The world’s largest independent community of personal trainers. We’re Dedicated to Improving the Perception of the Industry, and Your Success. Join thousands of fans on Facebook, because that many trainers can’t be wrong.

5 Steps for Dealing With Anterior Pelvic Tilt

by Eirik Garnas

Decrease the risk of knee pain, lower back pain/injuries, and other musculoskeletal disorders with these 5 tips…

Anterior Pelvic Tilt Causes | thePTDC | Anterior Pelvic Tilt Symptoms
Share This

The number of people experiencing bad posture and back or knee pain is steadily increasing, and millions of dollars are spent each year on pharmaceuticals and other symptom-based treatments to alleviate the pain.

However, as most coaches/trainers and other practitioners involved in corrective exercise know, a minimal amount of proper training is a far better long-term option. One of the most common postural deviations you will encounter is excessive anterior pelvic tilt (APT). Some visual cues of APT are:

  • A forward tipped pelvis;
  • Increased lower back curve (sway back);
  • A “bulging” (not necessarily fat) abdomen.

These visual cues, in combination with a screening that reveals stiff hip flexors, poor glute and abdominal strength, and compensation patterns, are good indicators of anterior pelvic tilt.

A certain degree of anterior pelvic tilt is normal – and usually unproblematic – excessive APT leads to poor exercise technique and increased risk of knee pain, lower back pain/injuries, and other musculoskeletal disorders.

Tilted Pelvis | thePTDC | Anterior Tilt

APT is of special importance to coaches and personal trainers, as clients in excessive APT typically display poor movement patterns in key exercises such as the squat and deadlift.

This pattern is characterized by overextension of the lumbar spine, lack of glute involvement, and quad and low-back dominance. Basically, excessive APT leads to compensation patterns and poor exercise technique, which in turn exacerbates APT.

Why This Postural Deviation Is So Common

Excessive APT is characterized by weak/lengthened:

  • Rectus abdominis
  • External obliques
  • Gluteals
  • Hamstrings

and strong/stiff:

  • Psoas
  • Iliacus
  • Rectus femoris
  • Tensor fascia latae
  • Erector spinae

This muscle imbalance pattern develops over time and involves reciprocal inhibition, a process where muscles on one side of a joint are relaxing to accommodate contraction on the other side of that joint.

Pelvic Tilt | thePTDC | Anterior Pelvic Tilt Correction

Excessive anterior pelvic tilt is especially common among females, and primary causes include a sedentary lifestyle (e.g., prolonged sitting), poor movement patterns and posture, and genetic predispositions.

As sitting for prolonged periods and performing tasks for extended periods of time utilizing poor posture lead to shortening of the hip flexors, increased tension on the lower back, and glute atrophy, there’s no surprise that so many people in the modern world display signs of excessive anterior pelvic tilt. The problems develop over time, and daily activities, like tying one’s shoes, can cause pain.


Bonus: Get the Checklist!

We’ve compiled a free checklist for dealing with anterior pelvic tilt for you to download. Simply enter your email below to get it:

Free Report: 5 Step Checklist for Dealing with Anterior Pelvic Tilt

Get this short guide complete with exercises and descriptions

  • See the exercises to use
  • Lots of images to guide you

In addition to your reports, you’ll also get FREE access to the PTDC newsletter, which you'll receive 2-3 times a week. Your email will never be shared and you can unsubscribe anytime. Privacy and terms at the bottom of this page.


Correcting Excessive Anterior Pelvic Tilt

Some believe that chiropractic and rehabilitative intervention are necessary for correcting this type of spinal deviation. However, after having coached many clients with APT, I’ve found that correct exercise is the most effective approach. This is also consistent with studies which show it’s possible to change lumbopelvicposture through strength training.

I think most trainers will agree that one of the keys to being a good coach is to understand that all exercises, mobility drills, etc. should be included only if they serve a purpose. This is especially important when training clients with muscle imbalance patterns, as poor exercise technique and selection only will worsen the problem.

I’ve tried various approaches for dealing with this postural deviation, and after a lot of trial and error (there’s only so much you can learn from reading science and theory on the subject), I discovered certain patterns regarding what works and what doesn’t and developed a step by step protocol that is very effective for dealing with APT. As excessive APT is one of the major challenges personal trainers encounter, this step by step plan can be a valuable tool to have in the toolbox.

