The pelvic stabilizers consist of all the muscles connected to the pelvis working in synergy to enable you to lift, push and carry (perform work).  They include:

• Erector spinae group (quadratus lumborum, multifidi, rotatores, iliocostalis)
• Abdominals (rectus abdominus, obliques, transverse)
• Gluteal muscles
• Quadriceps muscles
• Hamstrings
• Hip rotator muscles

In this video, I demonstrate the proper form for doing these exercises:

Think of your pelvis as a powerful hinge; a “bio-mechanical hub” that connects your torso to your legs.  The pelvis’ engineering enables you to stand upright and bear a load by serving as an anchor/ attachment point (resistance-counter force) for the muscles performing the work. It is truly a biological marvel and should be targeted for exercise so that one can meet the physical demands of life more easily.

Examples of common activities that heavily rely on pelvic stabilizers:

• Standing up from a seated position; sitting from a standing position
• Bending down and lifting something from the ground
• Putting your carry-on luggage in the overhead bin of an airplane
• Lifting up a child
• Throwing a football
• Jumping across a puddle

The exercises involve moving a kettlebell, which resembles a cannon ball with a large hand grip, by using the power generated from pelvic thrusting.  The repeated thrusts are created by alternating antagonist-agonist* function of the pelvic stabilizers.

*Muscles work in pairs.  The muscle that is undergoing a concentric contraction (getting shorter as it contracts) is called the agonist while its counterpart, referred to as the antagonist offers stabilization and measured control of the movement.  Muscles  switch from being agonist to antagonist and vice versa, depending on the movement.   Examples: biceps-triceps, quadriceps-hamstrings.

Although it looks like the arms are involved due to their obvious swinging motion, they are actually not being exercised.  The arms serve to connect the weight to the pelvis structure, like a piece of rope. The kettlebell “drags” your arms with it and moves via inertia after being propelled by the rhythmic pelvic thrusts.

Initiate the thrust with your leg muscles, driving power through your feet and channeling it into your pelvis and core to swing the weight forward.  Do not use your arm muscles to swing the weight, and try to keep your lower back straight.  The worst thing you can do is put too much load on your lower back muscles in the flexion position– this can cause a severe back injury, so avoid doing this.

The benefit of developing your pelvic stabilizer muscles’ strength and coordination is that it will be much easier to move your body; to make it do work.  Going up stairs, getting out of and into your car seat, and lifting and carrying heavy things will be much easier.  You’ll be pleasantly surprised!

Kettlebell exercises burn up a lot of calories, so they are also good for weight loss.

Remember to use good form and start out with a light weight, working your way up as you develop muscle strength and coordination.  Kettlebells can be as light as 2 pounds and as heavy as 50 pounds.  The one I am using in the video is a solid 40 pounds.

The underlying theme of this blog is that by making strategic changes in your daily routine, you can save yourself a lot of pain and dysfunction now and later on in your life.  And it’s my desire to share with you some of these simple changes.

Isn’t this a simpler and smarter way to live, rather than being indifferent or oblivious to the fact that your body slowly loses its resiliency as you age, and not taking appropriate, protective measures?  If you perform regularly scheduled maintenance to your car, it will last a lot longer than if you do not.  The same goes for your body, but the stakes are a lot higher.

One Popular Reason Why People Develop Pain

The problem I see is that most people forget that when you are in your 20s and 30s you can get away with things like prolonged sitting, staying out late and eating unhealthy things like burgers and fries frequently.   At that age your human growth hormone is still giving you that fountain of youth energy and your musculoskeletal system, especially your joints, is still in good working order.

However, through your 40s-60s, your job and/or family responsibilities increase and you have less time for yourself, and you think you can take the same abuse that you took in your earlier years.  This is where problems start to manifest.

You see, health problems such as degenerative disc disease take years to develop.  Take an x-ray or MRI of your neck or low back, and all those nasty osteophytes, thinning discs and crooked spines you see didn’t start yesterday.  They started perhaps ten or more years prior.

So, you are either in a situation where you can do lifestyle modifications to reduce the chances of disorders like this from affecting your health and quality of life; or, you already have the disorder, but need to find ways to stop it from progressing and/or reduce its impact on your health and quality of life.

You see, as long as you are alive, your cells have the capacity to regenerate or transform.  Depending on the current state of your health and therefore your body’s recuperative capacity, it could take a long time or a relatively shorter time to see results.

For example, if you are overweight; a smoker and drinker and have a negative impression of life, those serve as extra barriers to healing.  Get rid of them, and you’ve got a better chance.

A Simple Exercise to Do Daily if You Sit a Lot

Back to those “lifestyle modification” tips that can help you avoid a life of pain.

Here is today’s example, an exercise called Wall Angels.  If you find yourself having a slouched upper back, rounded lower back and forward lunging neck, you’ve got to try these.  When done regularly, they can help restore and maintain good posture.

