This blog post offers exercises and stretches to help fix a Posterior Pelvic Tilt.

A Posterior Pelvic Tilt is where the pelvis is rotated backwards from the ideal neutral position.

(This pelvis position can be described as having a “tucked tail bone”.)

In This Blog Post:

• Is It Bad?
• Causes
• Muscles Involved
• Tests
• Posterior Pelvic Tilt Exercises

Is A Posterior Pelvic tilt Bad?

No – Having a Posterior Pelvic Tilt is not inherently “bad”.

(There are many people with a Posterior Pelvic Tilt with no symptoms at all!)

However – The potential issues with a Posterior Pelvic Tilt arise when the pelvis habitually gets locked into this position.

The pelvis position can significantly affect the rest of your posture.

As the pelvis tilts backwards, there will be a loss of the natural curve in the Lumbar Spine (Hypolordosis).

Without the natural arch in your lower back, the Lumbar Spine may be predisposed to developing issues such as:

causes

If I were to blame just one thing, I would say: Sitting.

You are either sitting too much and/or sitting with bad posture.

(… And if I were to guess, I would say that you are probably doing both!)

Excessive sitting causes certain muscles that control the position of the pelvis to get tight/overactive and/or weak/inhibited. (See below)

As a result – there is a muscular imbalance around the pelvis region causing a net force to tilt backwards.

Muscles involved

The muscles mentioned below will specifically be addressed in the exercise section of this blog post.

a) Tight and/or Overactive Muscles

(These muscles will benefit from Releases and Stretches.)

b) Weak and/or Elongated Muscles:

(These muscles will benefit from being Activated and Strengthened.)

How can you tell if you have Posterior pelvic tilt?

Here are simple tests that you can perform to see if you have a Posterior Pelvic Tilt.

a) Standing Assessment

Instructions:

• Stand up.
• Place one finger on the Anterior Superior Iliac Spine (ASIS)
  • This is the pointy bone at the front of the pelvis.
• Place another finger on the Posterior Superior Iliac Spine (PSIS).
  • This is the pointy bone at the back of the pelvis.
• Compare the height of these 2 land marks.

(Keep In Mind: Everyone has different shaped and sized “pointy bones”. This can influence the results.)

b) Moving

Pay attention to the curve of your lower back when you are sitting, squatting or picking something off the floor.

If there is a rounding of the lower back, it is very likely that your pelvis is tilting backwards.

(Keep in mind: Rounding your lower back is not inherently a bad thing. However – it may be associated with pain in the lower back in some individuals.)

Posterior pelvic tilt Exercises

Follow these steps to fix your Posterior Pelvic Tilt:

STEP 1: Releases
STEP 2: Stretches
STEP 3: Joint Mobilizations
STEP 4: Improve Hip Rotation
STEP 5: Activate the Inhibited Muscles
STEP 6: Pelvic Tilts
STEP 7: Maintain Neutral Pelvis
STEP 8: Daily Activities
STEP 9: Other Things To Address
STEP 10: Tips

1. Releases

It is important to release the tight muscles that are involved with holding the pelvis in a position of a posterior tilt.

These muscles include:

a) Hamstring

Instructions:

• Sit down on the floor with your leg straight in front of you.
• Place the back of your thigh on top of a foam roller.
• Use your body weight to apply an appropriate amount of pressure into your Hamstrings.
• Roll on top of the foam roller.
• Make sure to cover the entire area between the back of the knee and back of the hip.
• Continue for 2 minutes per side.

b) Gluteal Muscles

Instructions:

• Sit on the floor.
• Place the back of your hip on top of a massage ball.
• Use your body weight to apply an appropriate amount pressure on top of the massage ball.
• Make sure to cover the entire back of the hip.
• Continue for 2 minutes per side.

c) Abdominal (Lower)

Instructions:

• Lie down on your stomach.
• Place a massage ball under the lower abdominal region
• Gently circulate your body weight on top of the ball.
• Be careful not to apply too much pressure.
  • (Do not squash your organs!)
• Use deep breaths to help relax your muscles.
• Continue for 1-2 minutes.

