A picture showing anterior pelvic tilt (left) and much reduced tilt (right). If you’ve been struggling with anterior pelvic tilt and want to learn the right way to fix it, then you’ve come to the right place. This article provides easy to follow exercises and step by step methods to follow in order to fix anterior pelvic tilt.
Anterior pelvic tilt (also known as “lower crossed syndrome) is becoming more prominent nowadays mainly due to the increased amount of sedentary time and in general, poor postural habits we’ve adapted because of the lifestyles most of us lead. However, it’s not something that should simply be ignored because not only can it lead to lower back discomfort, but it can also cause inhibition of the gluteal muscle group (gluteus maximus, gluteus medius, and gluteus minimus). The sum of these effects and then lead to a reduced range of motion at the joint in addition to reduced force production capabilities. Pain and discomfort can be chronic by products of joint inflexibility and reduced force production can hamper gym performance (specifically key compound movements such as deadlifts and squats can be effected).
We will begin this article by discussing what anterior pelvic tilt is, what causes is an some of the negative consequences associated with the condition. Having established the necessary background, we will go through four essential steps that can be utilized by anyone to easily correct anterior pelvic tilt. Lastly, I will summarize all of this information in an easy to implement, 10 minute corrective routine that can be used daily to reduce anterior pelvic tilt. Without further ado, lets get started.
What Exactly is Anterior Pelvic Tilt?
The pelvis is composite bone formed by multiple bones (sacrum and coccyx posteriorly and ilium, ischium, and pubis anteriorly). The bones of the pelvis are firmly fused through fibrous joints to provide stability as this critical region is utilized for almost all bodily movements. The pelvis provides key functions such as articulating the head of the femur. The head of the femur attaches to the acetabulum and is covered by two key ligaments – the ischiofemoral and the iliofemoral ligaments.
Forward tilting of the pelvic girdle (as the entire region is called) alters an individuals postural pattern causing the hips to pushed back, the glutes to stick back to a greater than normal extent, and the abdomen to stick out in front (see picture below). The sum effect of these changes results in the accentuation of the arch in one’s lower back. A curvature in the lower spine occurs normally, but can be accentuated by multiple factors (covered in the next few paragraphs) and lead to a more pronounced concave curvature in the lumbar region of the spine.
Anterior pelvic tilt looks something like the red-loop covered picture to the left. The picture on the right (covered by a green loop) indicates a normal amount of tilt in the pelvis and the accompanying curvature of the lumbar spinal section.
Anterior pelvic tilt is relatively well characterized and has some common symptoms which are as follows:
- Lower back pain (Youdas et al. 2000)
- Chronic lower back tightness
- Knee hyperextension when standing
- Low activation of gluteal muscles
- Tight hamstring muscles
A visual assessment of one’s normal relaxed posture (use above picture as a guide) in combination with these listed symptoms can be used to self diagnose anterior pelvic tilt. Do not fret if you suffer from this condition, as it is relatively easy to acquire and also relatively easy to correct! Read on to see how.
What Causes Anterior Pelvic tilt?
There are numerous causes for anterior pelvic tilt, having identified the underlying root of the problem it becomes much easier to reduce the causing factors and correct the issues at the source:
- Prolonged sitting with poor posture (in an anteriorly pelvic tilted position)
Many people’s jobs (or hobbies) necessitates prolonged sitting. This in itself has been associated with numerous health risks. Sitting with improper posture, can cause numerous musculoskeletal problems.
- Physical inactivity
Strengthening the muscles which control body posture through targeted, regular exercise can alleviate postural issues.
- Genetic predispositions (e.g. bone structure of the pelvis)
The pelvis is a complex joint that is kept stable by numerous muscles, ligaments, and tendons. The bones which make up the pelvis (and the placement/strength etc. of these fibrous tissues) are often genetically controlled.
- Poor exercise technique (excessive lower back arching during the squat or deadlift)
Improper form keeps your trainer up at night… it also causes numerous postural issues which have themselves have knock-on effects.
