A holistic approach to maintain optimal function, prevent potential issues and support future generations
A holistic approach to maintain optimal function, prevent potential issues and support future generationslife is a series of cycles. What goes around comes around—the circle of life.
Cultural references aside, circles and cycles are also a theme in the human body. There are many examples of round or circular-shaped structures. One of the most unique and key examples is the female pelvic girdle.
The pelvic girdle is a complex structure of bones, ligaments, muscles and fascia. It plays a massive role in supporting the upper body, transferring forces from the lower extremities and protecting reproductive organs. Pelvic stability is vital for women’s health and well-being, impacting everything from movement efficiency to pregnancy and childbirth. However, this stability is not static; it undergoes cyclical changes throughout the menstrual cycle due to hormonal fluctuations. Understanding these changes, their implications and how the body is interconnected is critical; not only for our female patients to maintain optimal function but to prevent potential issues and support future generations.
CPS and the menstrual cycle
Cyclical pelvic stability (CPS) refers to the ability of the female pelvis to maintain its structural integrity and functional efficiency throughout the menstrual cycle despite the hormonal fluctuations and biomechanical changes associated with it.
The menstrual cycle, driven by fluctuating levels of estrogen and progesterone, influences pelvic stability. These hormonal shifts can affect several aspects:
- Ligament laxity: Estrogen, particularly during the ovulatory phase, can increase ligament laxity, making the pelvis more flexible. While this is essential for childbirth, it can temporarily reduce stability and increase the risk of joint strain or injury.
- Muscle activation: Hormonal changes can alter muscle activation patterns and strength, affecting the ability of muscles, including the pelvic floor muscles, to support the pelvis and control movement.
- Fluid retention and incontinence: Fluid retention, common during certain cycle phases, can increase pressure on pelvic structures and cause discomfort.2
It’s important to note these hormonal influences do not weaken the pelvic floor musculature; they only affect stability. But as you can see, hormonal influences can be viewed as both positive and negative, which is why understanding cyclical pelvic stability requires a holistic view of the body. The body functions as a kinetic chain, where movement and stability in one area influence movement and stability in others. The feet, often overlooked, form the foundation of this chain.
How the feet impact pelvic stability
Many people may not think of the feet as the first part of the body that supports the pelvis. However, as DCs, we understand the feet are the kinetic chain’s foundation. Forces from the ground travel upward through the feet, ankles and legs, ultimately impacting the pelvis. Disruptions in this kinetic chain can lead to potential injuries, so it is essential to maintain proper alignment. This dramatically affects our patients’ overall ability to live their lives fully.
Foot posture and mechanics significantly influence the kinetic chain and how these forces are transmitted and distributed. The arches of the feet, acting as shock absorbers, help maintain proper alignment of the legs and pelvis. If our female patients present with overpronation, this can lead to internal rotation of the legs and altered pelvic alignment, which can strain pelvic ligaments and muscles, leading to pain and discomfort. Similarly, oversupination can also disrupt optimal alignment and force distribution, potentially affecting pelvic stability.
We also must consider myofascial lines, interconnected chains of muscles and fascia running from the feet to the pelvis (and beyond). A perfect example of this is the deep front line. This myofascial marvel begins with the plantar fascia and posterior tibialis, then moves into the soleus and adductors before reaching pelvic floor muscles like the obturator internus and iliopsoas. It continues up the spine and into the deep neck flexors, so its importance in posture and stability cannot be overlooked. Dysfunction in the feet can create tension or imbalances along these lines, affecting pelvic floor muscle function and pelvic stability.
Maintaining cyclical pelvic stability
We’ve looked at CPS through a multifaceted lens, and supporting our female patients also takes a multifaceted approach.
- Chiropractic care: Research supports chiropractic care for pelvic-related issues.
- Regular exercise: Research supports engaging in activities that strengthen core and pelvic floor muscles, especially during pregnancy.
- Foot care: Choose supportive footwear and an orthotic that allows for natural foot movement. Custom flexible orthotics alone have been shown to increase weight-bearing function by more than 30%.
Final thoughts
CPS is a dynamic process influenced by hormonal fluctuations throughout the menstrual cycle. Recognizing the body’s interconnectedness, including the crucial role of the feet, is essential for women to maintain optimal pelvic health. By adopting a proactive approach that includes exercise, foot care and professional guidance when needed, women can support their bodies and navigate their cyclical changes with greater ease and resilience.
Erin Stubblefield, DC, CPPM, graduated from Palmer College of Chiropractic in Davenport, Iowa, in 2006. After practicing privately for several years, she transitioned to full-time teaching. In 2024, Stubblefield became a certified physician practice manager. She owns Sunflower Consulting LLC and serves as a healthcare and practice coach. She resides outside Kansas City and is a published author and continuing education presenter. For more information, go to footlevelers.com.
