Learn more about anterior pelvic tilt, and learn 5 corrective exercises to help with this common problem.
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It is simple to identify anterior pelvic tilt. Two telltale signs are:
* Exaggerated Lumbar Curve
* A bulging abdomen even when the person has low bodyfat
The client’s waistline will be most prominent when it is diagonally parallel to the ground. However, the front of the client’s pants will be angled downwards, not horizontally.
It’s the tricky part. You need to determine if anterior pelvic tilt is something you should address in your client’s training program. It is a continuum, just like every other human trait. Some people just have a naturally curved pelvis and a prominent butt.
For others, however, anterior pelvic tilt can be a sign of a dysfunction. It’s both a result of existing dysfunctions as well as a risk factor for developing new ones.
Anterior pelvic tilt problems are obvious signs by quadriceps dominance and low-back dominance. Trouble activating the glutes is also a sign.
Poor exercise performance, especially on movements such as the deadlift and squat, can be caused by APT problems. There is also a greater risk of injury and low-back pain. All of these can contribute to an increase in anterior pelvic tilt.
CONTENTS
*The science behind anterior pelvic tilt
* Common causes of anterior pelvic tilt
*How to correct anterior pelvic tilt
Step 1: Learn how to lie in your pelvis
Step 2: Continue to the standing pelvic tilt
Step 3: Finish the hip hinge pattern
Step 4: Strengthen your muscles that support posterior pelvic tilt
Step 5: Pay attention to spinal alignment when deadlifting, squatting, pressing, or other compound lifts.
*What about sets?
*Squeezing your glutes and posteriorly tilting your pelvis throughout the remainder of the workout
*FAQ
1. What muscles are weak at anterior pelvic tilt
2. Is it possible for anterior pelvic tilt to cause tight hamstrings
3. Is anterior pelvic tilt a cause of back pain?
4. What is the time it takes to correct anterior pelvic tilt?
*Final thoughts
Anterior pelvic tilt: science and practice
The “neutral” pelvis, which we refer to as a tilted pelvis, is actually slightly tilted forward–less than five degrees for men and ten degrees for women. This leaves you with a slight lordotic curve. An anterior tilt with a perfectly flat lumbar spine can cause posterior pelvic tilt.
Anterior pelvic tilt is characterized by a narrow, stiff hip flexor. The iliacus and rectus fimoris can be tight by nature or as a result of training or lifestyle changes. (We’ll get to that in a minute.) They pull your pelvis forward which in turn lengthens or weakens your Hamstrings.
Reciprocal inhibition is a method by which muscles on one side a joint need to relax in order to accommodate muscle contractions on the other.
Similar results can be seen in the lumbar region. The lumbar curve is exaggerated when spinal erectors become too active. This causes your stomach muscles to become weaker and lengthen, which can lead to a bulge in your stomach that your clients don’t want.
Anterior pelvic tilt: Common causes
The anterior tilt of women is naturally higher than that of men. They also have a greater likelihood to develop an excessive anterior pelvic tilt. These are the most common suspects.
Lifestyle of seclusion
The hip flexors are reduced by prolonged sitting. While the glutes are inactive (not much can they do while you’re sitting on their), the spinal extensors keep your spine upright.
Activity patterns and movement
Imagine a client who is active but has a job that keeps him tied to a desk most of the day. This would be combined with a long commute.
Sitting can cause problems in her ability to do common exercises in the gym. The lumbar extensors may play too big a part in squats or hip extension if the glutes or hamstrings aren’t firing properly. Similar to overhead presses: The spine erectors may pull the torso in a swayback position. Although the movement feels natural to the client, it can lead to back, knee or hamstring injuries over time.
How to correct anterior pelvic tilt
I have worked with many clients who suffer from anterior pelvic tilt. Strength training has been the best way to improve lumbopelvic alignment. This protocol was developed over many years of trial and error. (There is only so much science and theory you can learn about the subject.
Before I go into detail about the exercises, let me tell you what doesn’t work. Hip flexor stretches are typically used to reduce anterior pelvic tilt. It seems to make sense. Why wouldn’t we stretch our hip flexors if the problem is short, stiff hips?
There are two reasons.
1. The problem is not solved by stretching the muscles. Dean Somerset explains how it can lead to even more back pain in this article.
2. Anterior pelvic tilt can be addressed by strengthening posterior tilt, which is the opposite movement pattern.
READ ALSO:15 Common Mobility Errors
Step 1: Learn how to lie in your pelvis
Many clients who exhibit the signs of excessive anterior pelvic tilt (bulging abdomen, back pain and difficulty mastering squat movement pattern) often don’t know how to posteriorly tilt their pelvis. My program starts with learning how to move.
The lying pelvic tilt, which is the best way to do it is “push your lower back in the ground” for most people.
Step 2: Continue to the standing pelvic tilt
“Squeeze your glutes” is a great cue to the standing pelvic tilt. Contracting the glutes will make it feel more natural.
Step 3: Finish the hip hinge pattern
The hip hinge pattern is best taught using the pull-through.
It looks very similar to the deadlift, kettlebell swing and other hip-dominant exercise. There is one important difference. The client’s resistance is behind him, so he has to shift his weight backwards.
I usually use three cues
1. “Chest high” at both the beginning and the end
2. “Push your hips back” in middle
3. At the end, “Squeeze your glutes.”
The cue that I won’t use “arch your back” is what I will discuss in a moment.
You will find people doing planks with an excessive anterior pelvic tilt every day in any crowded gym.
