More and more in practice at Lushington Chiropractic in Eastbourne I’m noticing people with an anterior pelvic tilt. I find the most common issue in these people is low back pain followed by hip pain. This is really really common and basically consists of weakness in certain muscles and tightness in others. I believe this probably comes on because of how we sit and how we stand for long periods of time. Here I’m going to describe how to tell if you have an anterior pelvic tilt and how to correct it.
Do I have an anterior pelvic tilt?
Anterior pelvic tilt is where when you look from the side your pelvis tilts forward providing a downwards slope in a forward direction. There is an easy way to tell if you have an anterior pelvic tilt. All you need to do is find the bony bit at the front of your hips and the bony dimple bit at the back and these should be in line. If you have an anterior pelvic tilt then what happens is the bony bit at the front will be below the bony bit at the back (see picture).
How can I correct my anterior pelvic tilt?
Being aware that you have an anterior pelvic tilt is the first thing. This means that you can make a conscious effort to alter this anterior pelvic tilt to help to correct it. The other thing you want to do is to identify if you have shortened muscles or weakened muscles and address these problems. This will mean doing stretching and strengthening exercises.
Muscle tightness and stretching
The easiest way to see if you have shortening of the key muscles is to do a simple test. This is called the Thomas test. This test basically tells you if you have a shortness in the muscles at the front of the hips and allows you to then stretch the muscles that actually need stretching.
The best place to do this test will be on the edge of the bed and it is often useful to have someone with you as they will be able to see better. Sit on the edge of the bed then lie on your back and bring your knees to your chest. Take hold of one knee and hold it closely, lower the other leg down and relax it. If the muscles are long enough then your thigh should make contact with the bed and your lower leg should be vertical with your foot pointing towards the floor. If you have a shortening of the muscles then one or both of these won’t happen (see picture). This then tells you that you need to stretch these muscles.
If the thigh does not touch the bed then the muscle you most likely need to stretch is the iliopsoas. This is a hip flexor which means it helps to raise the knee up towards the chest. The most important thing about this stretch is that your knee is behind your hip (see picture). You also want to make sure that you push your hip forward and bend your body to the opposite side. Hold this for 30 seconds and repeat twice each side that was short. For the best results do this multiple times a day.
If your lower leg doesn’t end up vertical then it means that you have a short rectus femoris or quadriceps. This muscle mainly straightens the knee but it also flexes the hip. The best way to stretch this is pulling your heel to your buttock but the key thing here is not to hyperextend the lower back. You want to keep the back flat and this will give you a better stretch (see picture). Again you want to hold this for 30 seconds and repeat twice on each side that was short. Again for best results do this multiple times a day.
These are the stretches I have found are the most effective in people with an anterior pelvic tilt. Mobilising the area is also a good idea and this is done by transitioning between an anterior pelvic tilt and a posterior pelvic tilt. I find a Swiss ball is very useful for this. You just rock backwards and forwards by tilting your pelvis, and not moving the rest of your body, twenty or so times to get the area moving and loosened off.
These stretches are a great place to start. To help to address the muscle weakness in anterior pelvic tilt then see my blog ‘anterior pelvic tilt and correction: part two’.
Yours in health,
Want to find out more about low back pain?
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By Mykel Mason
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