HOW TO FIX AN ANTERIOR PELVIC TILT

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Do you have the Donald Duck syndrome (aka Anterior pelvic tilt)?

…And is it the cause of your pain?

Has anyone ever told you that your bottom sticks out a lot? Or that your stomach seems to
protrude forward?

Here might be the reason why…

With this posture, the pelvis is in a position called the Anterior pelvic tilt.

What is an Anterior pelvic tilt?

This is where the pelvis is in a forward tilt position.

(It somewhat resembles the pelvic position of my favorite childhood Disney character,
Donald duck.)

Characteristics

 Forward tilt of the pelvis

 Pronounced lower back arch
 Glutes (your bottom) that stick out
 Protruding stomach

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Why is it a problem?

As the pelvis is the foundation of your spine, it is common for an Anterior pelvic tilt to
drastically affect your whole posture.

If your pelvis is in the wrong position, your whole posture will be out of position as well. (…
This is a big problem!)

It could be the one reason why you have so much pain and tightness in your body.

How to tell if you have an Anterior pelvic tilt?

Instructions:

 Stand up.
 Locate the land marks: (check out the picture above for the points.)
 Pointy bone at the front (ASIS) and
 Pointy bone at the back (PSIS).
  Compare the relative heights.

Interpretation: If you have an Anterior pelvic tilt, the ASIS will be significantly lower in
comparison to the PSIS.

Note: It is normal for the pelvis to have a slight forward tilt (5-10 degrees). This is what I
refer to as a “neutral pelvis”. (see above)

Note #2: Everyone has different shaped and sized “pointy bones”. This is just a general
guideline to quickly determine if you have an Anterior pelvic tilt or not.

What causes an Anterior pelvic tilt?

The main cause is excessive SITTING!

Not that I am spying on you right now, but chances are that you are doing both of them
right now!

Excessive sitting causes the muscles that control the position of the pelvis to
get tight, overactive, weak and/or inhibited.

As a result, there is an imbalance of pull around the pelvis region causing a net force to
forward tilt (Anterior pelvic tilt).

Target muscles for Anterior pelvic tilt

Tight/overactive:

 Iliopsoas
 Tensor fascia latae
  Rectus femoris (Quadriceps)
 Lower back erectors
 Longissimus, iliocostalis
 Quadratus lumborum
 Thoracolumbar fascia
 Latissimus dorsi
 Anterior fibres of the adductors

Weak/inhibited:

 Gluteal group
 Hamstring
 Abdominals

“Help me! How do I fix my Anterior pelvic tilt”

Anterior pelvic tilt exercises

Interested in fixing your posture?

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It’s a 6 step process:

To fix your Anterior pelvic tilt posture, you need to:

 1) Determine if you can Posterior pelvic tilt.

 2) Stretch the tight/overactive muscles.
 3) Strengthen/activate the weak/inhibited muscles.
 4) Finding neutral pelvis
 5) Strengthening exercises with neutral pelvis
 6) Maintaining neutral pelvis!

1. Can you do a Posterior pelvic tilt?

Video from Ryan Kennedy

READ THIS:

If you can not tilt your pelvis back into a neutral position whilst standing without
excessive compensation of your torso and/or legs, I would suggest that you focus
more time on the stretching exercises .
If you can, I would recommended that you focus more time on the strengthening/control
exercises.

2. Stretches and Releases

Before you can start to strengthen any of your weak muscles that are contributing to your
Anterior pelvic tilt, you need to stretch the tight muscles which may be inhibiting them in
the first place.

Target muscles:

 Iliopsoas
 Tensor fascia latae
 Rectus femoris (Quadriceps)
 Lower back erectors
 Longissimus, iliocostalis
 Quadratus lumborum
 Thoracolumbar fascia
 Latissimus dorsi
 Anterior fibres of the adductors

a) Hip flexor stretch

Instructions:

 Assume the lunge position as above.

 Perform a posterior pelvic tilt
 “Tuck your tail bone underneath you”
 Keep your glutes contracted.
 Lean your torso away from the side you are stretching.
 Aim to feel a pulling sensation at the front of your hip.
 Hold for 30 seconds.
  Repeat 2-3 times.

b) Quad/TFL stretch

Instructions:

 Whilst standing, pull your ankle behind you as to bend your knee.
 Stay up right and keep your knees in line with each other.
 Perform a posterior pelvic tilt and drive your hips slightly forward.
 Aim to feel a stretch at the front of your quadriceps.
 Hold for 30 seconds.
 Repeat 2-3 times.

c) Groin stretch

Instructions:
  Sit on the floor with your back against a wall.
 Assume the position as shown above.
 Sit up at tall as possible.
 Try to create an arch in your lower back.
 Slowly push your knees down towards the ground.
 Aim to feel a stretch in the groin.
 Hold for 30 seconds.
 Repeat 2-3 times.

d) Lower back stretch

Instructions:

 Sit down on a chair.