- Imbalanced strength training (not enough glutes/ab training)
Training all the muscles in the body, and focusing on muscles on both sides of joints is key to a well balanced workout routine. Postural muscles are often harder to train and thus overlooked when planning a gym routine.
- Muscle imbalances from sports
Sports often accentuate the work of some muscles over others. These imbalances in strength can give rise to numerous problems that can materialize in different ways.
- Foot pronation
Many postural issues start at the ground. Improper foot ergonomics can have knock-on effects given that they negatively impact posture and necessitate compensatory adjustments in the rest of the body.
Despite all of these potential contributory factors, anterior pelvic tilt most commonly arises nowadays due to extended periods of sitting with improper posture. The below figure shows extreme sitting postures with that on the left exhibiting anterior pelvic tilt when sitting whereas the figure on the right exhibits posterior pelvic tilt in similar sitting position. Neutral is ideal and falls somewhere between the two extremes!
It’s important to note that a slight anterior pelvic tilt is perfectly normal. Research shows that about 85% of healthy males and 75% of healthy females exhibit a slight anterior pelvic tilt.
A “normal” degree of tilt looks something like the below photo.
Despite that, problems can start to arise in those who have a more prominent anterior pelvic tilt. Bodies respond differently to strain and what may be a normal level of tilt and well tolerated in an individual may cause significant postural discomfort in another. These discomforts can compound when those with excessive anterior pelvic tilt lift weights. More specifically, weight training that focuses on the muscles of the lower back/pelvic girdle can push an already unbalanced muscle core over the edge.
Performing loaded movements like the squat and deadlift with an anterior pelvic tilt (caused in this case by an arched lower back) accentuates and focused the stress on the lower back and reduced the amount of force that can be produced during the exercise. Prolonged activity can result in tightness of the lower back and pain. This chronic tightness prevents regular progression in the gym (wont be able to lift heavier weight) and also prevents proper activation of the gluteal muscles which is integral to multiple exercises deadlifts.
If this is the case for you, its certainly something that should be corrected sooner than later. Not only to reduce the amount of discomfort that is associated with the condition, but also to allow for improvements in the gym that accompany progressive increases in force production.
The “Science” Behind Fixing Anterior Pelvic tilt
Before diving into the a quick and easy corrective routine, it is important to know the reasoning for and the evidence behind it.
As discussed previously, Research indicates that overtime, certain muscles become overactive and others become underactive. The imbalance which results leads to anterior pelvic tilt.
In a typical scenario, the muscles that form the abs (rectus abdominus, transverses abdominus, internal obliques, and external obliques) as well as the glutes (maximus, medius, and minimus) become weakened. The hipflexor muscles (iliacus, psoas, and recuts femoris) and erector spinae muscle group become overactive.
The muscles in question can be seen in the photo shown below. It does not take an extensive understand of human anatomy to see that the imbalance caused by over/underactivation of the highlighted muscle groups can cause a forward tilting of the pelvic girdle.
How does one go about solving this issue? You should focus on the two overlying principles listed below:
- Stretching the overactive muscles and focus on the hip flexors. Tightness in the erector spinae is a consequence of rather then cause for the forward tilted pelvis. Therefore, working on the iliopsoas muscles which bring about hip flexion is key. Your hamstrings may also feel tight if you suffer from anterior pelvic tilt. Tightness in this muscle group is also a consequence of, rather than a cause for the abnormal tilt in the pelvic girdle. Stretching the hamstrings, while beneficial in its own will not alleviate the problem. The position of your pelvis when in anterior pelvic tilt “pre-stretches” the hamstrings which gives you the false impression that they’re tight. Often times, stretching them will do more harm than good.
- Strengthening the underactive muscles. As mentioned previously, the abdominal muscle group and the glutes are the two main muscles you should focus on strengthening to alleviate the cause of anterior pelvic tilt. People with anterior pelvic tilt will often have trouble activating the glutes and relaxing the hip flexors. With that said, the cause of weakness is apparent. Given this propensity, caution should be exercised in strengthening the underactive musculature around the pelvic girdle. The routine outlined below is carefully selected to maximize glute activation and is specific to the issues faced by those with anterior pelvic tilt.
