Why Anterior Ilium Rotations Keep Coming Back: What Pelvic Therapists Are Missing

If you keep correcting anterior or posterior rotations of the ilium – yet they keep coming back – this episode can change how you assess the pelvis forever. Lynn invites pelvic health therapists to look beyond bones, SI mechanics, and muscle energy techniques to uncover what may actually be driving these stubborn patterns. You know that quiet inner nudge that says, “There’s more going on here”? This episode confirms it. Listen in as Lynn reveals two often-overlooked structures that can torque the pelvis and prevent corrections from holding. If you’re ready to stop chasing symptoms and start finding answers, you won’t want to miss this conversation.

✨ Episode Highlights:

• Why anterior ilium corrections often don’t last
• The hidden role of uterine mobility in pelvic alignment
• How round ligament restrictions can torque the pelvis
• When repeated corrections are a cue to go deeper
• Expanding pelvic assessment beyond traditional PT training

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Transcript

This meeting is being recorded. Are you only addressing the ileum in the pelvis? If so, I invite you to tune into this session, tune into this episode as I dive into what may be causing some of those anterior rotations of the ileum beyond just the bones.

But before we dive into that, I want to just let everybody know that... As a pelvic health therapist, when you address the pelvis, are you...

If addressing anterior rotations of the ilium, anterior or posterior, if that's all you're addressing in the pelvis, I want to, I don't know, that's not what I want to say.

Thank you. Else might be going into your rotation, so now we have to be beyond what you may already know.

As pelvic health therapists, are you addressing anterior rotations in the pelvis? If so, I invite you to pay attention to this episode as I discuss what else might be causing these anterior rotations of the ileum beyond what you might be considering.

But before we do that, I want to let everybody know that we are in the month of February. And that our course highlight this month is the Pregnancy Pain and Beyond course.

And if you are interested in checking out that course, note that you will be saving $50 off of that course this month.

And this Pregnancy Pain and Beyond course is geared more towards the superficial structures of the muscles and fascial systems.

And it really dives deep into baby's position in the body and what might be causing those positions and what baby positions might be causing some of the common pains that pregnant clients complain of.

And I do go into detail of how to address some of the most common issues and pain issues that pregnant clients complain of.

So, um, I have to say that the response from this course alone has been greater than all my other courses.

I've had so many therapists come up to me and go, Oh my gosh, Lynn, I really love this course.

So you've done a great job in putting it together. So thank you to everybody who shared that. And I would love to share it with those of you that would like to dive deeper into understanding more about pain, pregnancy pain, and also baby's position, including breech position.

So I do cover how we can address that without causing baby to turn. We're not informing or encouraging. Let's see.

We're not forcing baby to turn. That's what I meant to say there. We're not forcing baby to turn. We are encouraging and we're creating greater space in the pregnant client's body to allow baby to choose a head down position if it wants to.

So please check out that course if you haven't already. Like I said, I've gotten some really great, great feedback on that course, and I'm excited to share that with you.

All right. So let's go ahead and dive into anterior rotations of the ilium. Now, I have to say early on in my career.

world. this your Aaron Okay. So Okay. Amy This is probably one of the biggest things that PTs, and I think most PTs listening in here, are like, when you think about the pelvis, you're always looking for anterior-posterior rotations, and like, especially sacroiliac joint dysfunction, we're always looking, well, is the ilium rotated one way, is it posterior, is it anterior?

And some of you may have learned some muscle energy techniques to help to try to correct that. Well, after learning about the spring testing to the pelvis, and understanding more about what I know about the pelvis with the influence of birth, I really have kind of taken this anterior-posterior rotation, it's not a backburner in my mind when I'm working with my clients.

However, it does occasionally show up, and it is prevalent, and most of you may be aware that when we have an anterior rotation of the ilium, there may be a leg length discrepancy that is creating that.

The ilium is going to anteriorly rotate to lengthen the short. And if you are constantly always finding your client with an anterior rotation, you keep correcting and correcting and correcting it, one of the structural issues could be a shortened femur or tibia fibula that is causing that leg to be shorter than the other, and that's why the pelvis is always going into the anterior rotation.

However, there are some other structures in there that I want to talk about in this episode. Now, for those of you that know muscle energy technique, the anterior posterior rotations, we're really focusing in on hamstring and hip flexors and seeing if we can make, and glutes, and seeing if we can make some good changes in the structural position of the ilium with focusing in on those muscles.

