Category Archives: anatomy moment

Anatomy Moment: A Trip Around the Hip

As we get into the summer months, I thought, what better time to write about the hip?  Just kidding -there’s no seasonal reason for my post, but I am inspired to spend some time breaking down the anatomy of the hip and pelvis, as I find in my classes and sessions that is it an often misunderstood (or not-well-understood) area.  As you know if you’ve been reading these posts for awhile, we are anatomy nerds here at Corpo Kinetic, and we love sharing.  Here we go!

What exactly is the hip?  In everyday language, it tends to reference a very broad area of the body including the boney points in the front where we would rest a belt, the musculature on the sides of the pelvis, and occasionally the glutes (butt muscles) as well.  Somewhere in that broad structure of bones and muscle we know there’s a joint called the hip socket or hip joint.  Are the muscles on the insides of our legs part of the hip?  What about the boney structure slightly above the glutes, in the center?  Is that low back or hip?

The general amorphous quality of the word “hip” explains why, if someone comes into our studio complaining of hip pain, our first question will likely be, “where in the hip?”  Outside of the Pilates studio, there may be no need to be so specific, but inside the studio, knowing specifically what part of your anatomy is bothering you can help us to better treat the cause of your discomfort.  When my anatomy brain starts to break down and explain the colloquial term “hip,” the first thing I go to is:

It’s actually many parts.

Look at that!  Look at how many labels there are!  And those are just the bones!  Those labels are just some of the many smaller parts which make up what we think of as the “hip.”  Labels and names are a fun thing to think about if you’re an anatomy nerd.  However, whether you’re ready to dive deep into learning anatomy or not, some basic knowledge about the function of our hip is useful in understanding why we have all those labeled parts.  When I think function of the hip, two things come to mind:

  • The hip is responsible for transferring the load of the upper body to the lower body.  (And that load includes the weight of the upper body as well as everything the upper body is carrying, from grocery bags to backpacks.)
  • Fluid mobility of the hip is crucial for keeping stress out of our knees, feet, and lower back as we bend, get up from sitting, go down stairs, and more.

Pilates works on creating stability in parts which are too mobile and mobility in parts which are too sticky.  When we look at core function, hip musculature which is not mobile enough can decrease the ability of your core to fire correctly.  On the flip side, hips which are too mobile can transfer unwanted movement up into the lower back, potentially causing pain and injury.  It’s all about balance, and luckily that’s something we thrive at in Pilates – creating balanced support for the body.

Let’s get down to business.  Here is our picture from before, a side view of the right hip.

If we were to have this person take a quarter turn and face us, we would see something like this, a picture of the right and left hips, connected by the pelvis:

Let’s break it down!  My first matter of business is a small clarification from the perspective of anatomical language.  “Hip” is a vague term, as discussed above, so for clarity I prefer to talk about the “hip sockets and pelvis.”  Remember all that other stuff from my initial question, “What is the hip?”  We had:

  1. boney points in the front where we would rest a belt
  2. the musculature on the sides of the pelvis
  3. the glutes (butt muscles)
  4. a joint called the hip socket or hip joint
  5. the muscles on the insides of our legs
  6. the boney structure slightly above the glutes, in the center

Number 4 from above is the hip socket.  The rest of the bones listed above (1 & 6), are part of the pelvis.  Numbers 2, 3 and 5 I would call muscles which move the hip socket.  Are all of these part of the hip?  Yes because that’s how we tend to talk about it in everyday language, and no because the hip socket is actually a very small component of the area we tend to refer to when we say hip, and the rest of our boney structure is the pelvis.

Starting with the pelvis, if you were to sassily put your hands on your hips, they would most likely land on a ridge of bone which wraps around the sides of your body, including the back and the front.  That ridge is part of one of the most easily felt bones of the pelvis called the ilium (actually, you have two, a right and left ilium).  Your hands are resting on a part of the bone called the iliac crest.  It’s easily felt because it’s not densely covered in muscle, as is the majority of the rest of the ilium.  The ilium bones serve several important functions, including housing and protecting our pelvic organs (those are important!), and providing large surface areas for muscles which move the hip socket to attach.

If you follow that ridge to the front and down a couple inches or so from the top, you’ll find a more pointy part which sticks out to the front.  This point is called the “anterior superior iliac spine.”  (Got that?  Anatomists often call it ASIS for short, so let’s follow their lead.)

The parts of bones which are easily felt and sort of “stick out” are often referred to as “boney landmarks” because they give us information on the placement of things we can’t as easily feel or see beneath the surface.  The ASISs are an important boney landmark for looking at the levelness of your pelvis.  Your Pilates instructor might check the levelness of your right and left ASISs to determine if your pelvis is level side to side.  We can also use the ASIS with other boney landmarks to determine if your pelvis is level front to back.

