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Losing your gut… Anterior Pelvic Tilt

Posted August 13, 2007 at 02:45 PM by Stephen Antel

Section: In The News, His Fitness, Injuries & Rehab, His Health, Physical Health

anterior pelvic tilt Losing your “gut” might be a little more than stripping down the fat at your waiste line.  There might be more involved. One of those factors could be something called Anterior Pelvic Tilt.  What is it, and how do you get it?

The term Anterior Pelvic Tilt is pretty self explanatory – the top of the pelvis is tilted forward.  In order to fully appreciate APT, you have to understand the musculature of the lumbopelvic region. Your hip flexors, rectus femorus, abs, glutes, spinal erectors, TFL, and hamstrings (just to name a few) are all involved with the positioning of your pelvis.  If any one muscle is over active or under active, you’ll have some form of anterior/posterior tilt.

APT is far more common due to our ever increasing sedentary lifestyles.  Sitting is a major culprit in the development in APT.  Sitting for long periods tends to shorten your hip flexors. Since your hip flexors attach to the top of the pelvis, when they shorten up, they pull the pelvis forward.  I like lists, so here’s a list of common causes for APT.

  • Shortened hip flexors
  • Weak abdominals – particularly the transverse abdominus (TVA for future reference)
  • Weak/under active glutes
  • Lengthened hamstrings
  • Tight spinal erectors

Here’s another list with some common effects of APT.
  • Protruding stomach and butt
  • Over pronation of the foot
  • Poor hip mobility
  • Thorasic extension
  • Low back pain

Now that you know a little bit about APT, let’s take a look at some ways to fix it.
Identifying APT and fixing it

There are a few ways you can check to see if you have APT.  Take a look at the bottom of your shoes.  Is there wear on the inside edge of the sole?  If so, it could be caused by APT.  The easiest and most telling way to look for anterior tilt is the belt test.  Stand next to a mirror, looking at yourself from the side.  Pay attention to the position of your belt.  If the font of your belt is lower than the back, then that’s a pretty good indicator of anterior tilt.  You’ll want to make sure that your beltline is at hip level.  If you pull your pants up to your belly button, this test won’t work, so pull your pants down a little Irkle.

So you have APT, what do you do about it?  A few simple stretches and exercises performed as part of your warm-up or as a separate routine on your off days can go a long way.  I don’t like prescribing reps, so do as many as you can with good form for 45 to 60 seconds.  These are the main areas you should focus on and why.
pelvic tilt2
Hip flexors – allows the top of the pelvis to tilt back into place.

  • Lunges with long strides.  Lower yourself until your back knee touches the ground, relax your back leg, move forward an inch or so to lengthen the stretch, then return to the starting position.  Be sure to keep your torso upright throughout the entire movement.
  • Twisting lunges.  While performing a lunge, if your left leg is forward, twist your torso to the left.  This stretches the right leg’s hip flexors.

Abs – pulls the bottom of your pelvis forward.
  • Hanging leg raises.  Hang from a chinup bar, keep your torso stable, and raise your legs.  Beginners should keep their knees bent.  If you’re a little further along in your training, try to keep your legs straight.
  • Front planks.  Assume a pushup position, but instead of being on your hands and toes, position yourself on your elbows and toes.  Keep your head up, and hold this position for time.  If you can’t hold it for 45 seconds, hold as long as you can.  Eventually, work your way up to 2 minutes.
  • Side planks.  Like a front plank, but on your side.  Your weight will be on one elbow and the outside edge of your foot.  Same rules apply here as the front plank.  Hold for time, then switch sides.

Glutes – pulls the top of the pelvis back
  • Glute bridges.  Lay flat on your back with your knees bent.  Using a yoga block or small medicine ball placed between your knees, squeeze your knees together, contract your glutes, and raise your glutes/low back off the floor.
  • Bird dogs.  Get on all fours, knees under hips, and hands under your shoulders.  While keeping your torso stable, kick one leg straight back, squeezing the glute at the top of the movement.  Don’t allow your shoulders to shift, and don’t allow your hip to drop.  The only movement should be your leg kicking back.

