Posterior Pelvic Tilt

Unfortunately a problem of the modern lifestyle many of us are living is that we sit for too long. It’s been said that at the speed that technology is advancing, posture is declining. This can and does come at a huge cost to our health and well-being. One of the most common and notable postural problems associated with too much sitting is the hunched “C” shaped appearance. Previously this was reserved to our older population, but with smart phones, tablets and social media, this is now commonplace in almost any age bracket. This hunched or “C” shaped posture is a sign of change right in the structural foundation of someone’s body. Literally, the framework the rest of the house is all built on, is shifting. The huge bones at the base of the spine act like the concrete slab or foundation block of any house, they can shift and rotate.  This shift can trigger a cascade of postural changes from the ground up. Imagine the pelvis were a vessel shaped like a glass of wine. Ideally you’d want the glass level so the wine stays neatly inside of it. There are two common postural deformities known as an anterior pelvic tilt and a posterior pelvic tilt. With a slumped posture, often what we see is a posterior pelvic tilt. Here the wine is being tipped out the back of the pelvis or lower back (wasting good wine & wasting your body at the same time).…

A posterior pelvic tilt has a strong association with disc problems, sciatica, constant lower back pain, piriformis syndrome, knee, hip and ankle issues, abdominal discomfort, shoulder tension, neck pain, headaches and migraines.  Often there is an associated spinal misalignment or stress on the nervous system. This can trigger an involuntary fight/flight response through the body which activates the internal stress response.  A common muscular response to this is aggressive overstimulation of some muscles with the combined shutting down of others. There is an imbalance that develops between the core muscles and legs. It’s this imbalance that makes the “flexed” or curled/hunched appearance quite common.

A posterior pelvic tilt is less common than anterior pelvic tilt however, the odds of having either an anterior or posterior tilt are increasing resulting in more and more tipping of the “wine glass” at the base of the spine. This tip or rotation places a strain on the total energy expenditure of the nervous system and working muscles to boot and with the right care and some deliberate focus changes can be made. A main thing to note is a posterior pelvic tilt will affect more than just the lower back.

Mechanically a posterior pelvic tilt can:

  • Weaken abdominals
  • Weaken gluts
  • Tenses hip flexors & quads
  • Tenses lower back muscles
  • Rounds and tightens upper back
  • Strains the upper neck muscles supporting the skull
  • Hunches or rounds our mid to upper back
  • Forces more weight through the heel
  • Potentially forces more pressure through the knee
  • Shortens our walking & running stride making hill running much harder.

So for office workers, drivers, pilots, students, gamers, cyclists and runners a posterior pelvic tilt can be very frustrating. For the career sitters and students, sitting down for too long can reflexively shift weight back into the“C” shaped appearance. Although comfortable when sitting, it can be hard to effectively stand tall and upright or to engage muscles like the gluts and abdominals effectively. This is also true for cyclists who although ideally would be powering the bike with their gluts, can easily slip into being hip flexor or psoas dominant especially when hunched over a tiny bike frame for long periods of time. If sitting goes on for long enough the psoas hyperactivity can actually start to shut down the gluts and abdominals. As for runners- for the elite or true runners this may not be an issue- mechanically running almost forces an upright, tall posture. If anything leaning forwards at the hips. However, for many of us running is a side hobby outside of work and life where we still sit way too long throughout the day. The imbalance this posterior pelvic tilt and prolonged sitting creates leans towards a hip flexor or psoas dominance. Hill running can be very tough, especially stair repeats. Every step is a pull of the hip flexor and there can be very little engagement of the gluts to start the drive. It’s quite common to hear “my gluts don’t fire” or “I can’t engage my gluts” and this isn’t just the running community.  This posterior pelvic tilt is switching off one of our main evolutionary advantages and traits- our glut firing. We need to get our booties back, to get the gluts firing again.

How do we switch the balance back from a posterior pelvic tilt and start to keep the glass of wine balanced perfectly? Unfortunately just willing it to change, saying “I’m just going to rock my hips forward” or just “strengthening it” will not cut it alone. When changing this pattern there are 6 Key steps:

The first two steps are the key to creating change:

1. Get checked and adjusted by a chiropractor-

It’s possible that stress on the nervous system from a mechanical, emotional or chemical cause is triggering a compensation reaction in the body. A posterior rotation can be a guarding reflex. For some, stress is felt as pain and tightness, for others it is a triggering of a more primitive “fight/flight” stress response. This deeply wired primitive response can trigger a physiological shift in our nervous system, alter the natural state of muscle balance and cause a postural shift. This can alter state of natural balance creating more stress stimulating a higher workload and fatigue level on the body. Chiropractic helps identify and unlock sites of restriction or tension throughout the body and reduce nervous system tension. Similar to the boat in the harbour with many anchors, pulling up the anchors, reducing the tethers or restriction holding the ship in port can help set it sailing again. The right sequence of chiropractic care can assist you in decreasing the workload of the body, reducing the stress response and assist you in creating change.

2. Deliberate practice-

The hardest concept with change is being consciously aware of what you are trying to change. The second challenging concept is knowing how you are going to change. Anders Ericsson, author of Peak believes that Deliberate Practice is the key to mastery of any skill. Thankfully changing posture will not take 10000 hours like many other true mastery skills yet some brain power and focus is required. If you have a posterior pelvic tilt deliberately thinking of one or two performance cues consciously throughout the day. Performance cues are not necessarily drills, but they are “awareness cues” that will help you monitor and shift what you are doing.

