Sitting for prolonged periods and a sedentary lifestyle are causing the anterior pelvic tilt to become a growing issue.
This unnatural tilt of the pelvis can have negative effects on your health.
The pelvis, as the primary attachment point for the thigh, back, and abdominal muscles, is critical to how we move and perform physical activities.
An imbalanced pelvis can cause postural problems, resulting in back pain, muscle stiffness, and limited mobility.
But, there’s good news.
Anterior pelvic tilt can be corrected through targeted exercises and stretches, and healthy posture habits.
In this article, I’ll dive into what an anterior pelvic tilt is, the causes of anterior pelvic tilt, its effects on the body, and the treatment options to realign your posture and alleviate discomfort.
Let’s get started!
What is Anterior Pelvic Tilt?
Anterior pelvic tilt, or APT, is a common postural misalignment characterised by a tilted or forward rotation of the pelvis.
This tilt in the pelvis is typically accompanied by an excessive curve in the lower back (hyperlordosis).
It is important to note that some degree of anterior pelvic tilt is normal; in fact, research indicates that as many as 75 to 85 per cent of adults exhibit an anterior pelvic tilt with no noticeable symptoms.
A pelvic tilt only becomes an anterior pelvic tilt once the forward tilt is greater than approximately 10 degrees.
What Causes Anterior Pelvic Tilt?
While there are several known causes of an anterior tilt of the pelvis – such as injury to or overuse of the hamstrings, gluteals, hip flexors, and hip extensors – the most likely culprit is a sedentary lifestyle and too much sitting.
Sitting for prolonged periods of time without proper posture causes the hip flexors to tighten and shorten, thereby drawing the pelvis forward and downward.
At the same time, the hamstrings, gluteals and core muscles lengthen and weaken, further contributing to an exaggerated curvature of the lumbar spine.
Here is a summary of the muscular imbalances of an anterior pelvic tilt:
- Tight hip flexors
- Tight quads/thighs
- Tight lower back
- Weak glutes
- Weak hamstrings
- Weak core
Severe and longstanding cases of anterior pelvic tilt, however, are associated with several symptoms, which we’ll discuss in further detail in the next section.
Why Is Anterior Pelvic Tilt Bad For You?
Aside from the muscular imbalances described above, there can be other symptoms associated with an anterior pelvic tilt.
Most people with mild to moderate pelvic anterior tilt will not notice any pain, discomfort, or decreased range of motion.
If left untreated, however, severe cases of anterior pelvic tilt can increase the amount of pressure placed on the vertebrae of the lower spine, leading to symptoms such as:
Low Back Pain
Anterior pelvic tilt causes the hip or iliac bones to rotate forward. This can lead to low back pain due to excessive lordosis (inward curving) of the lumbar region.
The forward flexed angle characteristic of anterior pelvic tilt places excess pressure on the anterior hip structures, resulting in groin pain.
Anterior pelvic tilt is associated with a tightening of the pelvic and thigh muscles – specifically the hip flexors and quadriceps. Tightness of the lower back muscles is also often seen in individuals with anterior pelvic tilt.
Femoroacetabular Impingement (FAI)
Anterior pelvic tilt may cause the femoral head to rub abnormally against the acetabular socket.
This occurrence, known as Femoroacetabular impingement (FAI), may be a contributing factor in the development of osteoarthritis of the hip as studies show.
Anterior pelvic tilt can lead to structural changes in the lower back region which, in turn, increases one’s risk of developing knee pain, lower back pain, disc degeneration due to excess pressure on the L4 to L5 segment of the lumbar spine (1).
How to Test for Anterior Pelvic Tilt
There are several ways to check if you have anterior pelvic tilt.
One way to determine whether you have anterior pelvic tilt is to perform what is known as the Thomas test, a method of diagnosis named after British orthopaedic surgeon Hugh Owen Thomas.
This test is used to rule out conditions that are frequently misidentified as anterior pelvic tilt, such as hip flexion contracture and psoas syndrome.
To perform the Thomas test:
- Lay down on a table with your legs hanging over the edge of the table at the knee.
- Next, bend the knee of one leg and pull it in toward your chest, using both arms to keep your leg in place.
- If the back of your resting leg lifts off of the table as you perform this movement, you have an anterior pelvic tilt.
An anterior pelvic tilt can result in a sensation of your hips being pushed back, causing your butt to protrude more than desired.
This condition may also give the illusion of having a larger belly than you actually do.
How to Fix Anterior Pelvic Tilt
Fixing an anterior pelvic tilt doesn’t always require professional treatment.
