A Case of the Tilt

Everything’s cool when you’re just chilling with your arms at your sides. Posture’s good: ribs are down, pelvis and lumbar spine are neutral (or close enough to it), breathing is normal.

Something crazy happens, though, whenever you go to pick heavy stuff up off the floor and press it over your head. All of a sudden, you turn into Donald Duck!

Credits to Bret Contreras for the Donald Duck imagery.

What caused this cartoon metamorphosis? You lost your neutral posture. Your ribs flared up, your low back arched, you stopped breathing into your deep belly, and you went into a nasty anterior pelvic tilt.

Geez Louise, what’s anterior pelvic tilt? Sounds like some sort of airborne illness. Quick, call 9-1-1!

Not so fast, cowboy. We just might be able to reel this bad boy in without the help of the paramedics.

What the Heck is Pelvic Tilt?

(A) Neutral Pelvis, (B) Excessive Anterior Pelvic Tilt

Imagine you have a cup of your preferred beverage on either hip. If your pelvis is neutrally aligned (picture ‘A’ above), the cups remain level. No spillage.

With excessive anterior pelvic tilt (picture ‘B’), on the other hand, your beverages spill out in front of you, right onto your shoes. What a waste!

Excessive anterior pelvic tilt can make your butt look pretty spectacular,

but it probably isn't the safest position for heavy lifting.

Now, let’s not get carried away: a little bit of tilt is perfectly normal. Contrary to the fearmongers on the subject, you could go your entire life with a slight tilt and never experience pain or dysfunction. In fact, lots of great athletes do just that, and so does Jen Selter!

When excessive anterior tilting of the pelvis occurs during a heavily loaded dynamic movement, however, it can be a mechanism for injury. (See my post on the importance of a neutral spine for the biomechanical explanation.)

Yes, We Can!

The source of this inability to control the pelvis is often multi-factorial. Muscular imbalances, lifestyle, participation in certain sports, genetics, mobility issues at the shoulders, and even simple ignorance regarding proper positioning are generally at play.

The good news is that when the source of the problem is muscular in nature, we have a few tools in our toolbox.

Keying in on the muscles surrounding the pelvis, we often see four commonalities with anterior pelvic tilt:

1. Underactive abs
2. Underactive glutes
3. Overactive hip flexors
4. Overactive spinal erectors (low back muscles)

In order to counteract these deficiencies, we must 

1. Strengthen the abs and glutes
2. Stretch the hips flexors
3. "Re-pattern" the faulty movement(s) (i.e. re-learn them with the proper pelvic position)

And voilá! (Don’t worry too much about stretching the spinal erectors. Steps 1 and 2 generally eliminate the need.)

Below are my 'Super Six' drills for making the above corrections. Use them as your warm-up, when you’re fresh as a daisy and primed for new motor learning.

Immediately following warm-up, work on the movement that's been giving you trouble (perhaps a deadlift or overhead press).

Focus on maintaining proper pelvic alignment by contracting the abs and glutes. Perform perfect reps only. Go light at first, and end sets well short of failure.

By the way, even if you don’t have any trouble maintaining a neutral pelvis, the exercises below are still a great warm-up in terms of “turning things on” and getting you ready to rumble.

The Super Six Drills

1. Deep Belly Breathing

This drill teaches you to engage your diaphragm, an important deep ab muscle. It also helps you chillax and get into the zone for the impending workout.

• Lie on your back with your knees bent and feet flat on the floor.
• Place one hand on your stomach and the other on your chest.
• Inhale slowly and deeply through your nose, feeling your belly (not your chest) fill with air.
• Exhale even more slowly and deeply, also through your nose.

Continue in this fashion for one to two minutes.

2. Dead Bugs

This drill also teaches you to engage your deep ab muscles, this time while dynamically moving the extremities.

• Lie on your back in an inverted table-top position (hips and knees bent at right angles and arms straight up towards the sky).
• Imagine you have a hockey puck atop your belly button.
• Pull the imaginary puck towards the floor to flatten your back completely.
• Inhale deeply, and extend an arm and the opposite leg towards the floor as you exhale, maintaining your flat back position.
• Return to the starting position, and repeat on the other side.

Perform a total of 6 slow reps per side (alternating).

3. Single-leg Glute Bridging

This drill teaches you to use your glutes (not your low back muscles) to extend your hips.

• Lie on your back with your knees bent and feet flat on the floor.
• Tuck one knee to your chest to posteriorly tilt your pelvis, and bridge up.
• Hold the top position for two seconds, squeezing your abs and glute all the while.
• Poke your cheek to make sure it’s working.
• Maintain tension as you slowly return to the starting position, and repeat.

Perform a total of 6 slow reps per side.

4. Posterior Pelvic Tilt Planks

This drill teaches you to use your abs and glutes to fight hyperextension of the low back.

• Set up in a plank with your elbows directly under your shoulders.
• Lift your hips to make a straight line from head to heels.
• Squeeze your abs and glutes like there's no tomorrow.

Perform a total of 3 10-second holds with 10 to 20 seconds of rest in between.

5. Yoga Cat-cow

This drill helps you find the end range of motion of your spine in both directions. The middle point of these two positions is neutral (i.e. posture 'B' from the top of the post).

• Set up on all fours in table-top position with your hands directly under your shoulders.
• Inhale deeply into a full hunchback position (spinal flexion), one vertebra at a time.
• Exhale deeply into a full arched back position (spinal extension), one vertebra at a time.

Perform a total of 6 slow reps.

6. Half-kneeling Pallof Press

This drill stretches the hip flexors and teaches your to maintain neutral alignment of the pelvis while resisting rotation.

• Fix a cable pulley or resistance band to a height of about 2 feet off the floor.
• Start off light with 10 or 20 pounds or an easy band.
• Set up with the inside knee down (on the floor, a pad, or a BOSU ball) and the outside leg up, hip and knee at right angles. 
• The closer the front foot is to in-line with the down knee, the harder the exercise will be. Aim for no more than a foot of separation. You don't want the front leg acting as a "kickstand."
• Squeeze the glute of the down leg so you feel a stretch in that quad/hip flexor.
• Exhale as you press the handle out, hold for 2 seconds, and return to the starting position.
• Squeeze your abs all the while to keep your ribs from flaring upward.

Perform a total of 3 10-second holds per side with 10 to 20 seconds of rest in between.

Down the Line

Once you’ve got your pelvic position in check (which can take anywhere from a single workout up to several months), feel free to defer the drills to post-workout for cool-down and maintenance purposes. For cool-down, work backwards, beginning with #6 and finishing with #1.

For the more advanced lifters out there, progress by incorporating a posterior pelvic tilt at the top of exercises traditionally performed with a neutral pelvis.

Good examples include back extensions, stiff-legged deadlifts, and hip thrusts:

Now, while squeezing your abs and glutes, wave goodbye to crummy pelvic alignment on your heavy lifts, and say hello to your new safe posture!