Anterior Pelvic Tilt? Add this to your routine
Are you in an Anterior Pelvic Tilt?
Me too.
First up, I’ll preface and say this postural position isn’t “bad" (even if the internet tells you otherwise). The problem becomes when we can ONLY access the anterior tilt position, and not others. This is when low back pain comes into play.
I was talking to a mama this week about an anterior tilt, why we find ourselves stuck in this “open scissor” position postpartum, why it matters, and a few ways I love to help postpartum moms find a more neutral / stacked position. I’ll be sharing a few of those strategies with you today :)
On the left, you can see how finding a more “stacked” position allows us to better manage pressure and stack our diaphragm and pelvic floor. The second from the left photo shows the “open scissor” presentation.
Why Anterior Pelvic Tilt and why does it matter?
An anterior pelvic tilt is a common postural position during pregnancy and into the postpartum period. During pregnancy the weight of the belly pulls us and our pelvis forward in space, resulting in a tipping forward at the pelvis and accompanying rib flare. If you turn sideways, you’ll often notice a big arch in the low back. This position is a totally normal adaptation from pregnancy. The ribs have to flare to make room for a growing watermelon out front :)
Why does it matter?
Shifts the length-tension relationship of the muscles: This position is a shift in overall orientation, and shifts the length-tension relationship of the muscles in the area. You may find it more challenging to connect to your lower abdominals, feel tightness in your hamstrings, and/or notice your hip flexors feel tight often too.
See more: Sometimes I love using props/constraints to help connect with your lower abdominals. Check out the video below. We are essentially using the wedge to maintain a posterior tilt.
2. Diastasis Recti Healing: This open “scissor” pattern can put additional pressure onto an already weakened abdominal wall and linea alba (connective tissue along the midline), making it harder to heal a lingering diastasis.
Related to healing a diastasis recti is getting a good 360 degree umbrella breath. Oftentimes the back / erector muscles can get really tight in this position, making it harder to breathe into the back body. With a tight chest and back, the air and pressure has nowhere to flow but out the front, on a healing abdominal wall. One of the great thing about breathing drills is we can use different positions to bias airflow into different areas of the ribcage and pelvis.
See more: Check out this Instagram post talking more about back body expansion and diastasis recti and one of my favorite breathing positions below.
3. Pressure Management and Building strength: one of the most important parts of returning to exercise postpartum is learning how to manage intra-abdominal pressure and finding a stacked body position (ribs over pelvis), particularly under load (lifting weight).
Your core system is a pressure system. It’s often helpful to think of it as a canister with a top (diaphragm), bottom (pelvic floor), front (deep abdominals), and back (back muscles/multifidus).
When our bodies are stacked (ribs over pelvis), it’s much easier to manage pressure flow within this canister / within our abdomen. The diaphragm and pelvic floor can function better as a team when both diaphragms (thoracic/pelvic floor) are stacked right on top of each other.
When we are not able to maintain this stacked body position, it’s much harder for the pelvic floor and diaphragm to coordinate and manage pressure flow, which is when pressure leaks may occur (e.g. diastasis, pelvic organ prolapse, hernias).
Summary: When you are stick in an extension pattern, your abdominal wall is in a lengthened position, making it harder to manage pressure, generate tension through the mid-line/connect to your lower abdominals, ease low back discomfort, and move more freely throughout our day. Working on variability in movement and finding a more stacked position during pregnancy and postpartum can key in managing intra-abdominal pressure, improving movement quality, addressing pelvic floor symptoms, and getting stronger. This is something we can work on together!
Where can I start?
Step 1: Breathing + Hamstrings
As long as I can remember I’ve been a flexible human and in an anterior tilt. I’ve practiced yoga for over 10 years and when I bend over and toes my toes I feel almost no stretch/tension in my hamstrings and can palm the floor.
Why does this matter? I struggled to lift heavy in a deadlift, partially because of all of this extra flexibility. In my case the hamstrings were not showing up to help anchor my pelvis from the back. The hamstrings are key players in finding a stack and finding control in the sagittal (front to back) plane of motion.
Being able to expand on the backside (since my low back always felt super tight and was working overtime) and get in a good position/stack can unlock so much.
A fun place to start: Breathing in a full squat position feels so good for some expansion in the lower back area. Sometimes I love just sitting on a foam roller, hugging knees towards my chest, and just breathing. Focus on getting deep breaths into the low back. It’s ok to go into that posterior tilt to help get that expansion, and we can practice this position throughout the day. If you’ve been in an anterior tilt for a while, finding that movement through the lumbar spine (low back) will actually feel really good, and hard to do.
See more: Instagram post breaking this down.
If this position feels pinchy in the hips, I’d recommend swapping it out. A supine rockback can be a great alternative, and gives you that low back expansion too (with added booty opening).
Step 2: Build glute, hamstring, and core strength
The hamstrings, deep core, and glutes are key players to maintaining a more neutral pelvis position, keeping the pelvic floor happy, and pulling us out of an anterior tilt.
I incorporate abdominal and hamstring work in EVERY warm up. If you’ve been living in an anterior tilt for a long time, it can be tough to connect with the hamstrings and find the posterior tilt without clenching on the glutes. Be patient. We need to teach the hamstrings to be a solid anchor once again.
I love starting with isometrics, and even a standard bridge position, just cued a bit differently. Isometrics are great for tendon health, the pelvic floor, learning how to own a position, and if you’re a bit more mobile - sensing tension. Below I have a sample progression and some of my favorite hamstring focused exercises to help reposition the pelvis and find a more posterior tilt.
A stacked body position is key to helping heal your core and pelvic floor. One way we can find this position is via breathing and building strength in our hamstrings, which provide an anchor from the backside. Check out the exercises above!
When we are in a more stacked position, we have better range of motion and overall improved movement (less aches and pains). A big mistake I often see with clients trying to find a stack is rounding through the lumbar spine and clenching the glutes and pelvic floor instead of using the hamstrings to pull our pelvis under. As you work through these exercises, remember to focus in on the hamstrings closest to the booty (our anchor) and keep the glutes relaxed.
Over time, we can apply this stack to strength exercises, utilizing props to help us maintain a good position and expand into different parts of the ribcage.
Questions on returning to exercise postpartum or how to address an anterior pelvic tilt? I’d love to chat!
Feel good mama!
xoxo,
Erica