The pelvis is the foundation of our body and its stability directly impacts our posture and movement patterns. Unfortunately, many people are unaware of a common issue known as pelvic tilt, which can lead to instability in the pelvis and, in turn, pelvic floor dysfunction. In this blog post, we’ll break down what a pelvic tilt is, how it contributes to pelvic instability, and most importantly, how to correct it.

What Is a Pelvic Tilt?

The pelvis is a bowl-like structure made up of several bones that come together to support your spine, organs, and the rest of your body. Its stability is directly influenced by what is connected to it. Which is the spine and lower extremities at the hip joints. The alignment of its own parts namely the sacrum and ileum, and our breathing which influences the overall posture have an impact as well.

Ideally, the pelvis should be in a neutral position. Meaning it is balanced and doesn’t tilt forward or backward excessively. However, due to various factors like poor posture, muscle imbalances, lifestyle choices, and injury, the pelvis can become misaligned. This leads to what’s known as a pelvic tilt. Misalignment is not something that is easily corrected by an adjustment. But by the combination of adjustment and corrective, functional movement exercises that instill the stable position to be a permanent fixture by learning how to sustain them!

What Are The Different Types of Pelvic Tilt?

There are different types of tilt in 3 planes: forward/backward tilt, side-to-side tilt, and rotational tilt. In this blog, we will explore the 2 common types of pelvic tilt that occur.

  • Anterior Pelvic Tilt:

This is when the pelvis tilts forward, causing the lower back to arch excessively. It’s often associated with tight hip flexors and weak gluteal muscles but the imbalance does not stop there!

  • Posterior Pelvic Tilt:

Posterior pelvic tilt is when the pelvis tilts backward, resulting in a flat lower back. Most often, the whole body is shifted in front of the ankles as shown in the video below. A posterior pelvic tilt can be caused by tight hamstrings and weak abdominal muscles. But the solution is NOT to stretch the hamstrings or do abdominal crunches! Our go-to type of exercise for all types of pelvic tilt is the developmental movement exercises inspired by studying babies’ move.

What Is The Connection Between a Pelvic Tilt & Pelvic Floor Dysfunction?

Pelvic floor dysfunction has to do with the pelvis and that includes its floor. Concentrating on the floor of the pelvis and disregarding the pelvis alignment always leads to the return of the symptoms. In fact, we need to stabilize the house (pelvis) that the pelvic floor is the floor of, first. There are many factors contributing to pelvic floor dysfunction and I strongly recommend you visit my blog which discusses the subtle signs of pelvic floor dysfunction that most often get missed.

Pelvic tilt and pelvic floor dysfunction relationship failure happens in 2 steps:

  • Dysfunctional movement patterns:

We all move but the quality of movement is the deal maker or breaker! Except for certain genetic conditions, dysfunctional patterns of movement start with deviation from what we innately learned to do. Which is going from the helpless infant stage to the running toddler stage automatically! This happens from injuries, lifestyle choices, and habits. The blueprint of movement adapts itself to the ‘new’ request/command and once that happens, the automatic movements become dysfunctional. This is the whole focus of the correction at our clinic that produces repeated successful results in stabilizing the pelvis and posture while removing the symptoms of our patients.

  • Pelvic Instability:

Pelvic instability can manifest as pain, discomfort, or reduced functionality. It can also affect your posture and how you move, potentially leading to issues like lower back pain and hip problems.

How To Correct a Pelvic Tilt

Most pelvic tilt presentations are fully correctable as long as there is no structural damage. Even in those instances, the level of dysfunction can be kept minimally with the right types of exercises. Here are the steps to follow:

  • Awareness:

The first step is recognizing that you may have a pelvic tilt issue. At first, pay attention to your posture! If you notice that you arch your lower back excessively or your pelvis is tucked under, it’s a sign that you might have a pelvic tilt. Secondly, pay attention to your feet and ankles. Are you stacked on top of your ankles, or leaned forward or backward? Third, pay attention to your stand-up posture. Are you slouched or sticking your chest out?

  • Breathing:

That is the first and number one step toward correction. Almost everyone breathes incorrectly. Watch this video to see where you stand and if you need to work on it. Use the video as a guide to practice. I recommend 3 correct breaths first thing in the morning before getting out of bed and at night before falling asleep. I recommend my patients to do it on the floor if they can and in a lying down position.

  • Core:

If you think your core is between your abdominal diaphragm and your pubic bone, you are in for a surprise!! Your core is your whole trunk!!! Your whole trunk, front, back, and sides need to ‘dance’ as one unit and know how and when to disconnect. This happens innately until we become dysfunctional. Once that happens, you have a modified blueprint of movement and since it is an alteration from the perfect design, the result is not optimal.

Need Help Fixing Your Pelvic Tilt?

After over 3 decades of being in practice, I have concluded that so far, the one type of exercise that has produced the best results and makes sense is those learned by studying babies. You won’t see babies do ab. crunches or have a leg day. You won’t see them do shoulder presses or deadlifts to strengthen and yet all of us have graduated from being helpless infants to running toddlers. It only makes sense to learn from nature and become diligent in our mindfulness if we are serious about our health, postural stability, and functional movement.

This baby is doing both a regular plank and side plank to strengthen the hip stabilizers in preparation to start walking. These patterns of movement are no secret and are well studied; it only makes sense to not re-invent the wheels and only duplicate what we KNOW to produce success.

Baby doing both push up

  • How to seek the right provider?

Not every clinician and rehab provider has the same style and treatment protocol; we all have our preferences accumulated over time. While it only makes sense to assume a clinician with the most experience should produce better results, it is not uncommon to see veteran clinicians that are set in their ‘old’ ways and not up to date. My suggestion is to:

  • Search on the web
  • Study the potential provider’s website to understand what they do
  • Study their reviews including the negative ones; repeated negative comments of the same nature should give you an idea
  • Contact the office and talk to the person answering the phone and trust your gut feeling
  • See if you can meet with the provider for a short time and again
  • Trust your feeling

If you have pelvic tilt with or without pelvic floor dysfunction symptoms and are seeking help, do not hesitate to contact me.

Dr. Shakib

Recommended Reading:

How to Tell if You Have Pelvic Floor Dysfunction?

Understanding Pelvic Pain in Men: Beyond Prostatitis