If you walk your hands back up to the top of your iliac crests (where you put your hands sassily on your hips earlier) and then follow the crest towards your back, they will slope down and together.  As you follow those slopes, you might feel two little dimples.  These are your sacroiliac joints, or SI joints for short.  In very close proximity to the SI joints are the posterior superior iliac spines (PSISs).  When you are standing and the PSIS and ASIS are level, then your pelvis is level front to back.

Did you have a hard time feeling the dimples or PSISs?  Don’t worry.  They are far less prominent than the ASISs.  When I was a new instructor, it took me quite some time and checking multiple different pelvises before I felt confident that I was on the right spot.  We use the PSISs as instructors because it is more precise, however a far easier way to check where your pelvis is on your own (and for everyday use precise enough) is to use a different boney landmark.

So – come back to your sassy hands on hips position.  Follow that boney ridge, your iliac crest down to your ASISs.  Keep walking your hands down and together.  We have more muscle here, so you may loose track of the iliac crest – you can use the crease in your pants where the leg meets the pelvis as a guide.  When your hands meet in the center, you’ll be on what we often refer to in the Pilates studio as the pubic bone.  If you look back at our front-facing picture above, they’ve labeled the point in the center as the “pubic symphysis.”  We actually have two pubic bones, a right and a left, which are connected by a dense and fibrous tissue called the pubic symphysis.  This connection is mostly immobile (and should be).  Fun fact, during pregnancy the body releases a hormone which relaxes all ligaments in preparation for birth, including the fibrous pubic symphysis.  This is why we modify certain leg exercises for momma’s-to-be.  Mommas need to be strong, and in most cases can work out hard, but we want to promote that strength without creating shearing at the pubic symphysis.

So – you know where your pubic bone is and where your ASISs are.  If you put the heels of your hands on your ASIS’s and your fingertips on your pubic bone, you can now line up your ASISs and your pubic bones in a vertical plane.  This is another way to tell if your pelvis is level front/back, and usually fairly easy for us to check on our own.

Let’s land on the iliac crests again (sassy hips), then take our trip back around to the PSISs and SI joints.  Walk your hands one more time down and together along the iliac crests and eventually land on those dimples.  Remember that the name of those dimples is the Sacro-Iliac Joint.  Iliac stands from the ilium part of the joint, which we’ve already visited.  Sacro stands for the sacrum, which is the broad flat part in the center back of your pelvis.  Here’s a view of the pelvis and hip joints from the back, as if the person were facing away from us.

It provides a good view of the slope down from the iliac crest (sassy hips!) to the sacroiliac joints, and the sacrum nestled in between the right and left iliums.   At the base of the sacrum lies the tail bone, or coccyx.  There is actually also a joint between the sacrum and coccyx, and the tailbone can move, occasionally being displaced.  The name of this joint is kind of fun:  sacrococcygeal.

At this point, we’ve visited three joints of the hips and pelvis which we often don’t think of as joints: the pubic symphysis (front, down, and center), the sacroiliac joint (on the back, the dimples at the top of the sacrum), and the sacrococcygeal joint (between the sacrum and tailbone).  These three are joints because they do move, but key to their health is that they actually don’t move very much.  Most of the movement in our hips and pelvis should come from the true hip joint – where the thigh bone meets the pelvis.  This joint is a classic “ball in socket” joint, and it’s mobility allows us to squat to the floor, climb mountains, ride horses, and much more.  This is the joint that we want to keep mobile, in all planes of motion, so that our smaller, less mobile joints are not overly stressed.

Phew!  I hope you’ve enjoyed this trip around the hip.  Now take your newfound knowledge and move it!  If you’re not coming to the Pilates studio today, taking a walk up some serious hills is a great way to get mobility and strength in your hips.  See you soon!

Anatomy Moment:  What is the core, really?

“Engage your core!”  You’ve probably heard this over maxim over the course of your life, whether in a group fitness class, at your Pilates studio, or maybe from your doctor advising you on how to safely lift those heavy items.  Even in the Pilates studio, where we’re known for core strengthening, what exactly we’re strengthening can be misunderstood, which brings me to today’s Anatomy Moment.  What is this elusive core?

The Intrinsic Core.   The intrinsic core, AKA intrinsic stabilization system, is most often what is meant when fitness instructors yell out “use your core!”  While “core” most often brings to mind images of abs, the intrinsic core is actually a group of four muscles, and only one of those is part of the abdominals.

