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Pelvic Tilt: What Is It and How Do You connected
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Designing programs that aim to improve body alignment and posture is crucial for rehab,
performance, and results. The goal of corrective exercise is to enhance the general well-being of
an individual by improving functional movement through either exercise or soft tissue
mobilization. Read on to learn more about misalignment of the pelvis and how you can use
corrective exercises to x it.

What is Pelvic Tilt?

The leading cause of movement dysfunction is muscle imbalance. Pelvic tilt is a common
contributor to lack of mobility, stability, posture, and motor control. Pelvic tilt is the positioning of
the pelvis in relation to the body. If your pelvis is out of positioning, it is usually tilted one way or
another and can lead to many other disruptions in the kinetic chain.

In a lot of pelvic tilt issues, the hip exors and extensors are heavily in uenced. Since these
muscles attach to the pelvis and lower back you can expect other pelvic region muscles to tense
up. These muscles include but are not limited to the psoas major, rectus femoris, and quadratus
lumborum. These muscles affect the lower back region and contribute to either good or poor
posture. 

You want to help your clients avoid any further issues that can arise with pelvic tilts, including
pelvic oor dysfunction. Once the ability to control the muscles of the pelvic oor is lost, it can
cause many other things to go wrong within the body. This is because the pelvic oor muscles aid
in organ function through muscle contractions.

It is important to implement corrective exercise into a client’s program to create a more durable
body and x current movement dysfunctions. Corrective exercise can help improve performance,
restore performance, and reduce the risk of injury.

Types of Pelvic Tilt Issues

The three most common types of pelvic tilt issues are anterior, posterior, and lateral pelvic tilts. If
you know that pelvic tilt is the positioning of the pelvis in relation to the body, you can then
understand that each type of pelvic tilt indicates the direction that the pelvis is xed in.

It is crucial that when identifying a client's pelvic tilt, you view these positions the correct way.
The terminology at rst can often confuse many tness professionals and clients if not explained
properly. 
Anterior Pelvic Tilt
This is when the front of the pelvis rotates forward and the back of the pelvis rotates up. An
anterior pelvic tilt, along with the other types of pelvic tilt issues, impact spine health and could
be a direct result of inactivity or how a client sits. Excessive sitting causes hip exors to tighten,
which causes a change in the position of the pelvis. If the hip exors take over spinal stability you
compromise pelvic alignment. This is commonly seen during pregnancy. This muscle imbalance
coincides with weak abdominal and gluteus maximus muscles. In this case, we can refer to it as
pelvic crossed syndrome or lower crossed syndrome.

Posterior Pelvic Tilt

Issues for this version are the opposite of anterior pelvic tilt issues. This is where the front of the
pelvis tilts up and back, while the bottom of the pelvis rotates under the body. Just like anterior
pelvic tilt, the spine is in a compromised position and the issue would bene t from corrective
exercise. Tight hamstrings are one of the biggest contributors to posterior pelvic tilt issues.

Lateral Pelvic Tilt

Each pelvic tilt is unique. A lateral pelvic tilt is when the pelvis shifts side to side, so much that
one hip is higher than the other. This leads to unilateral muscle imbalances throughout the body. 

The erector spinae muscle group often affects this tilt and should always be addressed in this
situation. To allow our lumbar spine to be in a neutral position, the pelvis should sit in line with our
shoulders. One side should never be higher than the other. 

Common Causes of Pelvic Tilt Issues

Pelvic tilts do not just appear from nothing. They develop through certain movements and even
inactivity. Finding where these imbalances lie and knowing how they can become worse can help
your clients achieve better results.

Hip Flexors
Anterior pelvic tilt is a result of tight hip exor muscles. When a muscle tightens, it shortens.
When hip exors shorten, hip extensors loosen up or lengthen. Hip exor muscles like the
iliopsoas, sartorius, and rectus femoris attach to the pelvis and the lower back. Due to the origin
and attachment sites of these muscles, their key role is in bending the hip. Excessive sitting and
poor posture keep the hips in a exed position for a prolonged period. Bending at the hips will
cause the front of the pelvis to rotate forward and the back of the pelvis to rotate upward. This
body position makes someone prone to an anterior pelvic tilt.

