An anterior pelvic tilt may be caused by a sedentary lifestyle or poor posture while sitting. Excessive sitting may result in tightness of the muscles that flex the hip (iliopsoas and rectus femoris) and extend the lumbar spine (lumbar erector spinae), resulting in an anterior pelvic tilt.
The tight hip flexors exert a forward pull on the pelvis, which causes a compensatory tightness of the hamstring muscles (muscles in front of the thigh) and associated weakness of the muscles that extend the hip (gluteus maximus) and abdominal muscles (rectus abdominis). The loose abdominal muscles allow the forward tilting of the pelvis. It can also be seen in conditions where the abdomen becomes bulky, such as during pregnancy.
What is anterior pelvic tilt?
Anterior pelvic tilt (also called forward pelvic tilt) is a condition in which the pelvis is positioned in a way that its front (anterior part) tends to move forward while its back (posterior part) rotates upward. The pelvis is a bony basin-shaped structure that acts as a connection between the trunk and the legs. It protects the abdominal organs (such as the intestines, urinary bladder, and internal sex organs) as well as supports and balances the spine.
In its normal position, also called the neutral position, the pelvis is tilted slightly forward (about five degrees in men and 10 degrees in women). This neutral position is important for proper posture, balance, and movement. Any variation from the neutral positioning of the pelvis is called a pelvic tilt.
A mild pelvic tilt may go unnoticed, but a significant anterior pelvic tilt can cause back pain, bulging abdomen, muscle strains, problems with balancing and posture, or limited range of motion.
How do you treat an anterior pelvic tilt?
The treatment of an anterior pelvic tilt largely depends on the type of the tilt, its severity, and its cause. Most people can be treated with exercises and physical therapy under a qualified physical therapist. In some conditions, especially unequal leg length (one leg being longer than the other, generally seen when the pelvis is tilted sideways), shoe inserts may be advised to facilitate movement with comfort. Surgical intervention may be needed in severe cases.
Physical therapy to fix anterior pelvic tilt mainly involves muscle strengthening exercises, stretches, and massages. Medications may be given to manage pain. Some of the exercises to correct anterior pelvic tilt include:
- Stand with the feet shoulder-width apart and toes pointing forward and slightly outward
- Keep the spine neutral and tighten the core
- Slowly lower the torso by pushing the hips back and bending the knees so that the thighs are parallel to the floor
- Hold for two seconds and return to the starting position
- Repeat 10 times for three sets
- Lie on the back with hands by the sides, knees bent, and feet flat on the floor at shoulder width
- Tighten the abs and buttocks (push the lower back into the ground)
- Raise the hips, making a straight line from shoulders to knees
- Squeeze the abs and pull the belly button toward the spine and hold
- Return to the starting position
- Repeat 10 times for three sets
- Get down on all fours on a mat
- Keep the hands under the shoulders at shoulder width and knees under the hips
- Keep the back parallel to the floor and pull the belly button toward the spine
- Reach the right arm forward while straightening the left leg back
- Hold for two to four seconds
- Come back to the starting position
- Repeat 10 times, and perform 10 repetitions for the other side
- Do three such sets
- Lie on the floor with the back flat and the knees bent at a comfortable angle
- Tighten the abs and squeeze the pelvis upward while pressing the back against the floor
- Hold this position for 10 seconds
- Relax and repeat several times
Half-kneeling hip flexor stretch
- Get into a lunge position with one knee in contact with the floor
- Keep the knees flexed at a 90-degree angle
- Squeeze the hips and the core so that the pelvis is pushed forward
- Lean forward to feel the tension in the hip flexor of the knee that is in contact with the floor
- Hold for 20 to 30 seconds and then switch legs
- Repeat 10 times for three sets
Health Solutions From Our Sponsors
UpToDate. Common Postural Malalignments. https://www.uptodate.com/contents/image?imageKey=EM%2F100726&topicKey=SM%2F14490&source=see_link
UpToDate. Cross Pelvic Posture. https://www.uptodate.com/contents/image?imageKey=EM%2F89722&topicKey=SM%2F13810&source=see_link
Johns Hopkins. Pelvis Problems. https://www.hopkinsmedicine.org/health/conditions-and-diseases/pelvis-problems
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