Anterior Pelvic Tilt: The Key To Back Pain Relief?
Anterior Pelvic Tilt and Back Pain Relief
Measuring postural and movement imbalance has long been the conservative approach of choice for chronic lower back pain relief. This entails a series of assessments to identify the alignment of your body, along with the length-tension relationships of muscles that control the position of your joints.
In particular, the position of your pelvis is a key region to assess. This is due to the fact that movement of the pelvis is directly correlated with the position of the lumbar spine. Out of the myriad of positions that the pelvis can assume, there are just a few that are extremely common and need to be addressed. In this post, we’ll start with the most common one, anterior pelvic tilt.
What Is Anterior Pelvic Tilt (APT for short)?
If you imagine your pelvis as a bucket of water, and you tip it forward, as if pouring water onto your toes, this would be tipping the pelvis in an anterior direction. Tipping it the opposite direction, in which you would be pouring water onto your heels, would be called a posterior pelvic tilt.
Anterior pelvic tilt is in fact a completely normal position for the pelvis. Under normal circumstances, men generally have 4-7 degrees of anterior pelvic tilt, and women typically have been 7-10 degrees. The problem arises when standing pelvic tilt is beyond these norm values, especially when correlated with back pain.
Its not uncommon to see a chronic back pain sufferer with 15 or even 20 degrees of anterior pelvic tilt. This excessive tilt can be a either a root cause or a result of back pain. Regardless of whether its the chicken or the egg, correction of the dysfunction results in pain relief.
Excessive APT can cause jamming of your facet joints and excess tension in the lumbar erector muscles. Joint irritation and muscle fatigue can definitely be causes of pain.
Anterior Pelvic Tilt: The Causes
There can be a number of root causes of excess APT. Some of which are simple to understand, while others are quite complex.
1. Muscle imbalances: These can be caused by chronically poor postural alignment, muscle or movement pattern overuse in work or sport
2. Forward head posture: Pelvic tilt is strongly connected with forward head posture. This is due to the body’s attempt to right itself. Forward head posture can be caused by a number of factors, even poor breathing!
3. Flat feet: Here I am referring to having no arch in your foot when you are not making floor contact
What to do in order to start correcting APT
The simplest way to start with the process of correcting excessive anterior pelvic tilt is to identify the muscles which are too tight and additionally weak. Next is to perform the appropriate corrective stretches and exercises.
I’ve designed a shortened version of the program I offer in my End Your Back Pain Now! dvd set here:
Download “4 Strategies For The Correction of Anterior Pelvic Tilt” (Click Here)
How often should you do back exercises?
When considering how often you should perform exercises when you have back pain, there are a number of things to consider:
1. Should you even be doing exercises at all?? How much pain are you in?
When evaluating pain, I use a visual analog scale (VAS). For example, on a 1 to 10, with 1 being “not much pain at all, and a 10 being “worst pain I have ever felt”. Exercises are generally appropriate when you are a 6 or lower. Anything above, rest, relaxation, and even massage therapy is acceptable.
2. What kind of exercise program are we talking about?
Exercises based on your unique muscle imbalances are usually targeted at your weaknesses, as in my DVD program “End Your Back Pain Now!”, and rarely involve the actual muscles that hurt, those can be done more frequently. Doing exercises that directly target painful exercises are not a good idea unless you are being supervised by an expert.
3. What intensity level are the exercises being performed at? (Probably the MOST important factor!!)
I see a range of back pain sufferers in my clinic, from average joe and jane, to weekend warriors, to elite athletes. It may surprise you to know that when high level athletes see me for back pain, I give them deadlifts, pullups, and other full body movements to get rid of their pain. Why? They are usually much more coordinated that the average person, and are used to higher levels of physical exertion. Using this approach helps them get better faster.
The more intense the exercises are, the less often they should be performed. For example, if an advanced athlete needs to deadlift, I usually only allow them to do so 1x every 5-6 days. However, if the weight is very light, I have been known to allow 3x per week, but only for a short period of time.
The lower the intensity of the exercise, such as a Swiss ball reverse back extension (a butt exercise), may be done daily, if no significant soreness results from doing it, and pain levels are monitored.
Pretty much the same goes for light pelvic tilting, and other exercises that target postural muscle fibers. However, as mentioned, caution must be taken to ensure that fatiguing the targeted muscle group does not “destabilize” the lower back or sacro-iliac joints, and cause pain.
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