THE PELVIS : THE ART OF ANATOMY

“The pelvis is a 3 part bony ring consisting of two innominate bones, an intervening sacrum, two diarthrodal sacro-iliac joints posteriorly, and a pubic symphysis anteriorly. The lumbar spine consists of 5 vertebrae and has 18 articulations. Together, they form a multi-link system of 8 skeletal segments commonly referred to as the lumbo-pelvic region.”

“The lumbo-pelvic region performs many functions… The sacrum functions primarily to sustain longitudinally applied loads, providing a base for the spine and protection for neural and visceral structures. The innominate bones function to sustain multidirectional loads, to provide a base from which leg and trunk musculature can act, and to protect neural and visceral structures. The sacroiliac joints permit controlled, acting to transfer load between the sacrum and innominate bones (between the trunk and lower limb). The five lumbar vertebral bodies function to sustain longitudinally applied loads and protect neural structures. The laminae and spinous and transverse processes function to protect neural structures and provide for muscle attachment to the spine. The intervertebral discs and zygapophyseal joints act to transfer and attenuate load between vertebrae and permit controlled motion.”

The above is a nicely articulated excerpt from the PhD thesis of Dr Steve Saunders, whom has been a mentor of mine for the past 8 years. Not the lightest of reads, but the complexity of the research reflects the complexity of the area.

An anatomical jigsaw, load transfer from three directions, force generation from trunk musculature and gravity, and the requirement of a delicate balance of mobility and stability for proper function means there is plenty of room for dysfunction to occur. But it also means that a lot of dysfunction can be managed by appropriately maintaining the equilibrium around the pelvis and lumbar spine.

The impact of treating the lumbo-pelvic region is enormous. This balancing act is best described as an art. The effect of a pelvic dysfunction can rotate the hip to predispose knee and foot injuries; or it can rotate the thorax in relation to the pelvis leading to thoracic pain, neck pain, headaches or breathing difficulties.

The pelvis in essence the centre of the universe for our bodies. If it’s in trouble our whole universe sucks. So, let’s pay it some attention.