How to fix an anterior pelvic tilt

Do you have the Donald Duck syndrome (aka Anterior pelvic tilt)? …And is it causing your bad posture?


BONUS download: Here are 3 BONUS exercises(PDF) to help fix your Anterior pelvic tilt! Download now!

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Not trying to be rude or anything, but has anyone ever told you that your bottom sticks out a lot? Or that your stomach seems to protrude forward?

… Here might be the reason why… With this posture, the pelvis is in a position called the anterior pelvic tilt.

anterior pelvic tiltanterior pelvic tilt

Anterior pelvic tilt? What does that mean? If you haven’t come across this word before, it is used to describe how the pelvis is tilted forwards. It somewhat resembles the pelvic position of my favourite childhood disney character, Donald duck.

Characteristics involve having a pronounced lower back arch, glutes (your bottom) that stick out and a protruding stomach.

// Why is having an anterior pelvic tilt a problem?

It is common for this anterior pelvic tilt position to drastically effect your posture (even up into the upper back and neck!)… That is why it is so important that you get it fixed as soon as possible. It could be the one reason why you have so much pain and tightness in your body.

If your pelvis is in the wrong position, everything else is going to be out of position! That is a problem!

// How to tell if you have an anterior pelvic tilt?

neutralanterior pelvic tilt

Stand up. Place one finger on your pointy hip bone at the front, and the other on your pointy bone at the back. (check out the picture above for the points. See it?… That’s the spot!)

If you have anterior pelvic tilt, the finger at the front of your hip bone will be significantly lower in comparison to the finger on the pointy bone at the back.

Note: It is normal for the pelvis to tilt slightly forward. This is what I refer to as a “neutral pelvis”. (see above)

Note #2: Everyone has different shaped and sized “pointy bones”. This is just a general guideline to quickly determine if you have an anterior pelvic tilt or not.

// Why do you have an anterior pelvic tilt?

You are either sitting too much or sitting incorrectly. Not that I am spying on  you right now, but chances are that you are doing both of them right now! Make sure you click on the post:  The correct pelvis position to find out how to sit properly and prevent this problem altogether.

Excessive sitting causes the muscles that control the position of the pelvis to get tight, overactive, weak and/or inhibited. As a result, there is an imbalance of the forces around the pelvis region causing a net force to forward tilt (anterior pelvic tilt).

aaaa

Anatomy 101:  Without going into great detail, here are a bunch of muscles that you will need to target to fix an anterior pelvic tilt.

Tight/overactive muscles:  Hip flexors, Tensor fascia lata, quadriceps, Lower back erectors, Thoracolumbar fascia

Weak/inhibited muscles: Gluteal group, Hamstring, Abdominals, Obliques


 

“Help me! How do I fix my anterior pelvic tilt”

Best exercises to fix your anterior pelvic tilt

… Let’s fix your posture now!

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Let’s fix your anterior pelvic tilt posture! You need to:

  • 1) stretch the tight/overactive muscles
  • 2) strengthen/activate the weak/inhibited muscles and;
  • 3) Train your brain to keep the pelvis in the neutral position.

1. Stretch/Release the muscles and structures at the front of the hip area

Before you can start to strengthen any of your weak muscles that are contributing to your anterior pelvic tilt, you need to stretch the tight muscles which may be inhibiting them in the first place.

// Hip flexor stretch

hip flexor stretch

Key points:

  • Make sure you feel the stretch where you are meant to feel it. There’s no point doing a stretch if it isn’t stretching you. In this stretch you should feel a pulling sensation at the front section of your hip
  • Hold the stretch for a minimum of 30 seconds. As you become more familiar with the movements, try to work your way up to holding for 1- 2 minutes.
  • I find this stretch is very much a game of angles. Once you are in position as instructed, move the hip around until you can feel the stretch  strongly.

// Quad/TFL stretch

Quad stretch

Key points:

  • Hold the stretch for a minimum of 30 seconds. As you become more familiar with the movements, try to work your way up to holding for 1- 2 minutes.
  • Stay as upright as possible. Resist the urge to bend at the hips as this will decrease the tension on the quadricep complex.
  • Hold onto something (like a wall) for balance
  • Drive your hips forward and tense your glutes if you feel that you aren’t getting a strong stretch.

// Groin stretch

butterfly stretch Long groin stretch

Key points:

  • Hold the stretch for a minimum of 30 seconds. As you become more familiar with the movements, try to work your way up to holding for 1- 2 minutes.
  • If you cannot feel a stretch in your groin muscle, try out the different variations. In some positions, you may feel the stretch more than the others.

// Lower back stretch

Lower back stretch

Stretching the muscles of the lower back can be slightly more difficult. If you have pre-existing lower back pain, please take care with these exercises. You may need to specifically address your lower back pain before fixing your anterior pelvic tilt if the pain is too much to do the exercises.

// Side stretch

Side stretch

Key points:

  • Hold the stretch for a minimum of 30 seconds. As you become more familiar with the movements, try to work your way up to holding for 1- 2 minutes.
  • As mentioned before, if you already have pain in your lower back area, take care when performing the exercise. If there is pain, change your position. If it still hurts, then stop the exercise.
  • Relax your muscles as much as you can. This allows for a deep stretch.
  • Make sure you feel the stretch from the side of torso. (see above)

// Releases

If you are having difficulty feeling the stretch of these muscles, try using a lacrosse ball (or something of the similar) to release the structures directly.

Ball QL

Key points:

  • If it hurts, you are likely on the right spot. Tight muscles will often be the painful ones when pressed.
  • A small amount of bruising can be normal after the first few times doing these self releases. However, it can easily be prevent by making sure your tool of choice is of the appropriate firmness.
  • Keep rolling over the area for a good 1-2 minutes, or until the tightness/pain goes away.
  • Avoid placing the ball directly in the middle of the spine.

 

2. Strengthen the  gluteal and abdominal group

Now that your tight/overactive muscles have been stretched and released, you are now ready to begin your strengthening of your weak muscles. Wake up those sleeping muscles!

a) To strengthen your gluteals:

// Bridge

Bridge start position bridge end position

  • Transition from position 1 to position 2. (see above)
  • Prior to the movement, engage your glutes to tilt your pelvis backwards into a neutral position. This should flatten your lower back onto the ground.
  • Engage core muscles.
  • Make sure you feel the contraction of your glutes more than  your hamstrings.
  • Bridge as high as you can go as long as you keep a neutral spine. Do not over arch your back. Hold the end position for at least 30 seconds.

Did you know that there is a condition called “Glute amnesia”? It occurs when the gluteal muscles have been placed in a poor position (eg. sitting) over a prolonged amount of time, causing them to stop working efficiently.

*** Go to this post if you would like a list of ALL the gluteal strengthening exercises that you can do!


 

b) To strengthen the abdominals:

// Dead bugs

Similar to your gluteal muscles, your abdominals which are connected to the top part of your front pelvis play a vital role in rotating the pelvis back into position.

Dead bug 1dead bug 2

  • Lie on your back with both of your knees bent in the air (Position 1)
  • Engage your core and abdominals group by drawing in your belly button
  • Tuck your tail bone
  • Keep your lower back completely in contact to the ground throughout movement.
    • Do not let your lower back arch!
  • Alternate the reverse curl of your knees towards your chest
  • Progression: Add 5-10 second holds in Position 2.

