Basic postural problems at the hip: anterior pelvic tilt

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A healthy hip is very important for efficient movement, since most of the power athletes display is generated at the hip. Jumping, sprinting or deadlifting: without a strong hip you won’t excel at these activities. If we look at posture the hip is just as important, since many times wrong posture can be traced back to adaptations at the hip. It is therefore only logical to start looking for postural problems at the hip, because many other postural issues will improve automatically, as soon as you “fix” the hip.

Before we delve deeper into postural problems at the hip please make sure you have read the two previous posts on the limitations of stretching in fixing movement and the role of the central nervous system in stretching. These are important aspects to understand and since they’re both very short posts, why not just read them ;-)

How the hip adapts to prolonged sitting

If we sit a lot our hip flexors “shorten” (for sake of simplicity I will stick with this terminology, but you know the truth now). As you can see most of the hip flexors connect the femur either to the hip or to the lower back.

If you have short hip flexors and stand up, your hip flexors will pull on the femur on one end and the hip, as well as the lumbar spine (lower back). This will cause the hip to tilt forward and the lumbar curvature to increase (excessive lordosis). Here is what Tony Gentilcore has to say on anterior pelvic tilt:

“Anterior pelvic tilt leads to hip internal rotation, which results in femoral internal rotation, which then causes tibial internal rotation, leading to, as you might’ve guessed, torque being ‘converted’ through subtalar joint pronation.”

(source tnation.com under ‘Is the Foot Actually the Problem?’)

So basically, anterior pelvic tilt potentially leads to lower back pain, hip pain (because of the rotated femurs), knee pain (because of the knock-knee position) and flat feet. Further up the body anterior pelvic tilt will get you a stronger curvature of the thoracic spine, because otherwise you’d be leaned backwards all the time. That overemphasized kyphosis will put you at risk for neck pain, shoulder pain, headaches and many other fun adventures.

In other words: you don’t want excessive anterior pelvic tilt.

Do you have anterior pelvic tilt?

Before jumping to conclusions you need to know how if you actually have anterior pelvic tilt or whether your pelvic tilt is normal. A certain degree of anterior pelvic tilt is normal in humans and women tend to have more anterior pelvic tilt than men.

One clue is the shape of your spine. The picture on the right depicts a normal spine (A), hyperlordosis (B) with respective anterior pelvic tilt and a flat back (C) with posterior pelvic tilt. You can also directly assess tissue length of the hip flexors by using the Thomas Test:

The Thomas Test

You either need a friend to observe you during this test or you use a video camera like a cellphone or the webcam of your laptop. Just sit on the edge of a table or another stable surface, grab both of your knees and lean back until your back is flat on the surface. Now let go of one leg and extend at the hip until your thigh touches the table.

Good result: your thigh touches the table, the knee is bent and neither hip nor leg rotate or move outward (abduct).

If you need to extend the knee (i.e. straighten it) to touch your thigh to the surface of the table, your rectus femoris is short.

If your thigh cannot touch the table even after you’ve extended your knee, your psoas are short.

If your leg and hip need to move to the outside for the thigh to touch the surface of the table, your tensor fascia latae is short (which means you might also have a tight iliotibial band).

Conclusion

If you look like person B in picture 2 and if you fail the Thomas test you have short hip flexors and are in need of a few corrective drills.

How to fix anterior pelvic tilt

There are several good stretches you can do in order to attack the hip flexors (psoas & rectus femoris, among others). One is what Kelly Starrett calls the “couch stretch”, because you can perform it on your couch in front of the TV (fast forward to around 3:00 if you don’t have time):

If you have the means to do this you can also use a Theraband or another rubber band to add some more tension to the exercise:

If you feel more like moving around you can bust out some walking spidermans with overhead reach. This drill also helps you fix adductor tightness:

With all these drills always remember: keep your abs tight as if bracing for a punch and tense the glutes of the leg you’re stretching. This will help stretch the hip flexors of that leg, since the gluteals and the hip flexors are antagonists (i.e. for one to shorten the other has to lengthen). Tensing the glutes will also help you relearn how to use them, while at the same time protecting your lower back. Your torso should stay close to vertical during most of those drills.

Imagine you’re trying to extend the back leg as far backwards as you can. Oh and one more thing: keep the knee of the front leg above the foot. Don’t let it travel beyond the toes (i.e. keep the shin close to vertical) and don’t let it cave in (move towards the middle of the body). Your feet point straight ahead and your knee stays above your toes.

Cliff notes:

  • Neutral Spine
  • Glutes tight
  • Abs tight
  • Shin vertical
  • Front knee above toes

There was also the issue of the short tensor fascia latae. Here are a bunch of drills to work on that:

And finally the glutes and the abs. To retrain the glutes to fire properly you can use the supine bridge drill. Start off with both legs and when you’re good at that you can switch to doing it with just one leg. Try to just tighten your butt muscles and leave your hamstrings as relaxed as possible. Touch your hammies and your glutes to see how hard they’re contracting. Really go for hard gluteal contractions. After you’ve gotten back up again try to imitate that feeling when extending your leg backwards while walking. Here is the drill:

Now for the abs you could go with a regular front plank or some advanced variation like the “bodysaw”:

Just get some furniture sliders or something similar and you’re good to go. Just remember: keep your back in good alignment like the guy in the video. No letting the hip sag or pike up. If you can’t do it longer than 10 seconds that’s totally fine. Rest and come back once you can go again. Just don’t ingrain faulty movement patterns. You know how hard it is to get those out of muscle memory.

Bottom Line

You now know how to determine if you have anterior pelvic tilt and how to fix it. If all you can motivate yourself to do is one drill, then do the couch stretch for 2 or 3 minutes per side. If you feel like working harder to fix your situation sooner you have some other drills you can check out in this post. Just don’t overdo it in the beginning, only to then quit after two days.

Do something small every day and soon it will add up big time. Promised.

The best way to improve your posture

Assess and Correct postural problemsPosture is a dynamic process, since there is always at least some movement going on, even if it’s “just” breathing. Because of that posture cannot be separated from movement. This also means the best way to train for good posture is by moving, but not just in any way, but you should be doing the right movements to achieve the fastest progress. A screening process could make the whole thing a lot more effective though.

The “Assess and Correct” DVD-set does just that. It was created by sought-after strength & conditioning coaches based on what they use in their job on a daily basis. In 27 self-assessments you will find out exactly which of the corresponding 78 corrective exercises you have to perform to improve your posture and athletic performance. It offers a lot more detail than most of us care to know.

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