You can correct it by performing exercises at home that target specific muscles.
By stretching the tight hip flexors, thigh muscles, and lower back while also strengthening the core, gluteal, and hamstring muscles, you can return the pelvis to its neutral position.
Doing this will not only help correct anterior pelvic tilt, but also help in reducing low back pain and preventing further spinal distortion .
Here are some simple steps to follow to fix anterior pelvic tilt:
- Massage and stretch the hip flexors
- Massage and stretch the quads/thighs
- Stretch the lower back
- Strengthen the glutes
- Strengthen the hamstrings
- Strengthen the core
Before turning to more invasive treatments such as painkillers or surgery, try these exercises that you can do at home to correct an anterior pelvic tilt.
1. Massaging Tight Muscles
Before you start stretching anything, you may want to first work on doing some myofascial release which we will cover in this section.
By doing so, you’ll see increased benefits from your stretching.
Foam Rolling the Hip Flexors
Start by loosening up your tight hip flexors, which can happen from sitting too much.
To do this, you’ll need a foam roller:
- Lie on the foam roller with it positioned above your thigh.
- Roll over a small area, applying pressure.
- Gently rotate your body from side to side to further target the hip flexors.
This will help alleviate the tightness in your hip flexors, which can lead to an anterior pelvic tilt.
Foam Roll the Quads
Next, it’s time to target your thighs using the foam roller. Here’s how:
- Place the foam roller under your thighs and apply pressure.
- Slowly roll up and down your quads, using your arms for motion.
- Repeat the process on the other side.
Doing this routine should help release any tightness in your quads.
Massage the TFL
To release further tightness in the hip flexors, you can roll out a hip muscle called the Tensor Fascia Lata (TFL).
This is like rolling out other hip flexor muscles, but you should tilt your body at a 45-degree angle.
Start by finding the TFL, then gently roll over that area.
If you find that a regular foam roller doesn’t provide enough pressure, try using a foam roller with ridges or a small massage ball.
These options will help you get into the muscles more deeply.
All-in-one Anterior Pelvic Tilt Foam Rolling Routine
Alternatively, you can try the foam rolling routine from the video above. It covers how to foam roll the following muscles:
- Rectus Femoris (centre of thigh/quad)
This video also targets the lat muscles to target tightness in the lower back.
2. Stretches to Fix Anterior Pelvic Tilt
After foam rolling and massaging out the tight muscles, you can now move on to stretching them.
Hip Flexor Stretch
The stretch shown in the video above is the main stretch you will want to try to address the problem of an anterior pelvic tilt.
- Start in a kneeling position with both knees on the mat and one foot in front, creating a 90-degree angle at the hip and knee.
- Use your front knee as support by placing your hands on it, if needed.
- Now, to get the stretch going, lean forward slowly while keeping your torso upright. You should feel a comfortable stretch in your groin and upper thigh of the rear leg.
- To maximize the benefits of this exercise, hold the stretch for at least 30 seconds.
While doing the kneeling hip flexor stretch, it’s essential to keep your glutes and abdominal muscles tight.
This will automatically bring your pelvis into a neutral position, ensuring proper form and maximum benefit from the stretch.
Stretch Out the Lower Back
The Child’s Pose is a simple but effective stretch for your lower back.
Here’s how to do it:
- Start on your knees, sitting back on your heels.
- Slowly lean forward and place your forehead on the floor.
- Reach your arms out in front of you, with your palms on the floor.
- Take deep breaths and feel the expansion of your back.
- Focus on keeping your lower back relaxed and elongating your spine, avoiding arching.
By performing this stretch, you’ll help to relieve tension in your lower back and realign your pelvis into a neutral position, which can also help with back pain.
Related: Best stretches for your lower back
3. Strengthening Exercises
This next section focuses on building strength in the muscles that are weak and need strengthening to help pull your pelvis into a neutral position.
Strengthen the Core: Planks
The plank exercise is the number one exercise to tackle an anterior pelvic tilt.
Someone with an anterior pelvic tilt will usually have a weak core and abdominal muscles.
A strong core should counteract the downward pull of the hip flexors on the pelvis, but because it’s weak in someone with an anterior pelvic tilt, it allows the front of the pelvis to be pulled down.
Here’s how to perform a proper Plank:
- Place your hands flat on the floor, just wider than shoulder-width apart.
- With your toes on the floor, tighten your glutes to stabilize your core. You should feel your pelvis align in the correct position.
