Pelvic Balance Dealing

with Shifts, Tilts, Rotations, and Their Effects

A Yoga U Online Course

with

Doug Keller

Transcript, Session 2

Eva Norlyk Smith: This is Eva Norlyk Smith with Yoga U Online. Welcome to

session two of our two-part online course with Doug Keller on Pelvic Balance

Dealing with Shifts, Tilts, Rotations, and Their Effects. We have a full program so

we will dive straight in. Doug, welcome.

Doug Keller: Thanks, Eva. Welcome back, everybody. Like Eva said, weve got a

whole list of questions that are on really good topics and theyre pretty well-related

to what were doing. So Im going to try to touch upon them as we go along or at

least indicate that Im addressing the issues raised in the question, and anything left

over we can deal with at the end. Yesterday, we were dealing specifically just the

issue of recognizing and noticing shifts, in particular of the pelvis and some of the

tilts that came with it. And today, well expand our perspective a little bit further

into the legs, addressing specifically the issue of a shorter leg, whether structural or

functional and also some principles for really stabilizing the pelvis. Because a lot of

questions were about the sacrum and just creating overall stability for the sacrum

and the pelvis itself, which is certainly part of this, and also to look as much as

possible at scoliosis, but of course, thats a huge issue with a lot of variations. I

think the essence of what were doing in these two days is really relevant and I

think very helpful to dealing with a lot of these issues and getting a lot of insights

into it.

Again, this is part two of Pelvic Balance. I did want to indicate the main sources of

my information, the factual information of what Im saying, is based upon the work

of Erik Dalton. He has a book called Advanced Myoskeletal Techniques. In the

second edition, he has a chapter on the short right leg syndrome. He also has a

couple of articles available on the web, and so Im drawing the information from

those articles. Hopefully, Ive done proper justice to the languaging of his articles

and also tried to simplify it down for what were doing here.

Once again, were starting with a kind of generalization, particularly when we talk

about short leg. Were generalizing by saying that in the greater proportion of

instances, its a shorter right leg. But of course, thats a generalization. So according

to what we observed, we can make modifications along the way. But its good to

just kind of start on the same page.

First of all before we get into structural leg length difference, to look at functional

leg length difference, where theres not an actual anatomical difference in the

length of the bones. But in this case, which is actually not so uncommon, one of the

two legs feels or acts as if it were a shorter leg or we treat it like a shorter leg. We

indicated last time some reasons for this. And it can be a combination of factors,

one of which are the patterns of rotation that we pointed out, compensatory

patterns of rotation in the body that possibly stem from fetal positioning in the

womb. So its something built into the structure of our connective tissue or fascia

that leads to these little rotations that lead to further variations on it.

The second is the pattern of side shifting the pelvis. And well be talking about how

when we shift the pelvis to one side, how we carry the weight on one leg or the

other, and what the effect of that weighting on one leg or the other has upon the

pelvis itself.

And a third factor is, along with the patterns of side tilts and rotations in the pelvis

which can cause side bends and rotations in the spine, ultimately contributing to at

least a functional scoliosis which well look at today. So whats happening in the

pelvis is going to affect whats happening in the spine itself. And the rotations

continue on up from there into the upper body, as well.

Somebody was asking if rotator cuff problems are related to whats going on in the

pelvis, and actually, I think the truth is kind of the reverse. Whats going on in the

pelvis can actually have a strong effect upon the rotator cuffs or the health of the

rotator cuffs. Ill try to touch upon that.

We were saying with these patterns of rotations, side shifting, and side tilts, there

are compensations that the body makes in order to accommodate these patterns.

And when the shifting gets a little bit out of hand, then we end up in this situation

of having decompensations or changes around the joints, especially at key points in

the spine with dysfunction of the joints as far as the cartilage, dysfunction in the

muscles, as far tension in the postural muscles, and also imbalances in the larger

muscles that we use for movement which are called phasic muscles. And then also,

the effect upon the nervous system where we mentioned the habits that we build,

of how we hold our posture, get kind of burned into the nervous system and

become what we consider to be the normal way of being, even though, technically

speaking, its not the normal way of being.

All of these flare up at major transitional points in the spine as we indicated

yesterday and around the sacrum, at the beginning of the ribs, and at C7, and at

the base of the neck. All of these are places of major decompensation. And this is

where scoliosis in particular flares up and becomes a problem, particularly in dealing

with yoga postures.

To look a little bit more specifically at the pelvis and rotations in the pelvis that

contribute to having a functional difference in leg length, we have to be clear there

are two kinds of rotation that can take place in the pelvic girdle. First of all, the hip

bones themselves can rotate around the sacrum. In general, well call this ilio-tilt or

an iliosacral tilt where often the rotation of the pelvic bone affects a twist or rotation

in the sacrum itself. In the illustration here, the right hip point is rotating down and

basically its an anterior tilt. Anterior, which means its rotating forward and down.

And the left hip bone is rotating up and back or posterior superior tilt. All of this

creates a twisting in the sacrum as well as a difference in the sit bones as well as in

the hip points themselves. Thats one kind of rotation that can take place.

A second kind of rotation is that the whole pelvic girdle, the hip bones and the

sacrum together, can rotate as a block around the lumbar spine. As shown in the

illustration here, the upper spine compensates for that when the pelvic girdle

rotates in one direction, the upper body (the spine and the ribcage) rotate to the

opposite direction to keep the body heading straight forward.

We also see indicated in the illustration that the thigh bones themselves can rotate

in response to the rotation of the pelvis, all of which will lead to considering

problems in tightness and weakness in the hips, the hip joints themselves. And so to

look at that specifically, we can turn to the specific effect upon the muscles from

these rotations starting with the pattern of what we mentioned last time as the

whole left vestibular, right motor dominance which means a majority of people

tend to use their left leg for balance and their right leg for movement or they tend

to favor their left leg for balance while using the right leg to do things.

The first thing to look at is the bodys reaction to using the right leg for movement,

particularly when the weight is on the left leg, as you can see in the illustration,

rolling the hip point back slightly. What often happens is the right hip point,

especially when the leg is perhaps a little bit more lax or, later on well see,

shorter The right hip point can tilt forward which causes tightness and shortness

in a number of muscles around the hip point, indicating the hip flexors like the

iliopsoas, the adductor of the inner thigh can get tight. And so well see also in the

pelvic girdle, when the pelvis is slightly rotated to one side which is something that

shows up in, for instance, Warrior I Pose where the legs are asymmetrical, but the

hips are facing basically straight forward. You start to experience the tightness that

happens at the inner thigh. Usually, when thats the back leg, you feel the tightness

at the inner thigh really pulling at the hip or jamming at the hip. All of this is that

tightness at the hip flexors, at the front of the hip. On the hip point, it tends to drop

down and forward.

This drop down and forward of the hip point, since theres a back end of the hip

bone, tends to exert a pull on the hamstring attachment so it tends to pull on the

hamstring attachment. It weakens the piriformis which destabilizes the sacrum.

Because basically, the piriformis draws back the thigh bone towards the sacrum,

causing more stability in the connection between the sacrum and the hip bone.

When the hip bone rotates forward, and especially when the leg rotates inwards, all

of that is pulling away from the hip bone, causing the piriformis to stretch or

weaken. So very often, there are problems of sacral instability on that side of the

pelvis and we can do small things to strengthen the piriformis.

