Anterior Pelvic Tilt

An anterior pelvic tilt is a short-arc anterior circumrotation of the pelvis about the hip joints, with the trunk held erect and stationary. An anterior pelvic tilt directly extends the lumbar spine and increases lumbar lordosis. 

Some physical therapeutic methods meant to manage low back pain incorporate anterior and posterior tilting of the pelvis.

These pelvic actions provide nearly small flexion or extension movements of the lumbar spine. Flexing or extending the lumbar region has several potential biomechanical outcomes.s

For instance, a patient with stenosis (a condition wherein the spaces in the spine narrows) can opt to undergo posterior pelvic tilt therapy. What happens is that you are flexing your lumbar spine, broadening the intervertebral foramen. This may ease the  symptoms caused by an impingement of an existing nerve root.

A person suffering from a posterior disc herniation, on the other hand, may be directed to hold his or her pelvis in a more anteriorly tilted position. Doing so can increase the lordosis of the lumbar spine. This posture may help avert a posterior movement of the nucleus pulposus, restricting or preventing pressure on the nearby neural elements.

What Exactly is Anterior Pelvic Tilt?

Your pelvis supports the way you walk, run, and lift your weight. It can also affect your posture.

An anterior pelvic tilt is when your pelvis is pivoted forward, which pushes your spine to curve. It’s often caused by sitting all day without enough exercise and stretching.

If you have an anterior pelvic tilt, you may see that the muscles in the front of your pelvis and thighs are fixed. Meanwhile, your muscles in the back are also vulnerable, meaning that your gluteus and abdominal muscles may also be weak. All of this can cause:

  • lower back pain
  • hip and knee pain
  • incorrect posture
  • forced hip and knee rotations

Luckily, there are some workouts that you can perform at home to help your pelvis return to a pain-free neutral position.

Some study implies that as many as 85 percent of men and 75 percent of women have anterior pelvic tilt, although they do not show signs. Nonetheless, it can alter one’s posture and can lead to other symptoms.

The Hip and Pelvis

In an anterior pelvic tilt, both innominate (halves of the pelvis) are pivoted in an anterior direction. The developed anterior pelvic tilt also produces an exaggeration of the lumbar lordosis.

It is important to measure the innominate individually as sometimes one may turn more than the other. Different factors may add to an anterior pelvic tilt, but typically it is from an irregularity of muscles pulling on the pelvis or lumbar region.

An anterior pelvic tilt is a component of a postural distortion pattern concerning the low back and pelvic muscles called the lower crossed syndrome. The lower crossed syndrome received its name from the pattern of tension in the muscles when the body is observed from the side.

There are two kinds of muscles in the body that play an essential role in the lower crossed syndrome.

The postural muscles are essential for keeping an erect posture during locomotion. When fatigued, the postural muscles tend to shift hypertonic.

The phasic muscles play a more prominent role in generating movement. Carrying a higher concentration of fast-twitch muscle fibers, the phasic muscles tend to fatigue more quickly and become vulnerable when overstressed. The inclination for the phasic muscles to exhaust is intensified by the law of reciprocal inhibition

The law of reciprocal inhibition is when a single muscle is stimulated while the antagonist muscle is neurologically hindered to contract. If the postural muscles are hypertonic, they normally restrain the phasic muscles.

Fundamental postural muscles that cause hypertonicity in the lower back and pelvic region are iliopsoas, erector spinae, rectus femoris, and quadratus lumborum. When hypertonic, these muscles expand the lumbar lordosis and produce an anterior pelvic tilt.

In addition, the postural muscles are responsive to the construction of myofascial trigger points as they grow hypertonic. The line connecting the areas where these muscles are located shows one side of the cross.

Reversing this group of muscles are the phasic muscles of the abdomen and pelvis. The phasic muscles in this area include the gluteus maximus, gluteus medius, and rectus abdominis. The line connecting between the phasic muscles sets the other side of the cross.

Our current sedentary lifestyle promotes the overuse of the postural muscles at the expense of the phasic muscles. That’s because the phasic muscles can become delicate from disuse.

Causes

Many schools of thought consider that anterior pelvic tilt is produced by imbalances in the musculature surrounding the pelvis. It’s easy to envelop your head around this theory, primarily because the muscles surrounding the hips are some large, powerful muscles. The glutes, hamstrings, hip flexors, and core muscles can somewhat influence the pelvis.

