Anterior Tilt Causing Pain? Try These Anterior Pelvic Tilt Tests

Sitting for long periods of time puts the muscle groups around the hips, pelvis, and back in a flexed position without a lot of activation. At the hips, the main muscle imbalance is between the hip flexors (e.g., the psoas major, iliacus, and rectus femoris of the quadriceps group) that shorten and the hip extensors (such as the hamstrings and glutes) that elongate. In the lumbar spine, muscle imbalance occurs between the spine flexors (abdominal muscles) and the spine extensors (including back muscles like the erector spinae and multifidi).

Since these muscle groups are effectively locked in short and long positions for prolonged periods, they start to adapt to the position they are used in over time.

With a lack of movement, the muscles of the legs, hips, pelvis, and spine don’t get the benefits that come from exercise. A sedentary lifestyle not only makes muscle groups weaker but also allows the supporting structures (ligaments, joints, bones) that rely on good stress and activation to weaken as well.

The body locks into an anterior pelvic tilt as a strategy to create stability when there is a lack of strong, balanced muscle groups. Walking, as mentioned above, is helpful to get the pelvis moving into anterior and posterior pelvic tilt positions as the big leg, hip, and pelvic muscles flex and extend with each step.

Because our body works as a whole, poor posture in one area leads to posture problems elsewhere in the body.

Tech neck, for example, doesn’t stop at the head or neck. Instead, the forward flexion of the neck and upper back often leads the rest of the spine to counter-balance with excessive lordosis and anterior pelvic tilt in an exaggerated S-curve of the spine. (Of course, the body uses other problematic posture strategies to balance as well.)

When posture deviation such as tech neck, thoracic kyphosis, or others cause imbalance, the brain coordinates with the body to create balance as needed. In this balancing act of the body, muscles compensate by becoming overactive whereas others become inactive and weak.

Muscle imbalances occur for different reasons — from pregnancy to neurological issues. By far, however, the majority of cases we see with clients coming into our clinics are due to one or more of the reasons described above. Lifestyle and the repetitive actions we perform daily play major roles in how well our muscles will or will not be balanced.

Sometimes, even when active, we unintentionally perform repetitive actions that strengthen the muscles that create this posture deviation. If you sit for work, sit to commute, sit to eat, sit to relax, and then choose activities in the gym like cycling or sitting strength training exercises, how do you expect your body to respond? That’s right, you adapt to sitting!

Can I work out with anterior tilt?

Common strengthening exercises like deadlifts, squats, push-ups, glute bridges, or lunges may be done entirely while in an anterior pelvic tilt — without ever going to a posterior tilt or hip extension. A lack of hip joint extension is usually compensated for by the pelvis tipping anterior. Of course, injuries are more likely to occur when altered mechanics such as this are present. When your body is supposed to move in a certain way but your postural dysfunction disallows it, you're likely to feel the consequences sooner or later.

Additionally, you might be (or have been) an athlete in a sport that required strong hip flexors. The strong iliopsoas and accessory hip flexor muscles help generate powerful movements to drive the legs forward in sprinting, jumping, kicking, and so on. For many sports where opening up the anterior hip into extension isn’t required, the compensation and eventual adaptation often shows up as anterior pelvic tilt.

It's best to correct your posture and function prior to working out if you can.

Don’t despair! Anterior pelvic tilt CAN be corrected!

This first anterior pelvic tilt test is a tough one for most people. Follow the instructions below on setting up in the starting position and then try to perform the movement described. Start with your heels against the wall and if you can't flatten all the way, try moving your feet away from the wall. Not too far, though, as you'll already be doing test #2!
Move back and forth from the starting position to the other a few times. How is the movement? Is it choppy or smooth? Difficult or easy? Does your lower back round or stay arched?

If you're a skier, then you likely know this one well! But quad strength is only part of the equation when it comes to pelvic function. Pay attention to how your legs feel when in the starting position versus when you flatten your back completely. Can you feel the difference?
Be sure you're wearing shoes or using a yoga mat for your feet to grip!

Pelvic tilts seems like a straight forward exercise, but you'd be surprised at how many people cannot perform this movement! Yes, in our pro-sitting and sedentary society, pelvic functions such as rolling forward and backwards has become lost for many. And this isn't an age thing! We see hip, pelvic, and lumbar issues in all age groups with this one.

If you had trouble with the pelvic tilts with your knees bent, chances are that this one will be tough as well. However, if the pelvic tilts were easy, then you're likely to feel more difficulty with your legs extended in this exercise.

With these tests, hopefully, you can determine if your pelvis is stuck in an anterior pelvic tilt. If you have regular lower back pain, knee pain, hip pain, or other symptoms like a decreased range of motion in the hips, it may be related to the rigidity of your pelvis.