<h1><b><i>The most common request I have from learners is to “deepen their anatomy knowledge &amp; understanding of the body”......</i></b></h1>
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<span style="font-weight: 400;">If you were like me, after passing your anatomy exam, you may at some point have thought “</span><i><span style="font-weight: 400;">ah I don't need to remember it all, I know how to teach a client to squat!</span></i><span style="font-weight: 400;">”. However we often subsequently learn that we are not so confident when things don’t go the way we expect or our clients move in ways we struggle to understand. This is when we start to wish we had the ability to recall anatomy better….right!?</span>
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<span style="font-weight: 400;">As a ‘non academic’ kinesthetic learner, &amp; in the last 16 yrs as an educator, I am very aware that one of the trickiest parts of teaching complex subjects like anatomy is giving learners techniques to </span><i><span style="font-weight: 400;">anchor</span></i><span style="font-weight: 400;"> each area of the body to a memory that can then be recalled when needed.</span>
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<span style="font-weight: 400;">Through a series of anatomy blogs &amp; webinars I will endeavour to offer movement practitioners a systematic approach to remembering parts of the anatomy that also has relevance in application.</span><b> </b>
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<span style="font-weight: 400;">Let me try to offer you insights into ways I was able to recall relevant anatomy using word association, the words history &amp; tactics to learn in the hope that it might offer information that is actually useful when training our clients. </span>
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<h2><b>Interesting Pelvis Facts </b></h2>
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<span style="font-weight: 400;">1). Elvis Presely was known as ‘Elvis the Pelvis’ because of the way he thrusted his hips around that, at that time, was controversially sexy.</span>
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<span style="font-weight: 400;">The pelvis is linked to feeling, or being perceived as, sexy - how might this influence how a client feels about their pelvis &amp; its function?</span>
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<span style="font-weight: 400;">2). Important functions of the pelvis are to support the hip joints as well as protect organs used for digestion &amp; reproduction.</span>
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<span style="font-weight: 400;">While movement is at the forefront of our considerations we must also keep in mind ‘functionality’ of each body part &amp; maybe broaden our thinking.</span>
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<span style="font-weight: 400;">3). The plural for pelvis is </span><i><span style="font-weight: 400;">pelves - </span></i><span style="font-weight: 400;">Years I spent not knowing there was a specific word when I stated ‘pelvises’ for plural instead of pelves!</span>
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<span style="font-weight: 400;">4). Male &amp; female human pelves are different. The female pelvis is wider &amp; more shallow (for child carrying &amp; birth) than the male pelvis. Prior to puberty there is little difference in young children. After puberty, the female pelvis is significantly larger than in males. However, women's pelvises narrow as they age.</span>
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<span style="font-weight: 400;">This is important when assessing a client's pelvis so we know that bony prominences like the PSIS, ASISI or AIIS will likely be positioned wider or narrower in women &amp; men. However if we have a long term female client or older females maybe we should not assume a wider pelvis automatically. </span>
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<span style="font-weight: 400;">5). Childbirth pretty much changes the pelvis forever due to a hormone known as relaxin which helps to soften the joints between the pelvic bones so they can separate during pregnancy &amp; childbirth. </span>
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<span style="font-weight: 400;">If our clients have recently had a baby, might be pregnant or have had babies we should understand about the potential effects of their hormones when assessing their pelvic function or even writing exercise programmes!</span>
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<span style="font-weight: 400;">6). The fetal development of the pelvis &amp; acetabulum seems to be highly related to mechanical stimuli, the most important being the gluteal muscular activity &amp; the simultaneous pressure of the femoral head.</span>
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<span style="font-weight: 400;">LOVE stuff like this as it highlights the importance of our pelvic muscles, even as a fetus!</span>
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<h2><b>Pelvic Biomechanics - The Bony Anatomy</b></h2>
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<span style="font-weight: 400;">The 2D pelvis in an anatomy book or even the 3D cast of a skeleton on top of a pole in the classroom are only individual examples of shapes &amp; sizes of pelves. When you actually see a variety of samples of real pelves (see how I am making up for the use of my new word - another tactic for never forgetting something!!) in a cadaver lab for example you can begin to appreciate just how different we ALL are on the inside too!</span>