Posture affects your spine, joints, muscles, breathing, energy levels and sometimes even mindset.  It is critical to have good posture if you expect to achieve optimal health in your life.

Give it a try; all you need is an empty wall with no obstructions:

The study participants were 272 people between the ages of 18 and 65 who complained of non-specific neck pain for 2-12 weeks.   They were divided into three groups, one of which took medicine only; one which received spinal manipulation to the neck only, and a third group that was just given home exercises and self-care advice.   Participants were asked to rate their pain at 2 weeks, 1 month, 2 months, 3 months, 6 months, and one year.    The method the study used to grade the pain was subjective rating (probably using a visual pain scale between 0 to 10, with 0 being no pain and 10 being the worst pain) and a Health Status questionnaire asking them their level of ability to engage in certain activities.

The patients treated by a chiropractor experienced the highest rate of success with 32 percent saying they were pain free, compared to 30 percent of those who exercised. Only 13 percent of patients treated with medication said they no longer experienced pain.

The conclusion of the study was that for participants with acute (recent onset) and subacute (usually meaning lasting more than two weeks) neck pain, chiropractic spinal adjustments were more effective than medication in both the short and long term. However, a few instructional sessions of home exercises and advice resulted in similar outcomes at most time points.

My comments:

Biomechanical neck pain can lower the quality of life significantly.  Imagine having to struggle to turn your neck all the time, and having to avoid exercise, sports and many recreational activities due to neck pain.  According to the researchers, neck pain affects 70% of adults at one point in their lives.

From my experience, biomechanical neck pain typically arises from some type of past trauma, and it doesn’t have to be major.   Examples include car accidents, sports injuries/impacts, horseplaying as kids; and hard impact generating activities such as running, horseback riding, parachuting, gymnastics, boxing, martial arts, and cheer leading.

A second, possible cause of biomechanical neck pain is ergonomic in nature; meaning, related to positioning of the body.  Long hours of desk work keeps the head relatively stationary (static) in a single position, allowing gravity to pull down on the head, over time altering the weight distribution on the joint surfaces of the bones that make up the neck.  Such an “activity” also promotes muscle deconditioning around the neck.  The term “deconditioned” means that the muscle is slower to respond to nerve commands, so it loses some ability to support,  guard and protect the cervical spine (neck).

The worst combination is someone who has a history of impact trauma to the neck who later gets a job that involves working at a desk for long hours at a time.  The trauma history sets the stage for neck pain, and the static positioning of the head accelerates the process over time.

The pain in biomechanical neck pain frequently originates in the joint surfaces of one or several cervical vertebrae, commonly the posterior facet joints (also called the zygapophyseal joints).  This is where most of the movement occurs when turning and bending the neck.    Orthopedic surgeons sometimes prescribe a facet block for neck pain, which is an injection of pain medications directly into the joint, usually guided by video fluoroscopy.  If the patient has degenerative disc disease, pain can emanate from the intervertebral discs, either as a disc herniation or internal tear of the disc.   If this is the case, neck surgery is typically the last hope.  The disc herniation may be able to be reduced by surgery, but if the surgeon feels that the  disc is beyond repair, discectomy (total disc removal) with surgical fusion is usually performed.  However, this is like trading one evil for another.  Surgeons know that when you fuse two vertebrae together, the vertebrae above and below the fusion bear an increased burden of providing the movement lost by the two fused vertebrae.  This will lead to accelerated degenerative changes to those areas as well, over time.

Neck pain can also emanate from the surrounding muscles and fascia.  Myofascial trigger points are focal, tender spots along a muscle that are believed to develop from trauma or microtrauma.  They may actually be a concentration of nerve endings on the muscle that developed following an injury.  These are best handled through manual therapies such as chiropractic, massage, exercises and stretches.

Some people get inexplicable muscle spasms of the neck.  This is usually accompanied with a migraine or tension headache.  A muscle spasm occurs when the nerves that control the muscle misfire, causing the muscle to maintain a constant state of hypertonus (involuntary contraction).  This results in muscle pain, fatigue and low grade inflammation.   Sometimes the spasm can be so intense that anti-spasmodic medications, ice, heat, and rest have no effect.  In cases like this, botox injections are sometimes used.  Botox injections are comprised of a weakened strain of the Botox bacteria, which has the effect of muscle paralysis.

Lastly, it should be mentioned that a poor, nutrient-deficient diet and smoking can make neck pain worse by denying the body critical nutrients needed for repair and maintenance of muscles, ligaments, tendons, nerves and bones.

The study, while emphasizing that chiropractic manipulation was superior to medications in reducing neck pain among participants, also mentions that home exercises and advice were just as effective.    It therefore seems natural that a combination of spinal manipulation and home exercises would be a good strategy to reduce or eliminate biomechanical neck pain.