Step 1 of the prescribed corrective routine will focus on learning how to properly maneuver your pelvis. This preamble is absolutely necessary prior to implementing exercises that are listed below and available elsewhere online. These exercises on their own will not prove beneficial unless you have the control required to manipulate pelvic position. So without further ado, lets delve into the details of our 4 step process.
Step 1 – Learn How to Posterior Pelvic Tilt
Having been stuck in anterior pelvic tilt and in order to kick the habit, you will need to first learn how to properly posteriorly tilt your pelvis. If you’re your body will cheat when performing corrective stretches and exercises which will not prove beneficial to you.
Exercise 1: Lying Pelvic Tilts
One easy way to learn to posterior tilt your pelvis is to practice this movement while lying on the ground. The support provided by the ground and the increased stability in this position is an ideal way to transition into the more complex exercises soon to follow. Begin by simply lying on your back with knees flexed and pointed upwards. You’ll likely notice that there is a space between your lower back and the ground.
You want to begin by flattening your lower back as you push it towards the ground. At the same time, you will squeeze (and activate) your glutes and tilt your pelvis to allow for this movement to happen. This action is called the posterior pelvic tilt. You can then go back to the starting position by relxing your glutes, tilting your hip in the upward direction, and moving your back away from the ground to allow for a space to be created between your lower back and the ground; you are now in anterior pelvic tilt.
Photo – above shows the anterior tilted position and below shows the posterior pelvic tilted position. This supported exercise is performed on the ground and allows the individual to gain control over pelvic movements, prior to progressing towards more complex exercises.
By going back and forth between the two positions (for about 10 repetitions), you will begin to become comfortable in controlling the tilt of your pelvis. This exercise can be repeated throughout the day, or daily as the need varies until sufficient comfort has been achieved. Exercise 2 is simply a progression of the first.
Exercise 2: Standing Pelvic Tilts
The next step in your progressive training routine is to repeat the previously discussed exercise in the standing position. The exercise is now less controlled, the support that was gained by performing the movement on the ground is no longer in place. Despite this change, the movement is nearly identical. Having mastered exercise 1 will allow you to perform exercise 2 with much greater ease.
Stand relaxed with your feet shoulder width apart. You’ll naturally be in an anteriorly pelvic tilted position. Then you want to squeeze the glutes to come into posterior pelvic tilt.
Exercise 2 is shown with the top picture (number 1) showing the anterior pelvic tilted position and the bottom picture (number 2) showing the posterior tilted pelvic position. The blue arrows indicate the direction of movement of the lower back and glutes in the picture.
Backward movement of the lower back and tilting of the pelvic girdle in the posterior direction will move you from the anterior to the posterior tilted position. The opposite movement to the sequence of events previously described will return the body to the anterior tilted position. The movement can again be repeated multiple times (about 10 repetitions), and throughout the day or on successive days to attain the desired results.
Step 2 – Strengthen the Glutes and Abdominals
Step 1 focused on learning to tilt your pelvis posteriorly. The strength and control gained in those introductory steps can be used to move towards strengthening exercises for the gluteal and abdominal muscle groups.
Exercise 1: Bodyweight Hip Thrusts
The first exercise maintains and targets the glutes! The hip thrust is an excellent exercise which can be performed unloaded to target one of the two main muscle groups involved in anterior pelvic tilt. The key however is to do the exercise properly.
The picture below will help better visualize the movement. Basically, you begin by having your shoulder on the bench with your feet on the ground the only other point of contact. You move your hips in the upward direction and towards the ceiling. Your shoulder blades should not leave the bench and the feet should be placed so that your shins are still vertical when the upward movement is completed. It may take a few attempts to figure out how far from the bench to place your feet initially. The body will try to compensate for a lack of stability through the range of this movement by arching the lower back. Being conscious of this compensation and avoiding it at all costs is the key to activating the desired muscle group; namely the glutes.