*** Go to this page if you are looking for more ways to strengthen you abdominals muscles to correct your anterior pelvic tilt.


// Another quick area to consider…

… Your feet!

If you have flat feet, it can cause your pelvis to tilt forward.

Here’s the best exercise for you:

shortfootx

Instructions:

  • Sit down on a chair with your feet on the ground.
  • Whilst keeping your toes relaxed, proceed to scrunch the under-surface of your foot.
  • If performed correctly, you should be able to feel the muscles under your foot tense up.
  • Hold this for 10 seconds.
  • Repeat 30 times.
  • Progress this exercise to a standing position.

 

 

3. Neutral pelvic position training

So, by now you should be fairly familiar with the stretching and strengthening your muscles that contribute to the anterior pelvic tilt. If you are still uncertain on some of the exercises, please feel free to contact me for further clarification.

The next step (and in my opinion the most important) is learning how to take control of your pelvic position throughout your day. If you can’t neurologically  control your pelvis (by consciously using your brain), the problem will continue to manifest no matter how much of these exercises you do.

How to determine the  correct neutral position: Remember those bony land marks on your pelvis that we went through earlier on in this post? If you can’t remember, click here to go back up to it.

// Pelvic tilting: To begin with, you will need to learn how to rotate your pelvis posterior (which is essentially the opposite of anterior pelvic tilt). If you cannot do this without your whole body moving to compensate, it is likely the soft tissue around your joints are far too tight and need to be stretched or released. If this is you, you will need to go back to step 1 where we talking about how you can loosen the structures of your pelvis.

// Plank: Now that you are familiar with the movements of your pelvis, the next step is train the muscles to maintain this good position. The plank position is a great way to train the endurance of these muscles.

Plank

// Functional movements: Great! You’re almost there!

All that we need to cover now is to apply what you’ve learnt in your day to day activities such as walking, sitting and standing. It is likely that your functional movements (… especially sitting!!) has caused your anterior pelvic tilt in the first place.

Key points:

  • Maintain the neutral position of the pelvis throughout movements. The key is to avoid any excessive movements of the pelvis.
  • Lightly engage the gluteals and abdominals throughout movements.
  • Avoid quadriceps dominant exercises.
  • Remember your body’s default setting is to go back  into your anterior pelvic tilt. You need to focus very hard to maintain the neutral position as much as you can. You need to train your brain as much as you need to work on your body to fix this.

 

 Be persistent with your exercises! 

Please note these are just general guidelines to address your anterior pelvic tilt position. You may find some exercises very helpful, and others not so helpful. As with any rehabilitation program, it needs to be individualised to cater for your unique presentation.

If you are still unsure of what to do after reading this article or if you are uncertain if you even have an anterior pelvic tilt or not, please leave a comment down below.

All the best!


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About

I am a physiotherapist who has personally experienced the pain as a result of bad posture. I would like to offer you some of the solutions that I and my patients have greatly benefited from.

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150 thoughts on “How to fix an anterior pelvic tilt

  1. I have been actively trying to fix my ATP for the past month now, mainly by stretching, and properly deadlifting with ATP in mind. I think whats helped me is always having my glutes on, no matter where i am or what movement im doing. Lately I’ve started having some knee pain sometimes when i am walking and flexing my glutes. Its usually just one knee and its relatively minor, but i was wondering what might be causing this. I try adjusting the angle of my feet or my stance but sometimes i feel the discomfort.

    1. Hi Hao,
      If you’ve noticed that the knee pain has occurred at the same time you have altered your glute muscle recruitment, then you’ve likely also altered the pressure going through the knee. Over the years, your knee has become accustomed to your Anterior Pelvic Tilt, and when you begin to correct your alignment, some pains can occur. This is all part of the process.

      Is it the front of part of the knee that is giving you the problem?

      Also- check to see if your engaging your glutes equally. Check out this post here if you’d like to have a look at some glute exercises.

      Mark

      1. Mark,

        First and foremost thank you for the reply and thank you for all the great work you do on this site, really good stuff. The knee pain occurs on the inside of the knee, and i believe its when im trying to practice the squat movement (body weight). i try to practice cues like “spread the floor”, “knees out”, and applying pressure to different parts of the foot during the squat. I really want to get back into the gym and start squatting but the lower back pain ive been dealing with makes me really afraid to go back and make it worse. i cant stand any more sleepless nights due to my lower back, but i really want to get stronger and fix these muscular imbalances.

        Thanks,
        Hao

        1. Hi Hao,
          Sounds like you’re getting fed up with your injuries. And rightfully so. It’s quite frustrating, I know!
          I actually see quite a number of patients with a similar presentation as you (both Knee and Lower back issues). And usually it is due to poor movement/postural patterns that you may developed and compensating for.
          If you are suffering from lower back pain, it may be a wise idea to first make sure that your lumbar spine is working properly. Doing these Back stretches will be a good place to start.

          Mark

  2. Hi,
    Thank you for the post. I have started with exercises to correct my APT. I have one question. My job requires long hours of sitting. Can you tell me correct posture to sit keeping in mind the APT?
    Thanks,
    Anakh

    1. Hi Anakh,
      Great to hear that you are starting the exercises to correct your anterior pelvic tilt.
      Have a look at this post: http://www.posturedirect.com/sitting-posture/. It goes through how to sit properly.
      In regards to your APT whilst sitting, you will need to make sure that you don’t flare out your lower ribs whilst you sit (see Step #3 in the above link). Keep stretching out your hip flexors and try to get up from your seated position every hour.
      [Also side note – if you have APT whilst standing, it does not necessarily mean you will sit with an APT. ]
      Mark

  3. Great post on fixing the anterior pelvic tilt~! I have this Donald Duck syndrome and I am pretty sure it is the cause of my weak bum muscles.

    My question to you: I will continue to do the exercises you have suggested, but are there exercises I can do to specifically strengthen my bum muscles?

    Georgie

  4. Hi Mark, thank you for this article. I have bad posture and yes it’s because I’ve been sat incorrectly. I will try it. I hope it really fixes my posture.

  5. Hi Mark, my 15 year old daughter has a pelvic tilt with curvature at thoracic and lumbar spine and limb length discrepancy. She’s had low back pain and buttock hamstring pain for 3 months, she’s fit healthy weight and wants to get back to the gym, she’s starting with a Physio who does clinical Pilates next week, will this be an ongoing problem for her in the future? Or can this be fixed completely?

    1. Hi Shelley,

      It is definitely possible to fix your daughter’s back pain.

      Pilates is a great form of exercise to get her core muscles working together to keep a neutral spine. The stronger she can control her core muscles, the more likely her pain will go away.

      In terms of her leg length discrepancy, I find that it is usually due to a twisted/tilted pelvis which can give the illusion that one leg is shorter than the other. Fix the pelvis, and you’ll like fix the leg length problem.

