Chances are if someone had an issue with anterior pelvic tilt before the pandemic lockdown, the lack of movement might have made it worse. Group fitness instructors will likely see more and more people in their classes who are exercising with some type of pain or imbalance, including anterior pelvic tilt. As an instructor, therefore, you may have opportunities to identify and correct musculoskeletal deviations in students (while staying within your scope of practice). Practicing this skill will keep you at the forefront of corrective exercise and help participants reach their health and fitness goals in a positive way.
This article explores how to assess the anterior pelvic tilt deviation during class, what exercises can make it worse and, finally, how to correct it.
See also: Corrective Exercises: Swayback Posture.
Anterior Pelvic Tilt
The pelvis is naturally rotated forward about 10 degrees in a standing position. However, if the front of the pelvis is too low in relation to the back of the pelvis, there is an excessive anterior pelvic tilt. Look for an anterior rotation of more than 10 degrees. An anteriorly rotated pelvis usually accompanies excessive lumbar lordosis (overarching of the lower back) and vice versa.
Pilates. While your client is lying supine on the reformer with her legs straight and head down, slide your hand (palm down) under her lower back (you should be able to get your fingers underneath). If you can slide your whole hand under, the lower back is probably arching too much, and she most likely has an anterior pelvic tilt. If the padding on the reformer is soft or your client has a large gluteus maximus, adjust your assessment accordingly.
Boot Camp. Instruct participants, while standing, to place their hands on the front of their pelvis, palms flat, with middle fingers touching. Most people will see only their first fingers when they look down at their hands. Teach your students to tilt the pelvis posteriorly, or under, until they see their middle fingers.
Exercises That Can Make Anterior Pelvic Tilt Worse
Pilates. The teaser is a great exercise for working the abdominals and hip flexor muscles. When performing the teaser, the hip/leg complex flexes and the torso and legs come together. This movement requires the pelvis to posteriorly rotate (tuck under) to ensure the hip flexes correctly. Since most people have an anterior pelvic tilt, the pelvis may not posteriorly rotate as it should. As a result, the abdominals and hip flexors will not work correctly, and undue stress will be placed on the lower back.
Boot Camp. “Superman,” or prone cobra, puts the spine into excessive extension and can make an anterior pelvic tilt worse if done incorrectly. Many participants cannot extend or arch the thoracic spine upward when lying prone. Therefore, when they perform spinal extension lying face down, they are likely to hyperextend the lumbar spine and anteriorly rotate their pelvis to an excessive degree to achieve the desired movement. This can lead to compression of the lumbar disks.
See also: Buddy Boot Camp
How To Correct Anterior Pelvic Tilt
Pilates. Instead of having your client perform teasers with her torso off the pad, ask her to remain lying supine. Place your hand on the front of her pelvis to ensure that when she flexes the hip (lifts the leg), her pelvis does indeed posteriorly rotate. She should not have to make a conscious decision to posteriorly rotate the pelvis if the hip flexors are working correctly. Coach her to slightly rotate the leg out and perform one leg at a time until she can coordinate hip flexion correctly.
Although the pelvis will posteriorly rotate, the lower back will not flatten completely. If the psoas major (the main hip flexor muscle) engages correctly, it will have a slight forward pull on the lumbar spine and will help keep it stable (the lumbar spine will be slightly arched).
Boot Camp. Performing prone spinal extension exercises with one modification can help ensure that participants do not hyperextend the lumbar spine or anteriorly rotate the pelvis. Coach clients to keep the bones at the front of the pelvis off the floor as they try to lift and extend the spine. They will need to engage the abdominal and gluteal muscles with a posterior pelvic tilt to ensure that the pelvis does not anteriorly rotate too much. As they increase their ability to extend in the thoracic spine, they will find that they can begin to focus less on stabilizing the pelvis and more on the action of extending the spine. This will help participants become more balanced and reduce their risk for a lower-back injury.
More Fun for All
If you can learn to assess participants, you will soon become familiar with their individual musculoskeletal imbalances. This will help you evaluate your program design and address pain while still creating a fun and energizing experience.
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