The key to successfully completing this movement is:
- To keep your lower back straight
- And to posteriorly tilting your pelvis throughout the whole movement as discussed in part 1
Body weight – hip thrusts are a great tool to strengthen core muscles, with a focus on the glutes. The movement should be performed from the position shown in the bottom picture, which avoids the curving of the lower back shown on top. Posterior tilting of the pelvis discussed in part 1 prior to the movement is key to activating the glutes
Posterior tilting of the pelvis should allow your body to line up, so that you should be able to draw a straight line from your head to your knees. You should also be squeezing the glutes and feeling them contract.
An alternative is to use glute bridges (with your back on the floor) and applying the same protocol. The goal, eventually is to build up to posterior pelvic tilt with a weighted protocol that really allows greater strengthening of the glutes with continued application over time.
Exercise 2: RKC Plank
The next exercise focuses on strengthening the abdominal muscle group, the second half of those involved in tilting of the pelvis.
There are many different exercises out there, that seek to target the abs. Those that suffer from anterior pelvic tilt should select exercises that minimize involvement of the hip flexors which, as discussed previously are already more active than they should be.
An example of a great exercise which ticks all of the boxes which we are interested in, is something called the RKC plank. RKC planks are very similar to the standard plank but are especially beneficial for those with anterior pelvic tilt. They better engage the abdominal muscle group, help minimize involvement of the hip-flexors, and help strengthen the gluteal muscle group; all things which we are hoping to work on.
EMG analysis of muscle activity by Bret Contreras showed that the RKC plank result in 4x higher lower abdominal muscle activation and 2x higher internal oblique activation than the standard plank! But, as always, the key is to perform these planks properly, in order to gain the maximum benefit.
RKC plank demonstrated with the key target groups highlighted in red and labelled. Note the hands are interlocked, the feet are slightly wider than shoulder width apart, and the pelvis is posteriorly tilted to allow for greater activation of the glutes and abdominal muscles.
Here’s some key points to keep in mind to ensure the proper execution of this exercise:
- Set up as you would in a standard plank (with elbows and feet shoulder width apart) but with your hands interlocked and your feet slightly wider than normal.
- Activate your abdominals by consciously attempting to draw your belly button towards your spine (in the upwards direction).
- Using what you learned and practiced in the two exercises in step 1, posteriorly pelvic tilt your hips by squeezing your glutes and continue to keep them contracted as you hold the plank.
- Hold this position for as long as possible without letting your lower back arch and while continuing to activate your glutes. Keep track of the time.
With subsequent iterations, the time can be increased in small increments while still remaining conscious of performing each component properly.
Step 3 – Stretching the Hip Flexors
Exercise 1: Psoas Stretch
The first stretch to be discussed is the “lunge stretch”. This stretch is one which many people know, but do not perform correctly. When done propertly this stretch allows one to focus on the psoas muscle.
To properly perform this stretch, use the following tips:
- Get into a lunge position with both knees bent at 90 degrees.
- Contract your abdominal muscles, again by thinking about drawing your belly button towards your spine. Make sure to move your hips into the posterior pelvic tilt position. The goal of this is to feel a deep stretch in the hip flexors in your back leg. Many will find initially that this position already provides a sufficient amount of stretching.
- For a deeper stretch, maintain your position of posterior pelvic tilt and lean forward slightly while contracting your abdominal muscles.
- For an even deeper stretch, the trunk region (upper body) can be rotated to the opposite direction from your forward planted leg. These steps can be progressed to after a few sessions of more basic stretching as they require greater comfort with the stretch and postural stability.
- Repeat the same stretch with the other foot in front, making sure to focus on the posture. To avoid having to count or time, hold each side for about 10 deep breaths.
The lung stretch is demonstrated – top picture (number 1) shows the placement of the forward leg with the middle picture (number 2) showing forward leaning movement while maintaining a tightened core and posterior pelvic tilt. Lower picture (number 3) shows a more advanced variation on the stretch, whereby rotation away from the planted forward leg is used.
Exercise 2: Rectus Femoris Stretch
The goal of the second stretch shown here is to specifically target the rectus femoris, which along with the iliopsoas makes up the hip flexors. In general, this muscle is tighter than the iliopsoas in those with anterior pelvic tilt.
