Pelvic Stability and the Role of Deep Core Muscles

Why Pelvic Stability Matters for Manual Therapy Clients

Pelvic stability plays a foundational role in postural control, functional movement, and the prevention of musculoskeletal pain. For manual therapy practitioners, understanding the deep core muscles and their relationship to the pelvis is essential for effective assessment, treatment planning, and long-term client outcomes.

Pelvic instability—whether due to muscle weakness, poor motor control, or injury—can contribute to a wide range of complaints. Low back pain, hip dysfunction, and even shoulder or neck issues may stem from an unstable or poorly supported pelvis. This interconnectedness makes pelvic stability a key focus area during both hands-on work and corrective exercise education.

Illustration of deep core muscles, including the diaphragm, transversus abdominis, pelvic floor, and multifidus, emphasizing their role in pelvic stability.

The Deep Core Muscles and Their Functions

The term "deep core" refers to a group of muscles that provide internal support to the spine and pelvis. The four key players are:

• Transversus abdominis (TrA): Often described as a natural corset, the TrA wraps horizontally around the trunk, stabilising the lumbar spine and sacroiliac joints.

• Multifidus: These deep spinal muscles run segmentally along the vertebrae, providing stability and fine control during spinal movement.

• Pelvic floor muscles: These support the pelvic organs and contribute to intra-abdominal pressure and lumbopelvic stability.

• Diaphragm: Often overlooked in core discussions, the diaphragm works synergistically with the pelvic floor and abdominal muscles to regulate intra-abdominal pressure during breathing and movement.

When these muscles function in harmony, they create a stable base for movement. Dysfunction in any one of them can lead to compensatory patterns, increasing the risk of strain or injury elsewhere in the kinetic chain.

How Manual Therapy Can Help

Manual therapy can improve pelvic stability by:

• Releasing overactive superficial muscles that inhibit deep core activation.

• Improving proprioception and neuromuscular control through soft tissue techniques.

• Educating clients about breath control and diaphragmatic breathing, which enhances core engagement.

• Collaborating with movement professionals or prescribing simple corrective exercises to activate and strengthen the deep core.

While massage alone won't "fix" pelvic instability, it plays a valuable role in supporting awareness, comfort, and motor retraining—especially when integrated into a broader care plan.

Supporting Your Clients' Stability Goals

Manual therapy practitioners are uniquely positioned to recognise the early signs of pelvic instability and guide clients towards better movement patterns. Whether you're working with clients recovering from injury or helping active individuals improve performance, a focus on pelvic stability can enhance results and reduce the risk of recurrent pain.

Encouraging conscious breath work, postural awareness, and gradual strengthening of the deep core creates a strong foundation for your clients’ everyday activities—and makes your treatments even more impactful.