We first need to think of our bodies in a slightly different way than we have been trained to do. The ‘core’ of your body is one of the hottest topics in fitness for the last few years. We hear time and again how important it is to strengthen your ‘core’ and the host of benefits that come from this process. We need to recognize the true core of your body.
What is your core? We typically think of the abdominal muscles as the primary core of your body, sometimes including the lower back into the grouping. While this is an aspect of your body’s core, simply just strengthening your abs is not the most effective, or even the most beneficial, regime for your body.
The real ‘core’ of your body, however, is not the abdominals, it is your pelvis. Think about it. If you have poor pelvic stability or poor biomechanics, then the rest of the body is drastically affected. Spinal alignment, leg length, posture, shoulder mechanics, knee stability (the list goes on) are all areas where problems can occur as a result of biomechanical and/or instability issues with the pelvis.
To date, most research and training focus is on anterior and posterior support for the pelvis. Just as important, however, is lateral stabilization. The primary stabilizing muscle for this is the gluteus medius. Lack of lateral stability is being found to be directly related to knee pain and back pain.
Ensuring that your pelvis is adequately stabilized is the first stage in maintaining optimal strength and support for the rest of your body, and making your core (pelvis) the power centre of all movements.
Let’s talk a little anatomy to give you a better understanding of what stabilizes and supports the pelvis.
During extension and flexion the hip joint is designed to move in the same plane and pattern on both sides. The symphysis pubis is the point where the two halves of the pelvis meet and the site of added need for pelvic stabilization. If the joint is not properly stabilized it is possible to have excess rotation through this area.
Excessive rotation of the two side of the pelvis around the symphysis pubis causes inflammation at the joint, which has several consequences. The first being pain, either local tenderness at the site, or referring down the inner thigh, and/or up into the abdominals. Secondly in chronic cases, sclerosis and bony changes of the pubis symphysis occurs. Focusing on treating the cause of the problem and prevention of the excess rotation is key to ensuring long term health and for developing maximal power output during physical activity.
A lack of pelvic stability also affects the surrounding joints. Much hype recently has focused on lower back pain and the abdominal muscles, with many articles and research papers being published discussing the abdominal muscle control of anterior and posterior pelvic tilt. Less commonly talked about is pelvic obliquity and its control.
Pelvic obliquity describes the tilt of the pelvis to the left or right side, what most people refer to as a lateral movement. This tilt of the pelvis during any bipedal activity is a result of the body’s centre of gravity being offset medially to the hip joint when standing on one leg. In essence, when you stand on one leg the centre of gravity for your body shifts and can cause the pelvis to drop laterally to one side. When we think about it, this occurs whenever we walk, run etc.
This results in the pelvis wanting to tilt downwards, away from the leg we are standing on. What happens if we don’t stabilize the pelvis? We either have excessive tilting of the pelvis or we fall over! As most of us don’t fall over, it can be said that our pelvis is being stabilized to some degree. We need to focus on the muscles contributing to this pelvic stability.
The main stabilizer of the pelvis in the frontal plane are the medial gluteal muscles, however we can also recruit the tensor fascia lata (TFL) muscle, which is attached to the illio tibial band (ITB) down to the lateral side of the leg to the knee. If the gluteus medius is not performing its job properly, the instability can lead to the surrounding joints, in particular, the knee joint. The most common scenario is weakness and/or insufficient contraction of the gluteus meduis muscle, which must be compensated by increased contraction of the TFL. The TFL is attached to the ITB and extensor retinaculum of the patella. The result is excessive lateral pull on the patella, resulting in mal-alignment and finally patello femoral pain.
Why is any of this important? We know that stabilizing the pelvis is important to preventing long term problems with the knee joint and the lower back. Both of these areas are common sites of injury and pain. As mentioned, posterior/anterior (back to front) stabilization is the most common focus when training, but we can’t forget about lateral stabilization.
Your primary hip stabilizer in the frontal plane is the gluteus medius. It is important to ensure that this muscle is not only strong but that it is being correctly activated during any kind of movement. Your gluteus minimus also acts to assist with hip stabilization. The largest of the three muscles, your gluteus maximus, has the primary responsibility of acting to extend the hip to generate movement, as in walking, jumping, climbing, squatting, etc.
This is where the abdominal muscles begin to play their role. Because your hip is not fixed against anything solid, the glutes need something to work against in order to create stability. This is the role of the abdominal muscles (in addition to their role of supporting the spine, but that is not the topic of this article).
Lateral stability of the pelvis is often overlooked. Many people in the industry are not even aware of its significance. As can be seen from the above description, ensuring lateral stability is just as important as posterior/anterior stability.
