“There is an ecology of bad ideas, just as there is an ecology of weeds, and it is characteristic of the system that basic error propagates itself. It branches out like a rooted parasite through the tissues of life, and everything gets into a rather peculiar mess.”
Steps Toward an Ecology of Mind
Chronically pulling in the abdominal wall in the name of health, strength or aesthetics is the most deeply held tenet of Western physical culture. It was likely first displayed by the men who introduced yoga into modern society with postures that pulled navel to spine. Yoga attempted further control of intraabdominal pressure with exercises like mula banda, which contracts the pelvic diaphragm.
In the early part of the 20th century, Joseph Pilates greatly expanded the idea of focused abdominal exercise toward a goal of establishing “core strength”. Photographs of Pilates reveal a forced physical condition where a perpetually contracted abdominal wall rotated his arms forward and his legs outward. Despite such a departure from natural physiology, a contracted and rippled abdomen became the central feature of ideal male form.
Henry and Florence Kendall were a husband and wife team of physical therapists who practiced in the 1940s and 1950s. They developed the concept of “neutral pelvis” where a line drawn between the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) is parallel to the horizontal plane in standing posture. The Kendalls described “pelvic tilt” as the degree to which the position of the pelvis deviates from “neutral”. They proposed that four muscle groups are responsible for supporting the pelvis in its proper alignment: the erector spinae, the hamstrings, the abdominals and the hip flexors. When these muscles are in “balance”, the pelvis was thought to be maintained in neutral alignment. Science has never been able to prove this theory.
Ida Rolf, creator of a myofascial release system called Structural Integration, asserted that the pelvis is “horizontal” when the bottom of the tailbone is level with the “top” of the pubic symphysis. Rolf’s views were based upon widespread misunderstanding of human pelvic position.
The neutral pelvis was brought further under scientific scruitiny during the 1990s when physical therapists Paul Hodges and Carolyn Richardson attempted to prove that certain muscles, particularly the transversus abdominis, provide core stability to the torso, thereby reducing back pain. Within a decade “core stability” was the mantra being repeated worldwide by exercise physiologists, yoga instructors, physical therapists, and others.
There is no such thing as the Kendall’s neutral pelvis because in standing with the lumbar curve in place the ASIS are rotated all the way forward, with the pubic bones positioned between the legs in a front-to-back direction. To stand with what is described as a neutral pelvis one must maximally tuck the tailbone under. Many Western scientific and medical disciplines, from anthropology to orthopedics, perpetuated the myth of the neutral pelvis by proclaiming that a 90 degree posterior rotation occurred when human beings became bipedal. In the conventional “bowl” orientation of the pelvis, a strong abdominal wall and fortified pelvic “floor” are the only defense against the weight of internal organs plunging down from above.
While physical therapists continue to debate which musculoskeletal alignments result in the most neutral pelvis, what about the position of the organs? For almost a century optimum posture has been described in terms of length and strength of muscles, when in fact anatomic placement of organs is primary in the analysis of human posture. The dynamics of breathing under the forces of gravity position the abdominal and pelvic organs in a specific way, which in turn defines natural human posture.
In a newborn baby girl, the urethra/bladder, vagina/uterus, and rectum/sigmoid colon form long, straight axes through her pelvis. When she begins to stand, walk and run under the forces of gravity, the movement of her respiratory diaphragm pushes her pelvic organs down and forward. By late puberty her organs have bent ninety degrees to rest atop her pubic bones and against her lower abdominal wall. The paired round ligaments of the uterus, which travel down either side of her lower abdominal wall and embed in the labia surrounding her vagina, assist this forward movement.
The bladder is tethered to the anterior abdominal wall by the median umbilical ligament, which extends from the top of the bladder to the umbilicus. Continuous with the umbilicus is a fibrous cord called the round ligament of the liver. What was once the fetal umbilical vein, the round ligament extends from the umbilicus to the inferior surface of the liver. The liver is the largest organ in the body, weighing in at 1200-1600 grams. The large falciform ligament separates right and left lobes and attaches the liver to the anterior abdominal wall.
The coronary ligament branches from the falciform ligament, extending over the superior surfaces of the right and left lobes, adhering the liver to the inferior surface of the diaphragm. The small intestine is also connected to the diaphragm by way of the Treitz ligament. The ascending colon and descending colon are fused to the posterior abdominal wall.
Anatomic motion of the respiratory diaphragm moves the liver, stomach, pancreas, spleen, intestines, bladder and uterus down and forward with every inspiration. Diaphragmatic breathing is not only “natural” and “correct”, it is the way the body is designed, or has evolved, to function.
Natural human anatomy is self-evident. All young children develop the same puffed out abdominal wall, which elongates as the child grows. By adulthood diaphragmatic-liver-abdominal wall support to the chest and shoulder girdle is evidenced by a “proud holding” of the upper abdominal wall.
The curvilinear abdominal wall provides direct support to the liver and bladder by way of central ligamentous attachments. Chronically pulling in the wall collapses fascial support and shifts intraabdominal pressure toward the pelvic outlet.
The concept of the neutral pelvis is based upon deep and age-old anatomical misunderstanding. Habitually pulling in the belly is foreign to natural sensibilities and has the potential of causing serious disorders, from hiatal hernia and gastritis to incontinence and prolapse.
Join us next month for The End of the “Neutral Pelvis” – Part 2 where we will discuss the thoracic cavity and the inherent danger of a postural model based in mechanical, reductionistic science.