Anterior pelvic tilt is a commonly seen posture. It is easily recognized when looking at a person in standing from the side by the characteristic large curvature of the lower back.
What is Anterior Pelvic Tilt?
The pelvis is a bony structure that connects that base of the spine to the legs. It has the ability to rotate or tilt in space. An anterior pelvic tilt occurs when the pelvis rotates forward, placing the front of the pelvic bones well below the level of the back. This tilted position increases the natural curve of the lumbar spine.
To check for anterior pelvic tilt, stand with your back flat against the wall and measure the space between your lower back and the wall. The natural curvature of your spine should allow a hand to slide into that space. Men normally have 4-7 degrees of anterior pelvic tilt, and women typically have between 7-10 degrees. If something much larger than your hand, like a paper towel roll, is able to fit back there then there is a chance you have a large anterior tilt.
Causes of Anterior Pelvic Tilt
It’s believed that this posture results when certain muscle groups shorten or become overactive and overpower the muscles responsible for rotating the pelvis in a posterior (backward) direction. One of the main contributing factors is likely prolonged sitting that over time can shorten the hip flexor muscles. For example, a person with tight hip flexors may have an exaggerated curvature of the spine when they stand due to the shortened muscles pulling the front of the pelvis downward.
Training errors, when certain muscle groups are emphasized more than others, may also result in an imbalance of the muscles around the pelvis. The body may also assume an anterior tilted posture to compensate for a problem away from the back such as overpronation of the feet or forward head posture.
Effects of Postural Dysfunction
While a clear link between anterior pelvic tilt and back pain has not yet been established, it is reasonable to think that the exaggerated curvature could affect the health and function of the spine and surrounding areas. An anterior tilt can also alter the alignment of joints outside of the back like the ankles, knees, hips, and neck leading to increased stress and possibly problems in those areas.
Exercises to Correct Anterior Pelvic Tilt
There are four primary anatomical components to an anterior tilt to address in order to bring the pelvis into a more neutral alignment:
- Tight (shortened) hip flexors
- Weak (lengthened) abdominals
- Tight (shortened) lower back muscles
- Weak (lengthened) glutes and hamstrings
Exercise 1: Posterior Pelvic Tilting
This exercise is probably the most important and likely should be mastered first since this movement is also used in the other three exercises. The posterior pelvic tilt motion is the exact opposite of the anterior tilt. I prefer to do this exercise in standing to improve the ability to control the position of the pelvis for standing and walking.
- Stand with your back flat against the wall with your heels placed about 6 inches away
- Press the lower back against the wall while keeping your shoulders and hips against the wall and knees straight
- Hold the position for 10 seconds then relax and repeat 10 times
Posterior pelvic tilting requires contraction of the abdominals and glutes (tighten your stomach and squeeze your butt). Take your time practicing this. You can place your hand, or have someone else put their hand, between your back and the wall to check and see if you’re effectively closing down the space between the wall and your lower back.
Once you’ve mastered the movement, remember what it feels like to posterior tilt. Try to keep yourself in a neutral position for the other exercises.
Exercise 2: Hip Flexor Stretch
This exercise is designed to stretch tight hip flexors. Attempt to maintain contraction of the abdominal and glute muscles while performing this stretch.
- Start in a half kneeling position with the left leg in front and the right leg behind
- Rock forward keeping your back straight until a stretch is felt in the front of the right hip
- Hold the stretch position for 1 minute and then switch legs and perform the stretch on the other side
- Repeat twice on each side
The advanced version of this stretch places the foot of the leg being stretched against a wall or couch. This may be beneficial for athletes who want to more aggressively target their hip flexors.
Exercise 3: Lower Abdominal Leg Lower
- Start lying on your back with both legs lifted straight in the air
- Attempt to lower both legs down to the floor while keeping the knees straight until the lower back begins to arch off the ground
- Only lower the legs as far as you can without the back lifting up
- Return to the starting position and repeat for 2 sets of 20 repetitions
It’s important to maintain pressure of the lower back on the floor by performing the posterior tilt described in the first exercise. It may be helpful to keep one hand under your lower back to make sure downward pressure is maintained. As abdominal strength increases the legs will be able to lower farther without the back arching.
Exercise 4: Bridge with Leg Kicks
- Begin lying on your back with both knees bent
- Lift your hips into the air as high as you can
- Once you are in this bridged position, kick one knee straight out and hold for 5 seconds
- Lower that leg down and kick and hold with the opposite leg
- After kicking with both legs return to the start position and repeat for 2 sets of 10
This exercise works the glutes and hamstrings. Make sure to not let the hips sag while performing the kicks.
Posture correction takes time. These exercises are geared toward developing strength and flexibility to help bring the pelvis and spine into a more neutral alignment. Holding the back in a neutral position can also be incorporated into other activities throughout the day. Consider forward head correction also, for improving alignment of the whole spine.
If you have any questions or suggestions for other exercises feel free to leave them in the comment section below.