Pelvic Tilt

Pelvic tilt happens when your pelvis tips further forward or backward than it should.

It’s OK if your pelvis isn’t perfectly level all the time. It moves with you throughout your day. But if you have excessive pelvic tilt, your pelvis will consistently tip too far in one direction, far enough away from neutral that it starts to cause pain or other symptoms.

Types of pelvic tilt

Healthcare providers classify pelvic tilt into two types. It depends on which direction your pelvis tilts:

• Anterior pelvic tilt: Anterior means toward the front of your body. This happens when your pelvis tips further down, more toward your toes than normal.
• Posterior pelvic tilt: This is the opposite of anterior. Posterior means toward the back of your body. Your pelvis tips backward, which lifts its front too far up.

Symptoms of pelvic tilt

You might not have any symptoms of pelvic tilt if it’s mild. But if your pelvis tips out of alignment for too long or too often, you might notice pain or discomfort in the muscles and other tissues around it. This commonly turns into back pain — especially lower back pain.

Excessive pelvic tilts may noticeably change your posture, especially when you’re standing straight. There’s no such thing as perfect posture. And it’s OK if you don’t stand or sit perfectly straight all the time.

But if you have anterior pelvic tilt, your butt will stick out, and your low back will arch because your pelvis is tipped forward. Posterior pelvic tilt can make your tailbone tuck under and low back flatten because your pelvis is tipped back too far.

Pelvic tilt causes

Spending a lot of time in the same position is the most common cause of excessive pelvic tilt. Especially if you spend a lot of time sitting down.

You won’t develop pelvic tilt from one long gaming session or a movie marathon over the weekend. But your body will naturally adjust the angle of your pelvis over time if you spend days and days in the same kind of position. Sitting at a desk every day for work is one very common reason you may develop it.

Our bodies are very adaptable. Normally, this is a good thing. But sometimes, your body will change too much. If you sit a lot, muscles in your legs, abdomen and butt adjust to this.

Sitting a lot can also weaken the muscles around your pelvis, including your:

• Glutes
• Hamstrings
• Hip flexors
• Abs

Normally, these muscles work together to help you maintain a stable, comfortable posture. But over time, they can weaken if you don’t use them often enough. As they lose strength or flexibility, they can’t hold your pelvis straight. And this can let it tilt forward or backward.

How doctors diagnose this condition

A healthcare provider can diagnose excessive pelvic tilt with a physical exam. They’ll ask about your health history and how you spend most of your time. Your provider can check your pelvic tilt by looking at your pelvis while you stand straight.

If they need to get a more specific measurement, they can check your pelvic angle. This is a quick, easy test that will let your provider know exactly how far in either direction your pelvis tilts. They’ll use either a physical or electronic device that measures the front and back of your pelvis, and if they’re out of alignment. It’s a bit like a level you’d use to hang a picture up. Instead of lining up the air bubble in the level, the device measures the difference in incline from front to back of your pelvis.

Your provider may order X-rays or other imaging tests to take pictures of your pelvis and the tissue around it. But this isn’t always needed.

How is it treated?

Your provider may suggest you work with a physical therapist. They’ll give you customized stretches and exercises to help you manage excessive pelvic tilt.

Usually, strengthening weak muscles and stretching tight ones will help correct pelvic tilt. The stronger and more stable these muscles are, the better they’ll be able to hold your pelvis in a neutral position.

Talk to your physical therapist about your daily routine. Tell them what you do for work, or if you spend a lot of time sitting. Let them know the kinds of physical activities and hobbies you do. There’s no right or wrong answer. But knowing what you do can help them suggest the best kinds of pelvic tilt exercises for you.

It’s rare, but your provider may suggest surgery to correct a severe pelvic tilt. This is usually only if physical therapy doesn’t help and you still have intense pain. Or if the tilt is severe enough that it’s damaging joints in your spine or hips.

When should I see my healthcare provider?

Visit a healthcare provider if you have pain that lasts for more than a few days in a row. Back pain is extremely common. And lots of issues can cause it. But that doesn’t mean you have to live with it. See a provider if you’re in pain more often than not, especially if it’s bad enough to make you change or avoid some parts of your daily routine.

What can I expect if I have excessive pelvic tilt?

You might have to make some small tweaks to your posture when you’re sitting. But you should notice less pain and discomfort as you strengthen the muscles around your pelvis.

Your healthcare provider will tell you what to expect if you need surgery to repair a pelvic tilt. They’ll give you a recovery timeline that matches your unique needs.

Remember, there’s no such thing as perfect or imperfect posture. Everyone’s body is slightly different. Try not to stress about your pelvic angle. Even if it’s causing symptoms, it’s correctable.