Posterior pelvic tilt cues could include: sitting or standing as tall as possible, leaning forwards when running, engaging the core muscles, not rocking too far back into the chair or engaging the gluts. These awareness cues do require brain power yet starting to think of them at specific times throughout the day will begin to create new nerve and muscle memory patterns and change old habits. If there’s one thing I’ve learnt with performance cues it’s don’t do them all at once. Deliberately practicing one cue a day is enough. Then the next day or even the next week try a different cue. The body and brain need focused attention and time to change.  Trying to be perfect from day 1 and do 6 different things is way too complicated and frustrating to the brain & body…..K.I.S.S.

These first two steps are important for maximising the speed and efficiency of creating a postural shift, especially when unlocking a posterior pelvic tilt. However, the following four steps; lifestyle modifications, mobility, rolling, stretching and strengthening can have enormous standalone benefit done singularly or combined.

3. Modifications for the home and office:

Little changes to positions that you spend a lot of time in can have a huge benefit. Even before undergoing a chiropractic care program or consciously performing deliberate practice, lifestyle modifications can be very impactful in creating change. Have a look at your home/work set up and see if there’s any way to improve one or two of the following.

            3.1. Sit high- When sitting keep your knees lower than the hips. This will encourage you to slide forwards in the chair versus rocking back. Think about this especially in the work chair, car and couch. SUV’s make this a lot easier in the car. For the car and office chair a small/flat lumbar support or pillow can really assist in helping your pelvis stay in a neutral or forward position.                       

3.2. Minimise couch time- The softer and lower the couch the easier it is to slouch backwards into the posterior pelvic tilt and “C” shape. An extra cushion in the small of the back when on the couch can minimise the slide towards posterior pelvic tilt.  Likewise if couch time is really just what the doctor ordered, then kick up the feet and literally lie down.

            3.3. Alternate sitting & standing- Here standing work stations are a massive benefit. The option of raising the desk and standing can literally “unlock” the muscular creep or tension building up. Prolonged periods of sitting can create a structural imbalance triggering posterior pelvic tilt. Some studies say that sitting should be never longer than 30 minute periods at one time and that 8 hours of sitting throughout the day creates an… Intermittent periods of standing can prevent the associated muscle tightness and spasm that goes hand in hand with a posterior pelvic tilt.

            3.4. Small but frequent breaks- most research shows that sitting for longer than 30 minutes straight creates a change in muscle tension & stress. If the option is there to even stand up, walk to the bathroom, walk to a neighbours desk then do so. These small breaks to wonders for changing patterns of behaviour.

4. Mobilise for a pelvic tilt:

If you are lucky enough to start adopting a few of the above, then you’ll already be starting to mobilise out of a posterior pelvic tilt. For others, deliberate practice is hard to fit in to the flow of everyday life. Here carving out 5-10 minutes a day for some mobility can really help. These 4 mobilising drills are a great step in changing the movement patterns and beginning to help lengthen and strengthen the necessary parts of your spine and hips.  Aim for 30 – 60 second efforts of each and right now, remember that doing more does not equal better. First move well then, and as good movement becomes habit, then move often…..

  •   4.1 Crawling
  •   4.2 Rocking
  •   4.3 Lunges
  •   4.4 Seals

5. Stretching and rolling your way out of a posterior pelvic tilt:

Before trying to muscle the way out of a problem make sure that we are strengthening the right movement, nerve and muscular pattern. This is why chiropractic care and deliberate practice are so important. Then, before rushing for the dumbbells and weights look at lengthening and waking up the muscles first. Sometimes, strength can appear as the “one size fits all” fix for everything yet we want/need a good selection of tools in the toolbox including strength, length and body coordination. With each of the below, the foam roller or release is a great way to precede stretching. The roller work can “wake up” and warm the muscle, priming it to fire and release. Rolling can assist getting the muscle ready for the stretch or strength session ahead.

            5.1. Psoas foam roller, release and stretch

  •   5.2. Glut foam roller, release and stretch
  •   5.3. Lower and upper back foam roller and extension stretch
  •   5.4. Quadricep foam roller and stretch
  •   5.5. Hamstring foam roller and stretch.

6. Strengthen optimising to correct a posterior pelvic tilt:

Once you’ve unlocked and created the new pathway, now is time to stabilise the new pattern. This locks the new shift and foundation in. Transitioning the new posture from being a conscious very deliberate action to one of unconscious competence. Once the new pattern is competent and unconscious it takes a lot less mental energy to do, it becomes a default pattern.  Here is where strengthening really comes in. As Dan John says- “First move well, then move often.” Now you know how to move, we’ve released any restriction and tension in the way and it’s time to strengthen the new pattern and make this pattern the new normal or habit.

  • 6.1 Standing on one leg
  • 6.2 Bench or chair assisted squats with dowel
  • 6.3 Squats lifting something
  • 6.4 Single leg sit to stand exercises
  • 6.5 Planks

Posterior pelvic tilt is rapidly becoming a modern day dilemma. Hopefully though we’ve been able to shed some light on things you could do to start creating a change today.  We believe that you have the power, sometimes we just need a little helping hand along the way.

If you have any questions on any of the above please reach out below. Additionally if there is anything in the videos that you need further help in visualising please contact us. Finally, if you found this useful and either you or a loved one wanted to begin Chiropractic care, we love to help you live life without limits!