2. Stretches

The next step is to stretch the tight muscles.

a) Hamstring

Instructions:

• Hinge forwards at the hip.
• Maintain the arch in the lower back.
• Stretch the Upper and Lower region of the Hamstrings:
  • Upper: Keep knee in a slightly bent position.
  • Lower: Keep knee in a completely straightened position.
• Aim to feel a stretch in the respective region of your Hamstrings.
• Hold for 60 seconds.
• Alternate legs.

(For more stretches, check out this blog post: Hamstring Stretches.)

b) Gluteal Muscles

Instructions:

• Sit down on a chair.
• Sit up right and keep your lower back arched throughout this stretch.
• Place your ankle on top of the other knee.
• Place your hands on the outer side of the knee.
• Pull this knee towards the opposite shoulder.
• Lean your torso slightly forwards.
• Aim to feel a stretch in the back of the hip.
• Hold for 60 seconds.
• Alternate sides.

c) Abdominal

Instructions:

• Lie down on your stomach.
• Place hands on floor directly under shoulders.
• Straighten your elbows.
• Keep your leg completely relaxed.
• Arch backwards.
  • Be careful if you have lower back issues.
• Aim to feel a stretch across your lower abdominal region.
• Breathe and expand your stomach as you stretch.
• Hold for 60 seconds.

(If you would like to see more stretches to the stomach region, check out this post: Abdominal Stretches.)

d) Posterior Capsule

Instructions:

• Assume the position as seen above.
• Make sure your knee is directly underneath your hip joint.
• Maintain the lower back arch throughout movement.
• Push your hips backwards.
• Feel a deep stretch in the back of your hip.
• Hold for 60 seconds.

3. Joint mobilization

Tight hip joints can make it very difficult to maintain a neutral pelvic alignment.

Here are a few ways you can reduce stiffness in the hip joints.

a) Hip Traction (Leg Straight)

(You will need a helper with this technique.)

Instructions:

• Lie down on the floor.
• Instruct a helper to firmly grasp your ankle. (See above)
• Relax your leg as your helper pulls your foot away from you.
• Aim to feel a pulling sensation in the hip.
• Hold for 30 seconds.

b) Hip Traction (Leg Bent)

Instructions:

• Lie on the floor in the position as shown.
• Anchor a thick resistance band to a stationary object.
• Flex your hip to 90 degrees.
• Wrap the resistance band as high up into the hip crease as possible.
• Move your whole body further away from the anchor point.
  • This to create tension on the band.
• Hold onto your knee with your hands.
• Keep the hip completely relaxed.
• Hold for 1-2 minutes.
• Alternate sides.

4. Improve Hip External Rotation

Hip External Rotation is the movement where the upper leg bone (Femur) rotates outwards within the hip socket.

If you do not have an adequate amount of external rotation in the hip, it may limit one’s ability to get the pelvis into a more neutral position.

For a full guide on how to increase external rotation in the hip:

See Post: How To Increase Hip External Rotation

To get you started, perform the following 3 exercises:

a) Butterfly Stretch (Lying Down)

Instructions:

• Lie down on your back.
• Place the bottom of your feet together.
• Bring both feet closer to your body.
• Allow your knees to lower towards the floor.
• Relax your legs completely.
• Aim to feel a stretch in the groin muscles.
• Hold for 30 seconds.

b) Supine Hip External Rotation

Instructions:

• Lie down on your back.
• Pivot your leg outwards.
• Keep your pelvis completely still as you move your leg.
• Aim to feel a muscular contraction in the back of the hip.
• Hold for 2-3 seconds.
• Perform 20 repetitions.

c) Prone Hip External Rotation

Instructions:

• Attach a resistance band around the ankle and anchor the other end to an immovable object.
• Lie down on your stomach.
• Bend your knee to 90 degrees.
• Move your body away from the anchor point to create a suitable amount of tension on the resistance band.
• Pivot your leg inwards.
• Do not move your pelvis.
• Aim to feel a muscular contraction in the back of the hip.
• Hold for 2-3 seconds.
• Perform 20 repetitions.

