Lower back pain is a common postural ailment that affects a large percentage of the population at some point in their lives. One of the causes of lower back pain is a postural issue known as anterior pelvic tilt. Anterior pelvic tilt pain describes back pain when tilting the pelvis forwards, causing the lower back to arch excessively. This postural imbalance can cause muscle imbalances, symptoms such as joint pain, sciatic pain, and ultimately, lower back pain. In this article, we will delve deeper into anterior pelvic tilt symptoms, explore the research that supports the connection between anterior pelvic tilt and back pain and showcase results of people who have resolved their anterior pelvic tilt pain using Functional Patterns.
What is anterior pelvic tilt?
The pelvis is the foundation of the spine and acts as the junction between the upper and lower body. The position of the pelvis plays a crucial role in maintaining good posture, balance, and stability.
When the pelvis is in a neutral position, the spine generally holds better alignment, and the muscles surrounding it hold a better balance of tension.This in turn improves the biomechanics of the whole body. For the most part, symptoms of a tilted pelvis are caused by an imbalance of muscle tension between the muscles that attach to the front of the pelvis and those that attach to the back. These include the hip flexors and the abdominals at the front and the glutes, hamstrings, and muscles of the spine at the back. This becomes a problem when the pelvis remains ‘stuck’ in this position and the body is unable to get out of the position or into a neutral position when moving or under load.
So does anterior pelvic tilt cause back pain?
The exact mechanism behind the link between anterior pelvic tilt and lower back pain is not fully understood, however, studies have demonstrated that an increase in anterior pelvic tilt will increase the amount of curve in the lower spine (1). This in turn can lead to increased stress on the lumbar spine, which can cause pain and discomfort.
Most commonly, people who experience lower back pain and stand with an anteriorly tilted posture, will have an increased anterior pelvic tilt compared to someone who does not have lower back pain. In more severe cases, anterior pelvic tilt is associated with worsening symptoms of pain that originate in the back and radiate down the leg (4).
Unfortunately, the research suggests that there is a bit of a ‘chicken or the egg’ scenario when it comes to anterior pelvic tilt and low back pain. A study of adults between the age of 18 and 55 years showed that although the participants who had low back pain were more likely to have an anterior pelvic tilt, it wasn’t clear if the tilt came before the pain or if they stood with more tilt because of the pain (3). However, what they did find was that the angle of pelvic tilt in those who had an anterior pelvic tilt and pain, was significantly greater than those who had a slight anterior pelvic tilt and no pain.
Another study investigated this issue further to see what happened when those with severe low back pain and an anterior pelvic tilt were put through a walking test. Interestingly, they found that not only did the participants’ pain worsen, so too did their anterior pelvic tilt! (2).
These findings suggest that there is a biomechanical component to why an anterior pelvic tilt and pain are interrelated.
At Functional Patterns we operate from the first principles perspective that the biomechanics of the body are fundamentally what determines whether movement is painful or pain free. In relation to this, it is rational to take the position that if a person is experiencing an imbalance in their pelvic position, then their biomechanics will also be operating in an imbalanced manner.The greater the anterior pelvic tilt, the greater the imbalance and the greater the likelihood the individual will experience pain in relation to their pelvic tilt.
What might all this tell us?
The Functional Patterns system takes a realistic approach in its methods to understand and solve this problem. Humans have walked on two legs for thousands and thousands of years. In all this time the muscles of the human body have been working in much the same way to assist us in doing the four main physical activities we are very good at, those being walking, standing, running and throwing.
Generally, our imbalance in posture is not only due to how we stand, but how we move. Imagine a pendulum swinging from side to side in a grandfather clock, if it stopped, it would stop right in the middle pointing down in line with gravity. Now imagine someone tipped the whole clock slightly to the right. Now if the pendulum stopped it would stop slightly to the right of the middle of the clock in an unbalanced position.
Now imagine your pelvis is like that pendulum and the rest of your body is like the grandfather clock. If when you stop moving and stand still your pelvis tilts forward anteriorly, then it is rational to say that something is ‘tilted’ or out of balance in your body. To address the anterior tilt, we must address the postural imbalance in your movement. Unfortunately, as we found in the research above, when there is already pain and a postural imbalance like an anterior pelvic tilt in the body, simply ‘moving more’ doesn’t correct for the imbalance can in fact make it worse.
In combination with the research and our understanding of human biomechanics, at Functional Patterns we find that there is one conclusion that is logical. The worse the anterior pelvic tilt, the more likely you are to experience pain, and concurrently, the more likely that your overall posture may be contributing to this issue.
When is an Anterior Pelvic Tilt required?