By doing some or all of these exercises on a daily basis, you should have less low back pain, better lower limb positioning (as evidenced by the wear on your shoes), and most importantly, lose that gut!  Well, that is assuming you don’t have a bunch of fat around your midsection, but that’s another article.

Happy lifting!

For resources and more information: [picture1]; [picture2]


42 Responses to “Losing your gut… Anterior Pelvic Tilt” (Leave a reply)
  1. mark from Dublin, Ireland said:

    Hi,

    I have an anterior tilt on the right hand side, but I think I did the original injury when I was 19 and now I’m 33. So I suppose I’ve allowed it to get worse over time. I am actually fairly fit but this prevents me from getting really fit. I have no idea about who to go to for advise about this in Ireland (or further afield).

    How can i find out what the right excercises for me would be to get over this issue?

    Thanks in advance for your help.

    Mark.

  2. Mark,
    I am a physical therapist and would be happy to help you with this problem.  But, I need to know more information.
    How do you know you have anterior tilt?  Have you seen a medical professional for this?  What was the original injury?  In what way does it prevent you from getting fit?
    If you prefer, you can email me directly ...
    Thanks,
    Julie

  3. shayne said:

    Hi, I am a former amateur bodybuilder who started having “alignment” issues 3 years ago which ended my bb career. I slowly started losing muscle and the great symmetry that I was used to my body having. Every doctor I saw just wrote me a referral to a different chiropractor who would ask me “where’s it hurt?”.  When I told them I had no pain they didnt do much else for me. After researching on line for years I now realize that I have an APT which has lead to all my upper body imbalances. What is the best type of specialist I can see to help me rehab my body back into alignment? I greatly appreciate your help! -Shayne

  4. Shayne,
    Unfortunately, not all alignment issues can be corrected through manipulation (the snapping and cracking that chiropracters do), some of it needs to be purposeful, conscious change in postural habits.  My advice would be to see a qualified physical therapist, preferably someone well-versed in weight-lifting.  You need someone to give you corrective exercise to restore proper postural alignment, and then exercises to rebuild your body.  You also want someone with some experience designing fitness programs, so that you don’t end up with another muscle imbalance.
    If you need help finding a specific therapist, or want more information, feel free to email me at

  5. Eddy M from Hong Kong said:

    Are there any exercises to avoid while you are trying to correct APT? 

    For example, shoulder dumbbell raises may put stress on the spine, causing arching of the lower back? 

    Also, would squats be a more effective exercise to strengthen glutes?

    Ed

  6. Well, as usual, it depends!

    If you have good gluteal activation and are well on your way knowing where pelvic neutral is, something like dumbbell raises can be a good stabilization exercise.  You need to be in neutral to start, and focus on staying in neutral while doing the raises.  You will be retraining your brain and body to keep your pelvis in a neutral, non-anterior tilted position.

    As for strengthening the glutes, again it depends.  If the glutes aren’t firing properly (lazy glutes) then you need to get them working again.  For this, I prefer supine hip extensions, progressing from double to single and then on a stability ball and then with a leg curl.  Once someone has good gluteal activation, then I think moving toward pull-throughs, Romanian deadlifts (double and single leg), kettlebell or dumbbell swings, Good Mornings, conventional deadlifts, and back squats is a good progression.  Squats wouldn’t be my first choice though until someone has good gluteal activation as it is too easy to “cheat” and use other muscles, like the quads and back extensors, which would exacerbate an APT.

  7. Joe from Washington State said:

    Great article, and I have been doing psoas stretches religiously for about three months, but I haven’t seen any results. My chiropractor says I have good posture, but my back sways in so badly. I have had this sway back since childhood, and I’ve always been told it is hereditary. Now I’m 25 and trying fix it. My back tends to tense up a lot though, which I think my sway back plays a part in. It really gets kind of annoying when people are always mention how I walk like a girl, or that my butt really sticks out. So, I’m trying to fix this, can anyone tell me what I may be doing wrong? I would like to get this corrected.

  8. Denise Shand from UK said:

    In 2004 I ruptured my TFL muscle and the tendon part of my rectus femoris distal to the reflected head.  Neither were treated.  This article has just salvaged me from beling I was insane!

