Background: The pelvic girdle is an important component of the human stabilization system, both during the maintenance of an upright standing position and during motor activities. Frequent functional and structural asymmetries within it can affect the structure and function of many organs and systems of the human body. The mechanism of their occurrence is not fully explained. The objective of the present study was to verify the hypothesis regarding the relationship between the value of pelvic asymmetry and the functional state of muscles that stabilize the lumbo-pelvic-hip complex, as measured by changes in their stiffness. Methods: The study group consisted of 40 young women aged from 19 to 29 years. The observational cross-sectional study incorporated the following elements: an interview, an anthropometric test, an inclinometric assessment of the magnitude of hip girdle rotation utilizing a duometer and tensiomyography. Results: Analysis of the variables examined in subjects with symmetric or rotated pelvises did not show significant differences between the studied sides in the two groups. Evaluation of associations between the magnitude of pelvic rotation and tensiomyography findings showed that with increased pelvic rotation, the stiffness of the back extensor muscles and the rectus thigh muscles increased only slightly bilaterally, and the contraction rate of the rectus abdominis and biceps thigh muscles decreased. Conclusions: The results of the tensiomyography study did not unequivocally demonstrate that changes in pelvic symmetry in the transverse plane are associated with dysfunction of the muscles that stabilize the pelvic girdle.

Department of Health Care Studies College of Polytechnics 586 01 Jihlava Czech Republic

Faculty of Arts and Educational Science University of Silesia 43 400 Cieszyn Poland

Faculty of Health Catholic University 034 01 Ružomberok Slovakia

Institute of Clinical Rehabilitation Faculty of Motor Rehabilitation University of Physical Culture in Krakow 31 571 Krakow Poland

Institute of Health Sciences Academy of Applied Sciences 34 400 Nowy Targ Poland

Research and Development Center Legia Lab Legia Warszawa 00 449 Warszawa Poland

Science and Research Center of Body Posture Kazimiera Milanowska College of Education and Therapy 61 473 Poznan Poland

SNP Central Military Hospital Faculty Hospital 034 01 Ružomberok Slovakia

Zobrazit více v PubMed

Krahl H., Michaelis U., Pieper H.G., Quack G., Montag M. Stimulation of bone growth through sports. A radiologic investigation of the upper extremities in professional tennis players. Am. J. Sports Med. 1994;22:751. doi: 10.1177/036354659402200605. PubMed DOI

Boulay C., Tardieu C., Bénaim C., Hecquet J., Marty C., Prat-Pradal D., Legaye J., Duval-Beaupère G., Pélissier J. Three-dimensional study of pelvic asymmetry on anatomical specimens and its clinical perspectives. J. Anat. 2006;208:21–33. doi: 10.1111/j.1469-7580.2006.00513.x. PubMed DOI PMC

Kanchan T., Mohan Kumar T.S., Pradeep Kumar G., Yoganarasimha K. Skeletala symmetry. J. Forensic Leg. Med. 2008;15:177–179. doi: 10.1016/j.jflm.2007.05.009. PubMed DOI

Maloney S.J. The Relationship Between Asymmetry and Athletic Performance: A Critical Review. J. Strength Cond. Res. 2019;33:2579–2593. doi: 10.1519/JSC.0000000000002608. PubMed DOI

Bussey M.D. Does the demand for asymmetric functional lower body postures in lateral sports relate to structural asymmetry of the pelvis? J. Sci. Med. Sport. 2010;13:360–364. doi: 10.1016/j.jsams.2009.02.010. PubMed DOI

Güntürkün O., Ocklenburg S. Ontogenesis of Lateralization. Neuron. 2017;94:249–263. doi: 10.1016/j.neuron.2017.02.045. PubMed DOI

Kurki H.K. Bilateral asymmetry in the human pelvis. Anat. Rec. 2017;300:653–665. doi: 10.1002/ar.23546. PubMed DOI