Pelvic tilts are common during pregnancy and are essential to delivery. During pregnancy be sure
to perform pelvic tilt exercises that help strengthen the core and surrounding muscles. Don’t
forget that post-pregnancy corrective exercises are just as important.

Hamstrings, Glutes, and Abs

The opposite happens for a posterior pelvic tilt. Tight hamstrings and glutes pull the bottom of
the pelvis underneath the body when the front of the pelvis tilts up and back. Tight abdominal
muscles pull the pelvis up, while weak lower back muscles do not respond. This creates a
posterior pelvic tilt issue. 

Quadratus Lumborum
If you’ve ever heard a client say they have one leg shorter than the other, then you might have a
client with a lateral pelvic tilt. A lateral pelvic tilt can make one leg appear shorter than the other.
In most instances, the quadratus lumborum is the main muscle responsible for creating and
correcting a lateral pelvic tilt. 

The quadratus lumborum muscle lies deep within the abdominal wall and attaches to both the
pelvis and lumbar spine. The key role of this muscle is lateral bending—bending from side to side.
This helps stabilize the pelvis. As this muscle gets tighter on one side of the spine it will begin to
pull the pelvis up on the other side, creating a lateral pelvic tilt.

To prevent pelvic tilt in your clients you must rst understand proper positioning of the pelvis. Be
proactive in assessing your clients to see if they have a pelvic tilt or if they show signs of one. As
a tness trainer, you should know if a tilt is present so you can prescribe a proper workout routine
encompassing the right corrective exercise.
How to Design a Corrective Exercise
Program to Correct Anterior Pelvic Tilt
First, determine what pelvic tilt a client has. Next, provide your client with an explanation of what
you discover about their pelvis and the surrounding anatomy. To con rm your professional
decision about their pelvic tilt you can perform a test to make sure your ndings are correct. This
helps build trust between you and your client and helps in designing their corrective exercise
program to x their pelvic tilt.

The Thomas Test is one of the most popular pelvic tilt tests for anterior pelvic tilt. For this test,
have your client lie at on a table with their legs hanging off the edge at the knees. Then have
your client pull one leg into their chest using both arms. If the leg that is at comes up off the
table then your client has an anterior pelvic tilt.

After you identify anterior pelvic tilt or lower crossed syndrome, create a program that aims to
loosen the hip exors and quadriceps. Along with loosening these muscle groups, the program
should encompass core and glute strengthening exercises putting the pelvis into a more neutral
position.

Corrective Exercises for Anterior Pelvic Tilt 

Use these corrective exercises when designing a program that addresses anterior pelvic tilt:

Lying Posterior Pelvic Tilt - Core and glute strength

Lying Glute Bridge - Glute and hamstring strength

Half-Kneeling Hip Flexor Stretch - Release tight hip exors

Bird Dog - Strengthen glutes and core stability

Plank - Glute and hamstring activation adjusting pelvis towards a more posterior position,
better than sit-ups because they support proper posture and encourage proper alignment
of the spine

Single-Leg Reverse Hypers - Glute strength

Dead Bug - Core and hip stabilization to align the pelvis

Quad Foam Roll - Myofascial release technique for quadriceps and rectus femoris

IT Band Foam Roll - Release the tensor fascia latae and iliotibial band

How to Design a Corrective Exercise

Program to Correct Posterior Pelvic Tilt
Determining if a client has posterior pelvic tilt issues can be as simple as examining the natural
lower back curve a client should have. You can identify a posterior pelvic tilt when there is no
natural curve in the lower back. You can even check to see where the posterior superior iliac
spine is in relation to the anterior superior iliac spine.

