The Physical Therapy Perspective of The Five Basic Principles of STOTT PILATES: Pelvic Position

By Patricia Staszak, PT

The second of the five basic principles of STOTT PILATES describes the optimal position of the pelvis.  Or, in physical therapy terms, it describes the position of the pelvis when it is in neutral.  The pelvis is comprised of three bones that form a ring around our lower abdomen. The two large bones that connect to form a ring are the inominate bones, and the triangular shaped bone in the back is the sacrum. As with all joints, when in a neutral position the level one muscles work better to hold the position. This allows the pelvis to do its job of absorbing shock as we put weight through our legs (Hertling and Kessler 485).

Pelvis – Anterior View	Pelvis – Posterior View

Neutral Pelvis

The neutral position of the pelvis is described as being when the ASIS and the pubic symphysis are in the same vertical plane.  So lets try to visualize this using the pictures above and below as a reference. When lying on your back, if your pelvis is in a neutral position, your sacrum will be flat on the floor and there will be a natural anterior curve of your low back – so your back isn’t pressed down into the floor.  Your ishial tuberosities, which are the two large bony prominences that you bear weight through while sitting, will be pointing directly to the wall opposite of you, not up towards the ceiling.  But most importantly, there should not be tension in any of the muscles in the area; we do not want gripping of the hips, low back or butt (Comprehensive Matwork 6).

In this position it is easiest to find neutral pelvis by rocking your pelvis forward and backwards so your back is all the way arched and then all the way flat, then relax into that balanced neutral position as described above.  Another way to think of it is to visualize a teacup placed on your pelvis.  If you are in neutral it should be balanced on your pelvis and the tea should not spill.

To find neutral pelvis position in sitting, we want to sit with our ishial tuberosities wide and with our weight centered on these bony prominences.  Remember, your ASIS and pubic symphysis should be in the same vertical plane. It is much easier to find and hold that balanced, neutral position when your feet are on the floor in line with your hips.

Optimally, we would like to be in neutral pelvis with all exercise and function; however there are a few instances when we use a slightly different position, such as the imprint.  The imprint is used when we want to protect the joints in our low back.  We do this with a few of our patients who have pain in the area, or those who have a large lordosis, or, arch in their low back.  But mostly we use the imprint because many of us are not strong enough to maintain the neutral position while performing abdominals strengthening with both of our legs in the air.  When this is the case, we recruit our level two oblique muscles to hold our pelvis in an imprinted position, as in the March exercise shown below (Comprehensive Matwork 3).

Neutral	Imprint

Imprint to Start	Inhale: Lift first leg
Exhale: Lift second leg	Inhale: lower first leg Exhale: Lower second leg

An imprinted position of the pelvis is a position in which the pelvis is slightly tilted backwards and the normal curve of the low back is gently flattened against the mat.  In this case, when lying on your back, the pubic symphysis will be slightly higher than the ASIS as the abdominal oblique muscles gently engage to pull the rib cage closer to the hip bones.  In the teacup example, we want to think of that tea dripping slowly into our navel, drip by drip. The reason that we pull in the obliques to help with this position is because they are level 2 stabilizers and we are recruiting them to help since our level ones are not strong enough to do the job on their own.  We do NOT want any tightening of your gluteals when moving into the imprinted position.  So do not initiate the movement by tightening your butt and tucking your pelvis.

Remember: your pelvis is in the center of our bodies.  It determines the position of our rib cage and head above it and its position affects the way force comes through our legs from below.  If it is out of alignment it can affect many other areas in our bodies.  Health care practitioners and exercise specialist all tell us to strengthen our core muscles.   But as we are doing all these exercises and movements, if we aren’t starting and staying in the right position at our pelvis, we may not be achieving the goal of the exercise. 

Okay, for all of you who are doing your exercises regularly, now you have a better understanding of neutral pelvis. Good luck, and if you have any questions feel free to contact us by phone or e-mail.