      Mark

      1. Hi- I’m 35- and actually sorta a similar case. I’ve been doing barre religiously for over 6 years and ride a bike as much as I can. I’m so chronically knotted, twisted, uneven — snapping etc at this point I’ve stopped barre- I’m doing Pilates and a more ballet based method. My lower abs push out even though I clearly have strength. Would a posture brace help train me?
        My pelvis wants to constantly tuck under, hip flexors pull in- shoulders pull up- it’s become really stressful on many levels.

        1. Hi Marissa,

          Thanks for your question.

          A posture brace is usually for pulling your shoulder backwards. It will probably have minimal effect on your Anterior Pelvic Tilt.

          For you specifically, I would focus on the dead bug exercises, or even perhaps the more advance ones which can be found here.

          It sounds like you are strong, but lack control of your strength. These exercises will teach you to control your torso, abdomen and pelvis together.

          Mark

  6. Hi Mark. I seem to have APT (my job requires me sitting in front of a computer for long hours).
    I’d like to know when I will start seeing results after doing these exercises; one month, two? Maybe more?
    And my last question, I read on some other places that to have good posture you must squeeze your glutes and basically move your pelvis forward, but that’s just impossible; my leg muscles get tight and I can just be thinking about pushing my pelvis forward all the time. Is this “pushing your pelvis forward” correct? Shouldn’t your body simply have good posture by its own after doing exercise?

    Thanks for your time!

    1. Hi John,

      In terms of how long it will take – that really depends on how bad your APT is, how long you’ve had it, how often are you doing the exercises, exposure to sitting etc. But, you really should see some differences within the first week.

      You want to aim for small progressions every week as this long standing issue takes time to resolve/improve.

      The exercises are designed so that they allow your body to be able to place your pelvis in the correct position. I would not suggest squeezing your glutes excessively as this could cause other issues.

      Try this:
      Keep lower ribs down

      Instead of focusing on squeezing your glutes, aim to keep your lower ribs down. This should help you maintain correct pelvis position. More info here: http://www.posturedirect.com/sitting-posture/

      Hope this helps.

  7. Hi Mark
    Thank you for the great article.

    Can you please explain the role/difference of the anterior pelvic tilt in relation to femoral anterior glide syndrome? To my understanding the femoral anterior glide will be caused by overactive glutes due to hyper extension. Is this correct? If so then would the treatment of femoral anterior glide syndrome essentially be the opposite to the anterior pelvic tilt? I know with FAGS you cannot stretch the hip flexors but does this also mean you should not be stretching the quads?

    I used to be a triple jumper and sprinter so lots of movement was extension based. Does the sway back attenuate femoral anterior glide? Would treatment of sway back be more parallel to treatment of FAGS?

    Cheers!

    I appreciate your help.

    1. Hi Iwona,

      What a great question!

      Anterior translation of the femoral head is usually (but not always) due to hyper extension of the hip (esp. if you did a lot of triple jumping in the past). This PUSHES the femoral head forward.

      … But you can also get it in anterior pelvic tilt especially if the hip muscles at front are PULLING the femoral head forward.

      In terms of how you would treat anterior translation of the femoral head, it really depends on what’s causing it in the first place. Do you know if you have sway back posture or an anterior pelvic tilt?

      Happy to talk to you through email if you would like to go more specific.

      Thanks.

  8. Hi Mark
    Thank you for the great article.
    Can you please explain the role/difference of the anterior pelvic tilt in relation to femoral anterior glide syndrome? To my understanding the femoral anterior glide will be caused by overactive glutes due to hyper extension. Is this correct? If so then would the treatment of femoral anterior glide syndrome essentially be the opposite to the anterior pelvic tilt? I know with FAGS you cannot stretch the hip flexors but does this also mean you should not be stretching the quads?
    I used to be a triple jumper and sprinter so lots of movement was extension based. Does the sway back attenuate femoral anterior glide? Would treatment of sway back be more parallel to treatment of FAGS?
    Cheers!
    I appreciate your help.

  9. Hey, I just learned that I have anterior pelvic tilt! My guess is that I developed it from wearing high heels daily and having two children which losened my abdominal muscles and ligaments. Thank you for a great page with great information. I’m attending pilates and will try doing stretches you have suggested 🙂

    1. Hi Natalia!

      Great that you’ve identified that you have an Anterior Pelvic Tilt. Now you can aim to fix it!

      Hope the exercises will help you.

  10. Hi mark I have had atp for years it got better a year ago but since I have started university it came back and no matter how much I stretch it is still there
    Can u give me a programthat I can do daily

  11. Hello Mark!

    Wonderful article! I’ve had this problem for about 3 years now, and it seems I’ve been treating it the wrong way all this time!

    I’m a thin and tall young man (24 y/o) that for some time didn’t eat properly nor exercise; it all started when I went to study abroad for a year and everything I did was drinking beer, go out to parties, late nights sleeps and NO exercise.

    After this year I realised my small abs and flat belly were gone (because I used to exercise quite a lot before), so I blamed everything to that great year that left me with this problem. The thing here is that I thought it was only a beer belly or the bad eating habits I used to have or the lack of exercise; so I started going to the gym and eating healthy… I did this for about a year. Must of my body changed very quickly (I have a fast metabolism and apparently it is not hard for me to build muscle), but I still had a swollen belly and it was AWFUL! so I went to different doctors and started treating for “distended abs” and “digestive disorder”, where the treatment was to eat healthy and exercise, what I was ALREADY doing.

    I never thought that problem relied on a tilt pelvis. I have to say that I don’t stretched my muscles often, not even when I exercise and because of my job I spend lots of time seated.

    I checked my posture and in fact my hips are pushed out and if I correct my pelvis, my stomach gets perfectly flat! I started doing the exercises you posted and already see results. I hope I can fully correct my posture soon.

    I’ll let you know how it goes! Thanks for your post!

    Cheers!

    1. Hi Gerardo,

      I am excited that you have seen some quick results with these simple exercises.
      Keep up the good work and looking forward to hearing from you.

      Mark

  12. Hi there. I am a tattoo artist and as such I am sitting/standing in all different positions throughout the day. I try to sit straight when I can, but it’s hard to know how to keep your spine aligned when you’re leaning all over the place. I have only just become aware of ATP, and always thought this was just the way my spine is, as I’ve had a deep lower spine arch for as long as I can remember. Do you have any tips for keeping my spine straight if I’m not sitting/standing in the standard way at my job?

    1. Hi Lee,

      Being a tattoo artist, I can see why you would find it difficult to maintain good posture in your line of work!

      On top of the exercises mentioned in the post, the main point with managing anterior pelvic tilt is to keep your abdominal area slightly braced.

      This will drop your lower rib cage down slightly. As your ribs are lowered, your deep arch in your lower back will decrease.

      The hard bit is maintain this abdominal brace throughout the day.

      Mark

  13. Mark, thank you, thank you thank you! for this. I had been having lower back and extremely tight hamstring and tight hips as well. I sit all day working on a computer and felt like this was causing my problem. You really explained this well and I have been trying your exercises for 3 days so far and can see a BIG difference already. I will keep you posted but so far a big THUMBS UP! Thanks again!

    1. Hi Mari! I am glad that you are already seeing results with these exercises. Keep up the good work.

      And please feel free to contact me if you need extra help.

