Синдром anterior pelvic tilt

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How To Fix an Anterior Pelvic Tilt: Stretches and Exercises

The anterior pelvic tilt is probably the most common problem when it comes to people’s posture.

It can make both your gut and butt protrude and it can also be accompanied by pain particularly in the lower back when standing for too long or walking longer distances.

Here’s the kicker:

If you don’t do anything about it there is almost no chance of it going away and could get even worse.

Luckily there are things you can do to reverse this problem and return your posture to normal and also relieve that back pain.

In this article, we will go over the right stretches and exercises that will fix your anterior pelvic tilt.

What is an Anterior Pelvic Tilt?

The pelvic tilt refers to the orientation of the pelvis in respect to the rest of the body and the thighbone. There are different pelvic tilt conditions an individual can suffer but let’s focus on the anterior pelvic tilt.

The anterior pelvic tilt refers to a situation where the front of the pelvis slightly drops while the back of the pelvis tends to rise making your stomach and butt stick out and causing a lot of arch in the lower back which can be painful.

This condition can be brought about due to shortening of the hip flexors and the lengthening of the hip extensors due to your lifestyle. Maintaining a poor sitting position for too long can be a big culprit. People who lift weights also tend to get an anterior pelvic tilt just due to the muscle imbalances many people get from weightlifting.

Causes of an Anterior Pelvic Tilt

1.Tight hip flexors and weak glutes

The main cause of anterior pelvic tilt is a combination of tight hip flexor muscles (iliopsoas) and having weak glutes and hamstrings. The tight hip flexors will pull your pelvis down and make it tilt forward and if you don’t have strong glutes to pull the pelvis back into position you then end up with a pelvic tilt.

2 Weak abdominal muscles and a tight lower back

Having weak abdominals is another thing that contributes to an anterior pelvic tilt. Strong abdominals are needed to counteract the pull from th0se tight hip flexors. If your abs are weak it makes it that much easier for your hip flexors to pull on your pelvis and tilt it forward.

Your lower back muscles will also be really tight which will pull the back of your pelvis up, weak glutes will be unable to pull it back down where it belongs.

We will need to strengthen the abdominals, obliques and the deeper internal obliques so they can help pull the pelvis back into the correct position.

3 Prolonged periods of sitting

If you are working in an office where you are sitting most of the time, the spine and the associated muscles along your pelvic can develop an imbalance which leads to anterior pelvic tilt. You will need to either stand more when at work or use correct posture when sitting.

Something like a Varidesk (pictured below) that allows you to stand while working at your desk is another good option for people that need to spend a lot of time on a computer or doing desk work.

4 Lack of exercises

You need to stretch on a regular basis. Strengthening exercises are also necessary to maintain the right posture. If you are not used to stretching and undertaking strengthening exercises, you are at a high risk of developing this problem.

5 Sleeping on your stomach

Sleeping face down on your stomach is another way that people can get an anterior pelvic tilt.

Sleeping face down basically makes your stomach sag further down into the bed forcing your back to over arch. This is why your back hurts when you get up in the morning, it’s been too arched for too long.

What’s the bottom line?

Your hip flexors and low back are tight and your abs and glutes are not strong enough to counter this tightness so your pelvis gets pulled forward.

You will need to stretch your hip flexors and lower back and also strengthen your glutes and abdominals to correct this problem.

Best Stretches to Fix an Anterior Pelvic Tilt

To fix anterior pelvic tilt, there are several stretches you can perform to get the pelvis into the right position. You need to target muscles along the hip areas. The stretches you can perform to fix the problem include the following:

Hip Flexor Stretch

This is an effective stretch which creates a pulling sensation toward the front section of the hip.

Try to move your hip forward until you feel a good stretch, while at the maximum stretch raise your arm above your above your head for increased effect. (use the arm on the same side as the leg that is being stretched)

You will likely feel a bit better and have less back pain immediately after doing this stretch.

Perform this stretch for 30 seconds for three times per side. For best results do this stretch several times a day, I know it’s inconvenient but it will help a lot.

Quad Stretch

A good quad stretch can also really help, it hits the quad and hip flexor really nicely to loosen them up.

Stretch and hold for about 30 seconds as your body gets familiar with the stretch. Maintain an upright position as much as possible. There will be an urge to bend but you should resist it because it can decrease the required tension along the quadriceps complex.

If you feel like the stretch is not enough, try to drive the hip forward as you tense the glutes.

Perform 3 – 30-second stretches per leg.

Child’s Pose

This yoga pose is really good for stretching out the lower back which can get very tight when you have an anterior pelvic tilt. The child’s pose will also feel great if you have been sitting at a desk all day.

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Assume the position as shown in the photo above and hold for 30 seconds, repeat 3 times. You can do this either with your hands overhead as shown above or at your sides if that feels more comfortable.

