Anterior pelvic tilt and subsequent corrections was brought up in several threads, and I thought it would be helpful to have a thread of its own to address it. KPC and others offered some good suggestions and it might be helpful to put them together. I should preface this by noting you shouldn't be freaking out abt APT or make it the focus of your efforts. Just be aware of it, and take the steps to correct it, if required. Here are some quick sign-posts and stream-of-consciousness stuff.


Several structural issues at and around the hips relate to the function and dysfunction of the pelvis. For simpification, it might be helpful to visualize the pelvis as a "bowl" with muscles attaching from above and below, in front and at the back. Some of these are tight and overactive, while others are weak and and inhibited (or slack). This causes the "bowl" to tilt.





Note that some forward tilt of the pelvis is normal. A few people are in posterior pelvic tilt. The general population (athletes and weekend warriors) are in APT.

Typically, the tight or overactive muscles include the rectus femoris, illiacus+TFL (other hip flexors), quads, spinal erectors, QL, etc. The weak or inhibited strcutures are the glute (max, medius) weak abdominals (external obliques, and possibly rectus abd) and hamstrings.

Tight hip flexors = weak glutes.

How to test for APT?

I'm not gonna go into this in detail. There are simple ways and complicated tests. In general you can assess pelvic tilt by checking for foot patterns (flat footed v pronation), side posture/photos (look in the mirror, and compare with above figures), and using common sense to figure out patterns and predispositions.


Why is APT bad?

> The tight hip flexors (rectus fem in particular) are linked with APT and anterior knee pain.
> Anterior pelvic tilt in conjunction with lumbar extension/lordosis is a recipe for lower back pain (extension and compressive loading of the lumbar facets
> Inefficient firing of the posterior chain. So loss of strength/power production
> Aesthetically not pleasing? (protruding lower belly)


"Fixing" APT and general corrections:


> Lengthen the hip flexors. Static stretch the hip flexors (transient lengthening: reciprocal inhibition).

TFL stretch, samson/warrior-lunge stretch.
Foam roll the hip flexors, and IT band, and quads.

> Strengthen the glutes. Weak/lengthened glutes are dominated by anterior hip musculature. Get them in gear so they are the firing correctly during hip extension, hip external rotation and knee stabilizing.

Activation work: Supine bridges, x-band walks
Strength and motor pattern work: KB swings (good call KPC), cable pull-throughs (excellent since there's no spinal loading), well performed deadlifts and squats- finish with the hips i.e. lockout and stand tall (I'm looking at you, smiley)

> Strengthen the abdominals. Work on "core stabiity"

Planks, side bridges, rollouts etc.

Train the external obliques:
Reverse crunches (supress hip flexor activity) and dragon-flags (do these if not contraindicated by existing lumbar issues)

> Improve your posture and "correct" yourself consciously.

Again, props to kpc for this as it is easily forgotten. Training cliche at play: You can't undo 23 hours of poor movement with 1 hour of good movement in the gym.

Wear proper footwear, correct your posture, don't wear high heels (I'm looking at you again, smiley)


That's all for now. Add stuff that I've missed, and comment. Hope this helps.

Any particular stretches you recommend of the MM DVD?

one thing i notice is that Cressey/Robertson don't say how effective the exercises are. I mean, are we talking a 5% correction? A 90% correction? Have there been any studies done? when i look at that pic of the spine, that looks like some major tilt that would require some major correction. if i'm sitting on my butt 8 hours a day at the office, then a few at home playing poker at night, is 30 to 60 mins a day of this really gonna do much? not expecting anyone to answer that; i'm just talking out loud.

Question: Will conscious correction--which intuitively feels like it will be a major factor in helping--feel like I'm doing kegels or squeezing my ass a bit while I go about my day to day activities? I think I have minor APT, and I think the problem is primarily weaker glutes and perhaps inflexible hips.

I've been looking at this over last few days. I have huge APT, and it is very unattractive (the fact that I'm fat doesn't help either). I might take a picture of it if I remember.

Here's an article I think was posted in the chat thread:

http://www.tmuscle.com/free_online_a...ce_couples&cr=

and this guy has put together some video links of the given workout:

http://lolfitness.wordpress.com/2009...epair-workout/

and I wrote up a description of the exercises so that I could print it off:
Hope that helps someone.

I will incorporate some of these exercises at work. I sit in a cubicle all day and have Outlook alerts pop up every hour saying "Mobility Training" so I don't forget.

It's really simple to get regular some isometric and static stretching in at your desk. I even have a Captain of Crush gripper at my desk.

I use dinner timer lite (you can google it, it's a free download). I set it at 20 mins just to stand up. It helps but it's not great.

I'm thinking about putting in a request to make my cube set up with a standing level desk. Ideally it'd be split up so I could stand most of the time but sit once in a while.

and thanks for the thread ab this is a subject I'm really interested in.

I had a Q in my log about adding in extra APT work with SS. Stuff like glute bridges and reverse crunches are easy enough to add in. But say I want to do pull throughs or KB swings after my workouts. What should programming look like there?

If you don't want to incorporate KB swings into the actual workout, where you might do something like 20x5, you can just GTG them and do a set whenever you see fit.

micman,

Many of the movements I listed are from MM. In general, movements that strengthens or activates posterior structures and stretches or inhibits anterior ones will be useful.

