When there is an issue, when we are faced with a problem we often look at that one thing and forget to take a step back and see what relationships there might be. In this case we are talking about back pain and the spine. We often overlook the fact that the spine is connected to the sacrum and the sacrum is connected to our pelvis. Then the pelvis connects with our thigh bone and so on and so forth. The most important relationship here is between the spine and the pelvis. We can include the sacrum as part of the spine.
As this NPR article articulately describes, our posture, spinal health and relative pain has more to do with our pelvis than it does with upper body or abdominal strength. In fact the idea that have to strengthen are “core” or abdominal region to reduce back pain can sometime be misguided. I am speaking from the lens of a yoga asana practice and by no means an expert in physical therapy, but from my understanding of the muscles and movement of the body abdominal muscle engagement shortens the muscles in the front of the body which brings the spine into flexion, which would be the rounded position we find ourselves throughout the day. In contrast if we engage our back muscles that is what often brings us into a more upright position.
If we dissect our rounded, hunched back posture that we often take in front of the computer, riding the subway, looking down and reading or texting what we find is that our spine is in flexion. Further what we see is that our pelvis is tilted backward (or a posterior tilt, for all of you anatomy geeks). Now, this is a bit of a chicken or the egg situation, does our slouching of the back and our spine create the tilt in the pelvis or are we tilted in the pelvis that causes the slouch in the back.
The answer is that it doesn’t really matter. What we can do is bring awareness to our pelvic tilt and help our posture, our spine and possibly alleviate any back pain that you might have. Here are a few ways to get in touch with your pelvis.
Make your way to your hands and knees. As you inhale look forward slightly past your finger tips, lift the chest and let your belly begin to lower towards the floor. Additionally, lift your tailbone up towards the ceiling. This is an extension of your spine and anterior tilt of your pelvis. Then, on your exhale, start to round the spine by lowering your head, tucking the tailbone under and letting the spine round upwards towards the ceiling. Here we have flexion of the spine and a posterior tilt of the pelvis. Continue back and forth as you pay attention to the movement of your pelvis and lower back.
Stand with the feet approximately hips width apart. Bend the knees slightly and place the hands on your hips. Try moving just the pelvis forward and back, an anterior and posterior tilt. See if you can articulate this movement. Notice how this movement affects above, the spine, your back and the abdomen. Take note of how it affects the lower half, the thighs and knees.
Sit down on to a chair at a height where your feet can be flat on the floor. Explore these two movements of the pelvis once again. If the chair is firm you may even notice the ischial tuberosities, what we call the sitting bones, rock back and forth. Start off with a deep slouch of the back and then begin to sit up tall as you tilt the pelvis forward and bring it into a neutral position. Do you know notice the difference? Does it feel like work? It might, especially if we are not accustomed to sitting this way our back muscles may become tired and achy.
I will be the first to say that yoga is not a cure all and if you are experiencing any sort of pain for a prolonged period of time I would suggest seeking the advice of professional. However, if you find yourself in situations where you have to stay seated for a number of hours out of the day, it may be helpful to explore how you sit rather than how much.