5. Activate the inhibited muscles

The muscles that are responsible for reversing the Posterior Pelvic Tilt need to be activated.. Wake up your sleeping muscles!

a) Hip Flexor Activation

Instructions:

• Lie down on your back.
• Tilt your pelvis forwards.
• Maintain the arch in your lower back throughout this exercise.
• Lift your knee up.
• Do not let your pelvis rotate backwards.
• Place your hands on top of the knee.
• Push your knees against your hands.
• Hold for 5 seconds.
• Alternate for 10 repetitions each side.

b) Lower Back Activation

Instructions:

• Lie on your stomach.
• Stretch out your arms in front of you.
• Lift your upper body and legs high off the floor.
• Aim to feel a contraction of the muscles in your lower back.
• Hold for 5-10 seconds.
• Repeat 10 times.

6. Pelvic Tilts

The next step is to learn how to tilt your pelvis forwards.

a) Pelvic Tilt (In 4 Point Kneel)

Instructions:

• Assume 4 point kneel position.
• Arch your lower back as you tilt your pelvis forwards.
• Aim to feel a contraction in the muscles of the lower back.
• Hold for 5 seconds.
• Return to neutral spine.
• Repeat 30 times.

b) Pelvic Tilts (In Sitting)

Instructions:

• Sit on the edge of a chair.
• Sit upright. Think long and tall throughout the spine.
• Proceed to tilt the pelvis forward.
• Aim to feel a contraction in the muscles of the lower back.
• Hold for 5 seconds.
• Repeat 30 times.

c) Standing Pelvic Tilts

Instructions:

• Stand up right.
• Tilt your pelvis forwards.
• Try not to move your torso or legs as you are moving your pelvis.
• Repeat 20 times.

7. Maintain Neutral Pelvis

In this section – The aim is to keep a neutral pelvis whilst performing the following movements.

a) Hip Flexion with Neutral Pelvis

Instructions:

• Assume the position as seen above.
• Make sure that your pelvis is in a neutral position.
• Engage your core muscles.
  • Think about drawing your belly button in and gently tensing your abdominal muscles.
• Lift your knee forwards whilst maintaining a slight arch in your lower back.
• Hold for 5 seconds.
• Repeat 20 times.
• Alternate legs.

b) Hip Bridge

Instructions:

• Rest your back on the edge of a chair.
• Maintain the arch in your lower back throughout this exercise.
• Drive your hips upwards.
• Hold for 2 seconds.
• Perform 20 repetitions.

c) Sitting Knee Lift

Instructions:

• Sit up right on the edge of a chair.
• Maintain the arch in your lower back throughout this exercise.
• Lift your knee as high as possible without rounding your lower back.
• Do not lean backwards.
• Repeat 20 times.

d) Knee Lift (Standing)

Instructions:

• Stand upright.
• Place your foot onto a block at knee height.
• Maintain the arch in your lower back throughout this exercise.
• Lift your knee as high as possible without rounding your lower back.
• Do not lean backwards as you lift your knee up.
• Repeat 20 times.

8. Daily Activities

You can perform all the above exercises, BUT… if you do not apply it to the positions you adopt throughout most of the day, then your Posterior Pelvic Tilt may continue to exist.

Since your pelvis has been in this position for some time now, your body is going to try and go back to it as a default setting. You need to resist this!

Be aware of your pelvis position.

Maintain a neutral pelvis throughout the following positions:

a) Sitting

“Sit on your sit bones”

Instructions:

• Sit down on a chair.
• Place your hands underneath each buttock cheek.
• Tilt your pelvis forwards and backwards.
• Feel for a pointy bone prominence under your hips.
  • These are referred to as your “Sit Bones”.