The posterior superior iliac spine sits at the back of the pelvis found by feeling for the two bony
landmarks in the lower back region. The anterior superior iliac spine is in the front as shown
below. If the two in relation are almost horizontal to one another, then this can be a sign of
posterior pelvic tilt as they should have a slight decline from front to back.

One a client tests positive for posterior pelvic tilt you need to address the issues by designing a
corrective exercise program. This program should include loosening tight and overactive glutes,
hamstrings, and abs. You must also consider strengthening the weak hip exors and lumbar
erectors.

Corrective Exercises for Posterior Pelvic Tilt 

Use these corrective exercises when designing a program for posterior pelvic tilt:

Seated Hamstring Stretch - Stretches tight hamstrings causing the pelvis to tilt backward

Superman - Strengthens weak glutes and lumbar spine

Cobra - Loosens tight abdominals, great for stretching the psoas muscle pulling your pelvis
forward
 Leg Raises - Strengthen weak hip exors

Standing Hip Raises - Strengthen weak hip exors

Figure 4 Gluteal Stretch - Release tight glute muscles

Good Morning - Encourage hip hinge movement and anterior pelvic tilt position

Glute / Piriformis Foam Roll - Release tight glutes

Hamstring Foam Roll - Release tight hamstrings

How to Design a Corrective Exercise

Program to Correct Lateral Pelvic Tilt
Examine your client to see if one side of the pelvis is higher than the other. Look to see if the
upper body leans one way more than the other. If this is the case, then the pelvis on the opposite
side is likely shifted upward and turned that direction. With either side of the ilium being exed
the other side is extended, causing the pelvis to rotate internally or externally. 

The Trendelenburg test can con rm weakness in the hip abductors. To perform this test, have
your client stand tall and lift one leg off the ground. If there is a signi cant drop in the hip of the
leg on the ground, then the client tests positive. It proves the glutes on that side are not
activating properly.

Looking for this asymmetry in a client is not hard to nd and once discovered you can design a
proper corrective exercise program. For lateral pelvic tilt issues, you need to target the weaker
and tighter side of the body along with glute strengthening exercises. It is also imperative to have
your client perform myofascial release techniques on the quadratus lumborum, erector spinae,
and core musculature. Body balance is extremely important and each muscle balances another.
With knowing this, you can understand how important unilateral corrective exercises are in a
program created to address lateral pelvic tilt.

Corrective Exercises for Lateral Pelvic Tilt 

Use these corrective exercises when designing a program that addresses posterior pelvic tilt:

Lying Reverse Leg Raises - Due to weaker hips, one sitting lower than the other, this will
help strengthen the weaker side

Standing Reverse Leg Raise (Glute Kick Back) - Strengthening the weaker side overtime will
align back with other xing the unilateral imbalance

Clamshell Exercise - Helps strengthen the gluteus medius located on outer area helping
stabilize your pelvis; creates more balance between inner and outer legs

Quadratus Lumborum /Oblique Overhead Stretch

Lying on Side Leg Lift - Strengthens the gluteus medius

Foam Roll Lower Back/ Quadratus Lumborum - Release tight quadratus lumborum pulling
on either side and erector spinae, lumbar spine

As always, make sure you know your scope of practice as a personal trainer. It is important to
understand what you legally can do when dealing with your clients’ movement dysfunctions. 

Learning how to identify and correct a client's imbalances plays a key role in their overall health
and wellbeing. ISSA’s Corrective Exercise Specialist course will help you learn how to guide
clients to help them correct those dysfunctions. Throughout this course, you can also expect to
learn how to help people with back, knee, shoulder, or any muscle-related pain.
 Click HERE to download this handout and share with your clients!

ISSA

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Corrective Exercise Specialist
The ISSA's Corrective Exercise Course will help you learn how to identify and correct the
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and certi ed personal trainers can bene t from this distance education course, learning
more about how people move incorrectly and how to guide them to correct those
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Please note: The information provided in this course is for general educational purposes
only. The material is not a substitute for consultation with a healthcare provider regarding
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