Alqadah A., Hsieh Y.W., Morrissey Z.D., Chuang C.F. Asymmetric development of the nervous system. Dev. Dyn. 2018;247:124–137. doi: 10.1002/dvdy.24595. PubMed DOI PMC

Traver-Vives M., Guillén-Villar A., Del Río L., Casinos A. Asymmetry in the length of human humerus and radius during ontogeny. Anthropol. Anz. 2021;78:151. doi: 10.1127/anthranz/2021/1068. PubMed DOI

Bibrowicz K., Szurmik T., Ogrodzka-Ciechanowicz K., Hudakova Z., Gąsienica-Walczak B., Kurzeja P. Asymmetry of the pelvis in Polish young adults. Front. Psychol. 2023;14:1148239. doi: 10.3389/fpsyg.2023.1148239. PubMed DOI PMC

Al-Eisa E., Egan D., Deluzio K., Wassersug R. Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: A comparison with standing. Spine. 2006;31:E135–E143. doi: 10.1097/01.brs.0000201325.89493.5f. PubMed DOI

Gum J.L., Asher M.A., Burton D.C., Lai S.M., Lambart L.M. Transverse plane pelvic rotation in adolescent idiopathic scoliosis: Primary or compensatory? Eur. Spine J. 2007;16:1579–1586. doi: 10.1007/s00586-007-0400-4. PubMed DOI PMC

Khamis S., Carmeli E. Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review. Gait Posture. 2017;57:115–123. doi: 10.1016/j.gaitpost.2017.05.028. PubMed DOI

Kuszewski M.T., Gnat R., Gogola A. The impact of core muscles training on the range of anterior pelvic tilt in subjects with increased stiffness of the hamstrings. Hum. Mov. Sci. 2018;57:32–39. doi: 10.1016/j.humov.2017.11.003. PubMed DOI

Yu Q., Huang H., Zhang Z., Hu X., Li W., Li L., Chen M., Liang Z., Lo W.L.A., Wang C. The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural system. BMC Musculoskelet. Disord. 2020;21:596. doi: 10.1186/s12891-020-03617-3. PubMed DOI PMC

Zhang F., Zhang D., Huang Z., Wang Z., Cai X. Morphological Asymmetry of Pelvic Rings: A Study Based on Three-Dimensional Deviation Analysis. Orthop. Surg. 2022;14:967–976. doi: 10.1111/os.13246. PubMed DOI PMC

Stȩpień A., Maślanko K., Rekowski W., Fabian K., Tuz J., Graff K. Analysis of the prevalence of asymmetry and muscle tone disorders in the first year of life among youth with idiopathic scoliosis: A retrospective case-control study. J. Back. Musculoskelet. Rehabil. 2022;35:1003–1011. doi: 10.3233/BMR-171075. PubMed DOI

Sorensen C.J., Johnson M.B., Norton B.J., Callaghan J.P., Van Dillen L.R. Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing. Hum. Mov. Sci. 2016;50:38–46. doi: 10.1016/j.humov.2016.10.003. PubMed DOI PMC

Lewit K. Manipulative Therapy: Musculoskeletal Medicine. 1st ed. Churchill Livingstone; London, UK: 2009.

Gnat R., Bialy M. A new approach to the measurement of pelvic asymmetry: Proposed methods and reliability. J. Manip. Physiol. Ther. 2015;38:295–301. doi: 10.1016/j.jmpt.2015.02.002. PubMed DOI

Manheim C.J. The Myofascial Release Manual. 4th ed. Slack Incorporated; Charleston, SC, USA: 2008.

Myers T. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Churchill Livingstone Elsevier; Philadelphia, PA, USA: 2014.

