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Anterior Pelvic Tilt: the most common lurking dysfunction?

First, lets get a definition so we are on the same page...

Anterior Pelvic Tilt (APT hereafter), clinically, is when the total tension around the pelvic framework is imbalanced enough to disproportionally tilt the ilia (hip blades) overly forward, leading to hyperextension of the low back and early compression of the hip joints. **In this article we are assuming the tilt is beyond normal limits and is a problem.

This forward tilting, if too extreme, may contribute to a host of consequences:

- Low Back Pain and/or stiffness

- Hip Pain and/or stiffness

- Dysfunctional breathing due to poorly positioned diaphragm

- Loss of / or "fake" hip extension

- Pelvic Floor weakness / Urinary Incontinence

- Lost ability to functionally squat or squat deeply

- Decreased access to abdominal and gluteal strength

- Torque on joints, primarily the hips, knees and ankle/feet

- Inability to tolerate standing too long, lying on hard beds/surfaces, or long walks/runs

- Overuse syndromes of the Low Back/Quadricep/and Hip Flexor musculature

- Upper body postural changes (shoulder blades, neck, head, airway, etc...)

- Chronically tight calves

- Perception of chronically tight hamstrings

- Loss of flexibility bending forwards, pain/discomfort with bending backwards

- Tendency to overload the knee, inciting knee pain/Jumpers Knee/etc...

- Hip Flexor strains in runners (no hip extension, overuse hip flexors in walking)

- Long, strained, or dysfunctional bowel movements

So...what is a normal amount of anterior tilt?

To answer this questions we do not need to get out special equipment and use x-ray to measure. Rather, we just intelligently observe. Be self aware. Here are some questions that may help someone determine if this tilt is too much, few or many may apply:

  1. Does standing too long cause low back discomfort?

  2. Are you unable to sit in a relaxed full squat?

  3. Does a hard bed make your back stiff in the mornings?

  4. Does your low back often get pumped and tight with exercise, running, or long walks?

  5. Does moving after sitting too long cause discomfort?

  6. Is a glute bridge/hip thrust, deadlift, or other hip movement primarily felt in the lower back instead of the glutes?

  7. Do you feel like you have a belly (protruding gut) even though you may be skinny? Or do you feel like your belly is too pushed out?

  8. Are your quadricep muscles overdeveloped or chronically tight?

  9. Do your hamstrings always feel tight, even if you regularly stretch them?

  10. Is it abnormally difficult for you to touch your toes?

These are just ten questions you can contemplate to determine if your tilt is too much. This can also be compared with a side picture of yourself relaxed. You may visually see some tilting that also matches with symptoms and answering "YES" to the questions above.

What if you visually see the tilt, but lack symptoms? I wouldn't worry about it just yet. If your glutes get sore when you train the butt, and your abdominals get sore when you train them and all or almost all of the above questions are NO, then don't think twice about it. Regardless if someone told you this is a "syndrome" you have, I wouldn't lose any sleep, just keep on keeping on.

Why is Anterior Pelvic Tilt and Low Back Pain So Common?

The most likely theory is just the evolutionary mismatch from what humans have been doing for thousands of years and what modern life looks like. As a society we sit too much, we move too little, we have too much routine, we are less fit, we walk less, we run less, we ruck (carry things) way less, we rarely squat unless its in a gym program, we relieve ourselves on toilets, we wear fashionable shoes with huge heels, and on and on...

These modern habits yield patterns. Some patterns are mild or benign, and others began a series of malignant breakdowns in how we function as a whole. Of course it should go without saying, the human organism is enormously complex and we must take into account the plethora of interacting systems within the body when trying to increase human performance, comfort and longevity. But from a biomechanics and orthopedic standpoint, these patterns tend towards entropy. Meaning they start a cascade of poor positions, restrictions, and compensations. To some degree, we cannot stop this from occurring, but we CAN slow it down and just possibly reverse some existing problems.

Anterior Pelvic Tilt Program

Due to high demand from our followers, listeners and readers. We have created a starting point program to address restrictions and limitations that are commonly associated with an anterior pelvic tilt or with a pelvis restricted in motion overall. IF you feel you are highly restricted in hip and pelvic mobility, it may be wise to begin with our Series 1 Program here.

However, if you are ready to attack the specifics of APT. We have just released our APT program here.

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