As such, if one or several muscles are tight or weak, it could pull the hips in the wrong direction.

Another school of thought states that anterior pelvic tilt is a normal and natural adaptation in human anatomy.

It has been observed that a majority of people encounter anterior pelvic tilt of about 12 to 13 degrees. This indicates that anterior pelvic tilt is not the devastating epidemic that most people believe it to be.

The anterior pelvic tilt is generated by the shortening of the hip flexors and the expansion of the hip extensors. This refers to an exaggerated curvature of the lower spine and the upper back.

The hip flexors are the muscles that connect the thigh bone to the pelvis and lower back. It is made up of four muscles, three of which are identified collectively as the hamstring muscles, and the gluteus maximus. They are used to run, kick, or bend at the hip.

Weak stomach muscles also play an important role in an anterior pelvic tilt. Plus, the pelvis comes in various shapes and sizes. This means that we have our unique ways of running, walking and squatting. So much so that for some people, a small tilt might feel quite normal.

So, to a certain degree, anterior pelvic tilt doesn’t significantly have to be an issue.

The developing shape of the spine, and the associated muscle irregularities, are often produced by prolonged periods of sitting. A lack of stretching or strengthening activities also adds to anterior pelvic tilt.

The difficulty arises when the tilt creates pain or discomfort. Some athletes will do heavy lifts and squat under notable weights with a serious tilt. They exercise with a tilt and sit, stand, and lay with one, too.

Over time, this can create pain (particularly lower back pain) and even injury. Fixing the root problem is needed.

Symptoms

Often, there are no symptoms connected with anterior pelvic tilt. Those that do have symptoms may see:

  • tensed muscles in the pelvic and thigh areas
  • weak gluteus maximus and stomach muscles
  • bad posture with the lower spine curving in, and a protruding stomach

Although the pain of the lower back, hips, or knees is frequently listed as a symptom, there is insufficient evidence to suggest this is produced by anterior pelvic tilt.

Risk Factors

Risk factors for the progress of anterior pelvic tilt involve:

  • continued periods of sitting
  • lack of physical activity
  • bad posture
  • genetics

Diagnosis with the Thomas test

While the posture and form of the spine can help to indicate anterior pelvic tilt, another method of diagnosis is the Thomas test.

Named after the British surgeon, Hugh Owen Thomas, it can be done to help recognize anterior pelvic tilt. To carry out this easy test, people should:

  1. Lie down on a table. The legs should be dangling off the table, at the knee.
  2. Pull one leg approaching the chest, bending and locking at the knee. Then, repeat the process with the other leg.
  3. If the pelvis is badly aligned, the back of the resting leg will lift off the table.

If it is important to extend or rotate the resting leg in any way, to hold it from raising off the table, it means a pelvic tilt.

Prevention Tips

The following tips may lessen the danger of anterior pelvic tilt.

  1. Avoid sitting for extended periods. Those who have desk jobs and other tasks that demand sitting for long periods should take regular breaks to stretch and walk around.
  2. Join in regular physical activity. This should include stretching and strengthening exercises.
  3. Assure proper posture, particularly when sitting. A comfortable and healthy workspace with an accurately positioned desk, screen, and seating is essential.

How to Fix Anterior Pelvic Tilt

For beginners, pay more attention to your stance.

When you sit and stand, are your pelvis and spine still neutral? If not, create a point of “tucking” your hips under. This easy tweak can be enough to fix minor tilts.

For severe tilts, you should consider hiring a coach, physical therapist, or chiropractor. You might have weak or imbalanced muscles throughout your pelvis.

While you can recover from your tilt with stretching, foam rolling, and mobility exercises, you may want to ask for some help from a medical professional to determine where exactly the issue is stemming from.

In cases of anterior pelvic tilt, the pelvis can slowly be returned to a neutral position using a variety of stretching and strengthening exercises. These exercises incorporate the following:

Squats

This is a full-body workout that helps stimulate the gluteus muscles, hamstrings, and quadriceps, among others.

  • Put your feet shoulder-width apart, toes aiming forward.
  • Drop yourself to a sitting posture until your thighs are parallel to the ground. Make sure you’re holding your abs tight and your back in a neutral state.
  • Push up to a standing posture and move your pelvis slightly forward by contracting your gluteus muscles.
  • Repeat the process 15 to 20 times.