      Mark

    1. Hey there Christy,

      As a rough idea, aim to do:

      Stretches: 2-3 times
      Strengthening exercises: 10-30 reps

      If you can’t do 10 (or you can easily do more than 30 reps), you will need to make the exercises easier/harder to fit into the rep range.

      Hope this helps!

  14. Hi Mark,
    This is an excellent article – extremely useful and totally revelatory! Just as a side note, I am an otherwise fit, healthy, young dude with no reason to have back pain – but quite the contrary, I’ve had terrible back pain for years now (starting about when I was 20-21, at least noticeably). Anyway, I thought I might write to you in more detail separately in terms of specifics, but I had two quick questions for you. One was if you had any data that would clarify the variance of opinion about certain exercises? For example, some advise against the plank as a method of handling APT, others support it. To be honest, I literally just discovered I have APT (your photo above is definitely dead on and there is no question I have a forward tilting pelvis) – and now I am sort of trying to actively deal with it. I am not sure if it is the sole source of my pain, but I literally cannot sit for more than 25-30 min before my hamstrings, quads, lower back, hips, etc start spasming or hurting, inflammed, etc! It’s terrible! I’m going to start with your set of exercises, but the second question is regarding the extent of disposition the hip can be in. Now that I am actually looking at it, not only do I have APT, but it appears one side of the hip is higher than the other, and also the pelvis itself appears rotated to the left a few degrees. Essentially, this is a 3 dimensional situation – forward tilt, one side higher than the other, and rotated to the left some degrees! Should I thus incorporate anything else into the above or will this correct naturally by doing this? As a further note, I am super flat footed and have been since birth – which I am unfortunately only just now starting to deal with (custom orthotics). Anyway, I don’t want to ramble on here, but wanted to see if you had any input on these two for now! Thank you very much for your help!

    1. Hi Luca,

      Thanks for your questions.

      1. Plank is a great way to treat APT. Why? If performed correctly, it will help you become familiar with the correct neutral position of the pelvis. On the other hand, if done incorrectly – will make your APT worse.

      2. It sounds like you have an asymmetric pelvis. This basically means, if I were to look at you from the front, side or back, your pelvis would not sit evenly in any view point. In conjunction to fixing your APT, you will likely need to address these other issues as well.

      To fix this, the first step is to make sure your pelvis is symmetrical when your’re sitting.Check out this post: How to position your pelvis in sitting. I can almost guaranty you probably sit favouring one side more.

      To go deeper into it, which side is the higher side?

      Mark

      1. Hi Mark, thank you very much for your reply. Makes total sense.
        1. On the plank, so essentially, I need to do it right. Honestly, I will mainly stick to your exercises above. However, I am physically fit and didn’t know if I should incorporate anything tougher, or just keep the gradient simple and start with the above? Some of them I find quite tough! Would you advise anything different or keep it simple to start?
        2. Wow, I see. Okay. Yes. So it would be my right hip, ie the right side that is higher than the other. The amount isn’t great, but it is definitely the case. I had it checked out for any leg length discrepancy and that doesn’t appear to be the case, so not sure how or why this would be. Does this answer your question? I am definitely interested in tackling the whole thing! Appreciate your help and any input Mark!

        1. Hi Luca,

          1. Keep it simple to begin with. Master the basics. Then progress.

          2. If you have your right hip higher, and you’ve ruled out a leg length discrepancy, then I would assume that you may not be activating your right glute muscle.

          If you go to Youtube, and search for: “glute medius wall push exercise”, this exercise should help balance out our pelvis. You might need to stretch out your right groin muscles as well.

          Mark

          1. Hey Mark,
            Tks again for your help and input. Very appreciated. Totally with you on both pointsm I’ll keep it simple as you say and will get onto that exercise as well. I don’t want to go to much more into it here (thought I might write to you separately if that’s alright with you) – but I did have one more question. I am an avid runner, and enjoy swimming as well. I have mixed info on running in terms of it being beneficial or not with such a problem (as APT), but only have positive data on swimming (essentially endorsing it). However I wanted to check with you first on this as I would like to continue running and swimming, but do not want to detract from these exercises I’ve started. Do you have any input on this? Tks again for all your help!

  15. Hi Mark,
    I’ve been suffering with horrible neck and upper back spasms for almost 2 years. This has led to thoracic outlet syndrome. About 6 months ago, my glutes and hips started killing me also. I recently discovered that i have an ATP. My pt thinks that my tight upper body led to the tilt. However, a trigger point specialist that I’ve been seeing believes that the ATP was caused by Morton’s toe causing my foot to turn in while walking which in turn led to the neck and upper back spasms and trigger points. What is your take on this?

  16. Hey,

    really great article! I’m starting these exercises this week 🙂 I was also sitting a lot in my life… I’m trying to reduce this as much as possible….

    I have one question:

    I started to strengthen my glutes some weeks ago. I did it every day. Also during the day (for example at the subway while standing 😉 After a while my left buttcheeck started to get tight and hurt. In addition my lower back on the left side started to hurt as well. Do you think I might have maybe overdone it?

    Thank you very much!

    Best,
    Michael

    1. Hi Michael,

      Great to see that you are taking action and doing the exercises!

      Just be careful not to over do the exercises. Your body has its limits and when you do something that your body is not used to, your body may start to ache.

      Gradually progress the intensity of the exercises.

      See how it goes!~

      Mark

  17. Hi Mark
    Thank you for this detailed plan! I’ve had this problem for 10 years (I’m 25 and was a horse rider). I have only over the last few months identified that it is ATP. After suffering a groin tear during exercise, I wanted to know why. Seems that it was the ATP! I think doing a PhD (what feels like eternal sitting) certainly exacerbated the issue.
    I’m getting right on to this plan tonight and am excited to see if it works after a while. I’m looking forward to no longer have a protruding belly!
    One question- do you have an opinion on sitting wedges for chairs?
    Again, thank you so much.

    1. Hi Jade,

      Sitting wedges are great. They help keep the pelvis tilting slightly forward which helps with good posture. (as most people tend to tilt the pelvis backwards)

      However, I would encourage you to try to maintain correct pelvic alignment using your muscles.

      Mark

  18. Hi Mark,

    Thanks for this article, very helpful indeed! I have had atp for years (close to 20 yrs) and never realised that it was a condition – just thought that’s the way my body was. I always had pain on my lower back but learnt living with it I guess. In the recent years, I started working out only to end up with a physiotherapist who advised me of my condition! Now, for a month I do most of the exercises mentioned here..I realised that my sitting posture is not bad, but when I stand close to a wall, one can actually put their whole hand through my lower back. Do you think it is still possible to correct mine?

    1. Hi Saranya,

      You have had your posture for a long time now, so it may take some time to see significant improvements.

      I know it can be discouraging at times, but we all have to start somewhere. But the good thing is that it only gets better from here on with your ongoing effort with the exercises 🙂

  19. I have picked up a number of strange posture and alignment habits over the past 5 years while trying to rehab 2 back to back ACL ruptures and surgeries. I am starting to think that maybe part of the reason is that I have developed APT, is this a common response to ACL trauma?