(Most people will tend to let their tail bone tuck underneath and sit behind the sit bones.)

b) Hip Hinge (aka bending forward)

Instructions:

• From a standing position, hinge forward from the hips.
• Make sure to maintain the arch in your lower back.
• Only bend forward as far as you can maintain neutral pelvis.
  • Tightness in the hamstring region should be the limiting factor to your movement.
• Repeat 20 times.

(For more exercises, check out this blog post: Hinge Exercises.)

c) Squatting

Instructions:

• Stand sideways to a mirror so that you can monitor the curvature of your spine.
• Practice squatting as deep as you can go.
• Only squat to a depth without letting your lower back round forwards.
• Maintain a neutral pelvis.
• Repeat 20 times.

d) Walking

When walking – be mindful of the position of your pelvis.

If it is comfortable, try to maintain a more neutral pelvis. (… but don’t force it!)

9. Other things to address

If you have tried all of the above exercises and you still have a Posterior Pelvic Tilt, you may need to consider specifically address the following postural issues:

a) Sway Back Posture

The Sway Back Posture is where the pelvis is pushed in front of the vertical line of the ankle.

As a result – the pelvis will tuck under and the torso will “sway back” in the attempt to compensate for the forward shift of the pelvis.

For a detailed guide on how to address this issue:

See Post: Sway Back Posture

b) Flat Back Posture

This is where there is a decrease in the normal curvature of the spine which can be associated with a posterior pelvic tilt.

For a detailed guide on how to address this issue:

See Post: Flat Back Posture

10. tips

Here are some quick tips to help you maintain a more neutral pelvis position throughout the day.

When Sitting:

a) Use a lumbar support

Using a lumbar support on a chair can help maintain the natural curve of the lower back and discourage the pelvis from tipping backwards.

b) Keep hips higher than knees

When sitting – Aim to have the level of your knees slightly lower than your hips.

This will encourage a more neutral pelvis position.

To keep your hips in a relatively higher position:

c) Large Belly Size

If you tend to have a large abdominal region, this will create a physical block between your pelvis and thighs.

This can make it difficult for the pelvis to attain the ideal position whilst sitting.

If you fall into this category, I suggest that you sit from a slightly higher chair so that there is adequate space at the front of the pelvis.

d) Avoid Sitting on Soft Couches

Couches are usually too soft, too low and too deep to provide adequate support for your pelvis.

e) Driving

Adjust your car seat appropriately to ensure you sit with good posture.

When Standing:

a) Do NOT butt/abdominal grip

Avoid overly tensing your gluteal muscles and/or abdominal muscles whilst you are standing. Relax!

b) Do not push your hips forwards

Avoid resting your hips in the forwards position.

This will encourage the pelvis to tilt backwards.

Sleeping Position:

a) How should I sleep to correct Posterior Pelvic Tilt?

If you sleep on your back, place a small rolled up towel underneath the arch of your lower back.

This will help maintain the arch required to keep the pelvis in a more neutral position.

b) Do not sleep on a soft mattress

A soft mattress offers no support to the pelvis and lower back region.

As a result – the pelvis may sink into the bed and place the pelvis in the posterior tilted position.

Aim for a firm (but comfortable) mattress.

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Conclusion

Posterior Pelvic Tilt is where the pelvis is in a rotated backwards position.

Although not inherently harmful, it may predispose you to lower back issues such as Disc Bulges, Sciatica and Muscle strains.

The main cause is likely related to prolonged sitting with poor posture.

To correct the position of the pelvis – perform the recommended exercises mentioned in this blog post to address the muscular imbalances.

Throughout the day, be aware of the position of your pelvis. Correct it as appropriate.

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Disclaimer: The content presented on this blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. It exists for informational purposes only. Use of the content provided on this blog post is at your sole risk. Consult a healthcare professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.