How Pelvic Stability Helps Low Backs!

Jessica Bento, Physical Therapist (Creator DVRT Rx Low Back Course, DVRT Restoration Certification, Knees Over Toes Course, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Course)

Starting off a new therapist waaaaaaaaayyyyy back in the day, I really didn’t know how to progress exercises, I had no system of progression when it came to my patients moving beyond certain exercises. If a patient couldn’t perform a specific movement I just went and tried to find whatever exercise they could perform. Looking back I could have made a bigger impact if I had more of a system especially, when it came to pelvic stability exercises. 

I pretty much did the same with each patient, almost like a protocol, and just hoped that it worked. I really didn’t have a method to progress them beyond what the “books” would say. When it came to patients that needed to focus on pelvic stability exercises all I had in my tool box was a few variations of bridging, clams, pelvic tilts (which I can’t believe I used as I type the words but that’s for another blog someday!), really bad dead bugs and a few others, but all table based exercises nothing progress beyond supine or side lying  exercises. That was a huge mistake, as we are upright beings so we should be able to progress pelvic stability to standing or weight bearing exercises in order or to see if people can really stabilize in more functional patterns. 

So what is pelvic stability and why are we taking about it?

Pelvic stability refers to the ability of coordinated activity between the lower trunk and proximal hip muscles during functional balance and mobility tasks in which the pelvis serves the proximal dynamic stability as to allow for effective lower limb mobility [1]

Basically the bodies ability to stabilize the trunk so the lower limbs can move and function properly. Which allows for rather basic activities, such as walking. 

 

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How does the pelvis become insufficient or unstable anyway? Well, it can be things as basic as a sedentary lifestyle, sitting with poor posture or for way too long during get day, pain can cause compensations to occur, so several things can cause some instability to occur. 

Pelvic instability can often be the cause of low back pain or SI joint problems as well as cause faulty movement patterns, so it becomes a focus in the rehab setting. 

So when you see us performing dead bugs, bird dogs, as well as the bridge marching variations which are all amazing core stability exercises since they challenge our ability to keep a “quiet” trunk while our extremities are moving. Where do we go from there though? How do we take our pelvic stability exercise beyond the ground? This is why I wanted to go over some of the best pelvic stability exercise you may not be doing. 

Once we have solidify a strong foundation on the ground with our base pelvic stability exercises as mentioned above, we can progress to standing which is where people really don’t focus upon but it is rather important, if we can stabilize on the gourd but not in standing there is no carry over to that stability and we can see issues arise. 

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