    I also find that my foot on the affected leg points ‘toes-out’ by quite alot, 45°+. Perhaps due to years of trying to protect the injured leg. Do you happen to have any articles on that? Currently I am trying to foam roll and loosen my glutes because it may be their tightness that is pulling my foot outwards? This is giving me minor success, wondered if you had anything more.

    Funny how after an injury you start to see how everything is connected! From the knee to the back to the neck to your behind!

    1. Hey Tom,

      I unfortunately do not have any article regarding your toe out pattern. It seems like you have something we call “Duck feet”.

      If you have been stretching and releasing your glutes with minimal success, try doing this exercise:

      Popliteus exercise

      Your toe out may be due to this rather than your glutes.

      Hope this helps!

      Mark

  20. Mark, I have either APT or a mild case of swayback. The only side effect I’m having is with my sleep. I wake up quite often with lower back pain(sometimes in my hip) . I’m pretty sure if I changed my mattress it would help a lot.
    What type mattress do you recomend?
    I’m thinking latex.
    The discomfort/ mild pain normally goes away shortly after rising from bed.TIA

  21. Wonderful article, Mark. Thanks for the tips! I’ve noticed that I’ve had APT for quite some time now, so I tried to get it fixed by visiting a physio. I had around 7 sessions which was a mixture of ultrasound and stretching, and it eased the back pain, but sometimes the back pain comes back, and my back is still super curved. I’m doing everything that I can – I don’t wear high heels any more, I don’t sit down for long periods of time, I do hip flexor stretches everyday as well as planks (although, I don’t plank everyday…). Any idea what else I can try? Should I see an chiropractor so they can have a look at my spine?

    Many thanks

    1. Hi Jade,

      If you have been stretching your hip flexors regularly, I would then recommend practising and getting good at the Dead bug exercise. This will help maintain the pelvis in a neutral position.

      Focus on keeping that lower back flat.

      Chiropractors are great. Just make sure they are giving you some exercises to help you maintain the effects of treatment.

      Hope this helps you.

      Mark

  22. Mark, thanks for sharing all your wisdom on this website! About 6 months ago, I found myself sitting on a hard chair for prolonged periods of time (7-8 hours/day for months, w/ very few breaks during the day). Since then, I have had really bad pain in the buttocks. It started on the left side only and now it’s both sides. On right side, pain is near the saddle region, so I’m thinking it may be bursitis? On the left side, it’s more centrally located and it’s a very sharp, searing pain, so I’m wondering if it’s the piriformis muscle pinching on the sciatic nerve. Anyway, I have had an X-ray and MRI of the lumbar spine- both came back normal. I also had an X-ray of the left hip – came back normal. I went to physical therapy for 5-6 weeks, and the main therapist I saw believed it was SI Joint Dysfunction. However, I stopped going because my pain was much worse after the visits. There was another therapist there who thought it might be muscle imbalances causing my pain. To complicate matters a bit further, I went to a podiatrist who said I have talotarsal dislocation (feet bones misaligned) and that could definitely cause alignment issues up the chain. I’m sorry this is so long, but I’m in my early 30’s and really want to be able to walk around the block pain-free again! Thanks for any advice you might have.

    1. Hi Jennifer,

      To better understand the exact location of pain, are you able to specifically mark on an image where you are experiencing your pain.

      Buttock pain can arise for many reasons and it’s very important that you find out what exactly is causing it. You have mentioned a couple of things… all of which could be true.

      In regards to your foot issue, it should not be of a significant problem if you only developed the pain from prolonged sitting.

      Looking forward to your response.

      Mark

  23. Hi Mark my wife is 73yrs of age with a Tilted pelvis been in chronic pain for 15mths she cann stand or walk without chronic pain MRI scans Xrays with the outcome slight wear and tear on the spine nobody has looked at the Tilt and the swelling around the hip area when lying hip movement is fine as soon as she stand thats the problem we are in England and do not appear to be able to solve the problem. could you please advise.

    Regards Mike Ferguson

    1. Hey Mike,

      It sounds like the problem is related to weight bearing of the leg.

      From this point alone, I would suggest doing semi-weight bear exercises such as Hydrotherapy (exercises in the pool) to see if that helps. As she has had long standing pain, it is important that she remains as mobile as possible (… but without over doing it, of course)

      Mark

  24. Hi Mark,
    Thanks for this post! I have been finding increasing lower back and hip pain and this article is very helpful. I know for certain that I have ATP. I have had mild lower back pain off and on for the past 20 years. However, I have found that after carrying 3 children, the problem has been aggravated. I have noticed in the last 6 years since my last two children have been born that I will get sudden wrenching cramps in my lower back/hips which seems to/feels like it is putting pressure on my sciatic nerve. Also, I do not sit a lot, (but I may be sitting wrong), I do however stand/walk a lot barefooted on hard wood/tile floors.
    I guess I have 2 main questions:

    1- Should the problem be addressed in the same manner listed in your article regardless of if the problem is caused by strained posture & muscle tone from child bearing instead of excessive sitting? I also have a mild case of diastasis recti. I am wondering if the abdominal therapy mentioned in your article would need to be altered to account for this, so as not to worsen but rather improve that condition.

    2- For exercise I have found running hurts my knees and feels like it compresses my lower back, so I prefer to cycle. It does work these hip/lower back muscles a lot, but with less pounding pressure. Is that not a recommended form of exercise if I am working to correct my ATP? Or are there some specific stretches that I can do so I can continue to cycle?

    Thank you!!
    Ann G

    1. Hi Ann,

      Some great questions there.

      1 – On top of pregnancy, Excessive carrying can also cause an Anterior Pelvic tilt. How? When you are holding something in front of you, the tendency is to over arch the lower back and puff the lower chest upwards (which causes the pelvis to tilt forward). You can do the same exercises as mentioned above.

      Your diastasis recti will benefit from the core exercises mentioned. Be sure to focus on drawing the belly button towards the front of your spine (think about sucking your stomach in) to engage the core appropriately. I would not encourage you to excessively tense your stomach muscles as this can cause further separation of the abdominal muscles.

      2- Cycling is fine. Just make sure you are engaging your core muscles and keeping your pelvis in a neutral position.

      The stretches in the post are great for you to do as well.

      Hope this helps you!

      Mark

  25. Hey Mark, I’ve been diagnosed with ankylosing spondylitis and suffer from severe sacroiliac pain at times. Just want to say thanks for this write up as I do believe I have APT (as a symptom from the above). The stretches really help to relieve the pain and tightness. I appreciate your work! Cheers, Marcus

  26. Hi Mark!
    Thanks for this article. I have recently discovered that I have ATP and I’m starting this routine to help correct it. Quick question: in addition to these exercises, I have been experimenting with trying flex my pelvis into the correct position as I go about daily life- squeezing my glutes and pushing my pelvis forword. I can do this okay when standing still, but I cannot put my pelvis in this position without locking my knees, which makes it impossible to walk around while maintaining this position. Is this normal or am I doing it all wrong? Will it fix itself after strengthining my muscles a little bit from these exercises? Thanks

    1. Hi Autumn,

      It could be that you need to focus a bit more on stretching and releasing your tight muscles so that it allows the pelvis to move independently of your knee position.