The intrinsic core is:
1) Your transversus abdominis.  The deepest layer of the abdominal wall.  These muscle fibers run horizontally, like a cummerbund around your waist.  Although they are an abdominal muscle, they don’t perform the typical sit up motion.  Instead, when they fire, they draw the abdominal contents closer to your spine, creating support and stability.  In your Pilates class, you’ve probably heard mention of “scoop your belly,” “bring your belly button towards your spine,” or “narrow your waistband.”  All of these are cues used to help you engage your transversus abdominis.2) Your multifidus muscles.  I love the multifidus muscles.  The are tiny muscles which run up your spinal column like stitching, connecting one vertebrae to the next (or in some cases to the second one above).  Like the transversus absominis, the multifidus are deep – they are very close to the vertebrae.  While the job of most back muscles is to create a back-bend, or extend the spine, when the multifidus fire they actually create support, holding space between the vertebrae.  This is a great thing for our spinal discs and nerves – space between the vertebrae allows for the nerves to exit the spinal column without impingement, and for the discs to remain healthy and plump, avoiding things like herniation or degeneration.  In simpler terms, multifidus are great for preserving a happy, healthy back over the long term, and I often see weak or inactive multifidus muslces when a client has back pain.  When you hear “lengthen your spine,” “sit tall,” or “elongate” in your Pilates class, these are cues to help the multifidus muscles fire.

3) The diaphragm.  The diaphragm is the main muscle of respiration, contracting with every inhale to pull air into the lungs, and relaxing with every exhale.  In your Pilates class, you are told when and how to breathe, and here’s why: the diaphragm is an integral part of your core.  The diaphragm sits at the base of your ribcage.  In relationship to the instrinsic core, I think of the diaphragm as the ceiling, the transvursis abdominus as the front and side walls, and the multifidus muscles as the stitching up the back.  All we need now to complete this cylindrical support system is the floor, which brings us to:

4) The pelvic floor.  While I’m listing the pelvic floor last, it is by no means the least important muscle of our intrinsic support system.  While most of us are relatively unaware of our pelvic floors in day-to-day life, we use them every day.  Excuse the crude example, but if you’ve ever been stuck in traffic and really had to go to the bathroom, your pelvic floor was contracted and working hard until you finally made it to the safety of a restroom. In daily, less-dire situations, the pelvic floor works with the diaphragm, which is contracting and relaxing with every breath, to maintain a  healthy amount (not too much or too little) of intra-abdominal pressure.  Ideally, this pelvic floor acts as a “pilot light” for the transversus abdominis and multifidus muscles.  As the pelvic floor fires, the transvursis abdominus contracts as well.  In a healthy core, the multifidi will fire at this time as well, and again, I’m emphasizing in a healthy, functional system, all of this will happen and our intrinsic core will be engaged before any arm or leg movements begin.  Ideally, this happens unconsciously.  It is also important to keep in mind that the intrinsic core is a dynamic system.  The core doesn’t bear down, brace, and hold.  Instead it maintains an appropriate amount of muscle tone based on what you are doing.  Less tone should be present if you are sitting on the couch, more if you are hauling rocks out of the yard.
If you have had back pain, had an injury, or tend to sit a lot, chances are this may not be happening optimally for you.  This is why we spend a lot of time in Pilates with very explicit directions for very simple movements.  You might hear,  ” Inhale to prepare.  As you exhale, narrow your waist, engage your core, then float your leg to table top.”  All that just to lift a leg!  The reason being is that we are retraining the core to fire before movement happens.  That muscular anticipation is magical.  It protects our spinal nerves and our discs from injury.  It creates support through the pelvis and lower pack so that we can do big, powerful movements with our arms and upper body.  The core is a big deal.

Anatomy Moment: Fascia Matters – but what is it?

roll-release4I have the pleasure of working with several clients whose work lives are in marketing.  One of them told me recently that “fascia is trending!”  I was secretly thrilled by this news, because anything trending that has to do with anatomy is just right up my alley.

If you’re like many of us, you may have heard of fascia, but you may be somewhat confused about what exactly it is, or why rolling on a foam roller or pinky ball helps your body. On that note, I give you Corpo Kinetic’s most recent Anatomy Moment: Fascia Matters.

Fascia’s family.  Fascia is classified as a “connective tissue.”  Connective tissue is a large, somewhat convoluted category which includes: bone, cartilage, ligaments, tendons, blood, lymph, fat, and fascia.  One of the main roles of connective tissue is to provide physical support for the body, and the network of fascia is no exception.

What is fascia? Fascia surrounds all structures in our body.  It is a slippery material which reduces friction and permits easy movement.

