If you’re here looking to learn about what causes an anterior pelvic tilt, congratulations on taking a big step toward improving your health and quality of life. Not only do you care enough to do some research–whether you know it or not, you’re already thinking in a way that’s conducive to solving problems. By understanding the root causes of why something is the way it is, you can begin to piece together the mechanisms in play that determine the outcome. When you understand the mechanisms, you can tinker with them to modify the outcome. First, I’ll discuss the mechanisms at play involving the anterior tilt pelvic muscle as well as the symptoms of a tilted pelvis. Utilizing a framework based on those mechanisms, I’ll help you understand how to get rid of an anterior pelvic tilt–including some common misconceptions.
How do you develop an anterior pelvic tilt?
Image by DCstudio on Freepik
In order to understand what causes an anterior pelvic tilt, let’s first come to a shared understanding of what is an anterior pelvic tilt. A core tenet of developing a shared understanding of terminology, explained more thoroughly in The Tyranny of Words by Stuart Chase, is considering that both “anterior” and “tilt” are terms that rely on the position of something else to derive meaning. Anterior describes being nearer to the front–in this case the front of your body. The opposite is posterior. Tilt in this case describes the slope of the pelvis, relative to the spine. Together, we can understand an anterior pelvic tilt as a pelvis that is tilted toward the front of a body.
Now that you understand relativity, you can appreciate that the key factor determining whether you are positioned in an anterior pelvic tilt or a posterior pelvic tilt is the position of the spine, relative to the pelvis.The sacroiliac (SI) joints, which connect the pelvis to the spine have a range of motion of only about 3 degrees from flexion to extension (Kiapour et. al. 2020). With such a small range of motion, when the pelvis tilts forward or backward, the lower spine (sacral and lumbar) tend to move in that direction as well. Most commonly at FP, when we see people stuck in an anterior pelvic tilt (refer to the first picture in the image to the right), they also exhibit hyperextension of the thoracic (mid) spine.
Results by Stephen McGuire from Ireland
Firstly this is because in a standing position, an anterior pelvic tilt tends to shift the pelvis and thus the center of mass forward. The body tends to compensate for this forward shift in center of mass by moving the upper body backward–usually by way of tilting the mid spine (and thus the ribcage) backward. This tends to compress the lower spine leading to common issues like lower back pain, sciatica, or even bulging discs. Is an anterior pelvic tilt always a bad thing? No, but it depends on the context and again on relativity. The question we must ask is at what point in a movement should the body utilize an anterior pelvic tilt. Based on our study of how the best athletes in the world move, we at FP have come to understand that an anterior pelvic tilt is necessary at times for optimal movement. In particular, we see an anterior pelvic tilt utilized in forms of hip flexion (bending over, hinging at the hip, and squatting) as well as during key phases of the gait cycle when walking and running. For example, in the Functional Patterns result to the right, you can see how a change in the degree of posterior tilt during one phase of the gait cycle has tremendous overall effects on the position of the rest of the body, trending toward optimal movement. By understanding the optimal degree to tilt, in which direction, at which point during a movement, you will be able to generate more force with less work and experience fewer negative side-effects.
Dangers of a sub-optimal pelvic tilt
If your pelvis is not tilted in the optimal direction (as determined by the position of the rest of the body) at any point while standing or moving, there are negative consequences. You will get less force output meaning your body will be working harder than it needs to in order to stand or move. Additionally, your body will begin to make adaptations to your structure in order to compensate for the misalignment. The cells in your body designed to create and destroy bone work on two simple principles over the course of about a 7 year cycle: (1) Bone-creating cells (osteoblasts) generate new bone along the path of force transmission through the body. (2) Bone-destroying cells (osteoclasts) remove bone that does not have force transmitted through it. When your body is misaligned due to an incorrect pelvic tilt, force is transmitted through the body through a slightly different path. Your osteoblasts and osteoclasts only speak “force transmission.” Therefore, they begin to build new bone along that new pathway and remove bone that does not follow that new path. This is how people end up with bones that are shaped differently from the common skeletal model you might see in science class or at a doctor’s office. Some common malformations that happen in the legs show up as bow-leggedness or the knee valgus you can see in this photo being corrected by Functional Patterns techniques.
Results by Kathy Alvarez
How to get rid of an anterior pelvic tilt
It’s understandable to want to learn what causes an anterior pelvic tilt so that you might do the opposite to undo your position. Is it tight hip flexors–or perhaps weak abs? A common misconception is that the solution of how to get rid of an anterior pelvic tilt lies simply in stretching or strengthening a particular area of the body. These targeted techniques always seem to ignore the broader impact on the body. For example, strengthening the abs with sit ups might fixate the mid spine into a flexed state causing further complications (refer to our article “Shredded Abs – Demystified” further details on this). In the same vein, passively stretching the hip flexors does not account for the asymmetry it creates on the muscular and skeletal system (refer to our article “Exercising With Sciatica, Addressing The Pain” for further information on this). At FP, we have found that instead of treating a specific symptom, the best and longest lasting results come from improving the system as a whole. Instead of asking what causes an anterior pelvic tilt, you’ll gain more actionable insight from trying to understand how you can get your body to move in ways that apply an anterior pelvic tilt and posterior pelvic tilt at the right time, in the right circumstances. Thankfully, Functional Patterns has spent the time figuring this out for you and formatted it in an easy-to-follow online course you can complete from just about anywhere with minimal equipment. If you’re serious about wanting to fix your anterior pelvic tilt and the health issues that come along with it, fix the system–not the symptom.
Kiapour A, Joukar A, Elgafy H, Erbulut DU, Agarwal AK, Goel VK. Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain. Int J Spine Surg. 2020 Feb 10;14(Suppl 1):3-13. doi: 10.14444/6077. PMID: 32123652; PMCID: PMC7041664.