Patients often seek out my practice as a Body Function Specialist, because they want a Functional Medicine approach to help solve their persistent pain whether it’s in the back, hips, knees, feet, etc.  

Many people already perform “core strengthening” exercises as taught by their trainers or physical therapists.  Unfortunately, contracting the abdominal wall muscles as a way to strengthen the core is only partially effective.  While it does offer support to the strained back and prevents the pelvis from tipping anteriorly, tightening just the stomach muscles allows posterior pelvic rotation, which can still shorten many muscles and limit pelvic flexibility.

In this video/transcript, I describe the importance of activating the “true core” as one of the first steps to achieving a more functional and flexible pelvis.  Many patients find that strategically activating the pelvic floor reduces their back pain and greatly helps their mobility.  

Transcription:

Hi, I’m Dr. Cathy Kim. Founder of Integrative Body Medicine and member of the Institute for Functional Medicine and Academy of Integrative Health and Medicine. 

This video explains how to access the deepest core muscles, to elevate the front of the pelvis, and help achieve a more neutral pelvis. 

Let’s look at the pelvis, which is shaped like a bowl. Imagine three puppet strings attached to our pelvis, one low in the front, and two at the top of the bones in the back. If you were to let go of the back strings, the pelvis would tilt backwards. If you let go of the front string, the pelvis tips forwards. It turns out that when we never access the puppet string in the front, we over-rely on the two back strings, otherwise known as the Quadratus Lumborum muscles. 

Most of us are not even aware that we have the ability to lift the pelvis in the front. So as our deepest muscle, the hip flexor gets tighter. We let our pelvis rotate anteriorly, dragging our upper torso down with it. 

So can we learn to lift up this third puppet string? Well almost everyone has heard of the advice that we need to “strengthen our core” to support our back and this is partly accurate. Most people interpret “the core” to mean the central abdomen, muscles of the rectus abdominis, the classic six-pack. But it turns out that, although building up strength in this area can help support the back, it still can’t save you from the relentless forward tipping forces of the hip flexor that we explained in the last video. The pelvis will still rotate anteriorly. The rectus just won’t let it tip over too far. 

To stabilize the pelvis and resist the anterior rotation force of this invisible hip flexor, we need to access a second deep invisible muscle group, the pelvic floor. The origin of the “true core”. Men and women both have the ability to access these muscles, and we do use them to stop our urine stream or hold our urine in when we really need to go. 

In fact, men and women have been using this for thousands of years to practice Yoga. It is called your Mula bandha, which is Sanskrit for a root lock. Isn’t that a fitting name for your true core? 

Many women have already heard of strengthening these muscles in an exercise called “Kegels” but traditional teaching advised to do these kegel exercises repetitively, usually while sitting, such as its stoplights. The limitation with doing these kegel exercises while seated is that in the end, it’s just an exercise that will help you hold your urine better. 

There’s been a shift towards making more exercises, more functional so that we can recruit the muscles in the correct sequence to correct our imbalance mechanics. If we mindfully use our root lock, while the pelvis is in motion, then our front puppet string opposes the hip flexor and thus helps stabilize the pelvis. 

This is now functional exercise for the pelvic floor muscles that you could potentially do a hundred times per day. As you enter your car, stand up and sit down at work, put on pants, and open heavy doors. So rather than do traditional sit-ups for your core, which actually shortens and tightens your hip flexor. Try lifting your pelvic floor and holding your pee. To activate your deep front puppet string, right at the moment that you get up from sitting or as you’re sitting down. Most people notice a reduction in back pain during this movement because they are using the front puppet string to reduce strain on the back. 

As an added bonus, accessing this Mula bandha recruits other muscles such as abdominals, and thigh muscles and helps to strengthen them just by living your normal day, without even going to the gym. 

If accessing your root lock makes sense to you and you’re wondering what more you can do to help your pelvis move even more towards neutral. Please watch my next videos. You can also visit my website integrativemedicine.com (now drcathykim.com) to learn more about my approach to whole-body health.