We need to focus on firing the glute medius during all exercises and movement patterns that involve the hip to ensure true pelvic stability.
When I work with anyone from the elderly to elite level athletes, I assess hip stability as my number one priority. Ensuring that this area is stable is necessary before attempting to deal with any issues surrounding the rest of the body. I have worked extensively with elite volleyball players and after stabilizing the pelvis I noticed the incidence of shoulder injuries and shoulder pain dropped drastically, as well as significant decreases in knee pain.
I know what you’re thinking, how do I asses and then correct instabilities in the pelvis? I will not go into a thorough description as that would take an entire book. For this, you will need to get acquainted with Gray Cook and the functional movement screen. This is a series of movements, such as the overhead squat, deep squat, and the in-line lunge, that are designed to check your movement biomechanics. Gray’s book is Athletic Body in Balance, and also has a DVD component that will allow you to see what the movements should look like. The book and DVD also provide corrective techniques to work towards improving mechanics and movements.
Once your biomechanics are moving smoothly it is important to maintain those patterns for as long as you are active (hopefully this is the rest of your life!). Continuing to follow a weekly reassement of the above exercises is an easy way to do this. Muscle activation patterns and the mind muscle connection become very important here.
You should be able to feel your glutes working during lunges, squats, deadlifts, plyometrics, and almost any other large body movement you are performing. If you are not feeling those muscles working, there is a good chance that they are not being activated properly, which means they are not adequately stabilizing the pelvis. During any movement it is necessary to enforce the neural connection between your brain and the hip stabilizers. Just by thinking about contracting the muscle prior to initiating the movement is a great way to do this. This will take a little more focus and attention, but it will be worth it in the long run. The simplest technique is to pretend you have a 100 dollar bill between your butt cheeks. In order not to loose it, you must squeeze your butt cheeks together. You may feel your knees want to turn out a little, and that’s fine. Do this isometric contraction 5 or 6 times, then immediately progress into your exercise ex. squat. The pre-activation of the glutes during the isometric contraction will assist you activating the muscle during the squat
Remember, good pelvic stability comes from a combination of glute and abdominal muscle control. You should also feel your abdominal muscles working as well. Especially when using heavy weight, your abs are working hard to provide support and stabilization and you should feel them. Often if you do not feel the abs engaging you are likely placing load onto the lumbar spine.
Incorporation and Movement Patterns
Now we must shift focus to ensuring that your body is putting things together from the base up. As I mentioned above, there is no point to fully engaging your glutes if they have nothing to work against to create body stability.
Training the abdominals becomes very important at this point. Crunches and sit-ups are not the most beneficial way to accomplish this. It is just as important to train the muscle to work in an incorporated pattern, as it is to make those muscles stronger. A crunch will isolate and strengthen the rectus abdominus but it will not create a neural connection between the glutes and the abdominus muscles. The glutes simply have no need to provide support to the hips when you are laying on your back and the floor or bench is providing that stability.
Exercise such as planks, hip bridges, woodchoppers, and stability ball core work, are the best to focus on building the appropriate strength and firing patterns in your abs. Once these patterns are strengthened, exercises such as squats, lunges, deadlifts, and pretty much every other multi-joint and compound exercise with increase abdominal strength and support.
This is where we begin to incorporate stability exercises. They should always be free weight based (machines will not build stability and improve movement patterns) and incorporate full body movements. Stability balls can be utilized very effectively once you have ensured that the proper firing patterns are happening in the hips and abs, so they are not the best place to start. The element of balance will reinforce the patterns you are trying to establish, however, if the correct firing patterns and movement patterns are not in place, working with the stability balls will exasperate the problems instead of correcting them.
The most effective and necessary technique to incorporate is unilateral training. Simply put, performing each exercise on one side of the body instead of both sides at the same time. This will give you the ability to focus on each muscle more effectively as well as identify possible imbalances between the right and left sides of the body. It is often these imbalances that create the most significant barrier to muscle firing and proper movement patterns. By working each side independently it is possible to identify and correct these imbalances. Gray Cook recommends performing up to 50% more repetitions for the weaker side until the imbalance is corrected.
When attempting to improve lateral hip stability, unilateral training is the only way to see and correct imbalances and weaknesses. If both feet are planted on the ground in a closed chain situation, a glute medius weakness is often missed as other muscles make up for the imbalance. A one leg squat, however, will instantly show you if your glute medius is stabilizing the pelvis. If you go into a one leg squat and your hip shifts a significant distance to the side, drops down or you have troubles balancing then you have some work to do.
