Q & A for The 16% - Pelvis shape change vs. Pelvis Orientation

[@inessiev]

I think this has just changed my life.

[@BillHartmanPT]

Thanks for watching. If you want more go to uhpnetwork.mn.co/

[@inessiev]

@@BillHartmanPT hi! I live in Portugal and for years have been trying to find someone to help me identify this pattern, needless to say almost all the doctors, physiotherapists etc completely blew me off. So I have to figure this out by myself but I seem to never really be sure if I have a left AIC right BC pattern, or some sort of opposite or weird compensation because I have almost zero internal rotation on my right hip, really bad pain on my hip, iliac crest and right QL. Terrible cramps on my right inner thigh, tense lower right abdomen, and a very right pronated foot (and left flat feet). I have been in agony! Years of trying everything... Do you still do online appointments with clients? Thankyou so much in advance. Inês

[@BillHartmanPT]

@@inessiev I'm currently not seeing online clients.

[@inessiev]

@@BillHartmanPT my loss :) thanks for answering! and thankyou so much for all your amazing videos, they will help me find a solution here...

[@BillHartmanPT]

billhartmanpt.com/ instagram.com/ facebook.com/BillHartmanPT/ twitter.com/BillHartmanpt www.linkedin.com/in/billhartmanpt/

[@kostasm.4296]

Hey Bill. At 4:20 when you say internal diameter of pelvis, you mean the pelvic outlet? If so, could this "widening" be seen as nutation? Or you are talking purely about shape change, and not relative movement (like nutation)? Also, about the hip ER/IR measurements you mentioned. The reason the IR is limited, is because those ER muscles are concentrically oriented, we max out their eccentric capabilities by bringing the knee to 90, so they can't eccentrically orient more to give us femoral IR in that position, correct? So, in that case, we can expect to have femoral IR in prone? If not, does it mean that there is some other reason that the f. IR is limited? Thanks ahead Bill!!

[@robertmclean2812]

How techniques would you use to reverse the orientation mentioned in the first scenario?

[@victorelmurr7122]

Around 2:20 - 2:25 you describe the reorientation of the acetabulum as moving anterior due to the anterior compression of the pelvis. Could you clarify how this happens? Thanks!

[@BillHartmanPT]

The shape change in the pelvis alters the position of the ER muscles and reorients the acetabulum just like moving the scapula on the rib cage. The ER muscles are concentrically oriented and push the head of femur forward into the acetabulum.

[@victorelmurr7122]

@@BillHartmanPT So the concentric reorientation of the ER muscles "pushes" the acetabulum anteriorly? Between 2:25 and 2:35 you begin by referencing the acetabulum moving anteriorly then switch to the femur which I believe is where my confusion is coming from.

[@BillHartmanPT]

@@victorelmurr7122 internal pressure promotes the acetabular position like a scapula moving into traditional IR. The force of the ER muscles pushes the head of the femur forward. This also contributes.

[@victorelmurr7122]

@@BillHartmanPT got it, thank you

[@jesusmartinperez8220]

If adductors contribute to anterior compresssion and so to concentric orientation of ER muscles (and counternutation) , why do you use, in other videos, adductor activation to promote internal rotation and nutation? Thanks

[@BillHartmanPT]

which video do you want me to address. Not all adductors do the same thing at the same time depending on position.

[@egortarkov7708]

Maybe because adductors become internal rotators in deeper hip flexion

[@brianpaxtonPT]

@bill Hartman What would like drive the excessive lumbar lordosis above the pelvis ? I’m assuming it’s coming from above the pelvis.. Would one want to focus on lower (below scapula) or upper thorax expansion ?

[@BillHartmanPT]

It's a shift in the center of gravity. Your target (upper or lower) depends on your extremity measures. the greater the limitation, the more likely you'll need inhalation posteriorly

[@brianpaxtonPT]

Bill Hartman thanks ! When you say shift in center of gravity driving the lumbar hyperlordosis , I’m assuming you are are referring to what’s stated in the literature as static sagittal balance of the spine (center of gravity) ? So the center of gravity shifts forward and in response we have increased activity of spinal extensor musculature to avoid gravity taking us flat on our face (which causes posterior compression) So with greater loss of hip Er vs shoulder Er one would focus on lower posterior expansion vs upper posterior expansion ..

[@BillHartmanPT]

@@brianpaxtonPT there is a constant forward/back shift associated with the exhalation compensatory strategies to maintain balance. You lose hip ER and shoulder at the same time. It's never one or the other unless you damage a constraint.