 Lean all the way forward.
 Aim to feel a stretch in the lower back.
 Hold for 30 seconds.
 Repeat 2-3 times.
e) Side stretch

Instructions:

 Whilst standing, lean your torso all the way to one side.
 Aim to feel a stretch in the side of your torso.
 Hold for 30 seconds.
 Alternate sides.
 Repeat 2-3 times.

... Having difficulty feeling this stretch?

Try out these other stretches: 12 ways to stretch the Quadratus Lumborum.

f) Releases

If you are having difficulty feeling the stretch in any of the above muscles, use a massage
ball to release the tight structures directly.
Key points:

 Place the ball underneath the muscle you are trying to target.
 Apply the appropriate amount of body weight over the ball.
 If it hurts, you are likely on the right spot. Tight muscles will often be the painful
ones when pressed.
 A small amount of bruising can be normal after the first few times doing these self
releases.
 Keep rolling over the area for a good 1-2 minutes, or until the tightness/pain goes
away.
 Avoid placing the ball directly in the middle of the spine.

3. Strengthening exercises

Now that your tight/overactive muscles have been stretched/released, you are now ready
to begin the strengthening of your weak muscles.

Wake up those sleeping muscles!

Target muscles:

 Gluteal group
 Hamstring
 Abdominals

a) To strengthen your Gluteals:

// Bridge

Instructions:

 Transition from position 1 to position 2. (see above)

 Prior to the movement, engage your glutes to tilt your pelvis backwards into a
neutral position.
 This should flatten your lower back onto the ground.
 Engage core muscles.
 As you drive your hips upwards, aim to feel the contraction of your glutes more than
your hamstrings.
  Bridge as high as you can go as long as you keep a neutral spine.
 Do not over arch your lower back.
 Hold the end position for at least 30 seconds.
 Repeat 3 times.

Did you know that there is a condition called “Glute amnesia”? It occurs when the gluteal
muscles have been placed in a poor position (eg. sitting) over a prolonged amount of time,
causing them to stop working efficiently.

Check out this post: Is sitting destroying your butt muscles? (… it has a list of ALL the
gluteal strengthening exercises that you can do!)

b) To strengthen your Hamstrings:

Hip lift

Instructions:

 Lie on the floor.

 Place your feet on the wall with your hips and knees bent at 90 degrees.
 Dig your feels into the wall and lift your tail bone off the floor.
 Tilt your pelvis backwards.
 This is to flatten your lower back onto the ground.
 Feel the tension in your hamstring muscles.
 Hold for 30 seconds.
 Repeat 3 times.

c) To strengthen the Abdominals:

Dead bugs

Your abdominal muscles are connected to the top portion of the pelvis at the front. The
play a vital role in rotating the pelvis back into position.
Instructions:

 Lie on your back with both of your knees bent in the air. (Position 1)
 Engage your core and abdominal group by gently drawing in your belly button.
 Rotate your pelvis backwards.
 This is to flatten your lower back.
 Maintain this lower back position. Keep it completely in contact to the ground
throughout movement.
 Do not let your lower back arch!
 Slowly lower the opposite arm/leg. (Position 2)
 Lower the better! (… but only if you can keep the lower back FLAT!)
 Progression: Add 5-10 second holds in Position 2.

Camel pose

Instructions:

 Assume the 4 point kneel position.

 Tuck in your tail bone to rotate your pelvis backwards.
 Engage your core muscles by drawing your belly button in.
 Exhale all the air in the lungs as you form this position.
  Hold this for 5 seconds.
 (or as long as it takes to completely exhale all the air in your lungs)
 Repeat 10 times.

… Want more exercises like this?

Check out this post: Core exercises for Anterior pelvic tilt

4. Finding neutral pelvis

By now, you should be fairly familiar with the stretching and strengthening of the muscles
that contribute to your Anterior pelvic tilt.

The next step (… and in my opinion the most important) is learning how to take control of
your pelvis position throughout the day.

If you can’t control your pelvis, the problem will continue to manifest! (… no matter how
many exercises you do.)

How to determine the neutral position of the pelvisThe main aims with the
following exercises is to:

 achieve a neutral pelvis in various positions and

 gain an understanding of what it FEELS like.

a) Pelvic tilting (4 point kneel)

Instructions:

 Assume the 4 point kneel position.

