We’ve covered how Osteitis Pubis is caused by the biomechanical flaws which overload your adductors, eventually causing OP. We’ve also covered that the issue is not weaknesses in one individual muscle, but rather weakness in the co-ordination and firing of groups of muscles across functional movement chains across the body. Finally we discussed that the deep front line is the true ‘core’ of your body and the most important functional chain to address when treating Osteitis Pubis.
Well then what role does your core play? If the DFL is the core of your body, what are the ‘core muscles’ that every physio, osteo and pilates expert you’ve visited has mentioned? Let’s address that now.
Deep Front Line: the rails of your body
Your body is a moving machine. Like a train on its tracks our ‘moving machine’ only works well when it moves within its limits. If you pull your leg back to kick a ball, and your hip slightly dislocates out of its socket, that ball isn’t going very far. Your DFL is a primarily fascial line whose job is to help maintain the stability of the major joints across your body. The adductors and hip flexors help keep the hip in its socket. The hip flexors and diaphragm help stabilize the spine. Most importantly the DFL works as one. As you stabilize your hip socket through the adductors you automatically stabilize your pelvis and lower back. The DFL is fascially connected web, pull on one part (the adductors) and you start to provide tension (support) to the other parts (the lower back).
The deep front line does an excellent job of keeping the joints of your body stable, especially when they are already in good position/alignment. The problem is when you are in unstable positions. When you twist to tackle someone, or jump and land on an angle. Your deep front line is important, but it can only do so much. When life throws some more extreme physical challenges, the DFL needs some extra support to keep your body in its ‘tracks’. Or more importantly sometimes it needs something to pull your body back into its tracks. This is where your ‘core’ comes in.
What are my ‘core’ muscles
The DFL is our train track, the fascial alignment which best maintains safe posture and stability through movement. If we stay on the DFL, we remain healthy and injury free. Unfortunately the pelvis and especially the spine are not solid objects. The vertebrae, each side of the pelvis, the sacrum and the rib cage can all move in their own directions. Keeping our ‘train’ on its tracks can be extremely difficult for our pelvis and lower back.
This is the ‘cores’ job. It is a system of muscles designed to help stabilise and control the movement of the spine and pelvis. You can think of it as a box (figure 1), with the pelvic floor (figure 3) at the bottom, the transverse abdominus (figure 2) on the sides (with the multifidus as the back) and the diaphragm (figure 4) as the top. If you look closely at the Transversus Abdominis (TA) you will see that its fibres connect directly on each side of each of the lower back (lumbar) vertabrae.
The core is effective. The Transverse abdominus contracts, pulling around the sides of the stomach at their attachments on each side of the lumbar verterbae. By pulling the spine in both directions the spine is pulled backwards, flattening and becoming still like in the image above (posterior view of the spine)
To increase the effect of the TA the diaphragm contracts; which pushes down the abdominal contents. Its as if a balloon is placed inside the transverse abdominis, as the abdominal contents push against the TA it contracts harder, increasing its stabilising affect on the spine. The pelvic floor also contracts, pulling up the pelvic floor to add to this effect.
In the end the core keep the spine stable, and firmly in the tracks of the DFL.
When the ‘Core’ Fails
What happens when the ‘core’ fails? The hip flexors (part of the DFL) will tighten, stabilising the lower back whilst also pulling you into an Anterior Pelvic Tilt.
Core activation and Osteitis Pubis
Obviously if your core is not activating you’re not stabilising your pelvis and particularly your spine effectively. Whether this leads to an Anterior Pelvic Tilt or not, the load and force of your upper body needs to be sent somewhere. For OP patients that’s your adductors.
Core issues constitute another piece of the complicated Osteitis Pubis puzzle. Keep reading through the rest of the pages and you’ll have a seriously good understanding of how to kick your OP for good.
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