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
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.
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A common email question I receive is about measuring pelvic tilt. The best way to measure pelvic tilt is with a specialized set of calipers that were developed by neuromuscular therapist Paul Chek. These can be quite pricey, and are only usually found in the offices of skilled therapists.
The other way to measure pelvic tilt, which is quick, cost-free, and easily done is home is by looking at your belt line in the mirror. Usually, the front of your belt line rests either slightly above, or slightly below the Anterior Superior Iliac Spine, which is the small bony protuberance just above your thigh. The backside of your belt line usually rests again just above or below the Posterior Superior Iliac Spine, which are found about 2 inches to the side of the spine.
When you look in the mirror at your side view, you will look at the angle of the belt line. For men, the line should be parallel to the ground, with neither the front or the backside higher than the other, with normal measuring 0-5 degrees. For women, the angle should be slighter lower on the front side than the backside within approximately 7-10 degrees being normal.
It is important to note, that these are the “textbook” normal values for pelvic tilt. It should not be the ONLY evaluation for normal function and balance of the core muscles. You should also evaluate the range of motion and strength of all the associated muscles in order to really test total function of this area. You do NOT have to be perfect, but close enough to be out of pain!