Whilst reading through this article you may be asking, “If an anterior pelvic tilt in my posture is not a good thing, why can my body go into that position?”
Something we want to stress at this point in the article is that the anterior pelvic tilt pain we are discussing is in relation to a postural position that your body cannot get out of. This means that the tension of the muscles around the pelvis is such that the body does not have the understanding nor control to appropriately move the pelvis from an anterior tilt, to a neutral position or even a posterior tilt when required.
In some contexts, an anterior pelvic tilt is a requirement to improve movement efficiency, however the body requires the appropriate control of the pelvis in order for this to happen correctly.
Take for example running. We know when we run, one leg moves forward as the other moves backward. During this movement, if the pelvis does not tilt forwards slightly, then it will roll backwards, causing us to run around in a position looking as if we are in desperate need of a toilet.
In this context an anterior pelvic tilt is required, and a good thing. Again, it is only when we cannot get out of the position that it becomes problematic.
So, your best solution is to use precise and intentional training strategies to ensure your body does not get stuck in this position. This will allow you to control your pelvic position appropriately relative to the activity you are engaged in!
Well, fortunately for you, if you are not already familiar with Functional Patterns, you have stumbled upon the system which takes the guesswork out of trying to figure out how to get yourself out of pain. Our approach targets, and corrects the postural deviations and biomechanics that cause problems like anterior pelvic tilt, and gets you moving in a more balanced and pain free manner. With Functional Patterns we don’t simply aim to manage the symptoms of anterior pelvic tilt pain, we address the problem as part of the whole body system.
We make the assumption that in reading this article you may be suffering from some type of pain you suspect is associated with anterior pelvic tilt, or you are simply looking to learn more about the association between the two . If this is the case, here are a few resources that may assist you in taking the next step to learning and addressing anterior pelvic tilt and the symptoms that can originate from it.
Ready to take the next step?
If you’d like to learn more about what causes an anterior pelvic tilt and how to begin correcting this postural imbalance you may like check out these two articles in our FP Knowledge Vault:
What Causes and Anterior Pelvic Tilt?
How to Correct Anterior Pelvic Tilt?
As you read through these articles you will recognise there is a precise process to follow in addressing the imbalances that cause anterior pelvic tilt and associated pain. This process follows the three steps depicted below.
If you are looking to learn this process to get yourself out of pain and improve your posture, getting into the Functional Patterns 10 Week online course is likely your next best decision. This course will set you off on the right path to correcting postural imbalances such as anterior pelvic tilt and other biomechanical dysfunctions. Click on the following link to check it out!
The Functional Patterns system has and is already showcasing fantastic results in correcting anterior pelvic tilt pain. Both Kyndall and Kyle are two examples out of thousands of individuals who suffered from a pronounced anterior pelvic tilt that led them to a life of ongoing pain. Engaging in the Functional Patterns approach to addressing their dysfunctions allowed them to drastically improve their posture and get out of pain.
Learn more about Kyndall’s journey to pain free posture here.
Learn about the symptoms Kyle was able to resolve here.
To sum up, anterior pelvic tilt pain is a postural deviation that is predominantly caused by muscular imbalance both around the pelvis, as well as throughout the whole body system. While researchers have not identified an exact mechanism behind this link, several studies have provided evidence to support the reality that anterior pelvic tilt symptoms are often associated with a greater likelihood of low back pain. this relationship. If you are experiencing the symptoms of a tilted pelvis that we have discussed here and suspect that anterior pelvic tilt may be a contributing factor, it might be time to take a closer look at your overall posture and movement. There is no better system than Functional Patterns to help you do so.
1. Day, J. W., Smidt, G. L., & Lehmann, T. (1984). Effect of pelvic tilt on standing posture. Physical Therapy, 64(4), 510-516.
2. Kuwahara, W., Kurumadani, H., Tanaka, N., Nakanishi, K., Nakamura, H., Ishii, Y., Ueda, A., Deie, M., Adachi, N., & Sunagawa, T. (2019). Correlation between spinal and pelvic movements during gait and aggravation of low back pain by gait loading in lumbar spinal stenosis patients. Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association, 24(2), 207–213. https://doi.org/10.1016/j.jos.2018.09.002
3. Król, A., Polak, M., Szczygieł, E., Wójcik, P., & Gleb, K. (2017). Relationship between mechanical factors and pelvic tilt in adults with and without low back pain. Journal of back and musculoskeletal rehabilitation, 30(4), 699-705.
4. Lim, H. S., Roh, S. Y., & Lee, S. M. (2013). The relationship between pelvic tilt angle and disability associated with low back pain. Journal of Physical Therapy Science, 25(1), 65-68.