There is a physical therapy office in the health club where my studio is located. I’ve always wanted to make time to go in there, compare notes and try to work out a collaboration of some sort. Last week I finally made it in a few times and watched the main therapist manipulate people and carefully listened to his descriptions.
For the most part I was all over it. Mention “anterior tilt” or “lateral flexion” and I go professionally weak in the knees. So, I was happy to be there among the cushions and Therabands.
Then he mentioned “neutral pelvis”. And my ears really perked up. He defined neutral pelvis as “the place where you [the universal You] are most comfortable sitting, standing or lying. The neutral pelvis position may change as the patient gets stronger or is better able to hold the pelvis stable.”
Wait – what?!
So I listened again and sure enough, he said it again. And again. And to make sure I really heard him correctly, I asked him about it after the day was over. He confirmed that statement vehemently. In fact, he looked disturbed when I tried to explain how I approached neutral pelvis.
I was taught that the pelvis is neutral when the bony landmarks of the pubic bone and the ASIS are on the same plane. The pelvis is not in an anterior nor posterior tilt, no matter how good or badly it feels. Now, I’m not talking about where I would place a client to perform an exercise because so much depends on the body, the rate of conditioning or deconditioning, the exercise, etc, etc. All I’m talking about is the actual neutral pelvis.
This got me thinking about the neutral pelvis variations within the Pilates community. After all, I haven’t stirred up any trouble lately. 
So, what is “neutral pelvis” to you? Do you work in neutral or do you stick to flat back? Let’s talk.
I’ve been teaching Pilates for about 3 years and have learned at least 3 different definitions of neutral spine. In my initial teacher training, I was also taught that ASIS and PSIS on the same plane equals neutral pelvis. At some point later (forget who and when) I learned that it’s common that level ASIS and PSIS equals neutral for men, but in women, it’s common for the PSIS to be a bit higher. These guidelines, I think, are both too general. Last spring I took an Anatomy Trains(R) for Pilates Instrutors course in Portland, OR, taught by Lauren Christman and she told us the best way to assess an individual’s neutral spine was in standing – have them anteriorly or posteriorly tip their pelvis and then stop when they are at their tallest standing position. I think my jaw dropped when I heard this – it’s so simple/obvious, but so brilliant at the same time. It allows for a common goal – length and decompression of the joints, but is also tailored to the individual’s unique anatomy.
Melinda:
Thanks for your comment! Very cool! I like the idea of a less “passive” way of looking at the pelvis. I appreciate you sharing. Kerrie Ann
In Body Control, we have a very finite definition for neutral – ASIS and pubic bone on the same plane. We explain that in this position the joints are as close to their ‘neutral’ position as possible, i.e. that each joint is in the middle of its range, not flexed or extended at all.
That being said, we also recognise that this may be difficult to achieve for some clients, and we talk about ‘the best neutral for you today’ and things like that.
Hi Kerrie,
I am currently going through a training certification (Body Arts and Science International) and am working on my practice hours. In BASI, neutral pelvis is ASIS and PS on same plane. The BASI faculty seem to feel that neutral isn’t a held position, but a place to compare all other pelvic positions with.
As I have been practicing more and more, I see that the concept of neutral pelvis confuses beginner clients.. only really body aware people seem to get it. When do you introduce neutral pelvis to your clients? After they have gotten some awareness of an abdominal and pelvic floor connection?
Thanks!
Jenny
Jenny:
Thanks! KA
Good morning! Personally, I introduce neutral pelvis from the get go, but that doesn’t mean the client stays there or works from there. I try to help them experience what it feels like to be all around the “pelvic clock” so that they can begin to build proprioception. Kinesthetic awareness can come to some immediately and can take years of repetition to fully understand. For me, I’ve found repetition to be a beginner client’s friend.