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<span style="font-weight: 400;">There are structural differences in pelvic flare, width, height, angles, tilts and prominences. So let's start with this wonderful centerpiece of our movement &amp; some history of the naming of their parts from our latin/Greek forbearers to see if it helps with our anatomy recall.</span>

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<span style="font-weight: 400;">The pelvis is often described as being made up of 3 fused bones (ilium, pubis symphesis, ischium) and the 2 fused portions at the base of the spine (sacrum, coccyx). Here are their meanings...</span>

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<b>Ilium</b><span style="font-weight: 400;"> is latin for flank or groin &amp; describes the large flatter bone that curves up over the side of our body (flank). They are what we tend to call our hips. If you put your hands on your hips it's likely you will automatically be holding these bones!</span>

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<span style="font-weight: 400;">(Note: in anatomy there can be similar names for different body parts. This is an example incase you come across it - the </span><b>ileum</b><span style="font-weight: 400;"> refers to the distal portion of the small bowel)</span>

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<b>Pubis</b><span style="font-weight: 400;"> - pubes/puberty, hair - well I guess this speaks for itself since I imagine every reader will have gone through puberty but maybe I shouldn't assume...</span><i><span style="font-weight: 400;">hey kids….ask your parents</span></i><span style="font-weight: 400;">!</span>

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<b>Symphysis</b><span style="font-weight: 400;"> means fusion &amp; so describes the front portion of the pelvis where the bones on either side meet or fuse as our pelvis forms. This is where pubic hair grows. So again should be understood if a female client discusses a condition known as ‘pubic symphysis dysfunction’ when this area is painful. Consider how to discuss professionally &amp; from a place of understanding albeit though it may be limited &amp; could require clinical intervention.</span>

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<b>Ischium</b><span style="font-weight: 400;"> is latin for hip joint or from the word </span><i><span style="font-weight: 400;">iskhi</span></i><span style="font-weight: 400;"> meaning loin. This one I always used word association to remember as it is in reference to the 2 sitting bones. My name for these ischium was ‘</span><i><span style="font-weight: 400;">itchy bum’ </span></i><span style="font-weight: 400;">because it sounds like their latin name ;)</span>

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<b>Sacrum</b><span style="font-weight: 400;"> is sacred or holy ‘the holy bone’ used in sacrificial rites &amp; in protecting genitalia, which back in ancient times was considered a sacred thing to do. This is the triangular wedge shaped lower portion of the spine that merges to the coccyx at the very bottom.</span>

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<b>Coccyx</b><span style="font-weight: 400;"> is the Greek word </span><span style="font-weight: 400;">kokkyx for </span><span style="font-weight: 400;">cuckoo or bird as they thought it looked like the bill of the cuckoo! This is also known as the tailbone so also possible to link to a memory of a bird.</span>

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<b>Iliac</b><span style="font-weight: 400;"> (spine) is related to or near the ilium &amp; it is in reference to the portion of those hip bones that is the rim on top as if it were the spine of the pelvis. It can be used to assess how well the pelvis moves during the Gillets pelvic function test along with the PSIS that are described below. </span>

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<span style="font-weight: 400;">(Iliac) </span><b>Fossa</b><span style="font-weight: 400;"> is the Greek word for </span><i><span style="font-weight: 400;">ditch </span></i><span style="font-weight: 400;">describes the dip of the concave surface on the inner surface of the ilium.</span>

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<span style="font-weight: 400;">Acetabulum</span><span style="font-weight: 400;"> is known as the vinegar cup and describes the ‘cup’ of the hip’s ball &amp; socket joint, where the head of the femur fits.</span>

