The Missing Key to Correcting Anterior Pelvic Tilt

If you’re a therapist or coach who regularly studies biomechanics you’ve undoubtedly heard of anterior pelvic tilt.  Anterior pelvic tilt (as shown in the featured image above) is when...

If you’re a therapist or coach who regularly studies biomechanics you’ve undoubtedly heard of anterior pelvic tilt.  Anterior pelvic tilt (as shown in the featured image above) is when the pelvis dumps forward excessively.  Although the anterior pelvic tilt is sometimes over villified, I do believe it plays a role in a lot of people’s pain and injury.  Some conditions that come to mind where anterior tilt can cause issues are with:

  • Extension Based Low back pain – Potentially during overhead pressing
  • Hip Pain – Femoral acetabular impingement in the bottom of the squat

Below is lower crossed syndrome (and upper crossed) popularized by the late Dr. Janda.

jandasyndromes

This condition is characterized generally by a few things:

  1. Inhibited (Weak / Not Working Properly) Abdominals
  2. Facilitated (Tight) Hip Flexors
  3. Facilitated (Tight) Low Back Musculature
  4. Inhibited (Weak /Not Working Properly) Glutes

Now, I think people understand that they need to mobilize the hips and strengthen and facilitate the glutes / core.  What I don’t see are many people working on the tight low back musculature.  As shown in the image above, this is definitely a part of lower crossed syndrome and anecdotally, usually is pretty stiff when people present in this posture.  If we want to get people out of anterior pelvic tilt and they have a stiff lumbar spine, we’ve got to get them more mobile back there.  The trouble is, I don’t see much information in the blogosphere out there addressing the issue.

I remember encountering this right after I took my first SFMA course.  I’d get to the box where my patient had a stiff lower back (into flexion) and just didn’t have any tools or ideas on how to correct this issue.  Since then I’ve had time to brainstorm, learn further (Shout out to Aline Thompson for the mentoring here) and experiment.  Here are a few easy exercises I’ve found to be pretty tried and true when attempting to address the lower back.

  1. Lower Back Soft Tissue Work – I’ll use my hands and or tools for this in the clinic.  I also like to do my soft tissue work with the patient in a slight stretch, so I’ll generally put them into a child’s pose during soft tissue work.  I generally am not a fan of foam rolling the lower back but in this case it can be a great tool to loosen up the musculature in the lumbar spine.
  2. Quadruped Posterior Tilts with Sit-Back – The goal during this drill is to maximally posteriorly pelvic tilt prior to sitting back into a child’s pose.  Ensure your patients or athletes don’t lose this tilt as they sit back
  3. Modified Rabbit Pose – I’m pretty sure I’ve stolen this one from the yoga world and I really like it.  In most stretches people won’t feel much of any stretch sensation in the lower back.  This stretch is different.  I’d just be careful about applying too much pressure into lumbar flexion as well all know that too much lumbar flexion under load can be problematic for the spine.
  4. Wall Roll-ups – This one can be performed on a stool against the wall or sitting indian style on the floor with the back against the wall.  The idea is to segmentally roll the spine up and down the wall, with one segment touching the wall at a time moving slowly all of the way up and down.  For those with stiff spines they will generally have big chunks of the spine come off the wall at once.  We’re attempting to minimize this.

 

So there you have it!  I hope next time you encounter an anterior pelvic tilt that you think needs correcting you keep the lower back in mind.  If you know someone who could benefit from this then please share!

Want more assessment techniques and strategies to improve your mobility?  Check out my latest assessment and correction digital product:

MM-Movement-Essentials-Cover

Monkey Method – Movement Essentials

The Ultimate Guide to Understanding and Fixing Technical Flaws in the Handstand, Muscle-up and Olympic Lifts

World’s Weirdest Spine (Next to Dave Tilley),

Dan Pope DPT, OCS, CSCS, CF L1

Categories
anterior pelvic tiltcorrective exerciseLower BackMobility
10 Comments on this post.
  • Misty
    22 November 2016 at 10:26
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    Thank you for this. I think this will be a huge help to me.

  • Lewis Walters-Girout
    22 November 2016 at 10:26
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    Thanks a lot for the mail all year I’m proud to be a healthy man and due to you I can practice this pain free with our studio.
    Now if I see this article then it should apply to me.
    If I’m in the snatch in the deadlift position and I go into a squat snatch I get a lock up on the way down causing me to stop at the tall position.I am not intiterly sure if it’s related to the hip position you are referring to but it’s like a bigginer when they exacute a air squat.

    • djpope
      2 January 2017 at 10:26
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      As in pain as you start to hinge from a standing position?

  • Lawrence
    18 December 2016 at 10:26
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    So….we know from Boyles work that the joint by joint approach teaches us that the lumbosacral complex is a stability based region, how does this coincide with adding mobility to an area that is already prone to losing stability

    Lawrence

    • djpope
      2 January 2017 at 10:26
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      Joint by joint is a starting framework for breaking down the body. Sometimes the “stable” areas get stiff also. This is a lot of times the case with anterior pelvic tilt. If someone is stiff there and has issues with APT I’ll work on loosening it.

  • Ben
    19 December 2016 at 10:26
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    Love the video on APT corrections. Good stuff.

    Ben Fairchild

  • Barry triestman
    19 December 2016 at 10:26
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    Nice review, surprised you did not mention spinal manipulation as a way to down regulate the lumbar spinal musculature.

    • djpope
      2 January 2017 at 10:26
      Leave a Reply

      Another great tool!

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