Pelvic pain affects individuals of all ages and genders and more so now due to our sedentary lifestyle; however when it comes to the treatment of pelvic pain, the musculoskeletal contribution and the role of posture is hardly ever considered. In this blog, we will delve into the reasons why your pelvis might be hurting, with a particular focus on the impact of posture.
The Anatomy of the Pelvis
Before we dive into the relationship between posture and pelvic pain, let’s understand the anatomy of the pelvis. The pelvis is a complex structure comprised of bones, muscles, ligaments, and joints. It provides support to the spine, houses and protects the reproductive organs, and acts as a foundation for the lower limbs. The position and alignment of the pelvis are crucial for maintaining proper balance and stability throughout the body. You can learn the details about the anatomy of the pelvis and pelvic floor in this blog.
Pelvis bones (courtesy of https://orthoinfo.aaos.org/)
How is Pelvic Pain Related to Posture?
- Misalignment:
Poor posture, such as slouching or tilting the pelvis forward or backward, can disrupt the natural alignment of the pelvis. This misalignment puts strain on the muscles, ligaments, and joints surrounding the pelvis, leading to pain. Over time, this strain can lead to chronic discomfort and contribute to conditions like pelvic girdle pain.
- Muscle Imbalances:
Poor posture often results in muscle imbalances around the pelvis. For example, sitting for prolonged periods with a slouched posture can weaken the core muscles, including the abdominals and glutes, while overworking the hip flexors and lower back muscles. These imbalances can create tension and pain in the pelvic region.
- Increased Stress on Joints:
Maintaining an incorrect posture can place excessive stress on the joints within the pelvis, such as the sacroiliac joints and pubic symphysis. This additional stress can lead to inflammation, joint dysfunction, and pain.
- Nerve Compression:
Poor posture can also compress nerves that pass through or near the pelvis, such as the sciatic nerve. Nerve compression can cause radiating pain, numbness, or tingling sensations in the pelvis, buttocks, and legs.
How to Improve Posture for Pelvic Health?
- Sit Correctly:
When sitting, maintain an upright posture with your feet flat on the floor. Use an exercise ball instead of the chair which activates the portion of the brain in charge of the upright position command. Through positive neuroplasticity, you can maintain a much better posture. Here is an exercise to activate the same portion of the brain that is in charge of better posture:
- Stand Balanced:
When standing, distribute your weight evenly on both feet, keep your shoulders square, and engage your whole trunk. Avoid excessive tilting or arching of the lower back. Here is what to watch for:
- Exercise Regularly:
Not every exercise is the same! We should never load a joint that is not centrated since that leads to injury and the stall in going to the gym. The best exercises that make sense to me, and hopefully to you align with the movement exercises that all babies do! Yes, if all babies go from helpless infants to running toddlers with no weight, bands or gyms, then why should we reinvent the wheels. Developmental exercises such as DNS or Dynamic Neuromuscular Stabilization are the type of exercises we do with our patients to bring back functionality in their movement and coordination of movement with their posture.
- Take Frequent Breaks:
If you have a sedentary job or spend long hours sitting, take regular breaks to stretch and move around. This can help relieve tension in the pelvis and reduce the risk of developing pain. This goes for everyone with or without pelvis pain.
What Kind of a Doctor Treats Pelvic Floor Dysfunction?
While there are many clinicians that treat pelvic floor dysfunction, the right kind of doctor is the one that looks at the issue from all angles and not only addresses the cause of the dysfunction (directly or refers out) but also treats the feeders of the cause as well. It is reasonable to say that regardless of what causes pelvic pain, the pain itself creates postural deviations and pelvis instability enough that THAT feeds the problem in a feedback loop. It is therefore important to attend to the functionality in movement, breathing and coordination of movement regardless of what else is causing the pelvic pain. Here is a video worth noting:
In my blog, “Are yoga exercises good for pelvic floor dysfunction?”, I outline what a comprehensive treatment for pelvic floor dysfunction should include. If you have chronic pelvic pain and your treatment seems to provide temporary relief or have limitations due to your pelvic pain, contact me.
Dr. Shakib
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