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<h2><b>Acronyms for Bony Areas &amp; Prominences </b></h2>
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<b>SIJ</b> <span style="font-weight: 400;">- Short for the Sacroiliac Joint which is where the sacrum sits inside &amp; meets the ilium. Often discussed because this area is commonly linked to our clients discomfort in this area. They may come to you with a diagnosis of SIJ dysfunction. This ‘joint’ is simply where 2 bones meet so therefore can only be dysfunctional if the softer tissues linked to its movement are problematic. Consider the load balanced on top of this joint &amp; the muscles that cross it (we will explore some of these next time in Pelvic / Hip muscles). Joints can ‘age’ though so you may hear of a problem known as sacroiliitis which is an inflammation of the joint surfaces. Again this can be caused by the breakdown of the ligaments linked to this area. So all of the above link back to our role in improving the intrinsic biomechanics of our clients pelvic function.</span>

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<b>PSIS</b><span style="font-weight: 400;"> - Short for the bony nobbly bit Posterior (at the back) Superior (upper portion) Iliac Spine (top of the ilium). Place your hands on the back of the hips, just below the waist line &amp; you ‘should’ be able to find your own PSIS. However some individuals have very prominent PSIS &amp; others are so subtle they are almost impossible to feel. They also can be found just below a dimple on either side of the lower back IF your clients has the dimples! This landmark could be used to identify if the pelvis has independent movement from one side to the other when the client lifts one leg at a time. </span>

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<b>ASIS</b><span style="font-weight: 400;"> - Short for another bony part of our pelvis known as the Anterior (at the front) Superior (upper portion) Iliac Spine (top of the ilium). This is one young girls can wish was more visible as it gives an appearance of slenderness that catwalk models push forwards during their walk. It is also the attachment site for that wonderful Sartorius muscle!</span>

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<b>AIIS</b><span style="font-weight: 400;"> - Short for, you guessed it, another bony prominence with this one being known as the Anterior (at the front) Inferior (lower portion) Iliac Spine  (top of the ilium). This one is below the ASIS &amp; is an attachment site for the rectus femoris muscle that is another key player that we should understand in our clients function &amp; limitations. </span>

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<span style="font-weight: 400;">These prominences are often used when doing postural analysis which is a subjective way of assessing or benchmarking how your clients stand or present when upright. </span>

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<h1><b>Differences in Design</b></h1>
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<span style="font-weight: 400;">We know we genetically differ &amp; as you can see here we can differ inside our bodies as much as we do on the outside but what does that mean to us as trainers? </span>

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<span style="font-weight: 400;">Coxa Valgus or Vara &amp; Femoral Version are good examples of terminologies for clients pelvis/hip geometry that differ in a way that may have clinical or movement relevance for their practitioner.</span>

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<span style="font-weight: 400;">These can be identified using simple manual tests that we offer on our <a href="https://www.biomechanicseducation.com/product/running-biomechanics-workshops/#tab-description" target="_blank" rel="noopener noreferrer">Running Biomechanics Workshops</a> for example. They can change the way we prescribe exercises or what we expect of our clients when they move. Hopefully these descriptions help to appreciate this….</span>

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<span style="font-weight: 400;">We need to add the anatomy of the femur bone or thigh bone as this relates to the HIP.</span>

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<b>The Femur</b> <span style="font-weight: 400;">is the largest bone in the body &amp; we will only discuss here the top (proximal) portion that relates to the pelvis. The other end (distal) will be discussed in the Knee Series.</span>

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<b>Trochanter</b><span style="font-weight: 400;"> comes from the Greek word </span><i><span style="font-weight: 400;">trokhos</span></i><span style="font-weight: 400;"> for wheel. It describes the large round feeling bony prominence at the side of the pelvis. It is a key landing site for the lateral glutes &amp; piriformis - to be discussed next time. </span>

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<b>Neck of femur</b><span style="font-weight: 400;"> is the part of the femur that looks like a neck sticking out from the medial side of the main femur thigh bone where the greater trochanter is lateral &amp; then ends in the ‘ball’ of the hip’s ball &amp; socket joint.</span>