Piriformis syndrome is, in many cases, not a problem in the piriformis being tight or

overly tight (which does often happen from things like driving with the leg rotated

out) A weak piriformis can also cause irritation of the nerve that runs down

through the hip. And that hip that tends to drop forward and down, both exposes

the nerve from the mobility of the sacrum and also exposes it because of the very

weakness of the piriformis.

What I found in forward bending with one hip that tends to tilt forward when you

do a forward bend like Uttanasana, that hip tends to drop forward more quickly,

which exerts a bigger pull on the hamstring which is where you feel the pull on the

hamstring, plus a kind of feeling of shearing on the inside of the hip or discomfort at

the outer hip. The better we work to ground that leg, particularly through the outer

heel to activate the piriformis and the gluteal muscles, the better that reduces that

forward tilt of the pelvis and helps to heal up the problems around the piriformis

and the hamstring attachment. So well be looking at how the weight is borne

specifically on the feet. And when the hip bone rotates or tilts forward, it tends to

throw the weight towards the front of the foot instead of towards the heel. And

thats one of the factors in the piriformis not working properly in the hip. So its

fairly simple to work with the feet to affect the hip but all this is related to that

forward tilt of the right hip.

By the same token, when we use the left leg for balance, it tends to rotate that hip

bone upwards and backwards. You can see in the artistic drawing here of the guy

standing more on his left leg, it tends to engage the quadratus lumborum and the

iliocostalis muscles in the space between the ribs and the top of the hip bone. This

is one of the things that tends to make the shoulder drop downwards. The

iliocostalis is an interesting muscle that runs along the spine underneath the

shoulder blade, from the neck all the way down to attach to the ilium. A lot of the

hot pains that we get underneath the shoulder blades arise from spasm in the

iliocostalis. This is also where tension in the neck can bring about tension around

the sacrum or the sacral joint from that jamming of the iliocostalis.

So well see discomfort around the sacrum or pulling in the fascial tissue or just a

general tightness that you feel when you do side bending poses like Triangle Pose if

youre short on the side, on the left side where theres quadratus lumborum and

iliocostalis tight When you do Triangle Pose away from that side so that side of

the spine is on the top of the spine in Triangle Pose, thats when you often get the

clicking or the popping in the back, or the feeling of pulling around the sacrum, or

kind of drawing on the sacrum. The Triangle Pose is stretching out those muscles

which are otherwise held short, which well see is relevant to scoliosis also because

that happens particularly in scoliosis. So the effect, as well see, of that rotation

upward and backward of the hip also tends to flatten the spine on that side,

whereas the spine on the other side gets a little bit more lordotic, affecting the

spine and hips, as well. But overall, weve been giving this picture of a forward tilt

of the right hip, a backward tilt of the left hip, leading to this kind of asymmetry.

And it largely starts with the sideward tilt of the hips that we were talking about last

night.

To kind of summarize what we were leading up to so far, the first step towards

dealing with these problems is to change the bodys habits from shifting to the left.

If the pattern is for the hips to shift to the left, we basically want to get the hips to

shift to the right. And the use of the block to do that was a useful tool for that.

There were questions about whether there were contraindications to using this

exercise with the block. The first thing to point out regarding the block is that it

does tend to work the piriformis along with the gluteus medius and the other gluteal

muscles. And so, if somebody has a tight piriformis or tends to get spasms in the

piriformis, if that person were to spend too long on a block, that could make the

piriformis grip worse and can cause a sciatic episode in that hip. By the same token,

to do it a little bit at a time to strengthen is not necessarily a bad idea. And then to

do small piriformis releases after that, such as Ardha Matsyendrasana or some of

the hip stretches.

A second question that came up was one participant said when they tried standing

on the block, it tended to cause pain in the knee and what was going on there? The

hip that we tend to shift away from, we were mentioning earlier, tends to make the

knee turn inwards or the thigh turn inwards. And it often has a tendency to make

that leg hyperextend. It can also, as well see, affect the arch of the foot. So if in

doing the block exercise, the knee starts to get really uncomfortable, if its

discomfort at the inner knee, Id highly recommend keeping a little microbend to the

knee, keeping the knee bent enough that the knee cap is facing towards the second

toe of the foot. Theres nothing wrong with doing this, keeping the hips just slightly

tilted forward, the knees slightly bent and the weight on the heel, and keeping the

thigh rotated once again so the knee is pointing the same direction as the foot. This

should help with discomfort on the inner knee.

If theres discomfort on the outer knee, thats a complaint thats coming from the IT

band and the outer hamstring, which is often stressed from the sideward shift to

the hips. So to do small warm-ups and stretching for the outer leg before trying to

strengthen that muscle hopefully will relieve the pain around that. And if thats not

working, then I would recommend, instead of standing on the block, simply to

balance on one leg and just to bend the other knee and perhaps put the toes on the

floor just to practice leveling the hips without quite so much weight being put on

the hip.

Because overall, when youre balancing on the block, youre basically replicating

what you do every time you take a step forward with your legs. When were

walking, we spend eighty percent of our time balanced on one leg in the same way

that we do it on the block. Whats happening with the block is were made much

more aware of the shifts that have to take place for the leg to really bear weight.

Whereas when were walking, we can get away with kind of shimmying the hips

around it or working the hips in different ways to stay away from that strengthening

exercise. So this is a focused exercise that really replicates the ideal action of the

hip when the leg is weight-bearing, such as when were walking. So overall, its not

a harmful thing to work with it.

That having been said, working with that as far as the hips shifting, we can also

take a look at a few more details about distortions in the pelvis that come about

from our tendency to shift to one side. One thing that you can notice when standing

upright or having somebody stand upright and you check their hip points is, as we

started the webinar, we were pointing out you can notice a simple difference in the

height of the two hip points. In the illustration on the left, the right hip point is

down and the left hip point is up. And this can come about from the side shift to the

pelvis or rotation or a combination of factors. If it comes primarily from the shift to

the hips and theres nothing distorted within the pelvis itself, youll actually find that

when you lie down on the back and have somebody check the hip points, lie down

reasonably straight and get the legs lined up and check the hip points once again,

its not unusual to find that the hip points actually are even with each other while

youre laying down and uneven when youre standing up. And that tells you that any

feeling of leg length difference or of the rotations and tightness and shifts in the

hips, all of that is functional, more as a function of the habits we have in weight

bearing and in standing, and not something structural within the hip or the spine

itself.

If the imbalance remains the same, then a number of things could be happening. It

could be that the pelvic bones themselves are distorted such as the sacrum being

off or the hip bones being off relative to the sacrum, in which case adjustments

from an osteopath or a bodyworker such a chiropractor would be appropriate. Or it

could be a sign of an affect upon the pelvis that comes from possibly a structural

leg length difference, one leg is actually physically shorter than the other in the

bone and its affecting the very alignment of the pelvis. So when theres a change in

hip alignment from standing to lying, thats more a factor of tone in the muscles

that come from our habits of standing. If theres less of a change or you find a

significant reversal, then theres something structural that may be going on.