A couple more for good measure: single-leg supine bridges, walking pull-back butt-kicks (as dr Q mentioned), single leg rdl, prone ITB/TFL stretch, etc

dero,

Like I mentioned 1 hour of good movement doesn't make up for 23 hours of ****ty posture and dysfunction. That said, a little goes a long way and a few degrees of correction is a lot. See kyles, stuff, correct your posture repeatedly until it becomes habit, take breaks to stand up, and do stuff that you can at your desk.

Also, correcting APT is part of a +ve feedback loop. To wit, the more you do activation stuff and correct APT, the better you'll get at say deadlifts, and the better you get at deadlifts, the better your pelvic tilt will get.

istew,

Conscious correction will help.

Whenever I think "lordosis" this is the first image that comes to mind:


Yeah, random, and not very useful. With that out of the way, this may be more helpful:


Anytime you feel your posture slacking, and becoming lordotic, besides focussing on the glutes, learn to brace your abdominals (cue: like you're about to be punched, not sucked in). As your core and glutes get stronger, this will be rather instinctive, and besides the benefits of better posture, you will be better prepared for random gut-punches by strangers.

kidc,

You can always incorporate this with SS.

Work on the glute activation stuff, quad and hip-flexor stretches pre-lift. While I don't want to go into detail, static stretching the hip-flexors is useful before squats and DLs because of reciprocal inhibition (in lay terms, you are "quieting the hipflexors and quads, and allowing the glutes and hams to be "louder" and activated).

You can throw in core work post SS lift: planks, side bridges, reverse crunches, pallof presses etc. (Don't go crazy with this and stack em all at once.)

As for pull-throughs and kb swings, both are great movements. I like pull-throughs after a lift because there's no spinal loading and it's movement-focussed. 2x10, 3x8, type schemes work well.

how heavy is a typical pull through exercise? Say right now my SS lifts are 200 Squat, 250 DL, what would be a good pull through weight?

Aight one more question.

Is the following a recognized static hip flexor stretch: you get on both knees as if in prayer and do the the glute activation/pelvic thrusting thing and hold it as long as you can?

I know it's kind of lol to be making up stretches when you have sources like MM, but I've sort of gotten into the habit of doing this while I play online poker and it gives me a really really strong stretch at the top of my hip flexors. More important it's something I could actually spend hours a day doing.

kidc,

Good page on pullthoughs with video:http://www.bostonherald.com/blogs/en...ould-be-doing/

Since it's done with a cable, it's hard to discuss appropriate weight. Remember though, that the focus is not how heavy you can go, but training the right movement pattern, firing the glutes, dissociating the lumbar spine from the hips, and finishing with the hips.

Anklebreaker, with this in mind (lol last sentence, btw):

Would replacing a desk chair with an exercise ball be advised? Obv majorly Manly Points off, but...

mm,

From what I can tell, no. It seems to be just a religious isometric glute-hold.

Here are some simple hip-flexor stretches:

> Samson/warrior lunge stretch:



Besides stretching the hip flexors, this has the added benefit of addressing upper body stability and mobility. For more deets:http://www.crossfitrockwall.com/cros...n-stretch.html

> TFL/psoas stretch (from kevenneeld.com)


> Rectus femoris

nice cans

When I think lordotic I think dancer. I'll add that trying to use conscience work to erect your self may be tricky since your somatic senses are off. People with ROM problems (I'm classifying APT) tend to not recognize their off-balance and won't know what normal feels like. I say do the excersizes in the OP and the problems will rectify themselves.

this thread should be stickied, v. helpful OP

I put it in the resource guide under misc. / tsearcher edit

If deadlifts strengthen your back, are they good for APT? Perhaps I'm being thick, but the deadlift is my best lift and I have quite severe lordosis.

Also, great last line.

istew,

Cue Dwight Schrute video. I'm not really sure. From some of the stuff I know, as well as naive intuition, I'd say sitting on a stability ball may be useful for short periods. For long periods, it may actually be bad for your back, not to mention extremely uncomfortably. Plus you have to be on the lookout for stabby co-workers.

DrQ,

Good Question. I should have clarified when I talked about deadlifts in the context I did, I was referring to the glute firing and hip extension in a correct deadlift, i.e. braced core, glutes and hamstrings doing their jobs properly and no hyper-extension. A bad deadlift can certainly be deleterious to pelvic health (when the lumbar spine bears the load), and promote lordosis.

One more question about DL. Does it activate the QL and paraspinal? I seen a few people who do DL and I notice a big issue with those muscles. Wouldn't those muscles shortening be a concern?

QL tightness is associated with overactive TFL, and indirectly as noted above, weak glutes.

Robertson:
Additionally, lateral hip instability (i.e. elevated on one side) will have implications up the chain, shortness of the QL, and some form of functional scoliosis. This is outside the ambit of this thread though.

To conclude, reinforces the need to strengthen the glutes, work on stretching the hipflexors (particularly TFL) and core stability (in the case of the QL, lateral).

Practical takeaways: stretch and roll them flexors, yo. Glute activation and strength (glute-ham raises deserve a mention), and spend a little time on planks and side bridges.

how do plank and side bridge exercises typically go? What are typical hold times and reps?

The quoted mentions tight adductors. Good stuff. Do splits also?