Pigeon Pose

This is another stretch that will feel really good as it stretches the rotators on the outside of the hip that get really tight with an APT. Going over these muscles on the outside hip area with a foam roller can feel great as well.

Hit this stretch for 3 sets on each leg holding the pose for about a 20-second moderate stretch.

Back Arches

This stretch will help you with your mobility in the lower back which is generally very tight and immobile in people who have an anterior pelvic tilt.

Perform this exercise for one set of 5 reps with 3-5 seconds hold. Do not arch to the point of pain or discomfort, keep in mind, you likely won’t be able to arch as far as the girl pictured above.

That covers the best stretches for the anterior pelvic tilt, those should have you feeling better and a lot more loose and limber. Doing the stretches alone likely won’t fix the problem. We also need to do some exercises to strengthen those weak muscles that are making this problem happen.

Best Exercises to Fix an Anterior Pelvic Tilt

Apart from stretches, there are also several exercises you can perform to help get rid of your anterior pelvic tilt problem. Here are the best exercises:

Pelvic Tilt Exercise

This exercise is effective at strengthening the deep abdominal muscles that help pull your pelvis back up into position. Make sure you rotate that pelvis up and press the low back against the floor and hold.

Hold the position for about 10 seconds then repeat three sets so that you can achieve great results.

Perform 15 reps for 3 sets on this exercise.

Bird dogs are a great exercise for your entire core and glutes. When you perform this exercise make sure your back is nice and flat. No saggy backs allowed, make sure you engage your core and keep your pelvis rotated into the neutral position as well.

Perform 20 reps alternating from side to side for 3 sets.

The Glute Bridge

The exercise targets the glutes and hamstrings really well if you do it right.

Make sure you are really mentally focused on hitting the glutes when you perform this exercise, it may take a little more concentration then you would think to really get your glutes firing rather than letting the hamstrings do all the work which can be easy to do on this exercise. Focus on those glutes!

As you get stronger at this exercise you can also do it using only one leg to make it more difficult or you can place weight on your pelvic area to increase the difficulty.

The exercise should be repeated for about 20 reps for 3 sets.

The plank is a good exercise that hits the inner abs that are so important when it comes to anti-flexion and good posture.

Start by lying face down on the exercise mat. Place your hands on the mat elbows should be directly under your shoulders. Tighten your thigh muscle as well as the stomach muscles. Lift the upper body and your thighs off the ground.

Make sure your back is straight the entire time, no sagging. Also be sure to keep that pelvis rotated up to the neutral position.

If regular planks get boring (trust me, they will) feel free to step it up with these plank variations to kick it into high gear.

Hold the plank position for about 60 seconds or as long as you can with a flat back and good form, perform 3 sets

The dead bug is another good exercise that hits the abs and the internal and external obliques.

To perform the exercise you need to lie down on your back. The knees should be bent facing upwards. Draw in the belly button and push your lower back against the floor as you engage the core and the abdominals group. If this is too easy for you then you also use a med ball for added difficulty as in the video above.

Perform 20 reps on each side for 3 sets.

Stretches and Workout Summary

The Stretches

Perform these every day for best results.

  • Hip Flexor Stretch – hold for 30 seconds – 2 minutes per side for 3 sets.
  • Quad Stretch – Perform 3 – 30-second stretches per leg
  • Child’s Pose – hold this pose for at least 30 seconds, repeat 3 times
  • Pigeon Pose – hold the pose for 2 seconds, perform this for 3 set on each side
  • Back Arches – Perform this exercise for one set of 5 reps with 3-5 seconds hold on the arch. Do not arch to the point of pain or discomfort (Skip this one if you are unable to do it without discomfort.

The Exercises

Perform these at least 2 times per week, preferably 3 for best results

  • Pelvic Tilt Exercise – Perform 15 reps for 3 set
  • Bird Dogs – Perform 20 reps alternating from side to side for 3 sets
  • Glute Bridges – 20 reps for 3 sets (use one leg or weights on your pelvis if they get too easy)
  • Planks – Do 3 sets for max time up to one minute. Use these plank variations to keep it from getting boring and make it more challenging
  • Dead Bugs – Perform 20 reps on each side for 3 sets

Prevention Tips

There are several actions you can take to prevent the formation of anterior pelvic tilt. Here are some of the steps you can take to prevent the health complication from affecting
you:

  • Avoid Sitting for Long Periods of Time, use a raised desk if you need to do desk work
  • Take the right Posture When Sitting if you must sit
  • Engage in Physical Activities
  • Do not sleep belly down, this only makes your pelvic tilt worse and will give you back pain in the morning. Sleep on your side instead.
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Conclusion

We have given you some great stretches that should help your anterior pelvic tilt a great deal. You will likely need to perform these every day for a few months to help you get loosened up. Many people do the stretches several times a day to reduce back pain, stay loose and get a faster result.