Before we turn to the structural leg length difference, of course well want to look at

what muscles need to be worked with in order to stabilize the pelvis for the sake of

the sacrum and for the sake of the tone of the muscles around the hips and the

lower back. Something weve touched on in other webinars dealing with Uddiyana

Bandha and Mula Bandha in particular, are to set some key actions for the

transverse abdominals in particular. The deeper muscles whose fibers run laterally

are kind of like a girdle wrapping around the waist, which are basically there to

stabilize the spine and to stabilize the hips and hip points themselves. The

transverse abdominals, which here are pictured in green, run all the way from the

pubic bone to the hips, around to the fascia to back, and up around the edge of the

rib cage. And when they contract, they contract from the waist towards the midline

of the body. They dont run lengthwise like the other abdominals, rectus abdominus,

but more run laterally. And so, when we contract these muscles, they draw towards

the navel. And their effect in the lower belly, the pit of the abdomen, it actually

draws the hip points slightly towards each other. Its not a huge movement, but its

a feeling of toning, kind of like the same action that you do if youre putting on a

pair of pants from last spring and you have to kind of narrow your waist a little bit

to get the belt buckle or to get the pants snapped. You kind of have to narrow the

waist at the front, drawing the belly in so the hip points draw towards each other.

And then having accomplished that, getting the pants snapped, you also have to

pull the pit of the abdomen in and up a little bit as if you were trying to zip your

pants.

So the two main actions here come from the transverse abdominals narrowing the

hip points, kind of like tightening the drawstring on your sweatpants or latching the

clasp at the front of the pants, and also an action of zipping up, drawing the pit of

the abdomen in and up. This second action involves rectus abdominus, engaging

rectus abdominus from below and also engages the oblique muscles that are used

for twisting but also the external obliques in particular, the fibers run from the

ribcage down to the lower belly. So when you draw the lower belly in like youre

trying to zip up your pants, this is a deep action of the oblique muscles, as well,

which connect back to that transitional point of the spine back at T12.

So these are basic actions of the core to cultivate. There are many ways to cultivate

this. One practice that is really worth trying out which is basically an abdominal

trainer for the transverse abdominals is to do the Cat Tilts which are familiar from

yoga classes. But the way the Cat Tilts are often practiced is people tend to hinge at

the spine, just using rectus abdominus to tilt the ribcage and the hips back and

forth. If you want to get more deeply into the core and to start to feel this action of

the engaging from the lower belly upwards, you can do a Cat Tilt by working

through the spine one vertebrae at a time. This is different from standing up and

going from Uttanasana up to standing, lifting the spine up one vertebrae at a time.

That puts a lot of pressure on the discs, which the discs dont necessarily need. And

it also puts unnecessary pull on the multifidus muscles of the back.

When youre on hands and knees, on the other hand, youre able to access the

abdominals without putting the same kind of stress upon the muscles of the back

and the discs themselves, particularly when youre lifting from the lower belly

upwards, youre less likely to overstretch the spine at the back. So in this case, as

you start from a neutral spine, you start by curling the tailbone down towards the

floor, drawing the lower abdomen in and up towards the spine. And this is where a

question came up in a number of cases about tucking the tailbone which

basically.. The tailbone knows what to do if the rest of the core is working. So you

dont need to actively tuck the tailbone. People tend to over-tuck the tailbone which

means tightening the pelvic floor at the back. And what happens is when people

tuck or scoop the tailbone, over-activating the back of the pelvic floor, it tends to

inhibit the very muscles of the core that were trying to access here. Particularly, it

inhibits the transverse abdominals as well as the multifidi and a number of other

stabilizers around the hips. So even people working with toning the pelvic floor

Physical therapists find, in general people tend to over-tighten the back of the pelvic

floor which is that basic tucking action which actually gets in the way of actions

which are more healthy for the sacrum, the sacroiliac joints, and for the spine itself.

So in this case, when you do the Cat Tilts, starting from the tailbone, youre not so

much tucking the tailbone like youre trying to pull your tailbone between your legs.

Rather, youre drawing the tailbone down, activating the gluteals a little bit, drawing

from basically your waistline down through the buttocks towards the sit bones. And

as you do that, beginning to tilt the sacrum and round the back, you find the lower

belly, the pit of the abdomen, in the space between the hip points and below the

navel, draw that back towards the spine and up. And if you do so, you can start to

round the back one vertebra at a time, going up through the lower back to about

the mid-back. And if you do it slowly, concentrating on one vertebra at a time, youll

actually feel the actions of the abdominals are wrapping from the outer waist

towards the midline, towards the navel, rather than simply pulling the ribcage

towards the pubic bone.

It is really helpful to have a partner stand or kneel next to you and just put a finger

on each of your vertebrae successively and have you As the person presses the

finger into the vertebrae, you have enough kinesthetic sense to round or press the

vertebrae up into your partners finger by accessing the abdominal muscles. Then

you really start to find the transverse abdominal muscles working and you start to

learn how to activate them. This exercise, in and of itself, is a great exercise

towards stabilizing the pelvic girdle, stabilizing the sacrum.

There have been questions about how to correct things or how to fix things after

childbirth. These kinds of exercises with the transverse abdominals are really good

for realigning or bringing tone back to the torso after childbirth. And its preferable,

once again to tucking the tailbone because it can happen after childbirth or after

other traumas that the tailbone gets a little bit diverted, pushed off to one side

whether the person falls down on the tailbone from skateboarding or something

else or the childbirth affects this. If the person works with scooping the tailbone too

much, it can aggravate the problems in the sacroiliac joints because the tailbone is

pulling sideways, and that exerts a sideways pull on the sacroiliac joints and the

sacrum itself. Its better to work towards bringing balance to the hip points using

the transverse abdominals and to let the tailbone follow that action, reorienting the

sacroiliac joint than to practice these actions of tucking the tailbone, which have

been so current in yoga for at least the last decade, if not more. The thinking

around that is changing quite a bit.

Thats one side of the stabilization of the pelvis is working with this kind of zipping

up of the abdominal muscles through the front body, accessing particularly the

transverse abdominals. The other side of the equation are the muscles called

lumbar multifidus or the multifidus muscles in general, which run up the spine. And

theyre shown in various ways in the illustration here. Theyre the muscles that run

from the sacrum, from inside the hip bone, up through the spine. And most of the

spine, theres one set of multifidus muscles or multifidi for each vertebra or each

joint at the vertebra. These are involved in rotation of the spine but they dont

create rotation because they run lengthwise. They run vertically. Rather, the job of

the multifidus muscles is to stabilize the spine, protect the discs, protect the nerves,

as you do twisting actions and also if you do particularly forward bending actions.

Overall, the tone of the multifidi help to, by their tone, maintain the lumbar curve

and they help to keep the spine upright during twisting. Which is why we try to

achieve a natural curve in the spine during twisting, so that the multifidus muscles

can do their job rather than being rendered incapable of doing their job by rounding

the back. You will notice that the multifidus muscles thicken around the sacroiliac

joint or around the sacrum. And this is for a number of purposes. When these

activate, they provide a stabilizing effect upon the sacrum. We can see in this slide

here and the case of the lumbar vertebrae slipping forward which can cause

discomfort in supine positions Some people who feel pain lying back on their back

in Savasana, it could be muscular tension on one side of the spine or it could be a

slight slippage of one of the vertebrae. In general, the slippage is called

spondylolisthesis. And the multifidus muscles are there in the sacrum to prevent

that. They hold on to the vertebrae especially where there is the lumbar curve to

keep them from slipping forward.

The real takeaway point in talking about these core muscles is to understand that

the transverse abdominals and the multifidus muscles work together. Its very hard

to consciously activate the multifidus muscles. They work really automatically and

on a subconscious level. But theyre very much hard-wired into our transverse

abdominal muscles. So if we learn to access the transverse abdominals which

stabilize the hip bones, automatically that fires the multifidus muscles which

stabilize not only the spine, particularly the lumbar spine, but also play a role in

stabilizing the sacrum and the sacroiliac joints, especially in cases of hypermobility

in the sacroiliac joints.

