Anterior Pelvic Tilt Or Shift? Why It Matters for Pain and Posture

The anterior pelvic tilt is one of the most demonized things, and hottest topics found in modern training today. Everyone and their mother seems to have an anterior pelvic tilt, and blame it for contributing to their pain and injury problems. We get countless clients who self report having this issue, and while it can be problematic in some, people are often led astray in their understanding of this problem. Like everything context matters, and what is actually present in a lot of cases is an anterior pelvic shift.

Tilt vs Shift?

First lets establish the difference between these two terms. A pelvic Tilt is a rotation of the pelvis either towards the front of the body (anterior) or towards the back of the body (posterior). Imagine a skewer going from the side of one hip to the other, or that your pelvis is a chicken on a rotisserie.  When it comes to tilting the pelvis, it should be assumed that the skewer itself doesn’t move in space as the chicken rotates around it.

A pelvic Shift is a shift of the whole skewer. This can be either to the front of the body (anterior), behind the body (posterior), or to the side (lateral). Again, for the sake of understanding we need to be able to differentiate one from the other. Many times tilts and shift present together and can be hard to separate, but there is a few good ways to help you spot the difference.

Spotting The Difference

A good indicator for pelvic tilting is someone’s waistband of their pants or shorts. If they are dropped towards the front this can indicate an anterior pelvic tilt. This is much more common than resting in a posterior tilt which would see the waistband raised at sit higher at front than the back.

A good way to spot an anterior pelvic shift is to draw a line up from the ankle bones to the hip joint itself. If the hip joint sits in front of the ankle bones and the legs are not vertically stacked, an anterior shift is present. This may also present with the belly being pushed forward and poor abdominal pressure.

Many times someone can have an anterior pelvic tilt and shift, but a lot of times it is mostly a shift, and when this is corrected relatively the pelvic tilt is no longer a problem. As a rule of thumb, always address the shifting first as it will likely relatively influence the tilt. Trying to posterior tilt your way out of an anterior shift will be futile.

Understanding Pelvic Positioning

Think of your pelvis and it’s potential tilts and shifts like the gears in your car. When driving at a certain speed, you need to make sure you are in the correct gear. It’s not wise to be in second gear while moving 100km/hour, just like the car will likely cut out if you attempt to pull out in forth gear.

Context matters greatly here, so for this reason one tilt or the other should never be demonized. It’s wrong to assume that you are “stuck” in one tilt and absolutely must always position yourself in the opposite. You need to understand where the rest of your body is and how this effects your pelvis in real time in order to make sure you are in the right gear.

For example, the gear or position required at the bottom of a squat vs standing will be different. Find yourself in the wrong gear at the wrong time and you can easily put pressure on your back and cause pain. Being in the wrong gear can also inhibit certain muscles from working and providing support to your joints.

This can be why people often report problems when trying to bend forward, sitting in their cars, or getting up off a chair. Momentarily the pelvis finds itself in the wrong gear. If you are constantly in the wrong gear then chronic or long term pain may result.

The Solution

Getting properly assessed is a great starting point in order to understand how your pelvis likes to behave. At Functional Patterns Dublin we do a postural analysis during our first session and help clients understand where their pelvis, and entire structure is spending most of it’s time.

We then begin to teach clients where their pelvis should be in certain scenarios so that they can find the right gear and position themselves appropriately. It’s also important to understand that certain exercises even though well intentioned, may actually be putting your pelvis into the wrong position and compounding issues in the area.

The general assumption is that we all suffer from an anterior pelvic tilt so are advised to do pelvic flattening exercises in order to combat the problem. As we discussed above, this assumption can be incorrect and actually in an attempt to improve the situation we can muddle it even further.

Conclusion

Before you totally demonize the anterior pelvic tilt, first understand the potential pitfalls of making this assumption. Learn about the full spectrum of pelvic movement and where you sit on it by getting properly assessed. Do exercises that help you find the right position or “gear” for your pelvis depending on many different scenarios. If you want more help understanding this or want to get assessed by our team reach out today and get started!