How to Self-Assess Your Movement Pathologies

Jennifer Pilotti

Coach

Yoga, Personal Training, Mobility & Recovery

A few years ago, I went to a workshop for a system that was gaining a lot of traction with well-respected fitness professionals. The workshop began with the anatomy of the diaphragm and ribs, eventually segueing into potential influences on the pelvis and femur.

 

As we went through the tests the system used, it became evident I was failing. By failing, I mean the relationship of my pelvis and ribs was less than optimal or, to borrow their terminology, pathological. As the instructor talked about all of the horrible things associated with this particular pattern, I found myself perplexed. I didn’t have any of the pain he was describing, but I clearly lacked a “neutral” resting position.

 

 

I went home and did what any good type-A-overachiever would do. I read the manual and began applying the techniques to myself, curious if I could “fix” my pathology, despite the instructor’s warning that if you were as messed up as I was, you needed a professional to perform manual techniques.

 

After quite a few months, several additional workshops in the system, and a couple of mishaps that involved deep internal bruising caused by repeated forceful exhalations and an irritated left hip from using a specific re-positioning technique because when I am told to contract I contract very hard, I found myself able to do movements and skills that had not been available to me previously. I no longer failed the system’s objective tests: I was passing, or “neutral,” as they described it. And though I felt different, I didn’t necessarily feel better, but again, I hadn’t really felt bad before.

 

Awareness Through Movement

In the midst of all of this, I began using Awareness Through Movement lessons, auditory lessons based on the work of Moshe Feldenkrais. Of all of the things I had tried and studied (and by that point, there were quite a few), the influence of the lessons on my body was profound. I began playing with concepts from both the lessons and other systems, as well as implementing things I was learning about motor control theory, gait, and nervous system activity while working with my clients. They began to feel better than they had in years and their movements changed. I could tell I was figuring out how to deliver what I was learning in a way that worked in a training setting.

 

However, the hip that was angered by the initial attempt of self-improvement was still an irritant and occasionally I felt like something was off. I have always done yoga and strength training, but I needed to stop over-coaching myself. Instead, I put my programming in someone else’s hands, followed the program exactly, and not only did my hip pain clear up, I began to feel a little bit like superwoman because I had developed the efficiency, proprioception, and back mobility to support the work I was doing and develop strength in a variety of ways. I could tolerate a fairly high volume without feeling vulnerable to injury because I had done, at that point, four years of preparatory work.

 

So what, exactly, did I do? I just want to remind everyone reading this I didn’t have any pain when I began my journey, so I am not offering a solution to pain. I became more efficient by changing my pattern, which opened doors to more mobility. I also had less sympathetic tone because my proprioception had substantially increased. The only way to get physically stronger is through repeated exposure to a stimulus that’s more than you are accustomed to, so I didn’t make myself stronger, exactly, though it could be argued I became stronger in a different way than I was before. Before we dive any further, let’s talk about what my pattern was.

 

The Role of the Ribs and Pelvis

I lived with my ribs flared and my pelvis tipped forward. For women, this is the typical “athletic” posture gymnasts have when they finish a routine, arms up, chest lifted. For men, this resembles the look many athletes have—the dip in the low back with the lower ribs lifted. It’s rigid in nature, and society rewards it because it looks pleasing to the eye. It indicates a powerful presence or, in my case, made me feel like I was standing up tall (at 5’1” the more height I can get, the better).

 

What happens when strong patterns are adopted is it becomes difficult to move the other direction? Movement options become limited, and when the area that’s become locked, for lack of a better word, is the center of the body, it’s going to affect mobility at other joints, since the upper and lower extremity attaches to the torso and pelvis, respectively.

 

The easiest way to change a strong pattern is to slowly introduce other options and make sure the person in question feels both different parts moving. It will feel like work at first because your muscles aren’t used to keeping the joints in these different positions.

 

When you are working on the ribs and the pelvis, there are a few ways to get things to move more fluidly and to be most effective, it requires integration with the breath. The diaphragm and the lungs are positioned so that the ribs can move during the inhale and exhale. If the ribs don’t move during breathing, that’s going to affect how the thoracic spine moves. Additionally, the diaphragm and the pelvic floor work together. When you inhale, both your diaphragm and pelvic floor move down. When you exhale, both move up. So we can also say that breathing allows the pelvis to move a little bit, except it doesn’t when the pelvis stays in one position and never deviates.