The research done on chronic back pain, especially noted here by Carolyn

Richardson and others, has really shown by measuring the activity of the muscles,

that the site of chronic back pain instability, a lot of the pain that keeps coming

back and coming back in the low back and sacrum, is correlated with a dysfunction

in the multifidus muscles and also with a dysfunction in the transverse abdominal

muscles, usually at the same level as the multifidus muscles, right in the location

where the pain takes place. So if we can get these muscles to get back on board

with firing properly, that does a lot to stabilize the pelvis in the matters of instability

that weve been talking about so far.

So to kind of summarize these points here, these muscles work best when the spine

is within its neutral zone or basically youve got the neutral curves of the spine or

you work within the range of the neutral curve in the lumbar spine and a neutral tilt

to the pelvis. So in other words, we dont work effectively with these muscles when

we go deeply into forward bends or backbends. Its the very kinds of even baby

backbends or basic work that a beginner does in warm-ups with the natural curve in

the spine, those are the most effective exercises for maintaining the stability of the

pelvis and the lower back.

Again the multifidus muscles work to support the inward curve of the spine and

they also go to work, as you start to go into a forward bend, stabilizing the spine,

which is why we start a forward bend with the curves of the spine. And as you go

deeper into the forward bend, of course, you go beyond the straight back. You go

beyond the curve of the spine. And its at that point, when the spine starts to round

in a forward bend that the multifidus muscles get to participate less and less in

stabilizing the spine, and then we start to rely upon the ligaments to protect the

spine because the muscles are no longer in a position to do so.

So when you start to go towards the end range of motion in a forward bend, youre

relying on your ligaments rather than your muscles which is why, as far as Im

concerned, curling up from Uttanasana one vertebra at a time puts far too much

pressure on the ligaments and doesnt really put the muscles in a position to

activate efficiently to really protect the spine as you come up. By the same token,

the transverse abdominals, as you go farther and farther into a backbend,

extending the spine, going beyond the neutral zone or the neutral curve of the

spine, the transverse abdominals have less and less protection and support to offer

to the sacroiliac joints, the sacrum, and the lumbar spine in general. They work best

in maintaining a neutral spine. Theyre working within that basic range. Again,

anything beyond that, youre starting to ask the ligaments to take care of you

rather than the muscles.

Some people in the Cirque du Soleil that do the really deep, deep backbends, they

basically have the flexibility in the ligaments that allow them to go that far. And at

the same time, theyre at a position where they have to really be careful because of

the instability created in the back there. So those are the factors of the stable back,

which leads to the question of how do you get them to work together with each

other? And some of the most basic actions that we see in warm-ups of yoga are

actually quite effective in getting the transverse abdominals and the multifidus

muscles to work together in a way that stabilizes the back. Particularly the exercise

on the right, of stretching one arm forward and the opposite leg back while on

hands and knees. It does a number of things. First of all, the transverse abdominal

muscles have to fire as you hold that position for a moment just to keep the hips

level, so you dont topple over or lose your balance. So automatically, its making

the transverse abdominals work. Its taking the spine into a small extension but not

a deep backbend so its actually firing and strengthening the multifidus muscles in

coordination with the transverse abdominal muscles. And this is a case where you

would not try to take the leg higher than the hip because that gets into the low

back muscles and into a different firing order of muscles than what were trying to

achieve here. All of this gets the body to work properly.

And a fact about the multifidus muscles in particular and stabilizer muscles in

general, you dont need to do heavy weight-bearing work on these muscles. Its not

like you have to strap weights to your ankles and increase the weight to make them

stronger. These muscles are kept healthy by simple repetition without a lot of load

on the muscles. What they found with the multifidus muscles in particular with their

dysfunction did not really come from weakness in the muscle, so much as an

inactivity because there is a disconnect between the nervous system, the brain, and

the muscles. As you go through a series of simple repetitions of motions without

going too far, the muscles strengthen up and start to activate quite well. So it

doesnt take a lot of work to get these things working properly. And these are the

most important aspects of how we keep the pelvis stable once we start to bring the

pelvis back in line and start to take it out of these sideward shifts. These are, of

course, most relevant to cases where we have habits of shifting to one side and

habits of tilting to one side. Theyre also important in cases of more structural

differences that cause problems. So this is something for everybody to exercise. Its

healthy for everybody to exercise. And we can take it into looking at problems of a

structural leg difference.

Here, when theres an actual difference in the length of the bone, you find a couple

of things appearing. Again, were taking it as typical that the right leg is shorter

than the left. Thats a generalization and its a fair one but its not an absolute strict

truth. In the case of a shorter right leg, youll find the right femoral head or the

head of the hip bone is lower than the left. And youll find a convexity on the side of

the short leg. You can see in the diagram on the right with the right leg shorter, the

spine is blowing to the right. And so, the most typical form of scoliosis that youll

find in this case is a C curve scoliosis where the spine bends in a C shape to the

right and you may find little compensating curves up above that. For instance, in

this figure, you can see he has a little leftward curve in his neck to compensate for

the C curve thats coming about from this pelvic tilt.

In cases of an S curve in the spine, whats most common is the lumbar spine tilts to

the left or bends to the left, and then the thoracic spine goes to the right making

the S shape. And so the S curve has a different tendency towards the tilt in the

lumbar spine. And so, there are other things going on there. In the case of a

shorter leg, it tends to be more related to the C curve of scoliosis, but you can find

it in other cases of scoliosis, as well.

The bodys response to a structurally shorter leg along with this convexity of the

lumbar spine, comes a rotation of the pelvis and a rotation to the sacrum within the

pelvis. The bodys response to all of these factors (the shorter leg, the lumbar

convexity, and the pelvic rotation) can vary from person to person. First of all, you

would kind of have the expectation that if the right leg is short, then kind of like the

Leaning Tower of Pisa, because the pelvis tilts to the right, you would expect more

weight to go on to the short leg or on to the right leg. Since the body would be

tilting to that side, it would stand to reason there would be more weight on the

right leg rather than the left which in some cases is the case. But its been pointed

out if you take into account the sort of Leaning Tower of Pisa principle, the leaning

Tower of Pisa does not have a central nervous system, which means the body

accommodates this sideward tilt in various ways. It can shift the body weight to the

left side, therefore putting more weight upon the left leg even if the pelvis tilts to

the right. This can contribute to that tightness at the front of the right hip. And also,

the motor dominance of tending to balance on the left leg while using the right, also

tends to make the upper spine tilt away from the lower side, so thats where you

find particularly the left shoulder dropping down as the thoracic spine tilts to the

left. These are two responses to the rightward tilt to the pelvis.

We can start to identify symptoms of the shorter leg which do bear upon which leg

is more weight-bearing because its not always the case that the left leg is weight-

bearing. In some cases, the right leg is more weight-bearing as the pelvis tilts to the

right. The person who bears more weight on the short, right side usually has

greater SI joint pain in the right hip and in the low back, and also a feeling of

compression around the sacroiliac joint. And with that, there can be (as we pointed

out) a forward rotation of the top of the sacrum or different various kinds of

rotation of the sacrum. And so, the sacrum can get compressed and go out on that

side and often need adjusting. Again, its that habit of bearing weight on the right

leg that contributes to that dysfunction and tends to perpetuate it even when you

get the sacrum adjusted from time to time.