 Hand under shoulders.
 Knees under hips.
 Find the end range of pelvis movement.
 Tilt your pelvis all the way forward.
 Tilt your pelvis all the way backwards.
 The neutral pelvis will generally be the midpoint of these two positions.

b) Sitting
Instructions:

 To position your pelvis in neutral whilst sitting, you will need to “Sit on your SIT
bones”.
 To find your sit bones, place your hands (with palms up) underneath your butt
whilst you are sitting on a chair.
 Feel for a pointy bony prominence.
 (This is your Sit bone!)

 Think of these bones as upside down TRIANGLES .

 The goal is to sit directly on the tip (aka the pointiest part) of the triangle (as
opposed to the side).
 This will place your pelvis is a more NEUTRAL position.

c) Standing

Instructions:

 Whilst standing, place your fingers on the ASIS and PSIS. (see above)
 They are the “pointy bones” that stick out the most.
 To position your pelvis in neutral, you will need to tilt your pelvis until the ASIS and
PSIS are approximately in line with each other.
 Keep in mind, it is normal to have a slight anterior tilt of 5-10 degrees.

5) Strengthening with Neutral pelvis

a) Bird/Dog
Instructions:

 Assume the 4 point kneel position

 Place your pelvis in a neutral position.
 Engage your core and glute muscles to lock the pelvis in place.
 Whilst maintaining this alignment, lift your arm and leg.
 Do not let your lower back sink in.
 Alternate between sides.
 Repeat 10 times.

b) Over head reaches

Instructions:

 Stand up right.
 Place your pelvis in a neutral position.
 Activate your core and glute muscles to achieve this.
 Whilst maintaining your pelvis alignment, raise your hands over your head.
  Do NOT let your ribs to flare outwards.
 “Keep the ribs down”
 The lower back should not arch.
 Repeat 10 times.
 To progress: Perform shoulder presses (with weight) in the standing position.

c) Pull downs

Instructions:

 Whilst standing with a slight forward lean, pull the resistance band downwards.
 Lock your pelvis in a neutral position.
 Activate your core muscles.
 Slowly let your arms recoil to the over head position.
 Your torso and pelvis should not move during this exercise.
 Do not let your lower back arch backwards!
 Pull the resistance band back to starting position.
 Repeat 10 times.

d) Plank

Instructions:

 Get into the plank position. (see above)

 Position your pelvis in a neutral position.
  Engage the core and glutes to stabilize the pelvis.
 Make sure your lower back does NOT sink in.
 Hold for 30 seconds.
 Repeat 3 times.

e) Strengthen hip flexors

Wait a minute… Why would you want to strengthen hip flexors?

In my experience, I find that most people are very weak in these muscles.

(In fact – The hip flexors may be tight as a compensation for being WEAK!)

 Whilst sitting with your pelvis in a neutral position, raise your knee as high as
you can go.
 Do not lean backwards.
 Hold this position for 5 seconds.
 Repeat 10 times on each leg.

6) Maintaining neutral pelvis

Great! You’re almost there!

All that we need to cover now is to apply what you’ve learnt so far in your day to day
activities such as walking, sitting, hinging and standing.

It is likely that your functional movements (… especially sitting!!) has caused your Anterior
pelvic tilt in the first place.

Key points:

 Maintain the neutral position of the pelvis throughout movements.

 Remember to lightly engage the gluteals and abdominals as you are performing any
movement/exercise.
  Avoid quadriceps and lower back dominant exercises until you can maintain a
neutral pelvis.
 Once you have a good control of your pelvis, you can start to work out your hip
flexors and lumbar extensors.
 Remember your body’s default setting is to go back into your Anterior pelvic
tilt. MAINTAIN A NEUTRAL PELVIS!
 You need to train your brain as much as you need to work on your body to fix
this.

7) Other areas to consider

Have you persisted with these exercises for your Anterior pelvic tilt… and still can’t seem to
fix it?

Consider addressing other areas of your posture that might be causing it!

a) Thoracic kyphosis

Having a hunched upper back may force the pelvis to tilt forwards.

This is to keep your head up right.

Check out this post: Hunchback posture: Fix it now.

b) Lumbar Hyperlordosis
If your lower back has an excessive arch (hyperlordosis), it may be locking your pelvis in an
anterior tilt.

Check out this post: How to fix your Hyperlordosis.

c) Flat feet

If you have flat feet, it can cause your pelvis to tilt forward.

Here’s the best exercise for you:

Instructions:

 Sit down on a chair with your feet on the ground.

 Whilst keeping your toes relaxed, proceed to scrunch the under-surface of your foot.
 If performed correctly, you should be able to feel the muscles under your foot tense
up.
 Hold this for 10 seconds.
 Repeat 30 times.
 Progress this exercise to a standing position.