The stretches won’t be enough on their own though, you will need to do the exercises as well. You should perform the exercises 2-3 times per week for optimal results.

Fixing an anterior pelvic tilt isn’t easy but like anything else in life, it can be done with hard work and persistence.

Pelvic Tilt

For our purposes here, consider pelvic “tilt” and “rotation” synonymous unless otherwise indicated.

Some anterior pelvic tilt is normal in both males and females. The current “norms” are between approximately 4 and 7 degrees of anterior rotation in males; 7 and 10 degrees in females. However, these ranges differ somewhat among sources. We assume “neutral” range as within the current approximate norms for each gender in the discussion below. Therefore, “anterior tilt” means rotation forward in excess of norm; “posterior tilt” means rotation back in excess of norm.

The human pelvis is made up of three separate bones — left innominate (ilium), right innominate (ilium), and sacrum/coccyx. The upper leg bones connect to the pelvis at the hip sockets (acetabula). The bottom of the lumbar spine connects at the top of the sacrum.

Definitions

Pelvic tilt is the amount of change in orientation between the pelvic bowl and the upper leg bones, as well as its orientation in space. Pelvic rotations we discuss here occur in two directions about a side-to-side axis through the hip sockets:

  • Anterior pelvic tilt – Where the top edge of the pelvis (iliac crest) is rotated forward and bottom edge (pubic bone) is rotated backward.
  • Posterior pelvic tilt – Where the top edge is rotated backward and bottom edge is rotated forward.
  • Hemi-pelvic tilt – Where one innominate appears rotated anteriorly or posteriorly in relation to the other. The other may either be rotated in an opposite direction or remain in neutral.
  • Lordosis – The natural concave “C” curve in the lumbar and cervical spine.
  • Hyperlordosis – Excessive “C” curve in the lumbar and cervical spine.
  • Kyphosis – The natural convex or rounded curve in the uppermost thoracic spine.
  • Hyperkyphosis – Excessive convex or rounded curve in the uppermost thoracic spine.

Pelvic Tilt Described

Pelvic tilt occurs in people of any age or sex. Functionally, the pelvis should live in a neutral state (as described in Terms above) and balance properly with the legs (femurs) below and spine above. The three bones of the pelvis can move in relation to one another a very small amount. While pregnant and during childbirth, women’s pelvic bones can (and must!) shift dramatically, temporarily. They can also shift in both sexes about several different axes of movement as a unit as required. Dysfunctionally, the pelvic unit shifts out of a neutral alignment in relation to the sacrum and lumbars and upper femurs to an exaggerated angle. This throws off alignment for the rest of the body.

Since the pelvis is in the approximate vertical center of the body, its relationship with the spine and legs is very important for posture and symptoms and compensation patterns resulting from dysfunctional posture. In lower crossed syndrome, for instance, the pelvic bowl as a unit becomes anteriorly rotated excessively. Problems can also occur in the central and peripheral nervous systems because of misaligned vertebral bones, and can affect abdominal organs. Needless to say, it is advantageous to maintain a healthy, neutral position of the pelvis.

As previously mentioned, pelvic tilt approximately occurs about an axis of a line drawn from one hip socket to the other. An anterior pelvic tilt is the next commonly found orientation of the pelvis after neutral in both genders, but more prominently in females. Different theories exist as to the cause. What is important to understand, however, are the biomechanical and neuro-musculo-fascial changes and compensations which occur when the pelvis is tilted and to have some idea of why tilt takes place.

Neutral Position

(Please note the consideration of “neutral” in the second paragraph in Terms above.) When in neutral, the various connections with the upper and lower skeleton are aligned in such a way as to distribute the weight of the entire body naturally and with the least amount of stress on joints, soft tissue, and bone. The sacrum serves as a base for the upper torso, head, neck, and arms when level. Wear and tear on the lumbosacral junction (L5/sacrum) is minimized. Our hip sockets, known as acetabula, are properly oriented to fit the heads of the upper leg bones (femurs) as the true ball and socket joints they are intended to be. Stress at these joints are as balanced and minimized as possible. When the body is seated in correct posture, weight is distributed on the “sits bones” (ischial tuberosities).

Anterior Pelvic Tilt

The sacral base becomes unlevel when the pelvis tilts forward excessively. Gravity acts upon the joints nearest to the L5/S1 vertebrae in the spine and at the sacroiliac joints on either side of the sacrum. Complicating things further, the two bottom-most spinal segments (L4 and L5) ordinarily rotate in opposition to each other when walking and running. If the sacral base is unlevel, the L5 vertebrae becomes improperly and poorly supported. The angle between it and its neighbors increases. Abnormal stress and resulting wear and tear then occur to the disc material between the vertebrae. This may cause localized pain or may contribute to sciatic pain travelling down the backs of the legs.