As we said, the right sacral base gets rotated forward which means that if you stick

your thumb in there, you can see how the sacrum goes a little bit deep to the inside

of the hip point or the PSIS. And the ilium is rotated forward and stuck or fixed. And

the sacroiliac ligaments on that side of the low back tend to be tender overall and

there can be a feeling of pulling in the sacroiliac ligaments, as well.

By the same token, it can often be the case that the person side shifts to the left leg

particularly if its their habit to balance on the left leg. And with that often comes

greater left-sided SI joint pain. And in that case, the ilium, the hip bone, gets

posturally rotated and stuck. It rotates back and gets stuck in that position and the

symptoms of this get worse during prolonged walking or running, particularly at the

outside of the left hip where the abductors, the hips shift off to the side.The

muscles of the outer hip, the abductors, are rubbing up against the outside of the

thigh bone during the course of walking at the left hip. And that can cause bursitis

in the hip. It can cause tendinosis or pain in the connective tissue, the tendons of

gluteus medius. And it can also contribute to tightness in the piriformis or piriformis

syndrome. As the weight shifts to the left and as the ilium rotates backwards, this

brings more weight to the outer heel, to the extent that it can actually cause

tightness in the piriformis. As long as the leg is weight-bearing on that side, these

symptoms or problems tend to get perpetuated.

So we can point out the habits of whats happening, whats going on in the pelvis,

can show up in the feet. And theres sort of a normal pattern or what Ive come to

expect as kind of a predictable pattern in the feet that I notice, which apart from

problems with leg length difference, is basically a generalization. The figure on the

right here, when the hip point is lower on one side (in this case, the hip point is

lower on the right side), the arch of the foot tends to drop down. The foot tends to

pronate and the knee tends to rotate inwards because the thigh bone rotates

inwards from a tightness of the adductors, the muscle of the inner hip.

And by the same token, as the left hip point is higher, that tends to roll the weight

on to the outer heel. That foot tends to supinate. And there tends to be more tone

in the thigh muscle and you can even see the thigh bone itself or the thigh rotate

out slightly, judging from the kneecaps, rotating out slightly. This is kind of a

pattern where theres just a rotation in the pelvic bones without necessarily getting

into problems of leg length difference whether structural or functional. And I often

see this in people that dont have the leg length difference going on.

Overall we can be aware of what our patterns are in our feet because its not

uncommon for us to have both patterns at once, one foot pronating a little bit more,

the other foot supinating a little bit more. One kind of practice you can do to bring

greater awareness to how you bear the weight in the feet is to stand up on two

blocks with your heel and the mounds of your toes, the knuckles, the mounds of all

your toes supported by the blocks. And its good if theyre really firm blocks like

wooden blocks or really hard plastic blocks. You basically set up your foot to be a

kind of bridge between the two blocks. You have as much space as possible

underneath the arch of the feet while having the heels and the mounds of the toes

support it. This automatically tells the arches of the feet to engage a little bit. You

can kind of play with shifting the hips backwards and forward and youre more

aware of when your weight goes into the front of your feet or back into the heel.

And as youre aware of that empty space underneath the feet, your hips naturally

gravitate to a more centered position over the talus bone or over the center of the

arch of the foot.

You can play with standing on the blocks, kind of finding the tone of the feet that

comes from that and then step off of the blocks onto a hard floor and feel how your

feet kind of drop into their natural habits or in some cases, their laziness because

the feet kind of know the floor is their so they can relax into it. Standing on that

empty space tends to wake up the feet and also give you an awareness of where

you tend to put the weight more towards the inner edge of the foot, the big toe

side, or the outer heel both of which are part of the feet that tend to be weight-

bearing.

There are characteristics that come with a flat foot. Theyre kind of listed here as

the weight comes more into the inner edge of the foot. Of course, the arch tends to

drop down but it causes problems of strain to tibialis posterior and to the tibial

nerve that runs from the inner arch to the inner ankle and tends to put more

pressure on the second toe so people more often fracture their second toe or get

problems in the second toe. And as you can see, it also puts more pinching on the

ankle where the arrows indicate the compression in the illustration here, as well as

promoting bunions, the kind of sideward shift to the big toe. All of this comes from

the weight falling to the inner edge of the foot.

By the same token, we can have the habit of supinating or throwing the weight to

the outer edge of the foot, in which case, the weight goes excessively towards the

outer heel. The big toe stays down and tends to get used, but the inner heel tends

to lift up. As a matter of fact, people tend to put a lot of pressure on the big toe so

theyve got problems arising in the big toe from having a supinated foot. Plus, the

outer ankle itself gets very stiffened, and so, people are susceptible to ankle sprains

or weakness in the outer ankle as well as fractures in the foot on the little toe side

of the foot or they have pain underneath the big toe itself. This is also a habit of

how we bear the weight in the feet which is affected by the rotations and shifts in

the pelvis. And by the same token, our habits for how we use the feet also affect

the rotations in the pelvis, in turn. So its kind of a chicken and egg problem going

on there.

Weve described this sort of normal pattern of the rotations and the effect in the

feet. When we get into the shorter leg problems, especially structural but

sometimes functional, we run into a kind of paradox where the body is trying to

adjust for having a shorter leg and a longer leg as far as it perceives it. So we have

slightly different patterns in the feet that lead to different kinds of feet pain which

dont quite fit the model we just described.

First of all, if the left leg is longer, the body is going to try to make the left leg

shorter in one way or another. And one way to make the left leg shorter is to make

the foot pronate or the arch of the foot collapse downwards. And this runs into a

paradox because when the hips shift to the left, that tends to shift the weight

towards the outer heel or the outer edge of the foot.

You can try this, if you want to stand up for a moment, and shift your hips from

side to side. Youll find as you shift your hips to the left, the weight goes to the

outer heel. And on the right foot, the weight drops to the inner edge of the foot.

And when you shift in the opposite direction to the right, the weight shifts towards

the outer heel of the right foot and the left arch tends to collapse down. This is

where the left foot gets a little bit confused, because the shift to the hips is putting

more weight on the outer heel. But at the same time, the arch is trying to collapse

downwards to shorten the leg a little bit so the hips are more level. And then that

ends up, basically leads to exhaustion in the foot as it wobbles back and forth

between the two side plus a certain amount of strain or twisting in the knee. Plus,

as the person walks, if the left leg is longer or behaves as if its longer, then their

habit when theyre walking, is they dont swing their left leg straight forward but

they circumduct, they kind of swing the leg around into place, which has an effect

upon the hip, as well. That shows up in the gait.

So as much as the body tries to make the left leg shorter, the body also tries to

make the right leg longer. And its principle way of doing this is to try to supinate the

right foot or throw weight to the outer heel. So the foot has a tendency to pronate.

The arches have a tendency to fall. There may actually be a bunion developing from

that tendency. And at the same time, the weight keeps getting thrown to the outer

heel to try to lengthen up or shore up that leg. So theres a kind of wobbling going

on in the foot here. And youll find from the thigh bone being shorter or the hip

dropping down, the thigh bone turns inwards or may turn inwards. And by the same

token, if you throw the weight to the outer heel, it makes the shin bone turn

outwards, which leads to a twisting in the knee which is generally called tibial

torsion where the thigh bone is twisting one way and the shin is twisting another.

