How to Fix Anterior Pelvic Tilt

Addressing this common form of poor posture can lead to less lower back pain.

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If you remember high school biology, you might recall that ATP is the stuff your cells make to keep you going. Well, switch two letters around and you get APT, which can stop you in your tracks.

Woman fixing her anterior pelvic tiltIf your iliac crests point more down than forward, you might have APT.

APT is short for anterior pelvic tilt. Part anatomical feature and part bad habit, APT is when your pelvis tilts more down than forward.

Ai Mukai, MD, a board certified physical medicine and rehabilitation physician at Texas Orthopedics in Austin, Texas, says APT is particularly common in women. Find out more about this type of poor posture, how it can lead to lower back pain, and pinpoint an anterior pelvic tilt fix that might work for you.

What is Anterior Pelvic Tilt?

Anterior pelvic tilt is a clinical term for a pelvis that’s tilted or rotated forward. Put your hands on your hips like your mother used to do when she was mad at you. Feel those bony ridges under your index fingers? Those are your iliac crests, and if they’re facing more toward the ground than directly in front of you, you probably have APT.

It usually happens when your hip flexors are tight and pull your pelvis down, and your glutes and hamstrings are too weak to counteract that forward pulling. Dr. Mukai says that anterior pelvic tilt back pain can be caused by sitting for long periods and regularly wearing high heels—both of which contribute to short, tight hip flexors—as well as weak glutes, hamstrings and core muscles

“APT causes an increase in lordosis, or a curve, of the lower back,” Dr. Mukai explains. “It can feel like the hip flexors are tight.” That can cause you a number of problems.

Affecting the lower back at typically the lowest two levels—L4-5 and L5-S1—there are some potential long-term consequences if you leave your anterior pelvic tilt untreated.

“You can be more vulnerable to disc issues in the lowest lumbar discs,” Dr. Mukai says. “This can include a compressed degenerative disc, disc tears, also known as annular tears, and even disc bulges and herniations.”

That’s why it’s best to see your doctor before attempting to fix anterior pelvic tilt.

Anterior Pelvic Tilt Exercises

Luckily, APT is eminently fixable. There are several anterior pelvic tilt exercises that can help you loosen up your hip flexors and strengthen your core and posterior chain, in addition to walking more and skipping the high heels. Dr. Mukai shares her top exercises for anterior pelvic tilt.

APT Exercise #1: Tail Tuck

Dr. Mukai advises “literally trying to tilt your tailbone forward, like you are tucking in your imaginary tail.” You can do this for 10-12 reps up to 3 times.

APT Exercise #2: Plank

According to Dr. Mukai, this core-strengthening exercise is “better than sit-ups.” She says, “If possible, do it in front of a mirror so you can make sure you're not arcing your back or sticking your butt out. If it's too difficult to do on your hands, you can go down onto your elbows. If you have wrist or shoulder issues, you can also do a plank on a raised surface, like a table or even your couch. Hold as long as you can with good form. You might start at just 10-30 seconds, but you can build up to minutes at a time.”

Woman doing plank to fix anterior pelvic tiltThe simple plank might be the safest and most effective core exercise ever devised. It's great for APT and much more.

APT Exercise #3: Glute Strengthening

To strengthen your glutes, Dr. Mukai recommends doing “clams” or side-stepping with resistance bands. She says, “For clams, lie on your side and raise each leg up and down 10-12 times for up to 3 sets. For side-stepping, put resistance bands around your ankle/shin area and step to the side on one side for 8-10 steps. Then turn and go the other direction for the same number of steps. You can repeat this for up to 3 sets.”

Woman doing band walks to fix anterior pelvic tiltBand walks (pictured) and clam shells are great for glutes.

APT Exercise #4: Glute Bridge

For this move, you’ll want your body to look like a literal bridge. Dr. Mukai says, “Lie on your back and lift your butt up off floor. Make sure your back is flat on the floor when your butt is on the ground. Hold the lift for 3-5 seconds, then slowly lower. You can do 8-10 reps for up to 3 sets.”

Woman doing bridge to fix anterior pelvic tiltGlute bridges can strengthen your posterior chain, which can help counteract tight hip flexors and point your pelvis forward.

APT Exercise #5: Hip Flexor Stretch

Lunge forward while standing or lunge and kneel with your other leg on the ground. “Then move your torso back a little while engaging the core to stretch the hip flexors in the front of the thigh/groin area,” Dr. Mukai says. “Hold for 30 seconds, then release. Repeat 3-5 times per leg.”

Woman stretching hip flexors to fix anterior pelvic tiltHigh lunge (pictured), low lunge, couch stretch, and yoga's Warrior I pose all stretch the hip flexors.

APT Lifestyle Solutions

Try these exercises, but if you don’t see progress in about a month, consider seeking out a qualified physical therapist for further instruction and supervision. And, if you have any neurological symptoms such as sciatica, shooting pain, numbness, tingling, or weakness, see a doctor right away.

Like any posture-related problem, improving anterior pelvic tilt and the pain that comes with it requires a heightened level of awareness about your posture and some lifestyle tweaks. To address anterior pelvic tilt on a regular basis, make sure you stick to good daily habits.

One easy way to do this is to schedule time in your day to do the above exercises or tack them onto a workout. Also, it can be helpful to set reminders in your calendar to get up and move around if you work at a desk all day. These little things can add up to alleviated anterior pelvic tilt and a less-painful back. 

Updated on: 06/24/21
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