If you are experiencing non-specific neck pain (don’t really know what caused it) for over two weeks and desire to try chiropractic, it’s important to choose a good,  qualified chiropractor.   Some of the signs of a good, reputable chiropractor are:

1.   Doesn’t try to convince you to purchase a long-term treatment program involving multiple adjustments per week.

2.  Asks you about your complaint:  the nature of your symptoms, how they started, how long you’ve had these symptoms,  how they affect your ability to do certain things; and questions regarding your general health.

3.  Gives you his/her diagnosis and uses standard orthopedic terminology that is consistent with what you are coming in for (doesn’t go off subject).   It meshes with the information you provided in #2 above.  You feel that the chiropractor listened to you, and responded with a meaningful solution that is clear to you.

4.  Gives you a treatment recommendation the same day:  the type of treatment and a brief description of it (spinal adjustments, modalities, supports); what to expect from the treatment, and approximately how long it will take.   The chiropractor should also disclose potential  risks and side effects of the treatment.   In my opinion, six treatments followed by a re-evaluation is a sensible treatment approach for most cases of subacute, musculoskeletal pain.

A chiropractor like this may or may not have a lot of reviews on the internet.  Use your judgement, ask friends and co-workers for referrals, and by all means, don’t be afraid to change chiropractors if your first choice turned out to be bad.

Regarding home exercises and advice for treating biomechanical neck pain, stay tuned!  I will be putting up an information-packed neck pain relief video on this topic shortly.

Related articles

• Questions to Ask Your Doctor About Neck Pain (everydayhealth.com)
• Why Do I Have Neck Pain? (everydayhealth.com)

Whiplash is the colloquial term for a neck sprain strain injury that comes about from the head and neck being “whipped” back and forth as the result of a short-lived acceleration and deceleration of the body. Perhaps the most common event that can create this is a car collision; specifically a rear end car collision. Other things that can cause it are roller coaster rides and other amusement park rides; bungee jumping; horsing around and similar types of accidents.

Let’s discuss whiplash from a car accident. You’re sitting in traffic, and all of a sudden you hear a loud screech and feel something powerful crash into the back of your car. You hear crunching metal, and maybe even shattered glass. Your back sinks into your car seat as your car is thrust forward from the impact, and your body suddenly stops and reverses direction. You instinctively grip your steering wheel and stiffen your arms to protect yourself, which braces your torso somewhat but because of the flexibility of your neck and the weight of your head, your neck bends back sharply and recoils violently forward, then back again until it rests. In that split second, your neck muscles, not having enough time to react do not protect your cervical (neck) spine and suffer microtears.  Swelling sets in; then soon after, neck stiffness. Depending on the force of the impact and other factors such as the speed and mass of the car that struck you; the amount of denting/deformation of your car, and your body type other areas can experience injury as well. This includes the upper shoulders, mid and lower back, jaw, wrists, knees and ankles. Most pain in a whiplash, however, is centered in the neck, upper shoulders and upper back.

I made a video on what to do for whiplash that illustrates a good home care procedure to alleviate the pain and rehab the neck.   If you’ve suffered a whiplash injury to your neck, and were cleared by the emergency room of any red flags, the goals will be:

1. Reduce pain and swelling
2. Reduce scar tissue build up by doing gentle, active stretches, even during the pain period
3. Restore joint (verbebral) biomechanics and neck range of motion
4. Strengthen surrounding muscles in the neck
5. Restore proper neck curvature

You’ll also want to get enough protein (whey protein is the best, followed by eggs and fish), foods high in anti oxidants, and drink enough fluids during your injury rehabilitation.  Taking 2000 mg Vitamin C is also a good idea, as it has shown to be helpful in wound regeneration.  Lastly, get out in the sun and expose your neck and back for about 20 minutes.  Sunlight stimulates Vitamin D synthesis and may have other beneficial effects on the cellular level.

If you were in a car accident and want extra reassurance,  find a chiropractor who has experience treating soft tissue injuries.  Don’t just go with the office that has the loudest advertising– make sure you are comfortable with the office and the doctor first after asking a lot of questions.  I have treated whiplash injuries in San Francisco for over 15 years and have had great success.  One of my most useful pieces of equipment for treating acute sprains and strains such as whiplash is the Solaris phototherapy unit, which uses therapeutic light between 660-800 nm wavelength.  Light at this frequency actually speeds up wound healing at the cellular level by increasing ATP production (basically, increasing cellular metabolism, which includes waste removal).  Once the pain and swelling is down, I initiate manual therapies to restore joint biomechanics and to rehabilitate the surrounding soft tissues to reduce the risk of chronic pain.

If you happen to live or work near San Francisco and were injured in a car accident, you can contact my office at (415) 627-9077.

You can find more information on whiplash on my website.