To make a long story short in correcting this, I find the bent knee poses like,

especially the Warrior II Pose, when you basically maintain good alignment of the

hip, the knee, and the foot in Virabhadrasana II, particularly in this case with the

right leg being the bent knee. Youll find the knee untwists itself in the process of

bending. The more you straighten the leg, the more we tend to lock into that

twisting which is why Im not a fan of locking the knees. It tends to amplify the

twisting that goes in the knee. Rather, a slight bend or even poses that bend the

knee tend to untwist the knee.

But its this twisting action taking place in the leg and in the foot that makes the use

of arch supports in the case of a shorter leg not entirely effective. The arch supports

are useful, but at the same time, simply having a support in the shoe while it helps

to level out the pelvis, doesnt really necessarily address the different twisting forces

at play in the hip, the knee, and the foot. Again, these are things that can get

untwisted in yoga poses, but the arch support itself wont necessarily resolve that.

There was a study reported on the New York Times about the use of arch supports,

and they found the evidence was inconclusive. They took a group of people that

have basically the same condition in the foot and the arch supports help some

people with that foot. Some people started to develop little microfractures in the

foot and they got worse. And some people it seemed to make little difference at all

in the foot. So it was actually very inconclusive about how effective the supports

were. And I think thats largely a function of not really addressing everything else

thats going on in the foot and the leg which can be addressed through poses that

tend to realign and work the leg.

There are all these twisting things going on in the foot, the knee, and the hip. And

all of this is, of course, related to the whole problem of scoliosis. Because

everything that weve described so far, particularly with a structural shorter leg and

a leg that behaves like its shorter is a functionally shorter leg. In both of these

cases, there can be that drop to the hip, the rotation to the spine, and the side

bending of the spine, all of which can multiply into a scoliosis. Scoliosis is basically

defined then with a rotation in the spine that manifests in different ways.

Its pretty easy to see at this point how this can begin with the pelvis. The effect

upon the muscles we can see, looking a little bit closer at how the muscles on, in

this case the left side of the spine, tend to shorten. As the spine rotates forward on

the right, it rotates back a little bit on the left. The muscles shorten. And again, the

lumbar curve tends to flatten a little bit on the left side of the spine, in this case

while the lordosis starts to increase on the right side of the spine with a sort of C

curve. And the rest of the spine accommodates for this, starting to do a corrective

curve in the upper back which can lead to different little other mini curves in the

spine.

Again, this tightness is something that you notice when bending sideways in a

Triangle Pose. If theres shortness on the left side of the spine, youll feel the pulling

and popping on the left side of the spine, which overall is a good thing, though if

the spine is tight and weakened from a condition like scoliosis, this can be overdone

and harmfully so. So well look at a couple variations for doing a more modified

version of sideward bending poses like Trikonasana that would be better in cases of

scoliosis and that tightness of the back in general.

There are other symptoms that go along with the scoliotic compensations. As we

mentioned, the shortening of the quadratus lumborum on the long leg side or on

the side where basically the waist is shorter in the space between the hip and the

ribs. This can be a sign of a longer leg or simply a tilt to the pelvis.

On the upper side around the upper back, you get problems around the shoulders.

The scalenes, levator scapula, sternocleidomastoic, upper trapezius, all of which can

be amplified into different forms of convexity in the upper back or just tension in

the upper back from a shoulder thats lifted up and, in many cases, kind of rolled

forward. And there are patterns that show up in walking of these scoliotic

compensations even though its not necessarily a full blown scoliosis.

How to address that? Again, we come back to our basic point, and Ive observed

this in working with people. I had one young man who had a pretty significant

scoliosis, an S curve in the spine with a left side bend in his lumbar and rightward

bend in his thoracic spine. To stand up on the block, you can see in the case of this

illustration with the rightward bend of the lumbar spine, when he stands on the left

block and levels up the hips, hes working the hips in a way that levels out the pelvis

and sacrum and basically makes the lumbar spine straight. There are still little

scoliotic bends in the upper back perhaps. In this illustration, you can see it in the

neck and a little bit in the upper back, but you made a good start towards working

with the muscles to start to balance out the pelvis.

And of course, when you got a structurally shorter leg, in that case once you work

with the muscles then to have a lift in the shoe for everyday use, that would be

useful once you start to retrain the muscles to work according to a new pattern.

And the exercises are meant to create this kind of re-patterning. What happens in

the upper body, the upper back and the neck, can be addressed by the actions that

we were talking about with the arms, plus starting to get into side bending postures

in particular.

As an example here, the figure doing Triangle Pose If somebody has an S curve in

the spine where the thoracic spine is the convex side In other words, his right

upper back is bulging outwards. As he does Triangle Pose, hes reaching the arm

out to the side in a way that gets the shoulder blade to work on the back, usually

not just the rhomboids, but also working with the serratus and the lower trapezius,

while at the same time maintaining length on the side that otherwise goes concave.

The usual tendency in a Triangle Pose going to this side in particular, is to go a little

bit too far as in the figure with the X on it where you tend to collapse on the

concave side and overstretch on the convex side. This particular illustration here is

meant to show how to work with that tendency, maintaining length on the left,

while doing strength on the right.

And by the same token, going to the other side, you would work with support for

the bottom arms. You could still work with the right shoulder blade, with the arms

supported on a chair or a block, while using the left arm to stretch the concave side

of the body, stretching the arm up, or even stretching the arm out overhead in line

with the spine to get a little bit more length on the concave side while maintaining

the strength and support of the convex side. Whats illustrated here is the most

important work for working with these muscles. We just want to maintain the same

kind of intelligence with going to the other side, just understanding which muscles

get locked into a short position and which ones get locked long.

I wanted to finish with one thing about better ways of determining if there is an

actual structural difference in leg length. This is kind of essentially a hint for looking

at the problem and for your own tendencies. How leg length is most often assessed

is somebody is lying on the back and then the person measures the relative length

of the legs according to the heels or according to the malleosis, the bones at the

inner ankle. What will happen is from changes in the muscles when lying on the

back, one leg will appear shorter when checking the inner ankle, when in fact the

leg length is actually equal or just the opposite of how they appear when theyre

standing. These different shifts or changes can come about from the effect upon

the muscles at standing. So its too easy for the muscles to influence the leg length

when youre lying on your back. To do the test while the person is lying on the back

can be confusing or inconclusive from the different pulls in the muscles described

here.

A better way of working is to have the person lie on their stomach as if theyre

doing Danurasana. The effect of this is to balance the pelvis on the floor especially

the hip points and minimizes or lessens or reduces the movement of the hip bones

themselves and also puts the hip flexors into a little bit of a stretch so we can

actually observe the effects of the muscles upon the legs. This is basically passive.

Its shown here just by the person himself with the knees bent, but you would

actually be supporting the feet with your hands to hold the feet in place. And so,

theres not too much contraction of the hamstrings or other muscles. At that point,

you would be putting your thumbs, perhaps on the heels or even better on the

malleoli, the bones of the inner arch of the foot here in this position. This prevents

ilio-rotation. And if one leg is actually shorter than the other, youll be able to see

from the start. Sometimes the knees dont quite line up evenly or more often, you

notice how one foot seems lower than the other foot. You can see that as an initial

observation if one leg or foot seems shorter than the other. Then you start to move

the feet back and forth towards extending the hip. You can take the feet back

towards the floor a little bit and then forward and then perhaps a little bit beyond

ninety degrees. And generally, if one leg is structurally shorter than the other, then

that short leg will stay short. It will appear the same as you go through all these

ranges without any significant change as you move back and forth. This is a test

thats called the Derifield Maneuver, so theres a technical name to it. And its found

to be a more effective way of observing if there is actual structural difference in leg

length.