For example, as you bend your arm, your bicep contracts, and as the muscle shortens it must glide easily across the underlying arm bone and the overlying skin.  If we didn’t have fascia, as we moved our muscles would rub on bone, nerves, skin, and blood vessels.  Think of an old track of carpet in the main passageway of the house which, after years and years of being walked on, has worn down to the threads.  Fascia prevents friction from causing a similar phenomenon in our bodies.
What is an adhesion?  If there is a problem in the fascial layers and they aren’t gliding properly, the fascia layers will adhere.  While this does prevent friction, it can create problems down the line.  Imagine pushing a shopping cart easily down the aisles – all four wheels spinning equally.  Now imagine that one of the wheels is sticky and no longer gliding right.  Instead of an effortless stroll, you’d be contorted and working unevenly to get that cart to roll in a straight line.

An adhesion is kind of like a “sticky wheel” inside the body.  If one part isn’t moving due to an adhesion, other parts will be moving or working too much, and pain can develop.  Some people feel pain around the adhesion or stuck area, and others feel pain around the part which is overworking.

roll-release2What is myofascial release? “Myo” stands for muscle, “fascial” is for fascia.  A myofascial release addresses fascial adhesions and tight muscles, working to release areas of tension.  Massage therapists perform myfascial release, and Pilates instructors will often use foam rollers and massage balls to show you how to perform releases on your own.

Ok, I have a foam roller and a pinky ball… Now: How often should I use it? For how long? When will I feel better?  

Rolling doesn’t have to take long, and is actually more effective if you do it more frequently for shorter periods of time than less frequently for longer periods of time – aim for 5-10 minutes a day.  While the length of recovery depends on many factors, I’ve seen significant improvement with rolling every day for only two weeks.

roll-releaseWhat should I roll?  How do I roll _______? You’re in luck!  Starting June 6, Corpo Kinetic will be offering monthly Roll & Release workshops.  Each workshop will include a brief anatomy discussion – what are we rolling and why? – before diving into 45 minutes of pure rolling bliss.  You’ll leave feeling better, and will have tools for self-care at home.

Anatomy Moment: Your Spine and Pilates

Happy, healthy spines start here

Our spines do important jobs for us – they allow for a wide range of movement, they support our upright posture, they transfer the weight of our upper body to our pelvis and lower body, and they house and protect our spinal cord, the neural pathway for sensation and motor control to the rest of our bodies.
Our spines are composed of 24 vertebrae, and while the individual vertebrae have regionally specific features, they also have basic components in common.  Each vertebrae has a large, rounded body, an open vertebral foramen, and several protrudingprocesses.

Body: The body of the vertebrae is designed to support weight and transmit load to the pelvis and legs.  When your Pilates instructor cues you to stack your spine, you are aligning the bodies of your vertebrae to best transmit force.  In between the bodies of the vertebrae lie our intervetrebal discs.  A slipped or herniated disc is one which has been pushed from its spot between the vertebrae, and is (most often) protruding partially into the vertebral foramen.

Vertebral foramen: The vertebral foramen is the passageway for the spinal cord and spinal nerves.  When the vertebrae are stacked, the vertebral foramen line up, forming an open canal for the spinal cord to pass.  A slipped or herniated disc which is protruding into the vertebral foramen may press on and irritate our spinal nerves – not a happy scenario.  Most back problems occur in the low back, which bears the load for the rest of the body.  As Pilates instructors, we spend a lot of time discussing how to utilize your core to stabilize your lower back.  When we load our spine, we want a stable, neutral lower back to protect that nice, open passageway for our spinal nerves.

Processes: Each vertebrae has three processes, or bumpy protrusions.  The spinal processes can be felt through our backs, and each vertebrae also has two transverse processes which project to the sides.  Processes provide a site for the complex network of our spinal muscles to attach: from our deepest three layers of intrinsic muscles, to the intermediate muscles of respiration, and finally to the superficial muscles whose contours we can readily see through the surface of the skin.

janet-lowbackOur spines are complex and fascinating, and the Pilates method has evolved as an ingenious way to keep your spine happy and healthy.  A healthy spine is mobile, and in your Pilates class, you work on spinal articulation – promoting mobility of each segment and activation of our deepest spinal musculature.  A happy spine is supported – all your core work in Pilates helps maintain that neutral, supported alignment as you cart groceries, sit at your desk, or pick up a child.

I have helped many people with unhappy lower backs strengthen and mobilize to get out of pain and back to life, and I believe that Pilates is unique in its comprehensive treatment of the spine.  Thank you for allowing me to share what I love!