Posture 101: Pelvic Tilt

If you’ve ever heard of someone with “swayback” or “no butt”, then you’ve seen the results of postural changes related to pelvic tilt.  The pelvis is a bony structure that connects the base of your spine to the upper end of each of your legs. A healthy pelvis is important for movement, stability and posture.

There are basically two types of postural deficiencies involving the pelvis: anterior pelvic tilt and posterior pelvic tilt.

The most common type of pelvic deficiency occurs when your pelvis is tilted forward, known technically as anterior pelvic tilt (APT). APT is more common in females, but many males have it too. This is a relatively common postural deviation characterized by a forward tipped pelvis, increased lower back curve (sway back) and sometimes a bulging (but not necessarily fat) abdomen. The tilt is a result of tight or stiff hip flexor muscles (posts, iliac, rectus femoris, tensor facia late, erector spinae) coupled with poor or unequal gluteal, hamstring, oblique or abdominal muscle strength.

Hyperextended knee • Normal Knee posture

Many people with APT also have hyperextended knees – meaning the knees are extended back behind the centerline (see image). This can be both a symptom and a cause of further discomfort.

A small pelvic tilt is normal, and usually doesn’t cause any problems.  Excessive anterior pelvic tilt can lead to increased risk of knee pain, lower back pain and injury, and other musculoskelatal disorders.

The opposite tilt, called posterior pelvic tilt (PPT), happens when the pelvic tilts backward.  The posture presents itself as “flat butt” and a slightly leaned back posture. PPT is much less common than APT.  Posterior tilt is usually found in people who stand still all day–perhaps behind a counter.  The most common problems include sciatica, lower back pain and neck pain.

How to reduce APT

Massage is perfect for lengthening the chronically shortened muscle (back and hip flexors)s.  Your therapist will use deep tissue, work on increasing range of motion in your hip joint and apply stretches where needed.  For the companion muscles (back flexors (abs), hip extensors (hamstrings and gluteal muscles), which are likely chronically overstretched, different deep tissue, range of motion and stretching techniques are used. A good therapist will also use other modalities, like proprioceptive and neuromuscular therapy, along with crossfiber and friction.

Together with home care exercises, which your massage therapist or personal trainer can help you with, you’ll see real and positive change in posture in less time than you think.  And the massage will have benefits beyond just the decreasing of APT, like leaving you calmer and more relaxed.