But you can also observe other things happening, as well. You might notice in

taking the feet up, bringing the hip into a little bit more extension, the short leg

actually seems to get even a little bit shorter. And that shortening or further

shortening of the short leg can come from muscular tightness in the sacroiliac or

lumbar region and also the hip flexors at the front. And basically, the way to correct

this is to work the gluteals.

In this example, the person is lying on his back and pushing his foot into something

steady like a wall or a doorway in order to activate the gluteal muscles and to get

the hip bone to rotate backward. So this is a case where the hip bone tends to

rotate anteriorly from tightness around the sacroiliac joint, from a rotation of the

sacrum, or from tightness at the hip flexors or the psoas at the front, to work the

gluteals tends to release that and tends to even up the spine. Its working on the

same principle as balancing on one leg. This is something people can do in a way

thats self-correcting without putting too much pressure on the sacrum or the

sacroiliac joint. And it also addresses that further shortening of the leg that comes

from the tightness in the hip, that comes in turn from having a shorter leg. It can

become a vicious cycle if this is not addressed.

The opposite possibility is that in doing the test, the legs seem to reverse in length.

In other words, the short leg gets longer and the long leg gets shorter. This can

more often be the case when the other hip or when a hip is posteriorly rotated and

stuck. Usually again, the left hip is rotated backwards and that tends to initially

make the left leg the shorter leg, and then it changes over as you go.

So if youve got a left rotated hip bone and a forward rotated right hip bone, youll

find this kind of reversal take place. You can work on stretching out once again the

front of the right hip in order to release that forward tilt. And Im becoming more

careful about making sacral adjustments in the case of the posteriorly rotated hip

where the hipbone is rotating backwards. Because in many of even the self-

adjustments that are given to people, sometimes people (for reasons that either

theyre not aware of or a physical therapist hadnt pointed out) theres other stuff

going on in the hip. And so in some cases, adjustment of the sacrum in that way

can cause further problems in the sacrum or pain or put things out. So I tend to

prefer the smaller self-adjustments, the strengthening exercises working with the

gluteals and working with, in a small way, with stretching out the front of the hip,

as well, in modified lunge postures.

In this case, hes got a block underneath the knee in order to really bring the

stretch more to the front of the thigh muscle as well as the front of the hip, instead

of the stretch going too much in the hip ligaments which is what often happens in

Anjaneyasana Other poses such as Warrior I Pose do tend to address de-rotating

the left hip which tends to get posteriorly rotated, but does it in a way in which

there can be more engagement of the transverse abdominals that tends to be more

protective for that.

So when you see a change in leg length, in other words, there is other stuff going

on in the hips that can affect the sacrum and thats a case where if you want an

adjustment in the sacrum rather than trying to self-adjust, you might want to look

into having a professional adjust the sacrum, just to check out what else is going on

in the hip because it could be a complicated tangle of things going on.

But overall, yoga practice will help to improve the situation especially if you focus on

the factors we mentioned earlier of maintaining the tone of the transverse

abdominals, as well as the multifidi working properly with the neutral spine. And

other things that we talked about in other webinars having to do with the core, with

Uddiyana Bandha And in many cases, also strengthening the piriformis to get the

piriformis to release which we can also address in the questions. But that kind of

covers the points that wanted to touch upon here.

If anything, hopefully what you get from this seminar is a little bit deeper

understanding of the issues that many people asked about in their questions, kind

of mysterious pains in the hips, the sacrum, the low back, stiffness in the hips,

problems in the piriformis where the causes are not evident but it seems to be a

nagging problem. If we address the sideward shift to the hips and start to work with

the hips to get the muscles in the hips to balance out by paying attention to how we

bear weight on the legs and so on, that can be a good productive first step towards

resolving the problems in the hips. So with that, Ill turn to any questions.

Eva Norlyk Smith: Yes, thank you so much, Doug. I think its wonderful that you

draw it back to that very simple thing that all these complex changes in the body

happen from this one simple thing of shifting the pelvis to one side or the other,

depending on how we bear weight on the leg. You didnt discuss the effects of

habits of sitting which for many people are as relevant as habits of standing.

Doug Keller: I think, first of all, you can notice our preferences in our hips show

up in the way that we sit. For instance, first of all, when we sit cross-legged, we

tend to prefer to have one leg cross in front of the other. Thats kind of our habit.

This puts the sit bones in a slightly asymmetrical position. You can feel what youre

doing with the sit bones by feeling where they are and even changing the cross of

the legs. It subtly affects the tone of the inner thighs with this rotation of the sit

bones. And when youre aware of this in sitting cross-legged, then in the more

normally seated position like sitting in a chair or especially in the car seat, you can

be much more aware of what your sit bones are doing and treat your sit bones as

being like two little feet. And you can actually sit upright in a way that you can draw

the sit bones more in line with each other.

In other words, if one sit bone is slightly slipping forward, that tells you that that hip

tends to rotate backwards, which often happens in driving in a car with the way that

we work the leg and working the gas pedal. If you pay attention to which sit bone

slides forward, which one slides back, this gives you a lot of clues about whats

happening in the lower back and how youre sitting overall.

One of the best poses for building awareness of the sit bones and working with it is

Baddha Konasana. Even its helpful to sit up on a block so its not as strong a hip

stretch. When you sit on a firm block with the feet together, the knees out to the

sides, you can pretty clearly feel where your sit bones are. You can also feel which

hip tends to open more quickly or which thigh tends to travel faster. In other words,

the knee that tends to come down faster in Baddha Konasana, thats the sit bone

that tends to slide under and starts to twist the hips. And you find as one knee goes

down faster, the other knee gets stuck and that hip refuses to open or feels tight in

the adductors in the inner thighs.

If you use the hands to lift your legs up to the same level to where you feel both sit

bones evenly on the block, then you can start to work the hips evenly from that

point, paying attention to the sit bones, youll be much more effective at opening

the hips and youll start to create a lot more steadiness in the hips as far as holding

the pelvis in a steady place for supporting the lower back to take a lot of those little

twists and rotations out.

And a little secret for Baddha Konasana is while youre working with opening the

hips in Baddha Konasana, if you do this action of toning the lower belly, especially

focusing on drawing the pit of the abdomen back towards the spine and up, youll

feel the hips release and open a little bit more. And it will also keep the hips more

stable so that the sit bones dont slide around quite so much.

So kind of a summary of my answer here is if you really start to, in symmetrical

yoga poses like Baddha Konasana, if you start to pay attention to your habits of

how you use and sit on the sit bones, you can carry that awareness into your habits

of sitting in everyday life and catch yourself when you start to slip and twist a little

bit. Because the pelvis does get rotated in our normal way of sitting and thats

where a lot of the tightness in the lower back or problems with pull in the lower

back and the sacrum begin. So you can be as aware of your sit bones in sitting as

you are of your feet in standing. And that goes a long way to addressing the whole

issue.

Eva Norlyk Smith: Yeah, thats beautiful. And then, there was a question from

Elizabeth in Charlottesville just along those lines. Shes asking if one can work on

balancing the pelvis while seated. And of course, thats what you basically just

discussed, that you have that same awareness while seated which is useful given

how long most of us sit.

Then there is a question from Jessica. She says, I have a hard time imagining how

to integrate these specific exercises in a flow or even Hatha class especially when

this is so body-specific. How do you integrate this into a class or if this for one-on-

one type work and yoga therapists? Perhaps I need more imagination.