During unilateral training it is important that the body remain straight in the vertical direction and that the hips, shoulders, and knees all remain in the proper alignment. See below for a description of what you should be focusing on with your hips. There should be no trunk rotation, shoulder rotation, or knee rotation, or lateral tilt of the pelvis. All of these areas should track in line with the direction of your foot throughout the movement.
Lastly, the TVA must be engaged and your back should be straight. Looking at your back, it should have the same curvature throughout the movement as it does when standing still with proper posture. This may mean you need to tuck the buttocks underneath the trunk, which will require both contraction of the abdominals and glutes.
Here is a list of some of the best exercises that will allow you to strengthen and improve your pelvic stability.
Planks are quite common around the gym now. Lying face down with only the tips of your toes and elbows touching the ground hold your body up in a straight line. The major technique flaw with planks, which you see all the time, is too much curve in the lower back. In order to ensure that your glutes and abs are providing the support for the exercise you need to squeeze your butt and tilt the pelvis underneath. You are looking to flatten the lower back to create that straight line from shoulder blades through to your legs. If your lower back arches down then your spine is taking more of the load instead of the target muscles (Glutes and Abs). Keep those glutes flexed and your transverse abdominus (TVA) activated by giving your bellybutton a slight pull inwards, and butt tilted underneath. Oh, and don’t stop breathing!
The hip bridge is essentially a reverse plank. Lying on your back with your legs bent at 90 degrees and feet flat on the ground, lift your hips until your body is in a straight line from knee to shoulder. Brace yourself with your hands and make sure you are next to a mirror. Now extend one leg out straight, ensuring that your thighs remain parallel to each other. There should be a small gap between your knees; your legs should be in a natural stance, so about shoulder width apart. As you lift the leg, ensure that the pelvis does not drop down to that side, or tilt away from you. It is always best to have someone watch you perform this exercise, as they will be able to better see slight changes in orientation. You should be feeling the gluts of the supporting leg working hard to keep the pelvis level.
Overhead squats and deep squatting patterns and movements are fundamental aspects of Gray Cook’s movement screen. The best thing you can do is find a trainer or strength coach who is familiar with these movements to teach them to you. If that is not possible, Gray Cook’s book and DVD will provide guidance for form and corrective techniques.
One leg squats, lunges, bulgarian squats, and step ups onto a box (your leg should be bent 90 degrees when you place your foot on box), are exercises that are familiar to most of you (if not you have some work to do as they all should be!). All of these exercises can be used to work on stabilizing the pelvic girdle as long as you pay particular attention to a few details. You will need an area with a mirror in order to watch your form, having a training partner or trainer watch as well will be of great assistance.
You are looking for a few key points for each exercise:
- Hips should be level. The pointy bit of your hip bone (iliac crest) that juts out is your measuring position. Ensure that they are level throughout the entire range of motion. Placing one hand on each side of the hips will provide you with an easy visual identifier to see if you are maintaining level hips.
- Pelvis should not rotate. You should have the hips oriented to the same direction your body is facing. Especially with lunges and step ups, an unstable pelvis will often result in a rotation of the hips. Those bone bumps at the front of the pelvis (ASIS) should always point forward.
- Pelvic floor angle. The easiest way to see this is to watch your lower back through the range of motion. If you begin to get a more pronounced inward curve as you move through the exercise you are most likely tilting the pelvis forward, and have relaxed your abdominal muscles. If this is happening you are increasing load on your lumbar spine. This situation is indicative of weak abdominal muscles. Imagine wearing a pair of jeans and placing both hands in the back pockets with your palms against your glutes and tucking the tailbone under the hips. You would feel your fingertips move forward and the palm of your hand move backward. This is changing the angle of your hips.
For lunges and step ups you should be aiming for no anterior/posterior tilt of the pelvis. For squats, you want to keep the pelvis as close to level as possible, however, there should naturally be a forward tilt at the bottom of the movement. To support this you must activate your TVA. So again, drawing in your bellybutton slightly towards your spine is the easiest way to accomplish this. You should feel your abs working for all of these exercises. Not to beat a dead horse, but in order for your glutes to contract and to raise your body upwards during the squat, your abs must be contracted and functioning properly, so the glutes have something to pull against.
For the first while you will find many of these things difficult and dropping the weight you are lifting will be necessary until you can ensure the technique is flawless. You will probably find yourself sweating a little more and your core temperature will come up as you actively engage almost every muscle in your body.
Maintaining the strength and stability of your pelvis will help to ensure you stay injury free. It can also help to increase your strength and often sport performance. Incorporate pelvic stability techniques into your program a couple of times a week and you will be able to maintain a strong foundation as you work towards your goals.
Often a simple change in the technique of your current exercises is all that is required to improve stability. Use the mirrors to watch the position of your pelvis, back, and knees, instead of just another day of posing.