chapter 10 pelvis

Introduction to Wisdom Teeth and Personal Anecdotes

  • Personal stories and experiences related to wisdom teeth removal and surgeries.

    • Concern for frequent strep throat in family members.

    • Surgeries mentioned include wisdom teeth, ACL surgeries.

    • Anecdotes about behavior during recovery, including humor and performances.

Pelvis Anatomy Overview

  • No muscles to memorize; however, understanding of structures required.

  • Pelvic Anatomic Components:

    • The pelvis as part of the appendicular skeleton.

    • Discussion about the joints: SI joint (sacroiliac), lumbar sacral joint, coccyx, pubic symphysis.

Sacred Joints

  • SI Joint:

    • Connection of sacrum to the ileum.

    • Key point of focus in pelvic motion discussions.

  • Additional Joints:

    • Lumbar sacral joint (L5-S1 articulation).

    • Pubic symphysis (cartilaginous joint).

Motion Dynamics of the Pelvis

  • Movements mainly focused on SI joint - nutation and counternutation:

    • Nutation: Sacral flexion, where the superior sacrum rotates forward and inferior sacrum moves backward.

    • Counternutation: Sacral extension, where the superior sacrum moves back and inferior part moves forward.

  • Minimal movement observed in clinical scenarios, but attention drawn to potential shifts (side-to-side) rather than forward or backward.

Practical Application of Movement Concepts

  • Practical mobilizations discussed for SI joint adjustments.

  • Mobility and tightness of surrounding muscles affecting SI joint position.

Anatomy and Function of Pelvic Components

  • Anatomy of pelvic girdle and understanding of structural components including:

    • Innominate bones (ilium, ischium, pubis).

    • Anterior and posterior pelvic tilting.

Tilting and Rotational Mechanics

  • Anterior Pelvic Tilt:

    • Creates increased lumbar lordosis, increases hip flexion.

    • Identified when ASIS positioned anterior to pubic symphysis.

  • Posterior Pelvic Tilt:

    • Flattens lower back, reduces lumbar lordosis, increases hip extension.

  • Lateral Pelvic Tilt:

    • Named based on which side is lower (i.e., right pelvic tilt = right side lower).

    • Resulting muscle actions: ADduction on higher side and ABduction on lower side during lateral motions.

Pelvic Rotation and Shift

  • Pelvic Rotation:

    • Identified by which side is more anterior (forward).

    • Forward rotation linked to improper functioning of rotators.

  • Lateral Pelvic Shift:

    • Describes a transverse motion of the pelvis, shifting center of gravity.

    • Connection to gait and standing postures.

Sacrum and Coccyx Structure

  • Sacrum:

    • Comprised of five fused vertebrae.

    • Articulates with fifth lumbar vertebra.

    • Discussion of foramina and relevant bony landmarks.

  • Coccyx:

    • Mentioned as distinct from sacral anatomy, but no specific details provided importancewise.

Ligamentous Support Structures

  • SI Joint and Related Ligaments:

    • Includes anterior, interosseous, posterior ligaments.

  • Pubic Symphysis Ligaments:

    • Mentioned but no specific details needed.

  • Reinforcement of lumbar ligaments (anterior and posterior longitudinal) and how they interact with overall skeletal function.

Clinical Applications of Pelvic Anatomy

  • Differences between the male and female pelvis illustrated by shape and orientation.

  • Clinical relevance of assessing pelvic structural alignments in physical therapy.

  • Overview of hip joint dynamics and their relevance in assessing dysfunctional motion.

Muscular Connections and Their Role

  • Overview of muscle groups associated with pelvic tilt:

    • Anterior Tilt: Hip flexors (e.g., iliopsoas) and trunk extensors (e.g., erector spinae).

    • Posterior Tilt: Hip extensors (e.g., hamstrings and gluteus maximus) combined with trunk flexors.

  • Role of gravity in maintaining posture and lateral pelvic tilts.

Stretching and Strengthening Routines

  • Discussion of tightness and stretching principles:

    • Hip flexors may require stretching when tight; hip extensors may require strengthening if weak.

    • Mention of reciprocation principles akin to upper body muscle groups for maintaining balance.

Concluding Notes & Questions

  • Encouragement to consider physiological principles in practical applications of pelvic anatomy and mechanics.

  • Inquiry about understanding and retention of material.

Appendix - Quick Reference Points

  • Systems of movement associated with anatomy:

    • Anterior/posterior pelvic tilt mechanics.

    • Rotation identification methods.

    • Lateral shifting principles and postural implications overall.