Typically, hip flexor stretches are often considered an essential component when trying to eliminate APT. However, while hip flexor stretching does serve a purpose, I’ve found that strengthening the posterior pelvic tilt movement pattern (as coach Contreras is a big advocate of) and ingraining good movement patterns in the gym and daily life are the keys to dealing with anterior pelvic tilt.

I want to emphasise that there are a range of spinal alignments that are considered “normal”, and although a lot can be done through strength training, some people will naturally have a more anteriorly tilted pelvic alignment. I also want to make it clear that although there are some universal characteristics of anterior pelvic tilt, not every trainee is the same. Assessing flexibility, strength, and movement patterns is therefore always a good idea.

1) Lying Pelvic Tilt

Many trainees who possess excessive APT have no idea their low back sway, bulging abdomen, back pain, inability to perform good squats, and/or poor glute strength are actually a part of a muscle imbalance pattern that, to a great extent, can be corrected. Also, folks in excessive APT often have no idea how to posteriorly tilt their pelvis. For these people, step 1 is to learn how to get the pelvis into a neutral position and posterior tilt. The lying pelvic tilt is a great exercise for achieving this, as “push the lower back into the ground” is an easy cue for most people to understand.

Anterior Pelvic Tilt Exercises | thePTDC | Posterior Pelvic Tilt Exercises

2) Standing Pelvic Tilt (SPT)

When the trainee manages to perform the lying pelvic tilt and understands how to control pelvic alignment, the standing pelvic tilt is a natural next step. “Squeeze the glutes” is an excellent cue for the SPT as it triggers the trainee to contract the glutes and posteriorly tilt the pelvis.

How To Fix Anterior Pelvic Tilt | thePTDC | Standing Pelvic Tilt

3) Learn and Ingrain the Hip Hinge Pattern

I’ve found that one of the most effective exercises for teaching clients the hip hinge pattern is the pull-through.

The movement pattern in the pull-through closely resembles that of the deadlift, kettlebell swing, and other hip dominant exercises. However, there’s one key difference. When performing pull throughs the band or cable is attached behind the trainee, and this helps force the client into a posterior weight shift.

Concentrate on keeping the chest high (without overarching the lower back), pushing the hips back, and finishing the movement by squeezing the glutes.

Correcting Anterior Pelvic Tilt | thePTDC | Band Pull Through To Fix Anterior Pelvic Tilt

4) Strengthen the Posterior Pelvic Tilt Movement Pattern/Muscles That Produce Posterior Pelvic Tilt

I’ve found that the cable pull-through and RKC plank are among the most effective exercises for treating APT. Posterior pelvic tilt hip thrusts, american deadlifts, and other exercises that strengthen the posterior pelvic tilt movement pattern and weak muscle groups (especially glutes and abdominals) are also great additions.

Fixing Anterior Pelvic Tilt | thePTDC | How To Fix Pelvic Tilt

How To Correct Anterior Pelvic Tilt | thePTDC | Cable Pull Throughs Exercises For Anterior Pelvic Tilt

5) Incorporate Squats, Deadlifts, Presses, and Other Compound Lifts With Good Technique

Spinal alignment
As many trainees tend to round their backs when doing hip dominant exercises, “arch” is often used as a cue when coaching deadlifts, box squats, etc. However, when coaching someone who possesses APT, this cue can often do more harm than good as the lifter ends up with an exaggerated lumbar curve.

While many inexperienced lifters (even those with no apparent postural problems) have a tendency to overextend their backs when locking out the deadlift, people in APT often display excessive back arch during the entire lift. This position is generally considered more damaging than the more commonly seen spinal flexion.

How To Correct Anterior Pelvic Tilt | thePTDC | Correcting Pelvic Tilt

And it’s not just during the deadlift that individuals with excessive APT display poor form. Swayback during presses, pulldowns, and a wide range of other exercises goes hand in hand with APT, and in combination with quad dominant lifting, poor glute involvement, and knee drift (squats) this poor alignment strengthens muscle groups that are already strong and set you up for injuries.