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<b>Coxa</b><span style="font-weight: 400;"> is a Latin word meaning hip or limb joint (koks-h)  </span>

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<b>Coxa Vara</b><span style="font-weight: 400;"> - this is when the angle at hip (specifically the neck of the femur in relation to the shaft of the femur) is </span><i><span style="font-weight: 400;">decreased </span></i><span style="font-weight: 400;">meaning abduction may be more limited. </span>

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<b>Coxa Valga</b><span style="font-weight: 400;"> (less common)</span><span style="font-weight: 400;"> - the angle at the hip (specifically the neck of the femur in relation to the shaft of the femur) is </span><i><span style="font-weight: 400;">increased</span></i><span style="font-weight: 400;"> therefore adduction may be more limited.</span>

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<span style="font-weight: 400;">Imagine you have a client who has been diagnosed as Coxa Valga….how might this alter your expectations when you write them a programme or train them in your facility?</span>

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<b>Femoral</b><span style="font-weight: 400;"> is </span><span style="font-weight: 400;">related to the thigh or </span><b>femur. </b>

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<b>Version</b><span style="font-weight: 400;"> or </span><span style="font-weight: 400;">Vers is Latin for turned or to turn.</span>

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<b>Femoral Version</b><span style="font-weight: 400;"> describes the rotation (of turn) of the femur in relation to the pelvis. </span>

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<b>Femoral Anteversion</b><span style="font-weight: 400;"> - this describes a femur that is rotated medially (inwards)</span>

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<b>Femoral Retroversion</b><span style="font-weight: 400;"> - this describes a femur that is rotated laterally (outwards)</span>

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<span style="font-weight: 400;">Imagine you have a client who has been diagnosed as femoral anteversion….how might this alter your expectations when you write them a squat programme or train them in your facility?</span>

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<h1>So What?</h1>
You tell me, from the above information, do you think we can use this information to improve our understanding of why each client moves in different ways?

These differences can be ok to a certain degree but in some ways it may contribute to our programme design...can you now describe why? how?

Would you like to learn ways to assess your client's pelvic function?

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<h1><a href="https://www.biomechanicseducation.com/product/pelvic-spine-biomechanics-online-cpd-training/#tab-description" target="_blank" rel="noopener noreferrer">Pelvic &amp; Spine Biomechanics Online CPD Training </a></h1>
You get 2 x online classrooms plus a pdf FULL of information AND this counts as credit towards your Diploma in Biomechanics Coaching<span style="font-weight: 400;"> </span>

<span style="font-weight: 400;">Find out methods to remember muscle anatomy of the pelvis along with actions!</span>
<h2><b>References;</b></h2>
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Benson, Emily. <i>A Woman's Pelvis Narrows as She Ages</i>. 25 Apr. 2016, https://www.science.org/content/article/woman-s-pelvis-narrows-she-ages.

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“Cooperstein R, Hickey M. The Reliability of Palpating the Posterior Superior Iliac Spine: a Systematic Review. J Can Chiropr Assoc. 2016 Mar;60(1):36-46. PMID: 27069265; PMCID: PMC4807681.”

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“Coxa Vara / Coxa Valga.” <i>Physiopedia</i>, https://www.physio-pedia.com/Coxa_Vara_/_Coxa_Valga.

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“Delaere O, Dhem A. Prenatal Development of the Human Pelvis and Acetabulum. Acta Orthop Belg. 1999 Sep;65(3):255-60. PMID: 10546347.”

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“The Femur.” <i>TeachMeAnatomy</i>, https://teachmeanatomy.info/lower-limb/bones/femur/.

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Rosenfeld, Jordan. “7 Essential Facts about the Pelvis.” <i>Mental Floss</i>, Mental Floss, 21 Sept. 2017, https://www.mentalfloss.com/article/502708/7-essential-facts-about-pelvis.