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Monday, 18 October 2010

The Problems with Anterior Pelvic Tilt


So What is Anterior Pelvic Tilt?

Well if you imagine your pelvis is a bucket of water and if your pouring water onto your toes, you are anteriorly tilted and if your pouring water onto your heels you are posteriorly tilted. Often people with lower back pain will have an anterior pelvic tilt and this can be because as your pelvis tilts forwards you are also increasing your lumbar extension (lordosis) putting lots of pressure through your spine. 


Vladimir Janda categorized this form of dysfunction as 'lower crossed sydnrome' and said it was often coupled with 'swayback', weak abdominals and increased lumbar lordosis.  The muscular weaknesses observed in this condition are detailed in the table below:


Tight 

Iliacus and Psoas 

Rectus Femoris 

TFL 

Adductor Group   

Errector Spinae   

Gastrocnemius,Soleus 


Weak/Inhibited 

Rectus Abdominis

Oblique

Gluteus medius

Gluteus maximus 

Hamstrings



Also the stress at L5/S1 due to this syndrome can also cause problems with the sacroiliac joint and knee.  Piriformis syndrome can also be implicated which occurs when the piriformis muscle gets tight and/or spasms, which causes the sciatic nerve to become irritated, literally causing a 'pain in the bum' and or down the back of the leg and  into the back.


So how do we fix this common problem in athletes?


Well firstly we need to address the soft tissue problems associated with lower crossed syndrome and these may include muscular adhesions, trigger points and active release at glute medius, TFL, iliopsoas and sacro-tuberous ligament.  Once we have done this we can progress into a stretching and strengthening routine addressing the problems listed in the table above. 



However when we have identified a condition like this it is important to realise that we cant just have all our soft tissue work done, then stretch and think that we have addressed the problem. It is important that posture is looked at and athletes actively try to change their posture by retraining and in this case strengthening the rectus abdominis is crucial.  A favourite exercise of mine for this is Gray Cook's curl up which when done correctly is excellent.





 


 



 

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