      Mark

  27. Mark,
    Thank you so much for this article and your enlightenment. I will be starting your stretches and exercises and I’m certain your program will correct my Donald Duck syndrome.

  28. Hey Mark.

    I noticed back pain when i “hanged” myself off a bar. I was holding and i wanted to see how would it feel if i let my core stop , and i noticed a good amount of pain in the lower back. It felt , and still feels like , if i were to let it SNAP (because i feel like it needs to be “pulled apart”) , i would maybe feel better ? Maybe even be taller for a cm or something. Lets get to the point ?
    I am 15 now , and …. im 100% sure i have APT. I mainly used my lower back instead of the abs to hold my posture , therefore creating so much tension on the back , compared to little to no tension the front. I have the “Donald D Syndrome” i guess. I see my back arched backwards along with my butt showing off too much. My stomach is going to the front as well and before i thought it was my chest being too small compared to my abs. I am also sure about the APT because i’ve been noticing small pain in the knees , and they often snap when i do a squat. I also noticed my knees are at the angle, and when i went to the doctor he said they’re perfectly fine, but he didnt look at my back , right?

    I need to know how much time would i need to fix this. I dont want this to affect my looks as well. Is around a month of doing this daily enough ? I want to rush , month would feel like a year, and im pretty sure i could do these for min. 30 min every day.

    Thank you for your time i guess , this is a long post.

  29. Thanks for the great information. I had no idea I had atp.(neither did various physios and doctors)

    I have patellar tendonitis and hip flexor pain. I have been doing these exercises for around 2 weeks and the first time in 6 months my knees are improving. I am able to activate my glutes on demand now which is a great improvement from before where they were completely lifeless.

    I’m hoping my hip flexor pain will improve, this only begun a few weeks ago. Also when I stand straight my shoulder blades poke out. Could this be another symptom of my atp? Thank you again.

    1. Hi Dave,

      Your ATP affects the whole body… so it is definitely possible that it may be causing your shoulder blades to poke out.

      However, you may also have local issues at the shoulder blade region as well that can cause it.

      2 main reasons for this:

        1. Tight chest muscles (Pec minor) – This muscle at the front of your chest can tilt your shoulder blade causing it to poke out.
        SOLUTION: Stretch your chest muscles out.

        2. Weak Serratus anterior muscle – One of the main roles of this muscle is to keep the shoulder blade flat on the rib cage.
        SOLUTION: Push up plus exercise.

        Mark

      1. Hi mark. I have APL( I use big shirts, it’s very bad looking) today I’m starting this experience…. how many months I’m trying this experience.. for correct my APL)

  30. Hey Mark,

    I first of all want to say great post! I have found the stretching and exercises very useful. Over the passed week I realized just how bad my anterior pelvic tilt is. My issue is finding the correct position for my pelvis to be in. My question is when I’m looking for the two pointy bones and I try to correct my pelvic tilt, I feel like my spin compresses and I feel shorter, Is this normal?
    Thanks in advance Mark, I really appreciate your articles as I discover more and more.

    Cheers,

    Liam

    1. Hey Liam,

      You may be over correcting the position of your pelvis.

      If in doubt – Move your pelvis to a slightly lesser degree as you find your neutral pelvis position. It may take some time for your body to get used to the new position.

      Mark

  31. Hi Mark,

    I recently discovered that I have ATP, and all this while I thought that I just had bigger bums hence tried as much cardio as I could but had no relief.

    My daily routine involves sitting at a desk for 9-10 hours and 3-4 hours travel sitting in a bus both ways

    Symptoms I noticed were recently were the following
    Bad posture obviously
    Back Pain
    Knee Pain (not often though)
    Feeling tired and Lethargic

    But since I started my job 6 years ago I only noticed fat in the hips 2 years after I joined thinking its FAT that has accumulated by long hours of sitting but that was ATP due to bad posture so I guess have had ATP now for almost 4 years

    Out of all the posts/blogs on the internet I think your’s is the best. Thank you so much for sharing all this information.

    I have a some questions I would like to ask you :
    1) Recently,I am being regular at the GYM and there are lot of exercise that I do. My Trainers have not heard of ATP hence I would like to know are there any stretches or Exercises that I should avoid ?

    2) Its alright if I lift weights ?

    3) I shall start the exercises mentioned by you today , when do you think I should atleast see some change in order to feel that the exercises I am doing are being effective ?

    Again, thank you so much and apologies for the long comment 🙂

    Rohan

    1. Hi Rohan:

      Here are some suggestions:

      1) Recently,I am being regular at the GYM and there are lot of exercise that I do. My Trainers have not heard of ATP hence I would like to know are there any stretches or Exercises that I should avoid ?
      You can do all exercises provided that you aim to keep your pelvis in a neutral position. You can still stretch your hamstrings – but don’t do it excessively.

      2) Its alright if I lift weights ?
      Hell yeah! Pay attention to how your body is responding to your exercises. If it feels uncomfortable or painful, change your technique.

      3) I shall start the exercises mentioned by you today , when do you think I should atleast see some change in order to feel that the exercises I am doing are being effective ?
      It really depends on a) how tight your muscles are, 2) how weak your muscles are and 3) how quick your body is to learn how to control the pelvis. You should see effects very quickly, but think about this game in the long term.

      Hope this helps you, my friend!

      Mark

  32. I have been looking for stretches and mild exercises for APT on/off for a few months now, and you have done a great job describing them and showing what to do! This will be the site I refer to as I start to try and better my back. Especially the stretches look really good as I feel a lot of tightness and a need to stretch, but I haven’t known how to stretch properly. It all looks fairly easy to do, as well, which is good since my overall muscle tone is weak from years of inactivity due to illness. I need a soft start and I’ve had trouble finding it =)

    1. Thanks for dropping by Maria,

      Glad to know that you are actively seeking to fix your APT issues once and for all.

      Please contact me if you need more help!

      Mark

  33. The Best site for posture ever! Thank you SO much! You are saving us. I always though I have a sway back but with your help, I understood my problem is a mixture of forwarded head, anterior pelvic tilt, and rounded shoulder. I am determined to solve it with the help of you. recently I have got very bad pains in my back and I know I should do something about it because I am only 27!!
    Again thank you so much!

  34. Hi Mark,
    I always thought I had a sway back but you have helped me understand that I have APT. I never really suffered pain from it in the past ( maybe because I have always exercised?).
    My question: I have been suffering from bilateral Achilles Tendonosis and I have very tight calf muscles. During pt the therapist told me that I have weak glutes and that was part of my Achilles issue. Could the apt cause the weak glutes and that in turn lead to Achilles issues? Also I’m thinking I might possibly have some disc issues (I am 57). Could apt be exacerbating that too?
    Thanks so much for your very informative articles and taking the time to answer questions.

  35. Hi Mark,
    I always thought I had a sway back but you have helped me understand that I have APT. I never really suffered pain from it in the past ( maybe because I have always exercised?).
    My question: I have been suffering from bilateral Achilles Tendonosis and I have very tight calf muscles. During pt the therapist told me that I have weak glutes and that was part of my Achilles issue. Could the apt cause the weak glutes and that in turn lead to Achilles issues? Also I’m thinking I might possibly have some disc issues (I am 57). Could apt be exacerbating that too?
    Thanks so much for your very informative articles and taking the time to answer questions.

