The pelvis and low back pain part I: mobility exercises to improve awareness and mobility

Your pelvis, the bowl shaped structure that hangs from the bottom of the spine, is comprised of muscles on the inside that help maintain intra abdominal pressure and muscles on the outside that transmit forces from the leg to the torso during walking and running and also control movement of the leg at the hip socket. (Intra abdominal pressure refers to the co-contraction of several torso muscles to keep the spinal segments stable).

The pelvis moves when you walk, rotating in an oscillating fashion up, down, laterally, forwards, and backwards. When the pelvis is coordinated with the rest of the body, the movement looks fluid, not stilted. When people try to alter the movement at the pelvis, either consciously or unconsciously because they don’t want to be perceived a certain way, they are trying to transmit a certain status or posture, they experienced trauma that has disconnected them from how the area moves, or they have been given instructions in group exercise classes about how to move (or not move) the pelvis, they are doing their entire body a disservice. When the pelvis isn’t integrating with the rest of the joints for efficient movement, other joints will move more or move less to create the mobility/stability the body needs to propel itself forward or accomplish a specific movement goal.

Let’s pretend your pelvis only knows how to rotate back, tucking under when you stand and tucking under more when you do things like lift your leg. The muscles that support posterior pelvic tilting (which is the term of a pelvis that’s rotated back), will be good at that movement, but they won’t be good at moving the pelvis forward or rotating the pelvis. Or maybe you have a pelvis that moves up and to the right really well, but doesn’t know how to move up and to the left, so you experience a constant ache on the right side of your low back. The muscles that tilt the pelvis up and to the right are good at that movement, and the muscles that move the left side of the pelvis down are good at that skill, but to create more balance, the muscles on the left need to learn to move the pelvis up and to the left and the muscles on the right need to learn to move the right side of the pelvis down.

There are a number of ways to gain better control of the pelvis. Let’s start with looking at how to feel whether the pelvis is moving or not. Learning to feel and consciously control movement in the pelvis is a great way to restore mobility and coordination and take a load off your spine because you can’t change what you can’t feel.

Exercise 1:

Pelvic tilts, three ways

Lie down on your back, with your knees bent and your feet flat on the floor. Take a moment to feel your pelvis on the ground. What does it look like? If you were to draw a picture of how it rests on the floor, which parts would be heaviest? Which would be lightest?

Roll your pelvis so your low back comes closer to the floor. Make the movement small and go slowly, not going to the point of discomfort. Now, roll the pelvis the other way, so the low back arches away from the floor. Go back and forth between these two movements four to six times.

Come into a seated position, either on a chair if the floor isn’t comfortable, or on the floor. Feel the sitting bones, the two bony knobs at the bottom of the pelvis, against the surface on which you are sitting. Roll behind your sitting bones. Make the movement small and don’t go to a place of discomfort. What happens to your low back? Now, roll in front of your sitting bones. Again, observe what happens in your low back. Go back and forth between the two positions four to six times.

Come into a hands and knees position. Imagine you have a tail. Move your tail slowly between your legs. Move your tail up towards the ceiling. What does your pelvis do when you move the tail between your legs? What about up towards the ceiling? Go back and forth between the two positions four to six times.

Lie on your back again. Take a moment to observe your sense of the pelvis against the floor. How does it feel now?

Exercise 2:

Tilting the pelvis sideways, three ways

Lie down on your back with your legs long and your arms overhead on the floor. If your arms don’t rest comfortably overhead on the floor, raise them up by your sides as high as you can, keeping the entire length of the arm supported against the floor.

Slide the legs to the right, keeping them long. What happens to the right side of the pelvis? What about the left side?

Bring the legs back to center and slide the legs to the left, again, keeping them long. What happens to the left side of the pelvis?

Go back and forth between the two positions four to six times. Make sure you are breathing, and remember to make the motion small, staying in a pain-free range.

Come into a hands and knees position. Pretend like you have a tail. Wag your tail to the right. Bring it back to center. Wag your tail to the left. Go back and forth between the two positions four to six times. How does that feel?

Come into a standing position, placing your hands on your hips. Keeping your legs straight, press your right foot into the ground, lifting your left foot the ground about an inch. What happens to the pelvis beneath your hands?

Return to center and press your left foot into the ground, lifting the right foot off the ground about an inch. What happens to the pelvis beneath your hands?

Go back and forth between the two positions four to six times.

Exercise 3:

Pelvis rotation, three ways

Lie down on your back, with your feet flat and your hands resting on your hips. Tilt the knees to the right. Let the weight of the knees tilt the pelvis. Keep the movement small, and make sure you can return the legs to the starting position. When you return to the starting position, tilt the knees to the left, letting the weight of the legs rotate the pelvis. Go back and forth between the two positions, four to six times.

What happened underneath your hands? Was one side more challenging than the other?

Come on to a hands and knees position. Reach your right knee into the ground. Lift your left knee half and inch off of the ground. Pause for a moment and lower the left knee back down. Reach your left knee into the ground, lifting your right knee half an inch off of the ground. Go back and forth between the two positions, four to six times.

What happens in your pelvis? Were you able to keep the rest of the torso still, not shifting weight from side to side?

Come into a standing position. Place your hands on the hips and step the right foot forward about 18 inches. Both feet will be on the floor.

Rotate the left hip forward as the right hip rotates back. You will feel the left hand coming forward and the right hand moving back. Bring the hips back to the starting position, but keep the feet staggered. Perform four to six, and then switch sides, stepping the left foot forward about 18 inches, keeping both feet on the floor, and rotating the right hip forward as the left hip rotates back. Perform four to six, and then relax with your feet together.

These simple awareness drills can be used as a warm-up before your workout or as a way to relax before bed. If one was particularly challenging for you, practice it four to five times a week for about a month. As it gets easier, notice if you feel any more movement in your pelvis when you are walking or any more control in your pelvis when you are exercising. Feeling how your pelvis moves makes it easier to prevent the pelvis from moving, which can be beneficial for improving hip strength and mobility, and core strength and mobility. Part II in this series will focus on learning how to improve the sense of stability through the pelvis through exercises that use the muscles in the core to keep the pelvis still.

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