So that's great. But I want to talk about a couple other structures that you guys might not be aware of and how it might be contributing to.

Two, anterior rotations of the ilium, and that is the uterus, okay? The uterus is the central hub of the pelvic space, and it sits down deep in the bowl of the pelvis, and remember, the body is going to protect the arteries, the nerves, and the organs, and if there is a restriction in any of those structures, the body is going to start contorting around that restriction to save those structures, and if we have any tension in the uterus, and the uterus is twisted or maybe tight on one side, the pelvis is going to torque a little bit to decrease that tension in there.

I have found that when I found anterior and posterior rotations of the ilium, if I go and address the mobility of the uterus, it changes the rotations in the ilium.

They're no longer And so I just would love to expand your awareness when you are focusing on the pelvis and you find an anterior rotation.

Yes, we can correct it and do what you do to correct it. I teach a correction position mobilization that it's a mobilization and a positional stretch that you can have your clients do to correct it.

And if it doesn't stay and it keeps coming back, that's the body's way of either, you know, one, we either have a leg link discrepancy and that's what's causing it, or we have a restriction in the uterus and the body is not liking it.

Another big structure, which is related to the uterus that can be facilitating these anterior rotations, is the round ligament.

Now think about the course of the pathway of this round ligament and how any restrictions in there is going to cause the ilium to shift.

So the round ligament starts in the anterior lateral aspect of the fundus, down deep in the pelvic ring, down deep in the pelvic bowl, and then it comes out laterally and it actually draws up the walls of the pelvis.

I've seen it in the cadaver lab. It's so cool, the pathway of the round ligament. So it goes up the walls of the bowl of the pelvis, and then it pierces into the inguinal canal somewhat closer towards the ASIS.

So maybe an inch to an inch and a half from the ASIS is where it pierces into the inguinal canal, and then it courses through the inguinal canal, and then it pops out near the pubic tubercle of the symphysis pubis joint, lateral to it, and then it goes down and inserts into the labia.

If we have any restriction throughout that passageway, as it's going into... So if you are dealing with anterior rotation of the ilium, please make sure you know how to check out the mobility of the uterus and how to treat the round ligament.

Okay. And when you do those things, then you may find that when your clients come back, they don't continue to have this anterior rotation.

Okay. So if something, if you correct something and your client leaves and you feel like you're corrected, but they come back with the same thing, you got it.

So dive deeper and you've got to get more curious to figure out what's causing that return of that pattern.

Now, it could be something that they're just doing themselves, the way they're sitting on a couch all the time, the way they're driving, or, you know, could be some postural pattern.

But please do a quick little assessment of the uterine mobility and see if the round ligament is restricted on the side that is anteriorly rotated.

And a round ligament that is in dysfunction is way thicker than a normal, happy round ligament. And you can feel the round ligaments on the labia majora.

You can just keep, you go across the labia majora and just see if you can feel for the rope of the round ligament.

And if you find it really easily, that's probably a ligament in dysfunction. And it's thicker and bigger when it is in dysfunction.

And that means that it needs help in its pathway moving through its Pathway to be able to have greater freedom of mobility in it.

And then that's going to help the ilium to not have to contort around it to take the tension off of that ligament and that organ.

Okay. So I hope listening into this podcast, those of you that have taken my pregnancy course, you know how to address the uterine mobility and the round ligaments.

If you haven't taken the holistic pregnant body course, you can figure out how to, you will learn how to treat the round ligament and the uterine mobility in this pregnancy pain and beyond course that we are highlighting this month.

So please check that out. Okay. So thank you everybody for listening up. And also I want you to pay attention in the next couple of weeks.

I'm going to be doing another recording, probably in March, around other ways that we can work with the pelvis, everyone, we need to get beyond anterior-posterior rotation in flare-out flare.

There's So much more that happens in the pelvis beyond that, that our PT training, OT training has not addressed.

And that's what I want to talk to you more about then. All right. My courses do it as well.

So keep on learning, everybody. Keep on learning. Thanks so much for listening in. Please share this episode with colleagues that may benefit from hearing this.

And I appreciate all the great work that you're doing out there in the world. Let's keep it up and let's support our mamas to have smoother births and faster recoveries.

Everybody take care and we'll see y'all in the next episode. Bye-bye.