Anatomy, Bony Pelvis and Lower Limb: Pelvic Fascia

The pelvis is the base of the vertebral column; the sacrum is the center of the base. The vertebral column is not a real "column," as it is flexible and adaptable. It is composed of a series of rigid bodies connected to each other by flexible connective structures. It needs a solid base formed of the pelvis with the hips and the lower limbs, but the pelvis is not a real "base." The biomechanical model applied to biological structures, termed biotensegrity, includes an alternation and a network of compressed structures (bones) and tensile structures (ligaments and fascias). The bones of the skeleton are not considered rigid support structures, but instead, elements of compression are immersed within the spaces of a highly organized organization: the connective network of tension. The pelvic bones, including the sacrum, are suspended and immersed in this network of elastic tension structures of the fascia system. The result is the pelvis, an anatomical structure in dynamic equilibrium, capable of movement in space, within which the internal organs and vascular, nervous, and visceral structures can dwell and perform their function without interference. The fascia is the connective system, which is placed in the middle between the external anatomical structures and the internal visceral structures. The connective tissue purposes are to surround, protect, balance, defend, and nourish all the body’s structures. At the pelvic level, clinicians can make a gross distinction between the external and the internal fascial system. The external system consists of the pelvic portion of the thoracolumbar fascia with its ligamentous thickenings and the perineal fascia system. The internal system, the endopelvic fascia, is a little more complex, as the connective tissue is organized in peri-vascular bundles, supporting structures, and peri-muscular and peri-visceral layers.