Juhl J.H., Ippolito Cremin T.M., Russell G. Prevalence of frontal plane pelvic postural asymmetry—Part 1. J. Am. Osteopath. Assoc. 2004;104:411–421. PubMed

Gelber J.D., Soloff L., Schickendantz M.S. The Thrower’s Shoulder. J. Am. Acad. Orthop. Surg. 2018;26:204–213. doi: 10.5435/JAAOS-D-15-00585. PubMed DOI

Hellebrandt F.A., Houtz S.J. Mechanisms of muscle training in man: Experimental demonstration of the overload principle. Phys. Ther. Rev. 1956;36:371–383. doi: 10.1093/ptj/36.6.371. PubMed DOI

Nelson A.G., Kokkonen J., Arnall D.A., Li L. Acute stretching increases postural stability in nonbalance trained individuals. J. Strength. Cond. Res. 2012;26:3095–3100. doi: 10.1519/JSC.0b013e3182430185. PubMed DOI

Miyamoto N., Hirata K., Miyamoto-Mikami E., Yasuda O., Kanehisa H. Associations of passive muscle stiffness, muscle stretch tolerance, and muscle slack angle with range of motion: Individual and sex differences. Sci. Rep. 2018;8:8274. doi: 10.1038/s41598-018-26574-3. PubMed DOI PMC

Kumagai H., Miyamoto-Mikami E., Hirata K., Kikuchi N., Kamiya N., Hoshikawa S., Zempo H., Naito H., Miyamoto N., Fuku N. ESR1 Rs2234693 Polymorphism is associated with muscle injury and muscle stiffness. Med. Sci. Sports Exerc. 2019;51:19–26. doi: 10.1249/MSS.0000000000001750. PubMed DOI PMC

Kuitunen S., Komi P.V., Kyrolainen H. Knee and ankle joint stiffness in sprint running. Med. Sci. Sports Exerc. 2002;34:166–173. doi: 10.1097/00005768-200201000-00025. PubMed DOI

Ličen U., Opara M., Kozinc Ž. The Agreement and Correlation Between Shear-Wave Elastography, Myotonometry, and Passive Joint Stiffness Measurements: A Brief Review. SN Compr. Clin. Med. 2024;6:27–35. doi: 10.1007/s42399-024-01658-6. DOI

Lee Y., Kim M., Lee H. The Measurement of Stiffness for Major Muscles with Shear Wave Elastography and Myoton: A Quantitative Analysis Study. Diagnostics. 2021;11:524. doi: 10.3390/diagnostics11030524. PubMed DOI PMC

Martín-Rodríguez S., Loturco I., Hunter A.M., Rodríguez-Ruiz D., Munguia-Izquierdo D. Reliability and Measurement Error of Tensiomyography to Assess Mechanical Muscle Function: A Systematic Review. J. Strength. Cond. Res. 2017;31:3524–3536. doi: 10.1519/JSC.0000000000002250. PubMed DOI

Lohr C., Braumann K.M., Reer R., Schroeder J., Schmidt T. Reliability of tensiomyography and myotonometry in detecting mechanical and contractile characteristics of the lumbar erector spinae in healthy volunteers. Eur. J. Appl. Physiol. 2018;118:1349–1359. doi: 10.1007/s00421-018-3867-2. PubMed DOI

Lohr C., Schmidt T., Braumann K.M., Reer R., Medina-Porqueres I. Sex-Based Differences in Tensiomyography as Assessed in the Lower Erector Spinae of Healthy Participants: An Observational Study. Sports Health. 2020;12:341–346. doi: 10.1177/1941738120917932. PubMed DOI PMC

García-García O., Cuba-Dorado A., Álvarez-Yates T., Carballo-López J., Iglesias-Caamaño M. Clinical utility of tensiomyography for muscle function analysis in athletes. Open Access J. Sports Med. 2019;10:49–69. doi: 10.2147/OAJSM.S161485. PubMed DOI PMC

Kozinc Ž., Šarabon N. Shear-wave elastography for assessment of trapezius muscle stiffness: Reliability and association with low-level muscle activity. PLoS ONE. 2020;15:e0234359. doi: 10.1371/journal.pone.0234359. PubMed DOI PMC

Park S. Theory and usage of tensiomyography and the analysis method for the patient with low back pain. J. Exerc. Rehabil. 2020;16:325–331. doi: 10.12965/jer.2040420.210. PubMed DOI PMC