As you squat, don’t let your knees go over your toes or rotate inward. Keep your back in a neutral stance. Do not straighten the curve of your lower back or overly arch your back. Engage your abdominals and glutes muscles.

TIP: Look straight ahead and imagine that you are about to sit on a chair.

Pelvic tilt

This workout helps strengthen your abdominal muscles and expands the muscles in your lower back.

  • Lie with your back on the floor in a neutral stance with your legs bent and toes pointing forward.
  • Draw your belly button in toward your spine, shoving your pelvis up toward the ceiling.
  • Squeeze your glutes and hip muscles as you tilt your pelvis forward. Hold it for 5 seconds.
  • Do 5 sets of this workout for 20 repetitions.

This workout will help your spine get in the proper neutral position. So be sure to monitor your progress.

Kneeling rear leg raises

This workout will help tighten your abdominals and stretch your back and your gluteus muscles.

  • Get down with your hands and knees.
  • Put your hands on the floor shoulder-width apart. Straighten your hips with your knees.
  • Make sure that your back is parallel to the ground so your pelvis is in a neutral state.
  • Draw your belly button in toward your spine and arch your back as you exhale.
  • Hold in this position for 2 seconds, and then bring your spine back to the neutral position.
  • Stretch one leg back and lift it until it reaches the same height as your body, so your raised leg and body are in alignment. Keep your spine in a neutral state.
  • Hold this position for up to 5 seconds as you lower your leg, and repeat up to 10 times.
  • Switch legs.

Make sure to hold your extended leg in line with your body. Arching your back too much can produce back pain.

Kneeling hip flexor stretch

This workout will help relax the hip flexors and increase your hip flexibility.

  • Step your left leg out in front of you and lunge until your right knee is leaning on the ground. Put a towel under your knee if this is uncomfortable. Your left leg should produce a 90-degree angle at your knee.
  • Take your pelvis forward by squeezing your glutes and abdominal muscles.
  • Lean forward from your right leg until you feel the pressure in the hip flexor and inner thigh of your right leg
  • Hold it for 30 seconds, release, and repeat up to 5 times.
  • Switch legs.

While in this stretch, you should sense no tension at the front of your thigh. The stretch shouldn’t hurt, although you should observe a slight tension in your hip flexors. Make sure to hold your pelvis slightly tilted throughout the entire stretch.

Glute bridge

This workout will strengthen your hamstrings and your gluteus muscles.

  • Lie flat on your back with your legs bent and your feet flat on the floor and hip-width apart then place your arms by your sides.
  • Drive your heels into the floor as you raise your pelvis off the floor until your upper body and thighs form a straight line.
  • Hold it for 2 seconds, lower down gently, and repeat 8 to 12 times.

Make sure you squeeze your glutes and abdominal muscles while in this position to have a correct bridge alignment.

Plank

The plank workout helps to target the stomach muscles and back.

  1. Lie face down on your exercise mat.
  2. Put your hands on the mat, palms down. Keep the hands straight under the shoulders.
  3. Squeeze the stomach muscles and the thigh muscles.
  4. Slowly raise the upper body and thighs off the ground, moving into a push-up position. Keep the body stiff and straight. Ensure the stomach muscles are contracted throughout the exercise.
  5. Hold the plank pose for as long as possible, working up to 60 seconds then gently drop the body to the floor.

When to See a Specialist

It is crucial to see a specialist if anterior pelvic tilt befalls in children, adolescents, or younger adults. Those who encounter pain or discomfort, or who notice that their pelvic tilt is growing, should also seek the help of a specialist. Meanwhile, those who wish to start any new workout program should consult a doctor first.

Final Thoughts

Sitting for continued periods without taking the time to stretch and move can cause an anterior pelvic tilt, which affects your spine to have an exaggerated curvature.

In addition to modifying your posture, this condition can generate back and hip pain. You can fix an anterior tilt by using exercise, stretches, and massage. If your job includes sitting for long periods, make sure to get up from time to time and do several simple stretches. You can also substitute a sit-down lunch with a walk.

Movement is vital to keeping yourself healthy. A sedentary lifestyle with little movement can increase your risk of back pain, poor posture, and more. Incorporating some simple exercises into your everyday routine can help your body move better, stand taller, and support itself.