Regardless of their goals, the first time I consult with a new training client, athlete or not, I want to get a good idea of what’s happening at their pelvis. After all, this is the center of their physical universe.
By evaluating the position and function of a client’s pelvis, and the musculature that moves and supports it, I can formulate a pretty accurate working image of how their body operates. This will help me to determine what weaknesses may be present, what activities are most suitable, and how I can best help the client.
Although it’s a great idea to get assessed by a trained professional, I realize not everyone has access to skilled trainers, doctors or therapists to evaluate their pelvic function. I’m hoping to give direction about a few simple partner-assisted tests that can shed some light on your own pelvic function, and possibly highlight a few areas where you might be able to improve.
I recently shared these techniques with Canada’s national champion and Olympic-hopeful beach volleyball partners, Martin Reader and Josh Binstock. Both men are very knowledgeable about athletic conditioning techniques and Josh is a chiropractor and kinesiologist himself. Since they live and train in Toronto, I wanted to be sure that these two elite athletes could monitor and assess each other’s pelvic function, which will help them to perform at their highest level.
With each of these assessments, pressure by the testing partner should be gentle, and the focus should be on identifying significant asymmetries between the two sides of the body. The person being tested should speak up instantly if any pain is felt at any time.
The position and alignment of your pelvis determines the quality of your movements and whether or not they are helpful or harmful to your body. Sometimes the large bones of the pelvic ring can become slightly misaligned, which affects the amount of internal and external rotation available at the hip joints. Although it takes talented eyes and hands, or imaging technology like X-ray or MRI, to get an exact assessment of pelvic alignment, a quick test of hip rotation can sometimes be a good indicator.
Start with the test subject lying flat on their back with legs straight. The tester should grasp one leg at the knee and foot, and bring the leg into 90˚ flexion, where the knee joint is positioned directly above the hip joint as shown. With the leg in this flexed, neutral position, the tester will rotate the thigh bone internally at the hip joint (the foot swings outward) and then externally (the foot swings inward), while keeping the knee in the same place and observing the amount of rotation. Ideally the test subject should have around 70-100˚ of total rotation with roughly a 2:1 ratio of external to internal rotation (ie. 60˚ external and 30˚ internal). Any serious restrictions in motion, or significant differences between the two hips, would call for more in-depth assessment and management.
Most of the movements we perform in our day require some amount of active hip extension. When lying face down, hip extension is required to raise a leg up off the table or floor. Ideally this action is performed in a proximal to distal sequence, meaning the muscles in the center of the body fire first to stabilize the pelvis, followed sequentially by muscles toward the extremities. To test this sequence, the test subject lies face down and the tester gently places a fist in the glute and hamstring of the leg to be tested. The subject keeps their leg straight and raises it 4-6” from the table. The tester should feel the big glute muscle fire to initiate the lift before the distal hamstring engages. If the hamstring fires before the glute, and the subject is unable to correct it, there is a faulty firing pattern that should be addressed. If the pelvis tilts or twists a lot, or the lower back arches excessively, inner-unit core stability may be insufficient and should be evaluated.
A great test of the ability to maintain a neutral pelvic alignment starts with having the test subject lie flat on their back with knees bent and arms up in front of their chest, with palms together. The tester holds the hands in place with one hand while attempting to push the knees to one side against the test subject’s resistance. The tester observes the alignment of the subject’s abdominal region and feels the quality of the resistance at the knees. With good 360˚ core stability and pelvic control the subject should be able to keep the back of the pelvis flat on the floor or table, without the knees moving to the side. Looking at the abdomen there should be no twisting or rotation of the abdominal muscles. Test both directions with equal pressure.