Anterior pelvic tilt: it’s that SCARY angle formed between the heights of two bony landmarks in your iliac crest.
A lot of health, exercise and rehabilitation professionals (myself included…just not anymore) will try to assess this through touch/measurement as a potential indicator of increased lumbar lordosis (more arch in your lower back) and extrapolate this to be linked with lower back pain. It all sounds fine & dandy, but unfortunately when those kinds of biomechanical ‘connect-the- dot’ claims are stacked up against the available literature, they simply don’t hold up. (Nourbakhsh 2002, Laird 2014). Believe me sometimes I wish they did! What a cinch it would be to hunt around for pelvic tilts in all my back pain patients, correct them, and voila, pain gone. Unfortunately it’s never that easy, for more reasons than I care to mention.
However, let’s say hypothetically anterior pelvic tilt was a causal link in people with lower back pain. How would you explain the fact that the vast majority of people WITHOUT any back pain already have an anterior pelvic tilt (Herrington, 2011). Doesn’t add up, does it? The fact is, most acute episodes of lower back pain aren’t very serious.
So what did we learn from this very short post?
• Anterior pelvic tilt is normal. If you DON’T have it you’re the oddball.
• You probably DON’T need to correct it if back pain is your problem. (Now this is not to say that improving mobility of the pelvis has no usefulness at all—for instance, in some people more movement options of the pelvis might serve as a way to get away from painful back movements/positions—it always depends. But this doesn’t mean that a tilted pelvis somehow created back pain, that’s silly).
• Anterior pelvic tilt does NOT have any convincing link with back pain, or at least the jury is still out on that one.
As always. Don’t sit still. Make moves.
Nick Hannah, PT
Build to Perform.
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Nourbakhsh M, Arab A. Relationship between mechanical factors and incidence of low back pain. JOSPT. 2002 Sept 32(9):447-460.
Laird R et al. Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review & meta-analysis. BMC Musculoskelet Disord. 2014, 15(229):1-13.
Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Man Ther. 2011 Apr 16(6):646-648.