While some experienced trainees prefer a rounded (upper) back position in exercises such as the deadlift, the general recommendation is to keep the spine in neutral. The coaching required to achieve this spinal alignment depends on the client.

When you’re coaching a client who displays a normal (neutral/slight anterior pelvic tilt) or posteriorly tilted pelvis, “arch” (or perhaps even better, “Chest up!”) is often a good cue during deadlifts and squats. For someone in excessive APT, keeping the chest high is still essential, but instructing the client to arch the back will often lead the client to overextend.

Besides the focus on spinal alignment, my two top cues for a perfect deadlift and squat are to spread the floor apart (push against the outside of your heels like you’re literally trying to pull the floor apart beneath you) and drive through the heels. When assessing a clients’ squat and deadlift technique it’s often wise to start with a side view, as this allows you to see whether the bar is traveling in a vertical line over the mid-foot (it should) and if the spine is in good alignment.

A quick note on neck/head position. “Tucking the chin” and maintaining a neutral neck position is always a “safe” tip, but to be honest I’ve found that it doesn’t really matter that much (as long as you don’t look up at the ceiling, to the side, etc.). Many of the strongest deadlifters in the world look straight ahead during the lift, and I’ve never found this head position to be problematic. Some coaches argue that you’re strongest when lifting with a neutral neck position, but if there really is an advantage to this position, then it’s quite small.

How To Correct Pelvic Tilt | thePTDC | Anterior Pelvic Tilt Correction Exercises

Squeezing the Glutes and Posteriorly Tilting the Pelvis During Training
It’s not just during lower body exercises that pelvic position is essential. Squeezing the glutes and posteriorly tilting the pelvis during exercises such as the press, push-up, chin-up, pushdown, and bicep curl is a good general recommendation.

While it’s not a requirement, posteriorly tilting the pelvis during these types of exercises stabilizes the spine and even gives you some static glute training. Also, when performing hip dominant exercises such as deadlifts, hip thrusts, and box squats, a good tip is to finish the contraction by squeezing the glutes.

Emphasizing PPT during training is especially beneficial for athletes in APT, but it also applies to other lifters who want to get optimal benefits from their workouts (Who doesn’t?).

Other Strategies That Can Help Speed Up the Progress:

  • Adding in some hip flexor and lower back stretches.
  • Postural training is an important part of treating APT, and especially paying attention to sitting posture is vital.
  • More glute strengthening and activation (e.g., PPT bodyweight glute bridges and hip thrusts) and abdominal work. Can be done at home.

Bonus: Get the Checklist!

We’ve compiled a free checklist for dealing with anterior pelvic tilt for you to download. Simply enter your email below to get it:

Free Report: 5 Step Checklist for Dealing with Anterior Pelvic Tilt

Get this short guide complete with exercises and descriptions

  • See the exercises to use
  • Lots of images to guide you

In addition to your reports, you’ll also get FREE access to the PTDC newsletter, which you'll receive 2-3 times a week. Your email will never be shared and you can unsubscribe anytime. Privacy and terms at the bottom of this page.

Want to Learn More?


References:

ChalÈat-Valayer E1, Mac-Thiong JM, Paquet J, Berthonnaud E, Siani F, Roussouly P. Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J. 2011 Sep;20 Suppl 5:634-40.

Smith A, O’Sullivan P, Straker L. Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain. Spine (Phila Pa 1976). 2008 Sep 1;33(19):2101-7.

Kritz M and Cronin J. Static posture assessment screen of athletes: benefits and considerations. Strength & Conditioning Journal. 2008. 30(5):18-27.

Scannell JP and McGill SM. Lumbar postureóshould It, and can it, be modified? A study of passive tissue stiffness and lumbar position during activities of daily living. Physical Therapy . 2003. 83(10) 907-17.y

About the Author
Eirik Garnas

Eirik Garnas is a nutritionist, blogger, writer for several health websites and magazines, and personal trainer with additional courses in sales/coaching, kettlebells, body analysis, and functional rehabilitation. Subscribe to his websiteDarwinian-Medicine.com and follow his facebook page if you want to stay up-to-date on his work.