Yoga and Anterior Pelvic Tilt
The anterior pelvic tilt is a hot topic in yoga and in manual medicine. Some people are overly concerned about the fact that their pelvis is tilting anteriorly without even understanding what it means. Let’s simplify the issues behind this increasingly common postural variation and learn how it can affect other parts of our body.
A normal pelvic angle is 30°; this means that our posterior superior iliac spines (the dimples above our bottoms) are slightly higher than our anterior superior iliac spines (the bones that stick out at the front of our pelvis). This angle can vary a few degrees either anteriorly or posteriorly due to our genetic makeup and even temporarily due to tight and/or weak muscles. An anterior pelvic angle of 40° is considered excessive and will produce a lower back (lumbar spine) curve that is also extreme. Our lumbar spine should have an anterior curve which is known as a lordosis; however, when this curve is excessive it is known as a hyperlordosis, which is not ideal. Cases of increased pelvic angles and lumbar hyperlordoses are very prevalent in today’s society.
Causes of increased lumbar lordosis include:
- Postural deformity
- Lax muscles, especially the abdominal muscles in combination with tight muscles, especially hip flexors or lumbar extensors
- A heavy abdomen, resulting from excess weight or pregnancy
- Compensatory mechanisms that result from another deformity, such as an increased curve in the thoracic spine (mid-back)
- Hip flexion contracture
- Spondylolisthesis (displacement of the vertebra above with relation to the vertebra below)
- Congenital problems, such as bilateral congenital dislocation of the hip
- Fashion (e.g., wearing high-heeled shoes)
Magee, J. David. Orthopedic Physical Assessment: Fourth Edition. Saunders. Toronto. 2002.
Cause number two from the list above is the reason that affects most. The majority of the population sits for at least eight hours a day while hunched over a desk at work; this can lead to a generic condition known as lower cross syndrome. This disorder consists of the following muscular issues: Weak or inhibited gluteal muscles and abdominals & Tight and shortened hip flexors and lumbar extensors
To better visualize this, observe the illustration that demonstrates lower cross syndrome. Take note of how the two weak/inhibited muscles create one line of the cross and the two tight/shortened muscles create the other line to complete the shape of a cross, hence lower cross syndrome.
When our hip flexors are tight, specifically our psoas, our pelvis rotates forward by the psoas pulling down on the lumbar spine from its attachment sites; this increases our lumbar lordosis and subsequently shortens our lumbar extensor muscles. This is most often seen in combination with weak abdominal and gluteal muscles.
Now that the reasons for this postural condition have been noted, the way to correct it is clear: reverse the causes. However, the distinction between inhibited muscles and weak muscles must be made first before rehabilitation can effectively begin. Inhibited muscles require the re-establishment of correct muscle firing patterns, while weak muscles need to be strengthened. Some individuals have weak muscles that are not inhibited; some have the reverse, and some have both issues to correct. Tight/shortened muscles require lengthening; sometimes stretching is sufficient and sometimes alternative soft tissue treatments such as Active Release Technique® and Graston Technique® are required to decrease scar tissue and increase the range of motion of the particular muscle.
If you are concerned that you may have lower cross syndrome, or simply a pelvic tilt, paying a visit to your manual health care practitioner (sports focused chiropractor, sports physician) will be well worth the time and money. They will be able to diagnose any underlying issues related to this condition and create an appropriate rehabilitation programs specific to the weaknesses and inhibitions they find upon physical examination. They will also be able to reduce scar tissue that may be contributing to your pelvic tilt (anterior or posterior).
Education is the ticket to eliminating these sorts of conditions from society. If we understand how to mitigate the risks for such generic conditions, we will all be much healthier individuals. Here is to learning more about our bodies!
Learn More about Dr. Carla Cupido.
About the Author
Protecting Wrists in Downward Facing Dog and Yoga Poses
I teach Hatha Yoga classes at a variety of Yoga studios, some with carpet and some with hardwood flooring. Regardless of the flooring type, I often see common hand-placement errors in wrist-loading Yoga poses like Downward Facing Dog that can chronically lead to compression injuries in the wrists.
Having the proper placement and understanding of how to manipulate the surface area of the hands can significantly reduce the incidence of wrist injuries in your Yoga practice. The first issue to address is the floor type that we practice Yoga on. Most people find practicing on hardwood floors hard for the knees and other pressure points on the body. To create cushioning, many people practice in studios on two Yoga mats. This doubling of mats creates a similar problem to practicing with a Yoga mat on a carpet. The thickness of two mats or of a mat on carpet causes the hands to sink into the soft support. When hand positions are even slightly off-balance, body weight is shifted even more into those sinking points. The wrists are next to fall into this compression and take this uneven energy. What causes this uneven compression?
Notice what happens to the connection points in the hands the next time you do Downward Facing Dog, Cat pose, Plank pose, Cobra pose or any other pose that positions your hands forward of the shoulders and applies pressure. As you move away from your hands in Downward Facing Dog or in the exhaled phase of Cat pose, do the inner regions of the hands (proximal index finger and knuckle) lift off the ground? Is there space flowing from the inner hand into the palm?
When the inner hand lifts in these loaded poses and when we practice on thick surfaces, body weight transfers heavily to the outer wrist joints. These outer joints become easily compressed and, for some, result in acute or prolonged pain. Considering how static pressure increases when we decrease the surface area that the pressure is being applied to, we can easily decrease this damaging pressure by bringing attention to how we apply energy into the hands. Before loading the hands in Yoga poses, align the wrists so the middle and index fingers roughly point forward or parallel with your mat. Send a gentle spread across the fingers without tension going into the wrists and arms. Allow a pause to lightly ground the proximal end of the index fingers and the index knuckles. Feel that you are already distributing your body forward out of the wrists and more evenly over the hands. Rather than the weight going into a small portion of the hands (high pressure), the weight is fanned out over a greater area (less pressure). As you set up the rest of the pose, keep applying this gentle, inner grounding of the index region. You may feel as though you are slightly spiraling the forearm inwards.
In Downward Facing Dog and Plank poses, this inwards spiral of the forearms, may draw the upper arm bones and shoulder blades forward. Therefore, a countering motion is required. A slight outwards spiral of the upper arms should be applied along with a light hugging of the shoulder blades back and down into the upper ribs. There are various Yoga equipment products that can aid in reducing wrist compression as well. But I first recommend exploring how you can change hand placement and energy applications. If possible, practice with only one mat and thinner cushioning under the hands.
Be more aware of the surfaces you practice on and add additional care to protecting the wrists in loading Yoga poses. As our practice is life-long, we need to perform Yoga poses mindfully to sustain the vitality of joints.