In order to perform this stretch, your forward foot should be planted firmly on the ground, with the knees bent and the back foot in contact with the ground at the knee (see picture below). The back foot can be supported by a bench or couch to allow for greater stability. The abdominal core should be contracted by drawing your belly button towards your spine AND moving your hips into posterior pelvic tilt position with which you are now familiar.
As you achieve this position, you should feel a deep stretch down the front of your thigh. You can slightly move forward and away from the bench so that your back knee is less bent for less of a stretch or move closer to the bench for more of a stretch.
Stretching the rectus femoris muscle which is part of the quadriceps and crosses the hip joint to participate in hip joint flexion. Two alternatives are shown, using a bench (left) and without a bench (right). As discussed above contraction of the abdominal muscles and posterior tilting of the pelvic girdle should be maintained throughout the stretch.
This same stretch can also be done without the use of a bench by holding onto something for balance and then pulling your back leg up towards your buttocks. The forward leg can be changed and each side held for about 10 deep breaths.
Exercise 3: Laying down iliopsoas stretch
Sitting on the edge of your bed, with your feet hanging off the edge of the bed and flat on the ground, you can prepare for the stretch. You then proceed to lay on your back on the bed, with your feet still hanging over the edge and possibly planted on the ground (depending on the height of the bed and length of your legs). You lift one leg off the ground and bend then knee, then proceed to move your thigh as close as possible to your chest; you can use both hands interlocked together and wrapped around this leg to keep it in place (close to the chest). The lifted leg will be stretching in the gluteal region and upper hamstring.
The main focus of this position and our goal, is to stretch the iliopsoas muscle in the leg still hanging over the edge of the bed. By virtue of lifting one leg, the other leg is passively stretched as the iliopsoas muscle is lengthened. You just have to let gravity do the work!
While in this position, implement the posterior tilting of the pelvic girdle which you have mastered previously.
To increase the amount of stretch, the bent leg can be pulled closer to the chest and/or the hip can be thrust in the upward direction (towards the ceiling) as done in exercise one.
The number of breaths you take can be used to measure the duration of time, hold the pose with each leg for 10 deep breaths, then alternate and stretch the other leg.
Step 4 – Implement This Into a Daily Corrective Routine
To sum this article up and to provide you with something to takeaway, here’s a corrective routine utilizing all of the exercises I previously discussed. This list can be used to easily implement the set of stretches and exercises into your daily routine.
Lying Pelvic Tilts: 1 set of 10 reps
Standing Pelvic Tilts: 1 set of 10 reps
Bodyweight Hip Thrusts: 3 sets of 10+ reps
RKC Plank: 2 sets of max holds
Lunge Stretch: 2 sets of 30 second holds each leg
Rectus Femoris Stretch: 2 sets of 30 second holds each leg
And I’ve also made a free PDF of the anterior pelvic tilt corrective routine which comes complete with exercise pictures, tips, and progression exercises so that you always have something convenient to refer to when performing the routine. You can access that file here.
Do keep in mind that when it comes to correcting anterior pelvic tilt, frequency and diligence are the most important factor that will determine your success in correcting your pelvic tilt. All of these exercises can be done at home so try your best to do these daily and you’ll quickly start to notice significant improvements.
Another thing to keep in mind is that you should always be aware of how your posture is throughout the day and while in the gym. If you sit or stand for extended periods during the day, then use what you’ve learned in this article to keep your pelvis in more of a neutral position. This is what’s going to prevent your anterior pelvic tilt from worsening or coming back after it has been corrected!
Similarly, when performing movements like the squat and the deadlift in the gym, you need to teach yourself how to maintain a neutral pelvis… AVOID ARCHING YOUR BACK!!! This will help you with strength improvement, especially in your leg workouts.
Anyways, that’s it for this article. Hope you all enjoyed it. Feel free to let me know if you have any questions down below. And give me a follow on Instagram , Facebook , and Youtube where I’ll be posting informative content on a more regular basis. Cheers!