Alfuraih A.M., Alhowimel A., Alghanim S., Khayat Y., Aljamaan A., Alsobayel H.I. The Association between Tensiomyography and Elastography Stiffness Measurements in Lower Limb Skeletal Muscles. Sensors. 2022;22:1206. doi: 10.3390/s22031206. PubMed DOI PMC

von Elm E., Altman D.G., Egger M., Pocock S.J., Gøtzsche P.C., Vandenbroucke J.P. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. J. Clin. Epidemiol. 2008;61:344–349. doi: 10.1016/j.jclinepi.2007.11.008. PubMed DOI

Bibrowicz K., Szurmik T., Lipowicz A., Walaszek R., Mitas A. Tilt and mobility of the hip girdle in the sagittal and frontal planes in healthy subjects aged 19–30 years. J. Back. Musculoskelet. Rehabil. 2022;35:1203–1210. doi: 10.3233/BMR-200176. PubMed DOI

Hermens H.J., Freriks B., Disselhorst-Klug C., Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J. Electromyogr. Kinesiol. 2000;10:361–374. doi: 10.1016/s1050-6411(00)00027-4. PubMed DOI

Stylianides G.A., Beaulieu M., Dalleau G., Rivard C.H., Allard P. Iliac crest orientation and geometry in able-bodied and non-treated adolescent idiopathic scoliosis girls with moderate and severe spinal deformity. Eur. Spine J. 2012;21:725–732. doi: 10.1007/s00586-011-2070-5. PubMed DOI PMC

Oleksy Ł., Mika A., Kielnar R., Grzegorczyk J., Marchewka A., Stolarczyk A. The influence of pelvis reposition exercises on pelvic floor muscles asymmetry: A randomized prospective study. Medicine. 2019;98:e13988. doi: 10.1097/MD.0000000000013988. PubMed DOI PMC

Yoo H.I., Hwang U.J., Ahn S.H., Gwak G.T., Kwon O.Y. Comparison of pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between people with and without nonspecific low back pain. Clin Biomech. 2021;83:105310. doi: 10.1016/j.clinbiomech.2021.105310. PubMed DOI

Bibrowicz K., Szurmik T., Kurzeja P., Bibrowicz B., Ogrodzka-Ciechanowicz K. Pelvic tilt and stiffness of the muscles stabilising the lumbo-pelvic-hip (LPH) complex in tensiomyography examination. PLoS ONE. 2024;19:e0312480. doi: 10.1371/journal.pone.0312480. PubMed DOI PMC

Biały M., Adamczyk W., Stranc T., Gogola A., Gnat R. The Association between Pelvic Asymmetry and Lateral Abdominal Muscle Activity in a Healthy Population. J. Hum. Kinet. 2025;97:1–22. doi: 10.5114/jhk/191098. DOI

Ackermann W.P. Goal-Oriented Chiropractic: Specific Diagnostic and Therapeutic Techniques According to Dr. Ackermann. 5th ed. Ackermann Institute; Stockholm, Sweden: 2012.

Gnat R., Saulicz E. Induced static asymmetry of the pelvis is associated with functional asymmetry of the lumbo-pelvo-hip complex. J. Manip. Physiol. Ther. 2008;31:204–211. doi: 10.1016/j.jmpt.2008.02.012. PubMed DOI

Gnat R., Saulicz E., Biały M., Kłaptocz P. Does Pelvic Asymmetry always Mean Pathology? J. Hum. Kinet. 2009;21:23–35.

Savory B., Kaute B. Pelvic shift or short leg syndrome as an avoidable cause of back complaints. Man. Med. 1999;37:304–308. doi: 10.1007/s003370050136. DOI

Pope R.E. The common compensatory pattern: Its origin and relationship to the postural model. Am. Acad. Osteopath. J. 2003;14:19–40.