Seen more often than unleveling of the sacral base are the complicated structural concerns that arise. The sacrum itself may nutate , counternutate , or become stuck against an articulating ridge of the ilium, creating a painful jamming at the sacroiliac joint.

More Anterior Tilt Complications

The hip sockets into which the femoral heads reside orient differently with excessive anterior tilt. This causes the head and neck of the femur to swing horizontally forward, causing an internal (medial) rotation of the leg. Rotation then continues down to the foot where it gives the appearance of the person walking “pigeon-toed”. The foot also pronates, meaning that it rolls toward the big toe, drops the arch, and flattens the bottom of the foot.

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Anterior tilt is readily seen in the low back by an exaggerated low back curve. When functionally caused, low back muscles and hip flexors become chronically tight and may be sore. Abdominal, gluteal, and hamstring muscles become chronically weak and neurally inhibited. These muscle imbalances result in the appearance of a bulging belly, an often forward-leaning upper body. With a forward center of gravity, body weight is felt more beneath the toes and balls of the feet than under the heel.

Posterior Pelvic Tilt

While posterior rotation is not uncommon in healthy individuals, it is found far less frequently than standard pelvic angle. A posteriorly-rotated pelvis affects alignment of the skeleton as well. The pelvis is turned under, flattening the low back and reducing or eliminating the low back curve. Without the lumbar curve, shearing forces transmit downward through the lumbar spine, resulting in a pinching feeling at the top and bottom of the lumbar spinal section.

The hip sockets reorient the femoral heads, too. This causes the head and neck of the femurs to swing horizontally backward, resulting in an external (lateral) rotation of the leg. Where an anterior tilt causes legs to rotate inward, a posterior tilt rotates legs outward, and is evident in the feet appearing to splay outward.

Causes of Pelvic Tilt

Pelvic tilt occurs for many reasons and causes can be quite complicated. The pelvis suffers from both cause and effect, meaning that pelvic dysfunction may cause other problems elsewhere and problems elsewhere can cause problems at the pelvis. Worse still, problems at the pelvis caused elsewhere can result in further complicating the original problem — a continuous cycle of dysfunction causing pain, that pain increasing dysfunction and causing more pain.

Let’s start at the feet and work up in looking at the various causes and effects.

Lower Body
  • One or both pronated or supinated feet can cause rotation of the legs, which causes discomfort or pain at the hip. To compensate, the pelvis tilts to lessen the strain at the hip joint. That tilt eventually hurts the low back and destabilizes the body’s core. Curves in the spine compensate, throw the head and neck forward.
  • Leg length discrepancies, which to some degree occur in a majority of the population, throw off the leveling at the hip. Pelvis compensates by tilting the short leg side of the pelvis posteriorly. A sideways strain occurs at the low back and a scoliotic “C” or “S” curve develops in the spine to keep the eyes level.
  • The knees. All kinds of knee problems, habits, surgeries, muscular or nerve dysfunction, predisposition (disease, genes, structural deformity), etc., can all result in action taking place at the knee. Most can result in a bowing in or out of the knees in relation to the proper angle between upper and lower leg bones. If the legs bow in (valgus knee), the pelvis will rotate forward to compensate. Bowing out (varus knee) results in a backward rotation of the pelvis.
Upper Body
  • Muscle laxity in the legs, hips, or abdomen leaves the body without proper core stabilization, so the joints compensate for the instability. A series of dysfunction takes place and crossed syndrome tilts the pelvis, freezes the hip joint, separates the pelvic bones from each other or jams them together, etc.
  • Carrying a baby prenatally. The extra weight pulls the belly forward, the pelvis rotates anteriorly, etc.
  • Poor sitting or standing posture. This can go both ways, too — poor posture causes pelvis to tilt and tilted pelvis causes poor posture. Slouching tends to posteriorly tilt the pelvis; sitting bolt upright tends to rotate the pelvis forward.
  • Rounded shoulders and forward head posture rounds the low back, posteriorly rotates the pelvis, naturally. Rounding the shoulders with a forward neck posture, but holding the low back from rounding, causes a person to anteriorly rotate their pelvis in order to compensate.
  • Any number of genetic predispositions and deteriorating diseases can cause excessive pelvic tilt.

Is Pelvic Tilt Correctable?

Correcting functionally caused pelvic tilt with manual therapy will avoid permanent damage to musculoskeletal structures. Permanent damage from pelvic tilt can take place in the ligaments, joints, disc material, and bones. While many of these occur naturally as we age, professionals are finding degenerative problems appearing in younger populations in recent years. The sooner corrective action is sought and undertaken, the sooner the cycle of pain and dysfunction can be reversed. However, constant vigilance must become the buzzword. It’s just too easy to slip back into poor postural habits, eventually undoing correctional work.

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