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Pelvic tilt is the orientation of the pelvis in respect to the thighbones and the rest of the body. The pelvis can tilt towards the front, back, or either side of the body.
Anterior pelvic tilt and posterior pelvic tilt are very common abnormalities in regard to the orientation of the pelvis.
- Anterior pelvic tilt is when the front of the pelvis drops and the back of the pelvis rises. This happens when the hip flexors shorten and the hip extensors lengthen.
- Posterior pelvic tilt is the opposite, when the front of the pelvis rises and the back of the pelvis drops. This happens when the hip flexors lengthen and the hip extensors shorten, particularly the gluteus maximus which is the primary hyperextensor of the hip.
- Lateral pelvic tilt describes tilting toward either right or left and is associated with scoliosis or people who have legs of different length. It can also happen when one leg is bent while the other remains straight, in that case the bent side's hip can follow the femur as knee lowers towards the ground.
- Left pelvic tilt is when the right side of the pelvis is elevated higher than the left side.
- Right pelvic tilt is when the left side of the pelvis is elevated higher than the right side.
Causes: 1) Anterior pelvic tilt is caused by increased lumbar lordosis and thoracic kyphosis, stretched abdominal muscles, tightened hip flexors. 2) Posterior pelvic tilt is caused by sway back and thoracic kyphosis, stretched flexors and lower abdominal muscles and tightened hamstrings.
Height impact due to anterior pelvic tilt, treatment and balance
Height impact due to anterior pelvic tilt
Anterior pelvic tilt (also known as lordosis, lumbar lordosis and lumbar hyperlordosis) has a noticeable impact on the height of individuals suffering from this medical issue, a height loss of 0.5-2.5 inches is common.
For example, the height loss was measured by measuring the patient while he was standing straight (with exaggerated curves in his upper and lower back) and again after he fixed this issue (with no exaggerated curves), both of these measurements were taken in the morning with a gap of 6 months and the growth plates of the patient were checked to make sure that they were closed to rule out natural growth. The height loss occurs in the torso region and once the person fixes his back, his BMI will reduce since he is taller and his stomach will also appear to be slimmer.
A similar impact has also been noticed in male to female transpeople who have weaker muscles in the lower back due to increased estrogen intake and other such treatments.
However, the cause of height loss in both situations is a little different even though the impact is similar. In the first scenario, it can be due to a genetic condition, trauma to the spine, pregnancy in women or a sedentary lifestyle (sitting too much causes muscle imbalances and is the most common reason for this issue) and in the second scenario, the estrogen weakens the muscles in the area.
Please note that merely slouching doesn't cause height loss even though it may make a person look shorter, slouching may lead to perceived height loss whereas anterior pelvic tilt leads to actual and measured height loss. To make it easier to understand the difference, if a person loses a vertebrae (which is around 2 inches in height) in his spine, it doesn't matter if he slouches or not, he will be shorter regardless of his posture. Anterior pelvic tilt, of course, doesn't make you lose a vertebrae but it bends them in such a way that your spine's vertical height is reduced.
- Stretch these muscles-
- Quadricep muscles
- Do a simple stretch by holding your foot and hold it while you bring it back towards your hips, just google the exercise if you don't get it. Make sure you don't curve your back.
- Hip flexor muscles
- Lunge stretches, make sure your back isn't curved.
- Erector spinae muscles (lower back)
- Hold a sturdy object and sit on your knees while your back is totally flat and rounded. Avoid deadlifts if your form isn't good. Some people have fixed their back by strengthening their back with deadlifts but that's not good for beginners.
- Strengthen these muscles-
- Gluteal muscles (glutes/hips)
- Glute bridge, do this on a mat. Bend your knees and raise your toes to activate your hamstrings.
- Hamstring muscles
- Do simple hamstring curls, raise your toes to activate your hamstrings. Don't put pressure on your back.
- Abdominal muscles
- Planks, half-crunches (but without using the hip flexors, lay down on a mat and bend your knees to isolate your hip flexors).
- To keep balance standing upright with anterior tilt, the spine is hyper-extended with the rectus abdominis lengthening and the erector spinae shortening. This is associated with lumbar lordosis. Lordosis does not always occur with anterior tilt when the weight is borne in other ways, such as when supported by the arms, or when the hips drift backward (posterior femur tilt) or when enough hip flexion occurs that a kyphotic spine can be balanced over an anterior tilted pelvis.
- To keep balance with posterior tilt, the spine is rounded with the rectus abdominis shortened and the erector spinae lengthened. This leads to lumbar kyphosis. Kyphosis does not always occur in tandem with posterior tilt, when the weight is born in other ways, such as on the hands, which can allow a posteriorly tilted pelvis with a neutral or even lordotic spine.
- To keep balance with lateral tilt, rather than remaining upright the femur usually tilts to keep the weight centered over it. This requires a muscular effort by the hip abductors (glutei medii and minimi of either side) to pull the pelvis up onto the femur. Otherwise, the pelvis would drop towards the airborne leg.
- Textbook of Th. Ex./1st. p. 73.
- Goel. Physiotherapy/Vol III. p. 208, 240.