    The right side of my pelvis is higher, my leg is externally rotated when I lie down and now when I walk it is internally rotated.  If I try and hurry I feel myself lunging forward.  The pain in my groin, TFL area, pelvis and hip are that bad, that I struggle every day.  Oh, yes and the lower back as well.

    I just wish someone would help me, it is so cruel.  I’m no spring chicken and need to get my life back.  My house and pension has long gone in supporting myself, so now I’m trying to sell everything I can.

    Any serious offers of advice/help please?

    Thank you so much.  Kind Regards
    Denise.

  9. hey hey from Australia said:

    hey, Im a student studying soft tissue therapies. as part of an assignment i am to treat a cl who has presented with a APT and an old 80% tear in rec fem approx an inch above the superior patellar tendon(occurred one year ago). i was wondering if you could give me a few promts or things to think about for my cl’s treatment. so far i am trp psoas, QL, hamstrings, gluts etc, and using PNF to stretch quads, and using PNF spiral diagonals to help strengthen gluts, hamstrings and psoas. do you think i am on the right tract?what els should i think about? and in what ways may the quad tear affect an APT?

  10. Paul from London said:

    Great article.

    Do you have any evidence of how long it takes for an anterior tilt to be corrected?

    On picture 2 I think you have the tilts labeled incorrectly.

  11. RH302 from Indiana said:

    I want to correct ATP as well as I also have anterior tilt .How I can control on these problems.I do lot of exercise but failed.Any body can suggest any good exercise for it.I would be thankful to you.

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  15. Stacey from Ventura. Calif. said:

    Hi,

    I believe I may have anterior pelvic tilt. I have really gotten into working out over the past 18 months and have lost a great deal of weight (70 pounds, maybe more).

    I eat right (none to few processed foods, small meals five times a day, etc.)

    I noticed there was an issue because my stomach, from a few inches below my rib cage all the way down to the base of my pelvis (in the shape of the abdominal muscles, otherwise) is hard but round.

    There is still a thin layer of fat over this area, but the muscle beneath is quite hard. It isn’t too much of a concern when I am standing, but when I lie down, my lower stomach seems to bulge quite a bit.

    It’s very symmetrical and hard, which leads me to believe that it’s muscle, and I have no symptoms of any issues concerning my reporductive organs, gastrointenstinal system, etc.

    So my question is: Is it common for your stomach to stick out (mine is like a hard little ball) with APT?

    I am pretty freaked out. : )

    Thanks,
    Stacey

  16. tokyoshouju said:

    professional for this?  What was the original injury?  In what way does it prevent you from getting fit?

  17. Nicolas from Australia said:

    Hi,

    I am a 25 year old young man. I’ve always been thin. Currently, I have a great deal of lean muscle mass - (I’m sitting at approximately 12% body fat, which is quite low).

    However, when I ‘relax’ my posture (ie: disengage my core muscles), I look like a pregnant man. I’ve been told my one person I have kyphosis, another lordosis - however , I’m quite sure that I have anterior pelvic tilt as well as improper spinal curvature.

    My posture and spinal curvature symptoms - for the most - are quite well managed and getting better; however, I’m wanting to correct my ‘Pregnant Male’ look .... it’s an embarrassing one to have.

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  22. Kim from Sarasota, FL said:

    Hello!

    I have been a long time suffere of APT, but after becoming a licensed massage therapist, I have begun to change my posture and I don’t have the pain I lived with for so long.
    My problem started when I moved from Colorado and into Florida.

    I can suggest to everyone going through this to get regular massage, preferably myofacial or someone who specializes in postural analysis. They’ll work on the specific areas and help lengthen the muscles involved.  Stengthening and stretching are also ways to help yourself at home. Get a full length mirror and check your posture continuosly. You must be conscious of how you hold your body. Flex the lower abs and squeeze your glutes when you walk or stand.

    To add in, climbing is one of the best ways to strengthen lower abs, glutes and adductors. Hence why my problem really started after moving into a flat terrain.

    Cheers!
    ~Kim~

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