“Anterior Pelvic Tilt” Sounds Slightly Risqué!
Unless you’re in the habit of thumbing through medical dictionaries for fun, the term anterior pelvic tilt probably doesn’t mean much to you. Unfortunately, it is an all too common postural problem that is often bandied around as the cause of all evil. In simple terms an anterior pelvic tilt is when the front of the pelvis drops and the back of the pelvis rises. This typically happens when the hip flexors shorten and the hip extensors lengthen.
Causes – we can sum these up as one word – “lifestyle”. By this, we mean the postures we operate in for the majority of each day. Standing for extended periods is tiring, and it is very easy for people to reduce fatigue by locking their knees back. This immediately causes a degree of pelvic tilt. However, the largest lifestyle factor impacting most people, is the amount of time that they spend sitting daily. The American Time Use Survey (2014) determined that the average American adult spends nearly 9 hours per day sitting. Nine hours! This quantity of sitting causes the muscle imbalance described above, and you guessed it, leads to anterior pelvic tilt. If you are a computer jockey, you probably beat that time easily – for example, 7 hours sitting at work (assuming your walk around on your breaks), an hour in the car, maybe 3 hours on the couch in the evening – that’s an easy 11 hours!!
Do you do this? – when working at a computer, many people unconsciously move forward to the front of their chair. To balance, they then lean slightly forward which instantly puts their pelvis in a forward (anterior) angle. Have a look at this picture (source Moizi.de ). This is a very common mistake by people trying to sit upright (thinking that will mean a healthy posture). The ‘natural’ tendency when sitting upright and forward, is to push your chest out and arch your lower back.
The Burning Question – Have I Got It?
The key question then is, “do I have this condition?” To be 100% sure you need to visit a professional such as a chiropractor or physiotherapist, but for those looking for a do-it-yourself assessment, you can try the “Thomas Test” to assess how tight your hip flexors are.
The Thomas Test
This test is very well known by physical therapists and is commonly used to determine whether your hip flexors are short and/or tight.
The easiest way to do the test is with a friend observing, but you could also easily video it if that is not possible. Sit on the edge of a solid table or another flat surface, hold both your knees and lean back until your back is flat on the table. Now, let go of one leg and extend it from the hip until your thigh touches the table.
If your thigh touches the table, and your knee is still bent and neither hip nor leg rotate or move outward (abduct), that is a good result.
If you need to straighten your knee to allow your thigh to touch the surface of the table, your rectus femoris is short. If your thigh cannot touch the table even after you’ve extended your knee, your psoas are short. If your leg and hip need to move (rotate) outwards for the thigh to touch the surface of the table, your tensor fascia latae is short. Any of these outcomes mean that it is much more likely that you have an anterior pelvic tilt.
The following short videos may also be useful in your diagnose.
The bottom line is that if you either stand, or sit, for extended periods, you are very likely to have a least some degree of anterior pelvic tilt. And . . . if you haven’t yet, you will have soon!
Darn, I Have Got It! What Now?
Well, the good news is that there are several ways to both fix and prevent an unhealthy pelvic tilt. The slightly less good news is that you will have to put effort into making the solution effective long term. So lets roll our figurative sleeves up and get started.
Because this postural condition is becoming so well known, there is plenty of science to back up a treatment plan. (There is also a fair bit of nonsense talked as well, which is why you have to be cautious if someone offers a amazing “quick fix” – our maxim is that if it sounds too good to be true, it probably is! )
There are 3 parts to a successful plan:
1. Stretching
2. Strengthening
3. Lifestyle change
Before we go further, have a look at the video below. It clearly explains the imbalance that between tight muscles and weak muscles that leads to an incorrect anterior tilt.
Stretching
The main muscles associated with an anterior pelvic tilt that need stretching are the hip flexors, psoas, and erector spinae. Usually due to extended periods sitting, they shorten and tighten over time. There are any number of stretches available with a quick Google search. One that we recommend is shown below.
Strengthening
Typically a person with an anterior tilt has weak gluteal muscles, abdominals, and hamstrings. The video below shows some effective exercises for toning and strengthening your glutes and hamstrings that you can do at home without equipment. Of course, if you belong to a gym you can get the trainers to design a specific programme for you using their specialist gear. Our current favourite abdominal strengthening exercise is the “plank” as it can be done at home without equipment. If you want something a bit more active, try doing kettleball swings – these things provide a great workout if you use them properly.
Lifestyle Change
The third, and most crucial, part of your treatment plan is making some lifestyle changes. Very, very, few people are born with an exaggerated anterior tilt. It is something that happens due to poor posture over time. To make a lasting and effective change, you will have to work at creating a healthy posture in the environments that you encounter daily. The environment that is most commonly associated with this condition is sitting. We wrote a post relevant to this topic recently which is worth a quick read at this point – Pain When Sitting – The New Lifestyle Illness. It contains practical advice regarding sitting in general. If you make the simple changes suggested you will go along way towards creating a healthier you. All the stretching and strengthening work will be ineffective if you continue to sit as you always have. One key tip we would like to add to the general advice, is always sit back into your chair to avoid the slightly forward leaning position described earlier in this article (we are assuming that you have a decent chair with a properly supportive back). This action alone will not ‘cure’ your problem, but it will most definitely help!
A Brief Comment on Posture Correctors
As we are a review site for posture correctors it would be remiss not to say whether or not any current products can help with your quest to reduce anterior pelvic tilt. In a nutshell, most products are waste of time for this purpose. However, two types that might help are; a chair lumbar support, and/or one of the new hi-tech products aimed at your overall posture. In the chair support category, we recommend the best as being the BackJoy Posture Corrector (our review here). The current best hi-tech product is the excellent Lumo Lift (our review here). Either of these devices will help you with your journey back to a healthy posture.