- Keep your neck and spine neutral by gazing at a spot on the floor about a foot in front of your hands. Keep your head in line with your back.
- Hold the Plank position for as long as you can.
For an anterior pelvic tilt sufferer, you may even want to hold your plank with a slight posterior pelvic (pull the pelvis towards the elbows) tilt to dramatically strengthen the core.
Strengthen the Core: Pelvic tilt
The Pelvic Tilt exercise may seem counterintuitive, but it’s been proven effective in strengthening your abdominal muscles while relaxing tight lower back muscles.
Here’s how to do it:
- Lie down on your back with your feet flat on the floor and your knees bent.
- Engage your abdominal muscles by pulling your belly button towards your spine. This should cause your pelvis to lift up towards the ceiling.
- Tighten your hip and glute muscles, and tilt your pelvis forward.
- Hold this position for 3 to 5 seconds, then return to a neutral position.
- Repeat this exercise 5 to 15 times.
Strengthen the Glutes and Hamstrings
In this section, we aim to target and strengthen weak glutes and hamstrings.
This will help improve your posture by pulling your pelvis into a more balanced position.
This is important because tight muscles can pull your pelvis forward, causing an anterior pelvic tilt.
By strengthening your glutes and hamstrings, you can counteract this effect and achieve better posture.
There are many ways you can strengthen the glutes and hamstrings, and really any exercise is fine however the ‘Glute Bridge’ strengthens the hamstrings and the glutes at the same time.
Here’s how to perform a glute bridge:
- Lie on your back with your feet flat on the floor and your arms at your sides.
- Lift your hips up until your body forms a straight line from your knees to your shoulders, making sure to keep your feet firmly planted on the ground.
- Hold this position for 2 to 3 seconds before lowering your hips back to the starting position.
- Repeat this movement 8 to 12 times.
One tip to keep in mind while performing the Glute Bridge is to push through your heels. This will help activate your glutes and get the most out of the exercise.
Any exercise which helps increase strength in either the glute or the hamstrings should help with fixing your anterior pelvic tilt.
The Donkey kicks exercise strengthens the glutes and lengthens the hip flexors.
Here’s how to perform a Donkey Kick:
- Begin by getting on all fours, with your hands placed directly under your shoulders and your knees under your hips.
- Keep your back flat and tuck your chin slightly, so the back of your head is in line with your back.
- Engage your lower abdominal muscles to prevent rounding your lower back and spine.
- Keeping a 90-degree bend in your right knee, slowly lift your foot straight up towards the ceiling.
- When you feel your back beginning to arch, return to the starting position and repeat the steps for the desired number of reps on the same side.
- Once you’re done with that side, switch legs and repeat the same steps for the desired number of reps.
Performing squats can help strengthen the gluteals, hamstrings, and quadriceps.
Here’s the step-by-step guide to performing squats:
- Stand with your feet shoulder-width apart
- Bend your knees and lower your body as though you are going to sit in a chair
- Keep your abdominal muscles contracted and your thighs parallel to the floor
- Maintain a neutral back, with your knees not extending farther than your toes
- Tighten your gluteal muscles while pushing back up to a standing position
- Repeat this exercise 10 to 15 times for maximum benefits
You should also be aware that people with an anterior pelvic tilt may find it hard to switch on and activate their glutes.
If you are someone who does a lot of sitting, it is not uncommon for your glute muscles to no longer ‘fire’ when they should, but rather they take a back seat as other muscles take over the slack.
There is also the possibility of developing a glute imbalance where one glute muscle switches off whilst the other one continues to work as normal.
If you have an anterior pelvic tilt, it’s important to make sure that BOTH your glutes are firing properly as this could prevent you from fixing your anterior pelvic tilt.
An anterior pelvic tilt is a condition that affects the alignment of the pelvis and can cause low back pain.
The good news is that it can be managed with the right exercises and lifestyle changes.
These exercises can help to realign the pelvis and relieve pain, but it’s important to keep in mind that results may not be immediate and consistency is key.
In addition to exercises, maintaining a healthy weight and being more active can also help to reduce the risk of developing an anterior pelvic tilt.
In fact, research suggests that a high body mass index (BMI) can increase an individual’s risk of developing anterior pelvic tilt.
Overall, an anterior pelvic tilt can be a challenging condition, but with the right approach and determination, it can be successfully managed.
Keep in mind that the information presented in this article is not intended to replace the advice of a medical professional.
If you’re experiencing chronic and severe pain due to misalignment of the pelvis, it’s a good idea to consult your doctor to rule out an underlying issue.