Anterior pelvic tilt is one of the most common postural imbalances, and one of the most common causes of general low back pain or tightness. An anterior pelvic tilt, also known as "lower crossed syndrome," is a common postural imbalance that can lead to many issues in the body including lower back pain, hip pain, and even knee pain. This condition occurs when muscle imbalances surrounding your hips pull your pelvis forward (anteriorly), leading to unnecessary stress being added to your spine and hips.

Generally, correcting an anterior pelvic tilt involves strengthening your deep core stabilizers, strengthening your hamstrings, lengthening your hip flexors, and lengthening the muscles in your low back. With this postural imbalance, you may complain of tight hamstrings, but this can often be a false sense of tightness. Let’s take a look at the anatomy of the pelvis to better understand this concept.

Your hamstrings start at the base of your pelvis (on your “butt bone”) and attach at your knee. With a pelvic tilt, your hip flexors can be so tight that the rotate your pelvis forward, placing your hamstrings on a constant stretch. This is felt like hamstring tightness, but in reality they are on a constant stretch and need to be strengthened to rotate your pelvis back to its neutral position.

As you can see, this also places compression to the lumbar spine (low back), which is where most people will feel the effects of having an anterior pelvic tilt. This causes the muscles in your low back to tighten up, leading to constant dull, achy pain.

Causes of an Anterior Pelvic Tilt

The most common causes of an anterior pelvic tilt come from sitting for long periods of time (ie. Sitting at a desk, driving). This can lead to issues such as:

• Poor posture

• Tight hip flexors

• Tight low back muscles

• Weak glutes and abdominal muscles

• Poor core stability

Correcting an Anterior Pelvic Tilt

The good news is that an anterior pelvic tilt is a postural imbalance that can be corrected through corrective exercise.

Here are a few of my favorite exercises that focus on core and pelvic stability to fix your anterior pelvic tilt:

1. Supine Posterior Pelvic Tilt Exercise

This exercise helps teach the proper method to “engage your core” that can be applied to other exercises. In my opinion, this is the most important foundation to any corrective exercises involving core and pelvic stability. This exercise specifically targets the transverse abdominis muscle, which is a deep core stabilizer that attaches to your spine and pelvis. Doing this exercise before other core strengthening will help prepare your body to properly engage your core and maintain pelvic neutral.

2. Cat-Cow with Resistance Band

This commonly known yoga move is a great mobility exercise for the lumbar spine and Sacro-lumbar junction. By adding a thick resistance band at your pelvis, this adds a slight distraction to create more space at the SI joint where most tension is felt. Start on your hands and knees, with your wrists directly under your shoulders and your knees directly under your hips. The band should be anchored directly behind you, placed on your hip bones. As you inhale, arch your back and lift your head and tailbone towards the ceiling. As you exhale, round your back and tuck your chin to your chest. Repeat this stretch for several reps.

3. Dead Bug Exercise

The dead bug exercise is an effective exercise for targeting the abdominal muscles and also helps to improve overall stability. Begin by lying on your back with your knees bent at a 90 degree angle and feet elevated in the air. Your arms should be straightened straight up above your shoulders. Begin by activating your core using the posterior pelvic tilt motion. Maintain this position throughout the entire exercise. Start be straightening your left leg towards the ground, and at the same time, straighten your right arm above your head. Bring both limbs back to their starting positions and repeat on the opposite side.

4. Hamstring Sliders

Hamstring sliders are a great way to strengthen your hamstrings while stressing both the eccentric and concentric muscle patterns. It is important to maintain core tightness (using the posterior pelvic tilt method) during the entire exercise. Begin by laying on your back; place your heals on top of the sliders (or use a towel on a wood floor). Press your hips into the air doing a glute bridge, then slowly slide your heals away from you. Without letting your butt hit the floor, pull your heals back towards you. This exercises can be made more difficult by doing one leg at a time.

5. Off-Set Farmer’s Carry

The off-set farmer’s carry is a core/pelvic dynamic stabilization exercise. The goal of this exercise is to maintain a neutral pelvis and spine with added weight. Begin by grabbing two different weights about 15-25 lbs apart in weight (can be dumbbells or kettlebells). Begin by standing upright with the heavier weight in your left hand at your side, and the lighter weight in your right hand pressed straight up above your head. With feet shoulder width apart, activate your core by using the pelvic tuck method. Begin walking forward for the designated distance (about 20-40 ft), focusing on slow and controlled steps, keeping your core engaged and spine in neutral the entire time. After reaching the designated distance, switch hands with the weights and repeat on the opposite side.

6. Banded Hip Distraction and Rotation

This exercise focuses on the mobility of your hip joint. You will need a thick resistance band and a foam roller or yoga block. Begin by anchoring a thick resistance band close to the ground. Sit on the ground facing the band and strap in one ankle by placing your heal on top of the loop, and crossing the band over the top of your foot. Push yourself back so that the strapped in leg is straight and you feel a slight pull in your hip from the band. Place the foam roller or yoga block under your leg, just above the knee, for support. Slowly rotate your hip internally and externally without lifting your butt from the ground. You shouldn't feel anything more than maybe a light stretch in your hip.

7. Banded Hip Joint Mobilizations

These exercises help target the joint capsule around your hip joint, which can get tight just like any other tissue in your body. Adding these types of exercises into your routine helps build overall mobility. Begin with a thick resistance band (like ROGUE or Theraband). Anchor the band at about knee height and loop one leg through the band. Get down on your knees and slide the band up as close to the hip joint as possible. First begin in a lunge, with the banded knee on the ground (use a pad for comfort), and the other leg out front. Begin rocking forward and back, ensuring that you are keeping tension on the band. This exercise can be done facing away from the band as well, or you can sit back into other hip rocking patterns. The idea is to create movement in the hip joint while the band is providing some tension.

8. Kneeling Hip Flexor Stretch

Begin kneeling on the ground with a mat or pad for comfort, with your right knee down and your left foot stretched out in front of you. Push your pelvis forward by squeezing your right glute and tucking your tailbone, and lean forward until you feel the stretch in the front of your right hip. For a deeper stretch, bring your right arm up and over your head to add more psoas into the stretch.

In conclusion, an anterior pelvic tilt is a common postural imbalance that can lead to a host of problems, including lower back pain, hip pain, and even knee pain. By implementing these exercises and stretches, you can help to correct your anterior pelvic tilt and improve your posture.

Just like anything else in the gym, consistency is key!!

As always, we always love to hear your feedback. For questions or comments please send me an email at rebecca.bodywork@outlook.com