 

 

Assess the Movement of Your Ribs and Pelvis

Here is what my adventures (and misadventures), taught me—the ribs and the pelvis can move in a variety of ways. The breath is an instrumental part of experiencing the sensation of work in the abdominals which increases a person’s sense of stability. Isometric contractions are important but are best taught after the person has had a chance to move in and out of the position a few times.

 

Different techniques have different places they like to start (and the rationale for all are legitimate). I like to start at the ribs because for most people the rib area seems to feel less vulnerable than the pelvis. An easy way to feel the ribs moving is to lie on your back with your knees bent and your feet flat on the floor. Take your right arm up in the air and the left hand on the left rib area. Begin reaching your right hand towards the ceiling. You will feel your right shoulder move away from the floor and your left ribs move towards the floor behind you and towards the pelvis. Do this 3-5 times.

 

Did you feel your ribs move? If the answer is yes, you are ready for the next instruction. Is this subtle? Yes, but that’s the thing—our current fitness culture has moved away from the basic principles of movement. Things like reaching in a relaxed manner should incorporate rib and shoulder blade movement and fixates instead on cues that feed into a more rigid posture. When you are lifting a heavy weight, you need rigidity otherwise you aren’t going to have the structure to support the load. However, when you are reaching for a glass on the top shelf, you need less rigidity and more give. Like all things, there’s a time and a place for maximizing intrabdominal pressure and a time and a place for letting your body just move.

 

Back to the instructions. This time, do the same thing, but as you reach, exhale and as you lower the shoulder back to the mat, inhale. Does that make the rib movement more clear?

 

On the last reach, with your right shoulder off of the ground and your left hand feeling how your ribs move down and back hold this position for three breaths. With each exhale, see if you can let your exhale be a little bit longer. With each inhale, try not to let your ribs pop forward. Repeat the entire sequence on the other side.

 

There is video of this below. It doesn’t look like much, but if you aren’t used to the position of the ribs, you will feel sensation in the abdominals. You can also add a ball between your knees, not to squeeze, but to gently hold so your legs don’t flop open (a common tendency for people with a more extended pattern).

 

 

Another way to do this in a hands and knees position. The video below shows a yoga egg horizontally across my back, right under my shoulder blades. I move the ribs that are located under my shoulder blades towards the ceiling and away from the ceiling three times, exhaling as I lift my ribs up and inhaling as I relax down. On the last one, I hold the rounded position and imagine my breath is going right across my back into the yoga egg. This encourages the muscles located at the bottom of the sternum and directly underneath to contract against gravity and hold the position. (This is the area I bruised with breathing way back when. It hurts just to think about it).

 

 

Next, let’s look at the pelvis. As mentioned above, a rigid pelvis doesn’t help with breathing mechanics. During the gait cycle, the pelvis (which operates as two halves when you walk) moves in a variety of ways—forward, back, sideways, and up and down, depending up which leg is swinging forward and which is on the ground. If your pattern is to walk around with a pelvis that has very little movement any direction other than anteriorly, you are limiting mobility in your hips. Since the hip socket is located on the pelvis, this should make sense. A pelvis that can move translates into hips that can move.

 

The exercise below is one of many ways you can isolate movement at the pelvis. I begin with a forearm and knee position with the yoga egg at the base of my sacrum where it connects to the pelvis. I like to pretend I have a tail (weird image, I know, but bear with me), and I am moving the tail between my legs. I feel the egg move up. Now, I move my imaginary tail up towards the ceiling, moving the egg down. After 4-6 times, I hold the tail between the legs position and I reach one leg out at a time, coming into a hollow body plank (just a fancy way of saying a plank position with the pelvis posteriorly tilted). I hold this position for six breaths, imagining that when I inhale, the breath is expanding the back of the rib cage and when I exhale, the ribs are moving even further away from the floor.

 

 

The final piece of this puzzle involves resting on the floor. When you are truly able to relax, your middle back will rest on the floor when your knees are bent and you are lying down. Below is a short guided body scan. I direct attention to various parts of the body, using the movement in the beginning to improve your sense of contact with the ground.

 

 

Posture Is a Reflection

The goal isn’t to walk around with a tucked pelvis and slouched posture any more than the goal should be to walk around with a military posture. You exist on a continuum of emotional states, physiological states, and biomechanical states. Posture is simply a reflection of that continuum. When you no longer find yourself remaining on one end of the spectrum and instead inch towards the middle, you may be able to move with more control and fluidity. And having more controlled movement options available makes endeavors in athletics and life a little bit easier.

 

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