Thursday 14 June 2018

Aligning Your Pelvis

by Beth
First, my disclaimer: Anatomy is not my strongest suit but through training, mentoring and study, I’ve learned enough of the basics to be able to execute and modify yoga postures to work with my body and those of my students. That said, here’s what I’ve learned about the importance of pelvic alignment generally and my pelvis specifically. 

I’ve always tried to do postures in the classic ways, but after menopause I began to experience a lot of discomfort in my hips, the right hip to be exact. Two years ago during a yoga training at Kriplau Center for Yoga and Health in Massachusetts, I learned the how, the why, and the what I needed to do to address the issue. 

The training I attended had nothing to do with anatomy but one of the free evening programs did. Always interested in beefing up my knowledge of anatomy in bite size pieces, I attended. Lee Albert, NMT, a recognized expert in neuromuscular pain relief, a massage therapist. and a yoga teacher, asked for volunteers who were experiencing pain in hips, back, neck, arms, shoulders, jaws, knees, etc. He put each of them in different physical positions, kept them there for about two minutes and then asked them how they felt. Without exception all said that their pain was either greatly reduced or gone. Then he explained the relationship between muscle imbalances and pain. In terms of the hips and pelvis, he said that the three main types of pelvic misalignments due to muscle imbalances are: 

Elevated Pelvis: One hip appears higher than the other. This is called Structural LLD and Baxter explained it clearly in his post, Friday Q&A: One Leg Shorter Than The Other

Rotated Pelvis: One side of the hip is more forward than the other.

Tilted Pelvis: A forward tilt that results in an exaggerated curve in the low back. 

The next day, I went to the spa desk to see if there was any chance to have a private session with him. There was one slot left and I took it. 

At the appointed time, he greeted me and invited me to take a seat in the chair at the far end of the room. We then chatted briefly about why I was there. He nodded, smiled and said that the way I had walked across the room and the position I took when I sat down told him a lot. He then had me lie on the massage table while he checked the natural external turn out of my legs. The upshot was that I have all three pelvic misalignments, most likely the result of muscle imbalances. After a few minutes of positional neuromuscular magic, he asked me how my hips felt. They felt great!

He listened to how I’d been doing my yoga postures and suggested that I might be over-stretching and making my imbalances worse. He then gave me a list of changes to make in how I sat, drove my car, and executed forward bends. The advice about forward bending was the same that Nina wrote about in her post Life-Changer: Bending Over Differently, which confirmed Lee’s recommendation and validated the way I’ve been forward bending since 2016! I also left with three yoga postures (see below) to address my muscle imbalances. He suggested that I do them three times a day for two weeks and said that if I did not find relief, I was to contact him. 

I literally floated out of the room. My whole lower body felt open, light, and full of energy. Because his recommended yoga practice was accessible and could be accomplished in 6-8 minutes at a time, I followed it exactly. It worked. Those three postures had been part of my practice, but doing them as a series, with modifications and holding each for 1-2 minutes completely changed my experience of them. 

I practice them regularly, and my hips and pelvis, are, for the most part, quite happy. Shakira, the Columbian pop singer, titled one of her albums, “Hips Don’t Lie.” Too true! Now, when my right hip screams, I have tools to turn the scream into a whisper. Here are the changes I’ve made to everyday activities: 

Sitting: I sit with a rolled pillow to support my lumbar spine (most of the time). 

Driving: My hands are now placed at the 8:00 and 4:00 positions on the steering wheel and a lumbar pillow is a permanent fixture in my seat. I’ve shared this tip with a few of my students and several have reported positive results. 

Working on the Computer: I keep my elbows close to my body with my arms bent at 90 degrees. Where I fail with this one is keeping the screen at eye level. I work on a laptop so until I purchase a separate keyboard and elevate the screen I’m only halfway there with this change. 

To manage my pelvic misalignment with yoga, I needed to work with three key muscle groups: quadratus lumborum (the hip hiker), the abductors (outside of the thigh), and the quads (front of the thigh) and learn how to stretch them correctly. That meant not stretching to my limit, which I am prone to do as an overachiever and perfectionist (see Yoga Therapy for Perfectionism). Instead I have learned to back off and stretch to roughly 80% of my limit and hold each posture for 1-2 minutes to focus the stretch in the belly of the muscle and not at the insertion points. If the stretch deepens during the hold, that’s okay as long as the impetus comes from the body and not the ego. 

The following series is now an indispensable part of my practice. I’ve found ways to do them standing, seated or lying down, so I have no excuse to neglect my hip and pelvic issues. 

Quadratus Lumborum Stretch: Standing Side Bend 

1. Come to a comfortable standing position.

2. Step your feet apart so they are slightly wider than your hips.

3. Place your left hand on your left hip or leg.

4. Inhale as you lift your right arm out to the side and up overhead.

5. Bend to the left until you feel a stretch along the right side of your upper body.

6. Hold comfortably while breathing easily. Start with 30 seconds and work up to 1-2 minutes (if your arm gets tired, rest it on top of your head).

7. Inhale to come up and exhale as you lower your right arm to rest in Mountain pose.

8. Repeat on the right side. 


Abductor Stretch: Supine Spinal Twist 

1. Lie on your back with both legs straight.

2. Bend the left leg and place the sole of your left foot on top of the right leg at a comfortable position (depending on your personal level of knee and hip joint flexibility).

3. Use your right hand to gently pull your left knee across your body and toward the floor. Feel the stretch on the outside of your upper leg and in your buttocks.

4. Hold comfortably while breathing easily. Start with 30 seconds and work up to 1-2 minutes. If your left foot slips off your right leg, you can let it ‘hang’ in the air if that feels comfortable.

5. To come out of the pose, inhale and release back to center.

6. Repeat on the right side. 


Quadriceps Stretch: Modified Dancer 

1. Come to a comfortable standing position with your feet about hip-width apart.

2. To help keep your balance, hold onto the back of a chair or place your hand on the wall.

3. Shifting your weight to your right foot, lift your back foot up behind you and bend your left knee. Then reach back with your left hand and grasp your left foot.

4. Bring your left heel toward the buttocks and press your thigh gently backwards. Feel the stretch in the front of your upper leg and be careful not to compress your lower back.

5. Hold comfortably while breathing easily. Start with 30 seconds and work up to 1-2 minutes

6. To come out, release your left foot and come back to Mountain pose. Rest there for a couple of breaths.

7. Repeat on the right side. 


There are other yoga postures that will address those three muscle groups and you can find several in the book Yoga for Healthy Aging by Baxter and Nina. If you would like more information about Lee’s work with pain and muscle imbalance, visit his website at www.leealbert.com


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For information on Beth Gibbs' classes and upcoming workshops, see Beth's Classes and Workshops and for information about Beth, ProYoga Therapeutics, and Beth's book and CD, see proyogatherapeutics.com.

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