvis is in a neutral position, which is the best position for spine health, and you can rotate your hips outward with your feet while standing, and at the same time tighten your hips and abdomen to find a neutral position.
Pelvic tilt can occur for the following reasons:
- If you sit on your legs for a long time, sleep on your stomach, sit or stand crookedly, etc., your pelvis may rotate horizontally with the spine as the axis, causing pelvic rotation and causing you to walk in a deep and shallow way.
- Scoliosis, long and short legs of the lower limbs, asymmetry of the bilateral hip joints, or degenerative diseases such as hip arthritis and knee arthritis can also cause weakness of one side of the lower limbs or misalignment of biological forces, which eventually leads to pelvic rotation, which in turn instabilizes the spine and aggravates pelvic scoliosis.
- External factors such as pregnancy and childbirth can also cause pelvic rotation, and women need to pay special attention.
After pelvic rotation, patients often have neck, shoulder, waist and leg pain, knee joint valgus, abnormal gait, etc., and due to the continuous passive traction of soft tissues such as pelvic peripheral nerves, muscles, and ligaments, it can cause inflammation and acute and chronic injury.
If the degree of rotation is severe, the pelvic organs can also be displaced, causing damage.
Therefore, pelvic rotation needs to be detected and treated early, and you can judge it through self-testing or professional testing.
Self-test method
Stand with your feet natural, stop walking in place with your eyes closed for 10 seconds, keep your feet still, observe the position of your feet, if your left foot is in front and your right foot is behind, it is a right rotation of the pelvis, and vice versa.
In clinical practice, professional tests such as observation method, overall posture analysis and detection method, and pelvic X-ray will be taken.
Observational method
The person should stand normally, facing the person at a position of about 1 meter, with the line of sight level with the person's pelvis, to check whether the distance between himself and the person's bilateral anterior superior iliac spines (a visible bony protrusion that can be felt on the outside of the abdomen) is consistent, and if the left side is closer than the right side, it is a right pelvic rotation.
Once you've figured out which side your pelvis is rotating, you can do muscle training accordingly to help your pelvis return to its normal position.
The "pelvic clock method" improves flexibility
The pelvic clock is one of the pelvic exercises that can enhance pelvic control, improve flexibility, improve pelvic tilt and rotation, and relieve lower back pain.
How to do this: Lie on your back with your legs flexed hip-width apart, adjust the distance between your feet and hips, and keep your spine and pelvis in a neutral position.
Imagine the pelvis as a clock, 12 o'clock near the waist, 6 o'clock at the coccyx or pubic bone, 3 o'clock at the left hip, and 9 o'clock at the right hip. As you practice, perform clockwise and counterclockwise rotations along the outer edge of the imaginary pelvic clock.
6 o'clock to 12 o'clock
First, you can practice the movement between 6 and 12 o'clock repeatedly:
When inhaling, move the maximum pressure point of the pelvis towards 6 o'clock, and do not arch the waist;
As you exhale, roll your tailbone inward, pull your pubic bone toward your navel, tuckle your ischial bones slightly inward, move your pelvis center of gravity toward 12 o'clock, and keep your buttocks off the floor.
3 o'clock to 9 o'clock
Next, practice moving between 3 and 9 o'clock: move the weight of your body to the left (3 o'clock) and lift the right side of your pelvis a little from the floor. Then change direction to 9 o'clock.
During this time, the knees should not shake as much as possible, and always point towards the ceiling. Keep breathing naturally, relax your shoulders, and don't exert yourself too much on your hips, abdomen, and thighs.
When moving, the speed should be slow and constant. After practicing freely, the breathing and pelvic movement are separated to achieve control of the pelvis whether you inhale or exhale.
It is recommended to exercise in groups of 10 in each direction of movement, and repeat 2~3 sets a day. After mastering it, you can take sitting and standing exercises every day to relieve the fatigue caused by sitting and standing for a long time, and improve the tension and pain in the lower back.
The pelvic clock is suitable for all people, especially postpartum women, and practicing the pelvic clock can better control the contractions of the pelvic floor muscles, which is conducive to the recovery of physical functions. ▲
Editor of this issue: Zhang Yu
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