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What You Don't Know About Pelvic Pain Could Hurt You

Updated: Jan 24, 2021

Manchester United Football Team

Manchester - my home city and my favorite football team (much better than the Arsenal (my wife's team!)). I remember many years ago one of the most prevalent injuries in soccer at the time was hamstring strains. That was until they hired a kinesiology expert, who assessed and discovered that regular stretching of the hamstrings was not solving the problem.

What they discovered is that by strengthening the hamstrings instead was actually reducing the occurrence of hamstring injuries in these professional athletes.

Today's article will plunge into the why a little deeper and teach you a simple exercise to strengthen your posterior chain muscles. Not sure what your posterior chain muscles are? Read on...

Anatomy 101 of the Pelvis

The core of my message today revolves around muscle-length tension relationships. I learned this many years ago through Paul Chek and the CHEK Institute, specifically how to assess (and not guess!) WHY muscles are imbalanced and HOW to correct them.

The hamstrings are comprised of three muscles - semitendinosis, semimemberinosis and biceps femoris. They originate from the medial aspect of the tibia and lateral aspect of the fibula, and attach into a single tendon to the base of the pelvis at the ischial tuberosity. Collectively, the calf, hamstring, gluteal and spinal erectors form the posterior chain muscles. Essentially, these are all the muscles that work in harmony to take your body from a flexed position into a neutral, or extended, position.

The hamstrings have the potential to be a strong and powerful muscle group and directly influence the position and alignment of the pelvis and, ultimately, the entire spine.

(1) If the hamstrings become too SHORT and TIGHT they will leverage on the back of the pelvis causing posterior rotation of the pelvis, flattening the lower back and increasing your risk for disc bulges;

(2) If the hamstring becomes too LONG and WEAK they will be too weak to hold the pelvis in a normal position and the pelvis will tilt the opposite way into anteriorly rotated position, overarching the lower back and increasing your risk for digestive disturbances and, for women, pregnancy issues; and

(3) If the hamstrings are considered in NORMAL tension this will help maintain a more ideal pelvic alignment, 0-5 degrees for men and 7-10 degrees for women, aiding in a healthy spinal alignment.

My 3-Step Solution:

Step 1. Test the hamstring muscle length.

Step 2. Begin to: a) STRETCH only if the hamstring is SHORT-TIGHT b) STRENGTHEN only if the hamstring is LONG-WEAK c) STRETCH & STRENGTHEN equally if the hamstring is NORMAL.

Step 3. Re-test each week initially, then monthly, and modify your steps in #2 as the muscle length changes.

A Simple Home Test

A quick simple test you can do, is have someone place their fingers on your pelvis on

two bony landmarks and judge the angle. On the front of your pelvis is the ASIS (anterior superior iliac spine) and on the rear side of the pelvis is the PSIS (posterior superior iliac spine). By placing one finger of one hand on the ASIS and another finger of the other hand on the PSIS, your friend can lean back and judge if the fingers are level, or if the ASIS is higher or lower than the PSIS.

Important - repeat on the left and right side of the pelvis as these measurements can be different each side!

Your Results Fingers are Close to Level (White Line)

For men this can be considered within normal alignment. The hamstrings should be equally stretched and strengthened.

For women this would indicate that the hamstrings are SHORT-TIGHT and therefore need more STRETCHING.

ASIS is LOWER than the PSIS (Red Line)

If this is a small amount it would be considered normal alignment (under half inch) for both men and women. The hamstrings should be equally stretched and strengthened.

If, however, there is a significant difference between the two fingers (greater than half inch) then I would consider your hamstrings to be LONG-WEAK and therefore need more STRENGTHENING.

PSIS is LOWER than the ASIS (Orange Line)

As this starts to happen it is indicating the hamstrings are becoming SHORT-TIGHT and therefore need more STRETCHING.

If you are a patient of mine, ask me at your next massage to measure your alignment more accurately using a goniometer device. If not, you could consult your trainer or physical therapist and ask them to measure your pelvic tilt angles.

Important Next Steps

Remember it is always better to ASSESS and not GUESS! Once you have an understanding of whether your hamstrings are SHORT-TIGHT, LONG-WEAK or NORMAL you can then follow a simple program to help rebalance your hamstring muscle health.

The benefits of maintaining healthy hamstrings include:

- Improved physical performance - walk/run/jump more efficiently, longer and faster.

- Better shock absorption - with any running or jumping, how you attenuate those forces through your hamstrings and related shock-absorber muscles helps minimize the unnecessary forces to your ligaments and tendons.

- A healthy pain-free back - when inflexible the hamstrings compress the sciatic nerve and can trigger sciatica and misfiring of other muscles in the hips and lower back.

- Increased range of motion of the hips and lower spine.

Of course, the body is comprised of over 600-muscles and it may seem like an overwhelming task to try to find balance in all of these soft-tissues on a daily basis.

My advice is: eat well, sleep well, think well, move well and get regular, monthly, deep-tissue massage.

Ultimately, listen to your body and make small 'atomic habit' changes.

"By the yard it's hard, but inch-by-inch, anything's a cinch."

Brian Tracey

Here is my recommend 'inch' for you this week - how to strengthen your hamstrings using the Bridge exercise. Follow my video instructions below.

Any questions, you can reach me at my clinic by phone: 403 589 4645 or email:

Please help me on my mission to relieve stress, tension and pain. Share this anyone you know that would benefit from this blog article :)

Yours In Muscle Health,

Jason Barlow, RMT

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