Doug Keller: The basic exercises we described so far, theyre essentially basic

warm-up exercises for a class. Some of the more specific exercises having to do

with the core, were things that we covered in the Uddiyana Bandha webinar that

was focusing specifically on the actions of the abdominals that stabilize the pelvis,

so there were more suggestions in the practice and the webinar given there. And

here, were focusing more on the imbalances.

But basically, incorporating a few of these exercises as a warm-up in the beginning

of class starts to activate the core muscles. And so, the body tends to work more

symmetrically during the course of the rest of the class so its a good place to start

from. And we gave some suggestions in last nights webinar of some standing

balances that could be incorporated into a flow as far as how you go back into a

lunge posture, how you go back into a Warrior I posture, and even work with

perhaps a Warrior III posture. So there are some thoughts in there.

And also, this webinar was more specific to people raising complaints, usually one-

on-one or privately about nagging problems that show up in the hips or the pelvis.

And this webinar was focused more on as a teacher or a therapist working with

somebody, how to recognize what are the patterns going on which can provide an

explanation for those imbalances. And so in that case, you would be giving more

specific exercises to that individual to work with out of class to build awareness so

that that person can bring that awareness into class. And then to start with basic

core exercises that really do focus on actions of Uddiyana Bandha as well as the

kind of Mula Bandha we discussed, to bring that into their practice would help to

maintain that stability and that centeredness to the rest of the class.

The nice thing about a yoga practice is youre practicing on two sides of the body,

kind of working towards symmetry. And its in the differences between the two

sides of the body, you also start to recognize the different kinds of tightness that

comes up. For instance, the tightness at the front of the hip that comes from the

hip being dropped downwards, you can notice that in a pose like Warrior I Pose

where on one particular side Like for instance, if the right leg is the back leg, that

hip tends to drop downwards and even shift to the left slightly from the tightness at

the front of the hip. You would pay attention to keeping the hips centered in the

Warrior I Pose and you would feel the stretch thats needed to that hip on that side

to really get length to release that downwardly tilted hip.

And by the same token, on the other leg, youre working the gluteal muscle in poses

like the Warrior II Pose as well as Warrior I to help to maintain the integrity of the

outer hip, the working of the gluteal muscles. So as you go side to side, you can

feel which side is weak. You can notice it from how the posture gets misaligned.

And as you work with better alignment on that particular side, youre pretty much

automatically working with the muscles that you need to. And so, Im always telling

students as we go from side to side, they can usually feel what side feels like the

good side. So Im always saying, Let the good side teach the bad side, or, Let the

good side teach the side thats having the problem on how to work into the pose.

And on the bad side or the weak side, it often involves coming out of the pose to try

to achieve the same sort of alignment. So as we go from side to side in a flow, you

do build this kind of awareness of symmetry between the two sides of the pelvis.

And you actually create a symmetry from doing the practice.

Actually, it takes a little bit less imagination than it seems. You can do a good flow

practice focusing on good alignment and action and really benefit from the practice.

And what were doing here is just fine-tuning our awareness a little bit more of what

it is were trying to achieve and what kinds of sensations of things going wrong

were being alert to.

Eva Norlyk Smith: I think the nice thing about yoga is that you dont have to have

this full analysis of whats going on in a persons body, because as you pointed out,

a lot of this is corrected over time particularly if you just learn to strengthen the

muscles and create more core stabilization.

Doug Keller: Yeah, I think thats where its important to point out. As much as

going through a flow is popular, the downside is if you concentrate too much on the

flow and moving from posture to posture, theres not a pause where people can

really take a pause to find stability in the pose, find alignment, and have an

experience of being there for a moment. And its in pure flow when there are not

pauses, so theres no stability in between, we tend to play into our weaknesses. And

so the parts of the body that are weak and needs strengthening, we tend to

collapse into or maintain that kind of weakness. And the weakness is, in some

cases, hypermobility. And so, a pure flow practice can accentuate the imbalances

and at the same time, a practice that simply focuses upon holding poses, we tend

to overuse certain muscles in trying to hold the pose for too long and we never get

to access the deeper, smaller muscles. So Im basically saying a balance between

flow and holding postures with nice intelligent transitions between the poses, thats

what really makes for a full practice that addresses the imbalances in the body in

the best way that weve been talking about.

Eva Norlyk Smith: I thought another important takeaway for me was

strengthening the multifidi, the important back muscles that are so involved in

stabilizing the lower back That its not the big backbends that do it, but its really

the small movements. In a pose that one often tends to overlook the Sun Bird Pose

which, is Table Pose with one hand stretched out and the other leg stretched out

Its easy to think its not a big pose but it is a big pose for that specific purpose, in

getting to a group of muscles that not that many movements or postures

strengthen.

Doug Keller: Yeah. I think that the deepest benefits of yoga practice actually come

from the smallest poses. And then beyond that, as we go into the deeper poses,

were basically increasing the range of motion of the body and stretching out the

bigger phasic muscles, but the center or the core of the yoga practice really

addresses this core stability. And its really the beginning students that benefit the

most from these moves as they focus on them. So if we get preoccupied for going

for the big poses or the deep poses, were actually missing out on the heart of what

the practice has to offer to us. Were kind of going for the outer fringes while

missing the core at the same time. So it is the stuff working with basically neutral

spine, working with small movements, getting back in touch with the body, and

getting the body back in touch with itself, thats really the therapeutic heart of a

basic yoga practice without even going into all the details and the specifics and then

to move from there as healthy. But to leave all that behind in the effort to get into

the advanced poses basically misses the point of the practice in pretty significant

ways.

Eva Norlyk Smith: Thats a beautiful point. Last question You made reference to

how pelvic alignment affects the rotator cuffs. You might want to just briefly explain

that.

Doug Keller: One key relationship is for the iliocostalis that runs up the spine. The

one in the center is a connection that runs from the sacrum, runs along the ribs,

underneath the shoulder blade all the way up to the neck. You can see if theres a

tilt to the pelvic bone or a shift to one side, it exerts a pull through the iliocostalis

(and other muscles, too, of course but the iliocostalis is a big one). And that pull

translates up the back into the shoulder blade, causing different misalignments of

the shoulder blade. Often, it can cause hot pains underneath the shoulder blade or

it can pull the head slightly to one side, or it can make the shoulder blade kind of

slide off the back a little bit from the misalignment of the pelvis. And as the

shoulder blade slides off the back, thats what makes the arm rotate inwards and

leads to a rotator cuff problem.

So its both the obvious case of a side tilt to the body like the man in the illustration

here whose left shoulder is dropped down as the hip is hiked upwards. That

sideward tilt to the body can put pressure on the shoulder and rotator cuff, but the

pull through the back thats exerted through the shoulder blade and into the neck

can also translate down into the shoulder and affect the rotator cuff. There are

direct muscular connections between whats happening in the hips and whats

happening in the shoulders, and to the ribcage overall. Thats the most basic and

most kind of obvious connection that I point to here.

Eva Norlyk Smith: Wonderful. Well, Doug, thank you so much for this really

extensive and thorough explanation of a huge and very important topic. Youve

offered us such rich material. Theres lots and lots to go back and find a little

nugget, and we hope it will continue to enrich your practice and your teaching for

quite some time to come. So again, everyone, thanks for joining us. And a special

thank you to Doug. Thank you so much for joining us again and for all your hard

work. We really appreciate it.