    1. Hi Joanne,

      When you have an Anterior Pelvic Tilt, your glute muscles are placed in an ineffective position. As a result, the glutes are hard to recruit and thus can be weak.

      Since your glutes are not working properly, your calf muscles (and your achilles tendon) has to work harder to compensate for the glutes.

      So, on top of direct treatment to your achilles, you should also aim to fix your APT.

      In terms of disc issues, that is fairly common with an APT. But better to get a scan to check that out.

      Mark

  36. Hi! Your website is awesome! I have ATP and would like to correct it because it has caused me lower back pain for awhile. I have 2 children now under 18 months and as a result, diastasis recti. Any suggestions for alternative strength exercises that won’t further damage my core but will help my posture problem? I know planks are a big no no, and bridges probably are too!

    1. Hi Antoinette,

      In my opinion, it is fine to do planks with diastasis recti

        providing that you are able to maintain

      :

      :

      a) Proper breathing
      b) Activation of your deep stabilising muscles
      c) Proper alignment of your ribs into the pelvis.

      If you are a bit hesitant to do planks, I would suggest you to focus on the “DEAD BUG” exercise as shown in the above post.

      Hope this helps 🙂

      Mark

  37. Hi mark, I have had a bad problem with my si joint for nearly a year meaning that I can’t play football anymore. I’ve tried stretching and strengthening exercises, but after reading your articles I have all the symptoms of an apt too. I have always been active and trained but the last 7 years I have gone from climbing everyday to sitting behind a desk and driving all day. I’ve wondered why my lower abs stick out even when I’m lean and my lower back has always ached. My hamstrings are very tight and so are my hip flexor and groin to the point where they cramp up very easily in certain stretches / positions. I am going to start your routine of exercise. Have you seen a link to apt and si joint pain / delayed recovery? Thanks for the great articles

    1. Hi Adam,

      From what I’ve seen in my patients with APT, there is a lot of “unlocking” of the SI joint (anterior rotation of the pelvis/posterior rotation of the sacrum).

      This causes a lot of friction and irritation to the SI joint and Ligaments surrounded the area.

      See how you go with these exercises first. Pay particular attention to the gluteal strengthening exercises as these are one of the main stabilisers of the SI joint.

      Please let me know how it goes !

      Mark

  38. Hi. I just stumbled upon your website and i think it could be helpful for me in my future endevours to fix APT but the problem is now im so demotivated as nothing seems to work. I’ve had APT since I was 12-13 due to sitting all day and playing video games on chairs throughout my teenage which are the growth years. I am 22 now when i realized this is a huge problem for me as i have a huge curve in my lower back.

    Now almost for the past 2 months I’ve been doing strengthening exercises for glutes and abs and stretching workouts for hipflexors and quads everyday and eating healthy but i haven’t seen any change in APT. No matter how much I workout the abs and glutes or stretch quads and flexors the front part of my pelvis and legs wont give in. Its always so tight and pulling my torso down. which in turn wont let my pelvis go back into a neutral position and stand straight. Although I have developed stronger abs/glutes now than before but no change whatsoever in my APT. I am even conscious of my posture all the time.
    This has made me think that either this extreme APT is embedded so hard in my neurological system due to it being established in my puberty/growth years or its just genetic. Whatever the case is im just frustated now and want to get rid of it asap. I even consulted a physical therapist who evaluated me and basically just gave the same stretching exercises that I already knew and some I was already doing. I need help. Thanks

    1. Hi Kiyani,

      It can definitely be frustrating! But if the exercises are not helping, we might need to try something else.

      It sounds like there may be other areas of your body that need to be addressed in order to completely fix your APT.

      People usually have an APT as a result of some sort of dysfunction elsewhere in the body. And for you, this is probably the case.

      How does the rest of your posture look like?

      Mark

      1. Other than this hyperlordosis I have a healthy body. My ankles, knees, legs are fine and straight and strong as well as my upper back, neck and shoulders. I’m 5’7 and about 155 lbs currently. I’ve never ever had any injuries or pains. The thing is that I’ve had this APT for almost a decade now and its really extreme. I am trying stretching and strengthening of the respective muscles everyday but to no avail. I know 2 months is not enough time to fix it, least of all for me but I should’ve atleast seen some improvement if it was working don’t you think?

        There is this one thing. I do sleep on my stomach and cant sleep on my back. I cant even lie on my back for for than a few minutes or I get tired. Same goes for standing.

        When I see a side-view of my body in a mirror, I see the front part of my pelvis being pulled down really hard and my but sticking out, and that hyper-extension in the lower back so I know its APT. If only I could elongate the muscles in the front part of my body (pelvic region) somehow I know I will stand perfectly straight. I’m even loosing an inch or half in my height as all my brothers are taller with exact same inseam lengths.

        What do you suggest. And Thanks Mark for your support, really.

        1. Hey Kiyani,

          Are you being effective with your quadriceps and Psoas/iliacus stretches? (are you feeling the stretch where you need to feel it?)

          Have you had any luck doing a combination of stretches and foam roll releases?

          Sounds like the muscles at the front of your hips are super tight! The longer you’ve had this issue, the longer it is going to take to see some improvements. Even if you have been consistent for the past 2 months, you have probably had this tightness building up for 10+ years or so.

          Looking forward to hearing from you.

          Mark

          1. Yes that’s exactly what I think too You are spot on in my case. The stretches I do feel them stretching my quads and hipflexors but I think what u said is that I’ve had it for so many years so I need much more time to see any change.

            And Yes the front part of hips are indeed super tight. I haven’t ever tried foam roll releases as I was never familiar with it. But I think I will give it a try as you suggested. I am really hopeful about foam rolling and the other day I did try testing this theory with a tennis ball and afterwards did feel a little bit longer and easier in the my front part of pelvis.

            I’l keep on going for a few months and I’l add the foam roll thing to my routine. Thanks for your support and suggestions and hats off to a fabulous website. Really the stuff dedicated to helping people in trouble is simply priceless!

  39. Hi,

    I understand that strengthening the glutes and hamstrings is important, but I seldom see deadlifts as a recommended exercise for people with anterior pelvic tilt. Along with the above stretches and exercises I am keen to incorporate deadlifts and hamstring curls into my workout. Could you please let me know if this is not recommended.

    Thanks.

    1. Hi Nab,

      Dead lifts are a great exercise!

      You just need to make sure that you do not over arch your lower back as this will mean that your pelvis is going into an anterior pelvic tilt in relation to your spine.

      Mark

  40. I just found I might have APT, question is how does it feels going from APT to Neutral? Will it have any affects on muscle building?

    1. Hi Sylvester,

      Since your body is probably used to the APT (including when you are lifting), suddenly switching to a neutral pelvis may feel a bit awkward at first.

      As all of your other muscles are used to functioning with the pelvis tilted forward, it may take some time for the other muscles to “re-calibrate” to work with a neutral pelvis.

      In the long run, although it will feel odd to being with, it will always be better to maintain a neutral pelvis.