The RKC plank is a posterior tilt exercise that involves simultaneous contraction of the core, gluteus maximus and the core, as well as tension in the legs, shoulders, and girdle. John Rusin DPT provides a detailed explanation of the exercise.
Step 5: Pay attention to spinal alignment when deadlifting, squatting, pressing, or other compound lifts.
For deadlifts or other hip-dominant exercises, most clients will use “arch your back” as a cue. The same applies to exercises that cause clients to round their backs like box squats.
However, telling someone with anterior pelvic tilt or APT to arch his back can cause more harm than good. When someone with APT arch their back during a deadlift, the lumbar curve can be exaggerated. This increases the chance of spinal damage.
For clients with anterior pelvic tilt, the deadlift is not the only problem exercise. There may be swayback when doing overhead presses or pulldowns. Poor glute activation in quaddominant clients could cause difficulty with squats and could lead to injuries.
READ ALSO: How to Fix the “Butt Wink” in the Squat
For deadlifts and squats, I find the best cues to use are “spread your floor apart” (that is, push against the outsides of your feet) and “drive through you heels.” Also, it’s important to look at the bar’s trajectory from a side perspective. The bar should move vertically over the middlefoot with the spine in neutral alignment.
The importance of neck and head position is usually less. A client might be told to tuck their chin, which can help keep the neck neutral. To be honest, it doesn’t matter as much as we think. It’s important to concentrate on the spine alignment, as long as the client doesn’t look up at the ceiling or to the side.
What about sets?
Clients with anterior pelvic tilt will want to do fewer reps of complex movements such as deadlifts and squats. Clients who do fewer reps have less chance of technique breaking down.
RKC planks work best when performed at a lower volume and with a greater effort. Clients are asked to posteriorly tilt their pelvis by contracting their abs and glutes. This will also create high levels of tension in the upper chest, chest and thighs. Ten seconds of this position can seem like an eternity.
This is why you will get the best results by using two to four holds and resting at least thirty seconds between each one.
It really depends on each client as to how much they are willing to do. It is important not to get tired from any movement that causes spinal alignment problems. These exercises can be programmed early in your workout to create the right training effect.
During the rest of your workout, squeeze the glutes while posteriorly tilting your pelvis.
Although it is not required, posteriorly tilting your pelvis while doing other types of exercises can stabilize the spine and give you some static glute training. You might cue a client who has an anterior pelvic tilt to squeeze their glutes during presses, pushups, pulldowns, biceps, and other triceps exercises.
It is also a good idea to remind clients to squeeze their glutes after they finish hip-dominant exercises such as deadlifts, hip thrusts and box squats.
FAQ
1. What muscles are weak at anterior pelvic tilt
You could have one of these or all. You might not have any problem with muscle strength.
An anterior pelvic tilt is characterized by short and stiff hip flexors, as mentioned at the beginning. If those muscles pull the pelvis forward, it means that the hamstrings must be compromised. They are usually shorter and weaker than they should. The same goes for the abdominals. The glutes are also often weak.
However, someone can be strong in all or some of these muscles. A person’s APT may be genetic or a result of how she uses those muscles. APT is especially beneficial for athletes who require strength, power, speed, and agility. APT can even be beneficial if the hip flexors are shorter and stiffer, and the hamstrings are longer to help athletes run faster or jump higher.
Similar results can be expected for lifters. Bret Contreras explains how APT can be used to increase deadlift force by increasing tension in the hamstrings. It can also be used to compensate for weak glutes in hip extension by using the spinal erectors.
You must address the movement patterns of your clients in all cases.
2. Is it possible for anterior pelvic tilt to cause tight hamstrings
Possibly. It could be. A muscle that is already stretched will reach its maximum tension faster than one without a handicap.
Here’s the problem: If your hamstrings are tight why not pull your pelvis into neutral?
Mike Reinold explains that the hamstrings might be fine. Because APT moves the top of your pelvis forward and the hamstrings attach to the bottom, any movement they make must be from a suboptimal location, even though they can move in an optimal manner.
This is all done in degrees.
3. Is anterior pelvic tilt a cause of back pain?
Anterior tilt and low back pain don’t seem to have a direct relationship. Chad Waterbury DPT, a physical therapist, says that “I don’t think it worth thinking about if someone is standing or walking around with it.” However, APT can be problematic if someone does rotational sports.
Consider a golfer with low back pain. Waterbury said, “The first thing that I’ll say to you is, ‘Show us your 5-iron posture.
Rotational athletes face two problems: swinging a bat, club or racquet while using APT. Thoracic rotation is the other. Waterbury states that most people have poor thoracic rotation. This means they are unable to rotate 45 degrees in each direction when seated with their hands behind their heads. It doesn’t matter if they have APT. You can compensate for this lack of motion by moving another thing, most often the lumbar spine. This is a classic case of low back pain.
Both problems can be solved. Shift your pelvis to a neutral position, before you swing (you’ll find a detailed explanation right here), and then work on thoracic rotation using drills such as these.
READ ALSO: How to train clients who have back pain
4. What is the time it takes to correct anterior pelvic tilt?
It is impossible to know. It’s possible that you won’t be able make permanent changes if it is a genetic trait.
But you canfix movement patterns. You can improve the effect of anterior pelvic tilt by focusing on how you sit, stand, and do key exercises.
Despite the fact that the anatomical changes may not be significant, it is possible to prevent them from becoming problematic and reduce the chance of injury.
Final thoughts
Last but not least, I want you to know that there are many alignments that can be displayed by humans without causing dysfunction. Before you begin a program to correct anterior pelvic tilt, make sure you assess your client’s flexibility, strength and movement quality.