Morris C.E., Bonnefin D., Darville C. The torsional upper crossed syndrome: A multi-planar update to Janda’s model, with a case series introduction of the mid-pectoral fascial lesion as an associated etiological factor. J. Body Mov. Ther. 2015;19:681–689. PubMed

Kouwenhoven J.W., Vincken K.L., Bartels L.W., Castelein R.M. Analysis of preexistent vertebral rotation in the normal spine. Spine. 2006;31:1467–1472. doi: 10.1097/01.brs.0000219938.14686.b3. PubMed DOI

Snijders C.J., Vleeming A., Stoeckart R. Transfer of lumbosacral load to iliac bones and legs Part 2: Loading of the sacroiliac joints when lifting in a stooped posture. Clin. Biomech. 1993;8:295–301. doi: 10.1016/0268-0033(93)90003-Z. PubMed DOI

Kopecká B., Ravnik D., Jelen K., Bittner V. Objective Methods of Muscle Tone Diagnosis and Their Application—A Critical Review. Sensors. 2023;23:7189. doi: 10.3390/s23167189. PubMed DOI PMC

Shortland A.P. Muscle tone is not a well-defined term. Dev. Med. Child Neurol. 2018;60:637. doi: 10.1111/dmcn.13707. PubMed DOI

Bravo-Sánchez A., Abián P., Sánchez-Infante J., Ramírez-delaCruz M., Esteban-García P., Jiménez F., Abián-Vicén J. Five-Compressions Protocol as a Valid Myotonometric Method to Assess the Stiffness of the Lower Limbs: A Brief Report. Int. J. Environ. Res. Public Health. 2022;19:14425. doi: 10.3390/ijerph192114425. PubMed DOI PMC

Calvo-Lobo C., Diez-Vega I., Martínez-Pascual B., Fernández-Martínez S., de la Cueva-Reguera M., Garrosa-Martín G., Rodríguez-Sanz D. Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points: A cross-sectional study. Medicine. 2017;96:e6287. doi: 10.1097/MD.0000000000006287. PubMed DOI PMC

Labata-Lezaun N., López-de-Celis C., Llurda-Almuzara L., González-Rueda V., Cadellans-Arróniz A., Pérez-Bellmunt A. Correlation between maximal radial muscle displacement and stiffness in gastrocnemius muscle. Physiol. Meas. 2020;41:125013. doi: 10.1088/1361-6579/abcdf4. PubMed DOI

Šimunič B., Koren K., Rittweger J., Lazzer S., Reggiani C., Rejc E., Pišot R., Narici M., Degens H. Tensiomyography detects early hallmarks of bed-rest-induced atrophy before changes in muscle architecture. J. Appl. Physiol. 2019;126:815–822. doi: 10.1152/japplphysiol.00880.2018. PubMed DOI

Huang J., Qin K., Tang C., Zhu Y., Klein C.S., Zhang Z., Liu C. Assessment of Passive Stiffness of Medial and Lateral Heads of Gastrocnemius Muscle, Achilles Tendon, and Plantar Fascia at Different Ankle and Knee Positions Using the MyotonPRO. Med. Sci. Monit. 2018;24:7570–7576. doi: 10.12659/MSM.909550. PubMed DOI PMC

Takakusaki K., Chiba R., Nozu T., Okumura T. Brainstem control of locomotion and muscle tone with special reference to the role of the mesopontine tegmentum and medullary reticulospinal systems. J. Neural Transm. 2016;123:695–729. doi: 10.1007/s00702-015-1475-4. PubMed DOI PMC

Takakusaki K. Functional Neuroanatomy for Posture and Gait Control. J. Mov. Disord. 2017;10:1–17. doi: 10.14802/jmd.16062. PubMed DOI PMC

Kaminishi K., Chiba R., Takakusaki K., Ota J. Investigation of the effect of tonus on the change in postural control strategy using musculoskeletal simulation. Gait Posture. 2020;76:298–304. doi: 10.1016/j.gaitpost.2019.12.015. PubMed DOI