What Is a Posterior Pelvic Tilt?

Posterior pelvic tilt is a condition in which the front of the pelvis rises and the back of the pelvis drops, while the pelvis rotates upwards.

The position of your pelvis matters a great deal to your spinal alignment and your low-back health. Posterior pelvic tilt is caused by an imbalance between the core muscles and the leg muscles. It can cause a variety of uncomfortable symptoms, such as tight hamstrings and back pain.

Treatment options may include exercises that target specific muscles, as well as sleep and sitting modifications that provide more lower back support.

This article discusses the causes and symptoms of a posterior pelvic tilt. It also covers treatment, including specific exercises to try, as well as sleep and sitting modification options.

Posterior Pelvic Tilt Causes

A posterior pelvic tilt is caused by the imbalance between the leg muscles and the core muscles. Muscles involved in a posterior pelvic tilt include the glutes, hamstrings, quads, the pelvic floor muscles, abdominal muscles, the diaphragm, and the muscles within the deep layer of your back.

A posterior pelvic tilt can be a long-term condition that may be due to your pelvis or hip anatomy, as well as your daily posture and movement habits, examples of which may include:

• Slouching while standing or sitting
• Sleeping on your stomach
• Lack of movement

These habits can affect the position of the bones that make up the lower back and may also lead to long-term tension and/or weakness in the muscles in that area.

How Do I Know If I Have Posterior Pelvic Tilt?

An excessive backward tilt of the pelvis can negatively impact your posture and lead to associated pain.

Symptoms of posterior pelvic tilt include:

• Appearance of a flat back and tucked glutes
• Slouched posture
• Tightness in your abdominal muscles or hamstrings
• Back pain, tension, or weakness
• Knee or hip pain

How to Fix a Posterior Pelvic Tilt

The pelvis, ribs, and head can be understood as structural units, or building blocks, of good spinal alignment. Aligning them properly is often the first step in attaining strain-free upright posture, as well as addressing symptoms associated with a posterior pelvic tilt. This can be done through:

• Targeted exercises
• Changing your sleeping position
• Making small changes to how you sit

Corrective Exercises

If any posterior pelvic tilt exercises lead to pain, it's best to check in with your healthcare provider or physical therapist before continuing.

Exercises that focus on the back, legs, glutes, and the abdomen can be especially helpful for a posterior pelvic tilt:

Modified Cobra Pose

1. Begin by laying flat on your stomach.
2. Put your forearms on the floor.
3. Move your shoulder blades down your back and open up your chest.
4. Hold for 20 to 30 seconds.

Straight-Leg Raise

1. Begin by lying on your back with legs outstretched.
2. Bend one knee and place the bottom of the foot on the floor.
3. Contract the muscles of the leg that is straight.
4. As you breathe in, lift the straight leg several inches off of the floor and hold for three seconds.
5. Exhale as you release the straight leg back to the floor.
6. Repeat 10 times on each side.
   

Toe Touch

1. Begin by standing with legs spread about shoulder-width apart.
2. Bend forward at the hips and reach for your toes.
3. Your hips should be directly over your feet.
4. Avoid bouncing while you hold your position for 20 seconds.
   

Supported Hip Bridge

1. Begin by lying flat on your back with your arms outstretched and placed next to each side of your body.
2. Bend your knees and plant both feet firmly on the ground.
3. Pressing into your feet, squeeze your glutes and abdominal muscles to slowly lift your hips up.
4. You may place your hands or a yoga block just below your low back curve for additional support.
5. Hold for a few seconds and slowly release.
6. Repeat 10 times.
   

Slouch-Overcorrect

1. Sit in a chair without leaning back for support.
2. Slowly slouch your back forward.
3. Hold in this position for a few seconds, unless you feel any pain. If so, return to sitting upright.
4. Ensure that your feet are planted on the floor.
5. Slowly begin to sit up as straight as possible. Keep in mind this can lead to a slightly strained feeling in your lower back or shoulders.
6. Hold this position for a few seconds.
7. Slowly release into a more relaxed, proper posture. Any strain, if applicable, should be gone.
8. Repeat 10 times.

Sleeping Adjustments

To help support your posture while sleeping:

• Avoid sleeping on your stomach.
• Place a small pillow behind your knees if you sleep on your back.
• Place a pillow between your knees if you sleep on your side.
• Put a rolled towel or small pillow beneath the arch of your back if you sleep on your back.
• Ensure that your pillow and mattress support the natural curve of your spine.

Treating Posterior Pelvic Tilt While Sitting

If you sit often for work or in general, it's important to make sure:

• You are sitting in a chair that allows for proper posture
• The table or desk that you use enables proper posture without any slouching
• You use a pillow for lumbar support, or opt for a chair with this type of support built-in
• You take time to move around and stretch, especially if you tend to sit for long periods of time

Summary

A posterior pelvic tilt is a condition in which the pelvis is tilted backwards, out of its proper position. It is caused by an imbalance between the leg muscles and the core muscles, which can be impacted by your anatomy, daily posture, as well as movement habits.

Symptoms vary, but may include a slouched posture, hamstring tightness, back pain, and more. Treatment often involves exercises that target specific muscles, as well as sleep position and sitting modifications.