Lecture Notes: Lumbo-Pelvic Hip Complex Movement Interventions

Introduction

• Focus on the lumbo-pelvic hip complex, integrating hip, pelvis, and lumbar spine.
• Importance of understanding biomechanics and anatomy for designing movement interventions.
• Initial focus on the pelvis; lumbar spine to be discussed in a separate video.

Pelvis Functionality

• Described as a fulcrum and relay station for forces, directing them up and down the kinetic chain.
• Keystone of the human movement system; stability and mobility here affect the entire kinetic chain.
• Critical for designing movement interventions and addressing movement dysfunction.

Kinetic Chain Needs

• Hip: Needs mobility; stable joint from a bony perspective (femoral head in acetabulum).
• Lumbar Spine: Needs stability due to its inherent mobility.
• Concept of "mostability" - hips need to become mobile first, then controlled for stability (Gary Gray).

Myofascial Meridians

• Visual representation of myofascial meridians or anatomy trains.
• 12 integrated systems providing tension and stability.
• Focus on the functional back line, back spiral line, and deep anterior chain.
• Posterior chain combines superficial back line with glutes and hamstrings.

Deep Front Line

• Overlapping muscles providing stability from lumbar spine through the pelvis to femur.
• Involvement of hip flexors, pelvic floor muscles, adductors.

Back Spiral and Functional Lines

• Includes glutes, hamstrings, contralateral erectors, and thoracolumbar fascia.
• Exercises like "Supermans" and "bird dogs" influence these lines.

Lumbo-Pelvic Hip Complex and Core Stability

• Key to core stability; involves 29 muscles acting on the pelvis.
• Core functions to produce, reduce, and control forces.
• Dynamic stabilization of joints above and below.

Hip and Related Structures

• Femur: Strong and stable femoral acetabular joint; prone to immobility.
• SI Joint: More stable but fixed; immobility in hips affects lumbar spine and SI joints.
• Imbalanced hips often lead to back pain.

Posterior Chain Musculature

• Includes gastroc, hamstring, glute max, thoracolumbar fascia, erector spinae.
• Glute max: Hip extensor, eccentric decelerator of hip flexion.
• Glute medius: Decelerator of femur, prevents patellofemoral syndrome and shin splints.

Anterior and Lateral Chains

• Hip Flexor: Psoas major and iliacus; pulls lumbar spine forward, influences hip rotation.
• Tensor Fascia Lata (TfL) and IT Band: Flexes and rotates the hip; associated with runners knee and snapping hip syndrome.

Quadriceps and Adductors

• Quadriceps: Influence hip and knee; prevent valgus collapse.
• Adductors: Stabilize pelvis and femur; act in swing phase and help in hip flexion.

Sartorius and Gracilis

• Sartorius: Flexes and externally rotates the femur.
• Gracilis: Works like adductors; involved in frontal plane motion.

External and Internal Rotators

• Deep External Rotators: Include piriformis; primarily rotate the femur externally.
• Glute Medius and Minimus: Act as internal rotators.

Conclusion

• Encouragement to think about muscle synergies rather than isolated muscle functions.
• Challenge to design movement interventions to improve these synergies.
• Example of complex movement synergies demonstrating stabilization and motion in three planes.