Anterior pelvic tilt is a change in posture that happens when the front of the pelvis rotates forward, and the back of the pelvis rises.
Some research suggests that as many as 85 percent of men and 75 percent of women, who do not show any symptoms, have an anterior pelvic tilt.
Anterior pelvic tilt is caused by excessive sitting or lack of physical activity. It affects posture and the shape of the spine, and may lead to other symptoms.
In cases of anterior pelvic tilt, the pelvis can gradually be returned to a neutral position, using a variety of stretching and strengthening exercises. These exercises include the following:
Squats strengthen the buttock muscles, hamstrings, and other leg muscles.
- Stand with the feet slightly wider than hip-width. Turn the toes slightly outward.
- Squeeze the stomach muscles, and keep the back in a neutral position.
- Breathe in. Lower the hips back and down, causing the knees to bend, until the thighs are parallel to the floor. The knees should not extend beyond the toes, and the heels should be firmly on the floor.
- Breathe out and slowly return to the starting position.
- Repeat 10 to 20 times.
This exercise helps to strengthen the abdominal muscles.
- Lie on the floor, face upward, with knees bent.
- Squeeze the abdominal (stomach) muscles, so that the back is flat against the floor. Bend the pelvis slightly upward.
- Hold this position for up to 10 seconds.
- Repeat for five sets of 10 repetitions.
Kneeling rear leg raises
This exercise stretches the back and buttock muscles, while strengthening the stomach muscles.
- Begin on all fours on an exercise mat. The hands should be directly under the shoulders, and the knees directly under the hips. Weight should be evenly distributed between the hands and knees.
- Tighten the stomach muscles.
- Reach the right leg back in line with the body, keeping the toes pointed and the leg straight. Do not arch the back.
- Hold the leg in position for 5 seconds. Lower and repeat 10 times.
- Switch sides and repeat the above process with the alternate leg.
Kneeling hip flexor stretch
This stretch helps to loosen and lengthen tight hip flexor muscles.
- Kneel down on the left knee, ensuring that the right knee is directly over the right ankle.
- Place both hands on the right thigh for stability. Ensure the spine is tall and straight.
- Tighten the buttock and stomach muscles, and keep the pelvis in a neutral position.
- Lean forward into the right hip, ensuring the pelvis and back remain stable. There should be a stretch in the hip flexor and inner thigh.
- Hold this position for 30 seconds. Repeat five times, aiming to stretch a little more with each repetition.
- Switch sides and repeat the above process to stretch the other hip.
The glute bridge
This exercise targets the buttock muscles and the hamstrings.
- Lie on the floor, face upward, and knees bent.
- Place the feet hip-width apart.
- Squeeze the stomach muscles so that the back is flat against the floor. Keep the stomach muscles engaged throughout the exercise.
- Breathe out and lift the hips off the floor, so the upper body and thighs form a straight line.
- Breathe in and gently lower the body to the floor.
- Repeat 10 to 20 times.
The plank exercise helps to target the stomach muscles and back.
- Lie face down on an exercise mat.
- Place the hands on the mat, palms down. Keep the hands directly under the shoulders.
- Tighten the stomach muscles and the thigh muscles.
- Slowly lift the upper body and thighs off the ground, moving into a push-up position. Keep the body rigid and straight. Ensure the stomach muscles are engaged throughout the exercise.
- Hold the plank pose for as long as possible, working up to 60 seconds. Gently lower the body to the floor.
The following tips may reduce the risk of anterior pelvic tilt.
- Avoid sitting for prolonged periods of time. Those who have desk jobs, and other roles that require sitting for long periods, should take regular breaks that involve walking around or stretching.
- Engage in regular physical activity. This should include both stretching and strengthening exercises.
- Ensure proper posture, especially when sitting. A comfortable and healthful workspace with correctly positioned desk, screen, and seating is important.
Anterior pelvic tilt is caused by the shortening of the hip flexors, and the lengthening of the hip extensors. This leads to an increased curvature of the lower spine, and of the upper back.
The hip flexors are the muscles that attach the thigh bone to the pelvis and lower back. They are used to run, kick, or bend at the hip.
The hip extensors consist of four muscles, three of which are known collectively as the hamstring muscles, and the gluteus maximus. They help to extend the hip.
Weak stomach muscles also play a role in anterior pelvic tilt.
The changing shape of the spine, and the associated muscle imbalances, are often caused by prolonged periods of sitting. A lack of stretching or strengthening exercises also contributes to anterior pelvic tilt.
Risk factors for the development of anterior pelvic tilt include:
- prolonged periods of sitting
- lack of physical activity
- poor posture
Often, there are no symptoms associated with anterior pelvic tilt. Those that do have symptoms may notice:
- tight muscles in the pelvic and thigh areas
- weak gluteus maximus and stomach muscles
- poor posture with the lower spine curving in, and a protruding stomach
Although pain of the lower back, hips, or knees is often reported as a symptom, there is little evidence to suggest this is caused by anterior pelvic tilt.
Diagnosis with the Thomas test
While the posture and shape of the spine can help to signal anterior pelvic tilt, another method of diagnosis is the Thomas test. Named after the British surgeon, Hugh Owen Thomas, it can be performed to help identify anterior pelvic tilt.
To carry out this simple test, people should:
- Lie down on a table. The legs should be hanging off the table, at the knee.
- Pull one leg toward the chest, bending and holding at the knee. Then, repeat with the other leg.
- If the pelvis is incorrectly aligned, the back of the resting leg will raise off the table.
If it is necessary to extend or rotate the resting leg in any way, in order to keep it from raising off the table, it indicates a pelvic tilt.
When to see a specialist
It is important to see a specialist if anterior pelvic tilt occurs in children, adolescents, or younger adults. Those who experience pain or discomfort, or who notice that their pelvic tilt is progressing, should also seek the help of a specialist.
Those who wish to begin any new exercise program should consult a doctor first.
What is posterior pelvic tilt?
Posterior pelvic tilt is the opposite of anterior pelvic tilt. It occurs when the pelvis rotates backward, causing the front to rise and the back to drop. It is caused by lengthening of the hip flexors and shortening of the hip extensors.
As with anterior pelvic tilt, sitting for long periods of time, inactivity, and poor posture all contribute to posterior pelvic tilt.