Neutral Hips and Pelvic Tilt

So what is Pelvic Tilt?

The term ‘Pelvic Tilt’ is all about your butt really. Do you stick your butt out or do you tuck it in? Ideally you don’t want to do either if you want to be a runner. I am not going to comment on why you would like to have a tilt as anatomically it is not ideal but aesthetically you may choose to tilt.

To push your butt out or to stick it backwards is an Anterior Pelvic Tilt. To tuck your butt under – common in the way we sit/slouch in a chair – is a Posterior Pelvic Tilt. We can tilt because if we couldn’t it would be impossible to bend over or reach up, but it isn’t a strong position for our body to be in.



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Why do I care?

As technology improves we are living longer and longer. At the moment though, we can’t maintain a head in a jar and so we need to take care of our body and the biggest issue people tend to have as they get older is a bad back. The lowest point of the back connects with our pelvis and so if our pelvic tilt sucks, it puts pressure on our lower back – aka the foundation structure of our spine – and then the whole spine sucks too.

How do I know where my pelvis sits?

Look at yourself side on in a mirrior or better yet, get someone to take a photo of you side on in your most comfortable standing position – not what you think is right but how you would normally stand. If your lower back has a big curve and you have some booty going on then it is possible you have an anterior tilt. If you have a flat lower back then it is possible you have a posterior tilt. You can also then look down at your feet front on in a mirror or by a photo. An anterior tilt causes legs to rotate inward, a posterior tilt rotates legs outward. An anterior tilt goes with a butt sticking out and a belly falling forward. Posterior has belly pulled in and tail tucked under.

Another way to identify a posterior tilt is to sit on the ground with your legs straight and your back against a wall. To get your legs straight and back against the wall, if you need to tuck your tail under, you have a posterior tilt.

A neutral pelvis will have a gentle curve in the lower back.

What is a bad tilt?

As a runner, both posterior and anterior tilts are detrimental to your body and run performance.

Anterior Tilt

Let me introduce you to a term that at the very least will change your thinking on an Anterior Tilt….KKB also known as “Kim Kardashian Butt”….now, this is something that may be a life goal for you and if so then honey, go for that butt! Just don’t be a runner.

Anterior tilt is common in people who have tight hip flexors. This causes the front of your hips to be stuck pulling down or shortening the hip flexors which is a powerhouse of strong running and the result is KKB, lower back pain from impinged discs which in turn may result in sciatica, knee pain from strained ITBs, stretched hammies (which then are useless in power generation assistance for running) and then following down the leg may include calf tears, achillies pain/strain and most of all…..plantar fasciitis.

Tight hip flexors are also common in people who wear high heels as they throw the balance forward which requires the hips to accommodate the leg position and throw the butt back to maintain balance in the body.

Posterior Tilt

Look at how a monkey/ape/gorilla sits on the ground with their butt tucked under. When they stand, it is difficult for them to straighten their spine into a neutral position. It is the same position many of us adopt in an arm chair or if we are slumping while watching TV or sitting at a computer desk for a long time.

In a posterior tilt your hip flexors are weak, hammies are too strong, abs are too strong

How do I change it?

Both Anterior and Posterior tilts can take many many months to rectify but each day you are consciously working on it is one day closer to a strong neutral pelvic position or strong foundation to your spine. The best first step is to see an Exercise Physiologist (EP – or a Physiotherapist if you can’t get to an EP) and have a postural assessment. The EP will work with you on your whole posture and correcting it by stretching and strengthening muscle groups and joints.

For Anterior tilts – if you are sure you have this and know what you are doing, stretching the hip flexors and strengthening hamstrings are a great place to start*.

For Posterior tilts – if you are sure you have this and know what you are doing, stretching the hamstrings, glutes and abs and strengthening hip flexors are a great place to start*.

*Please be smart and seek advice from an allied health professional on this. Many PTs are great with prescribed exercise but not necessarily good at assessing to make an accurate prescription for your whole musculoskeletal structure and given we are talking about your spine being impacted, you really want to get this right. My recommendation is to find an Exercise Physiologist – this is their core business.