The team at Village Physiotherapy and Rehab have just spent the last 2 weeks revising, learning and perfecting our assessment and management of hip and pelvic pain and conditions.
A common misconception is that the joints in your pelvis do not move. Well we’re here to tell you that they do. Yes, they only move a small amount, but the joints move and shift with all kinds of movements performed in everyday life. We call these movements, intrapelvic torsion, transverse pelvic rotation, lateral pelvic tilt, sacral rotation, nutation and counternutation. All these movements are normal but should always return to a neutral starting point and be balanced between left and right. An imbalance between left and right at rest or with movement can lead to pain. This pain can be in the lower back, pelvis, groin and areas further away (feet, knees, neck).
Some common muscles that cause abnormal pelvic postures include erectus spinae, piriformis, bicep femoris and iliopsoas. Erectus spinae (ES) for example, is a muscle in the lower back that helps extend the torso upwards. Conversely, ES will pull the back side of the pelvis upward, therefore forcing it to tilt forwards (anteriorly). To complicate this more, if only the left ES is firing abnormally it will cause the left side of the pelvis to tilt anteriorly. This causes a twist in the pelvis and places stress on the sacroiliac joint (SIJ). Again, this joint is not designed to move a great deal and will therefore communicate this to you by stimulating a pain response.
How can the pelvis cause pain in other areas?
If your pelvis has a twist, the remainder of your body will attempt to compensate for this. This occurs by for example by one of your feet being “squished” so that you feel like you are walking straight. This “squishing” of the foot may then stimulate a pain response. Traditionally you would see a practitioner who will assess your area of pain (foot). You may improve for a period of time, but due to the pelvic twist remaining you foot gets “squished” again. So you seek more treatment. Basically without correcting your pelvis, your foot pain will remain.
What to expect?
Pain in any area of the body may be stemming from poor loading through your pelvis. At Village Physio we will provide a thorough assessment to determine where your problem lies. We then work with you to minimise your symptoms. This is achieved through hands on treatment (e.g. massage, dry needling, mobilisations), and exercises to encourage your body to normalise. Discussions will be had on ways we can modify your home and work habits to prevent this issue recurring.
If you are suffering pelvic pain or think your pelvis may be the cause of pain in other reasons, come visit any of our amazing physios where we will help get you back on track.
Written by Dean (Physiotherapist)