Anterior Pelvic Tilt

An anterior pelvic tilt, also known as Janda's lower crossed syndrome, may be one of the factors contributing to your low back discomfort/pain. A few symptoms that your pain may be rooted in an anterior tilt include:

  • Difficulty standing after an extended period of sitting
  • Low back discomfort/pain when lying flat on your back, which is alleviated by a pillow under your knees or lying on your side with your legs bent

If you lack these symptoms, you may still have an anterior tilt. It simply means that one of the muscles that create an anterior tilt, the iliopsoas, may not be tight enough to cause those specific symptoms yet. 

What is an Anterior Pelvic Tilt?

Whether you have an anterior tilt can easily be assessed by finding some specific landmarks on the pelvis, known as the ASIS and PSIS, and observing their relationship. Basically, if the front of the pelvis is lower than the back, you have an anterior tilt.

What Causes an Anterior Pelvic Tilt?

An anterior pelvic tilt is caused by a force couple of muscles above and below the pelvis.

The back muscles, which extend the spine, pull the back of the pelvis up:

  • Quadratus lumborum
  • Lumbar erector spinae
  • Lumbar transversospinales

In front of the pelvis, the hip flexors pull the front of the pelvis down:

  • Iliacus and psoas, also known as iliopsoas
  • Rectus femoris

When both of these sets of muscles are chronically shortened, an anterior tilt results. 

What Problems Can it Cause?

An anterior tilt can also increase or aggravate the occurrence of:

  • Low back pain
  • Muscle tension and fatigue
  • Hamstring injuries
  • Irritated facet joints
  • SI joint dysfunction

How is it Treated?

In order to appropriately address an anterior tilt, we are interested in two sets of muscles:

 Chronically Shortened Muscles:

  •  Back extensors
  •  Hip flexors 

Note that both of these muscle groups are listed above as contributing to an anterior pelvic tilt.

Chronically Overstretched Muscles

  • Back flexors (abdominals)
  • Hip extensors (hamstrings/glutes)

As you may have already guessed, the solution to this postural deviation and accompanying dysfunction is to lengthen the chronically shortened muscles and strengthen the chronically overstretched ones.

The Role of Massage

Massage is particularly well suited to lengthening the chronically shortened muscles. Deep tissue, range of motion, and stretching techniques are tailor made for this task.

Dysfunction in both sets of muscles can be addressed with other techniques, such as proprioceptive techniques, neuromuscular therapy, crossfiber, and friction.

Other Strategies

Strengthening the chronically overstretched set of muscles can be achieved through exercises which target those muscles. You may be comfortable doing this on your own, but I highly recommend getting advice from an experienced professional trained in rehabilitative exercise. This could be a physical therapist, or it could be a personal trainer. 

If you go with a personal trainer, just be sure that they understand your specific goals and have a rehabilitative perspective. You're not necessarily looking for someone to put you through the ringer. You need specific, targeted exercise.

The final tool for addressing pelvic tilt is to have someone assess your progress over time. This is something that your massage therapist or other healthcare practitioner should be able to do. 

If you would like have your pelvic tilt evaluated and discuss treatment options, click here to schedule a "Discover Your Path to a Pain Free Life" session now.

- By Lovelace Linares

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About the Author

My name is Lovelace Linares. I have been practicing massage in Atlanta since 2001. I taught all aspects of massage for nine years, five of which I directed the massage program at the Atlanta School of Massage.

I'm a bit unconventional in my thinking. I believe that self discovery is the purpose of life. Through it, we can all achieve our greatest potentiontial, both individually and as a society.

To that end, i believe that true relaxation comes from two things: (1) Alleviating pain that you are aware of and (2) addressing tension you are not aware of. Self-awareness is the key.

My practice is located inside Urban Body Studios on the scenic Atlanta Beltline. Orthopedics, Deep tissue, Swedish massage, neuromuscular therapy, Thai massage, and stretching are some of the techniques that I use in my practice.

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