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
Standing Tall: Why Posture Matters
Remember how your mom used to always lecture you to stand up straight? Well, she might have made some mistakes over the years (that outfit in your 5th grade school picture), but on this one, she’s right. Posture matters more than you may think.
First, let’s talk about your body, starting at the top. Each inch your head is forward of your shoulders doubles the amount of weight it puts on the rest of your body. Although the average head only weighs between 8-10 pounds, your upper back (and then lower back and hips) will become misaligned if your head “lives” in a forward position – all in an attempt to balance your now-too-heavy head.
And, unless you sit in an ergonomically perfect workstation, chances are you round forward over your keyboard or laptop like something straight out of the latest episode of the “Walking Dead.” Most of us, sadly, are in the process of developing this posture. Blame the Internet (we’re talking to you, Mark Zuckerberg) or your boss (for making you work too much).
What happens to our bodies? Back pain, neck pain, hip pain and knee pain. And, let’s not forget your breathing. Collapsing forward compresses your lungs, reducing their capacity by 30 percent or more. Your organs can’t function properly, and neither can your muscles, joints, or connective tissue.
Posture also matters for your mental health. Good posture allows you to breathe more fully, calming your nervous system, which can help with everything from good sleep to good moods. Plus, standing up tall makes you feel more confident. Slouching pulls your energy downward, even making walking and balance more difficult.
What to do? First, analyze your own posture. Do your shoulders slouch? Is your head forward? Do you have back or neck pain? When you walk do you have a tendency to lean forward and feel like you’re lifting your knees towards you?
Since it is vital to have extension in the upper torso in standing posture, the starting place is simply awareness of how you’re standing or sitting. Imagine lifting out of your pelvis, shoulders back, head looking slightly above the horizon.
Don’t spend too much time sitting at your desk, especially in bad posture. Take a walk. Inhale your arms overhead and slightly back. Regularly engage your lower trapezius to draw your shoulders away from your ears, and your rhomboids to draw your shoulders together.
And balance the forward posture with a lot of back bends. Stretch your pecs and anterior shoulder muscles with anahatasana pose (think child’s pose with your hips over your heels, reaching your tailbone and chest away from each other). Camel pose has been called the “antidote to sitting” because it stretches the entire front of your body.
If you have access to a Pilates reformer, you’re in luck. Do seated arm circles to take your shoulders through a weighted stretch, and turn around for chest expansion to, well, expand your chest and your lung capacity. Or just lie down on a mat, extending arms and legs long on the floor, and lift up, fluttering arms and legs in opposition while breathing deeply.
Most importantly, throughout your day, remember to stand up straight. Don’t slouch. Just listen to mom on this one. You can still argue about your clothes, your politics, and what’s for dinner. On posture, she’s right.