      Mark

  41. Hi Mark,
    First of all Thnk u very much for helping the people by sharing the info on internet,
    I cant write english well so plz understand what i am trying to explain
    Sir i m a bodybuilder (intermideat level) 5 months ago i train my legs so hard for biger quads
    I got good size on quads But 2 month ago i fell in the mirror my glutes are looking too big
    i did search on internet about this I found my some mistake ,going to heavy squat put attetion on glutes mor than quads And my foot position were littel wrong
    Then i stop the leg exercise bcz when ever i do problem become more (glutes become tight)
    After skipping i have lose size from quads but not from glutes
    Now i found on your website that i have (Apt)
    I have started the stretches
    Hip flexor
    Quads stretch
    Plank (my body goes on vibrate)
    I hav’t train abs ever in the gym bcz i was not having abdominal out but from last month my lower abdominal is out
    lower back have no mass and so tightnes (small lower back i have )
    I just want to fix my posture soon
    1=Can i do leg rais or knee raise for lower abdominal
    I am affraid that they will tight my hip flexor too
    2=.And what about the leg workout routine should b stop bcz i dnt want more bigger glutes
    3=what to do with my hamstrings i dnt know to stretch them or strength in mirror they look big i dnt know they r strong or week
    & Is morning (walk or running) is good or bad for apt ,
    Sleeping on soft matress or hard which is best for apt,

    1. Hi Farhan,

      To answer your questions:

      1. You can do leg raises, but I would suggest you start from a flexed hip at 90 degrees first. This will hopefully target more so your lower abs rather than your hip flexors.

      2. Continue with your leg exercises. You just need to reduce your weight so that you can focus on keeping that pelvis in a neutral position as possible.

      3. “Bridge” exercise (mentioned in post) is a good place to start strengthening the glutes/hamstring. Walking/running is fine as long as you focus on neutral pelvis. And in terms of sleeping, the general rule is to sleep on as firm mattress as you can comfortably sleep on. Check this post out for more info on sleeping position.

      Mark

  42. > Sir I myself can’t differentiate and tell about the problem actually
    wat is to be…I have problem in left pelvic moving front and right
    scapula dyskenesis..i dont know how this problem starts but at age 10 i
    fall down from wall and left ankle tilted I can’t can’t walk one month i
    didnt see any doctor that time i am in village some person did massages
    and after 1 month pain gone and i left about this..then at age 17 one day
    morning i wake up from bed and ran for some issue..that time i got pain in
    left side front hip..after this problem happen i cant able to walk properly
    still now ..last 7 years i am seeing multiple specialist doctors
    neurologist and physiotherapist I had been taken 4 MRI 1 CT scan more x
    rays EMG EEG blood test.. But result comes normal..problem not corrected
    yet..
    >
    > I can’t sit stand and walking properly.. Posture deviation.. I told this
    to doctor But they are not understand my problem they seeing only reports
    giving only tablet and take conventional Physio therapy..this can’t help
    me..
    >
    > Lots of side effects one physio put cervical traction after this I have
    pain in occipital region..my neck posture change gets forward head
    posture.

  43. Great article . Have you heard of the don tight method ? He recommends a lot of corrective excercises and ab work .
    However I have a lot of snapping hip along with my anterior tilt . A few years ago I had Acl reconstruction and went back to bilateral excercises. Silly me, now I have a major glute imbalance . That side on the left now also had a foot injury so the QL is tight as the hip is also lower that side .

    I was doing lots of straight leg raises with control but found core strengthening helps . However , should my focus be bringing the glutes up to balance ? I’m doing only kolat retail work now and it’s working .

    Also how about back extensions ? As the spinal erector a attach into the posterior part o the pelvis am I right in saying they are weakened via anterior tilt ? Therefore strengthening might pull the pelvis up?

    1. Hi Dixon,

      If you have a significantly weaker glute muscles, strengthening the lagging side should definitely be a priority for you.

      You can still do back extensions with an anterior pelvic tilt, however, you want to make sure that you perform the exercise with a NEUTRAL pelvis.

      Mark

  44. Hey Mark! Thanks a lot for such an informative article! I have been searching a lot of articles on this topic and found yours to be the most appropriate and helpful. 🙂

    I have been suffering from APT since an year and it’s very embarassing. I have to study a lot so I guess its due to excessive sitting while studying.

    I have decided that I will do all these exercises regularly now that I don’t have to am less busy with studies.
    When is the right time to do these? Can I also include a cardio workout routine before this? I used to do a specific cardio workout earlier like an year ago and guess I took like a really very long break from it. Kindly tell me if I can do these exercises after the workout.
    And sorry for the long comment. Thanks.

    1. Hey there Squid,

      Thanks for your compliments. 🙂

      In regards to when to do the exercises… Any time!

      You can definitely do cardio workout routine before hand… but make sure that you are trying your best to maintain a relatively neutral pelvis.

      Mark

      1. Thanks for replying Mark! 😀
        Sorry I ll be troubling you again with my questions.
        Thank you .I have tried these exercises with the cardio and will keep doing so to see results.
        The thing is I dont sweat at all during this routine , so I searched about the condition and turns out it is called hypohidrosis. It seems like a very dangerous situation as it can cause overheating of the body and well I feel really dizzy after the exercises. I am drinking lots of water to stay hydrated before and after the workout but it’s really bothering me I dont wanna die . Just kidding. I do sweat when it’s hot ( usually the back ) but there is very less sweat so I am worried. I also got damaged and tanned my skin over the years because where I stay is hot and I loved roaming around in the sunshine . Idk why though.
        I am assuming you might not be familiar with this condition but if you are , kindly let me know what I can do to sweat after work out. ( why wouldn’t I want to sweat , it’s healthy!)
        If not , its ok. I already appreciate your reply and great articles a lot! 🙂

  45. Hi Mark,
    I was researching my problem and I have to say, yours is by far, the most detailed article on APT I saw on the net.Thank you for this.

    I’m kinda stuck cuz I don’t know if I suffer from anterior pelvic tilt or sway back or a combination of the two. What do you think ?

    http://m.imgur.com/a/kspi7

  46. Hi Mark !

    I came across your site while researching my problem and I have to say: yours’ is the best,most comprehensive article on APT I read online. Thank you for writing this !

    I’m kinda stuck cuz I don’t know if I suffer from anterior pelvic tilt or sway back or a combination of the two. What do you ?

    1. Hi Raj,

      The main difference would be that your Greater trochanter sits in front your ankle joint in Sway back posture.

      Where as in an Anterior pelvic tilt, the Greater trochanter will sit in line with the ankle joint.

      Mark

  47. Mark,

    I am 26 years old, healthy 5’10 weighing 205 lbs with 15% body fat. I sit a lot at work and have a long commute but I work out regularly. My back is always stiff and I have hurt my back a few times even when doing exercises properly. I realized that my back was arched way too much which was causing me to get injured. I started doing research on why that is the case and came to find out that I have anterior pelvic tilt. I looked at body sideways in the mirror, lets say my case is a lot more extreme than average anterior pelvic tilt.

    After reading this article, I am confident this regiment will help me relieve my back pain and fix my anterior pelvic tilt. This is the most detailed article I have read so far and I plan to reading more of these.

    I thank you for posting this and will provide feedback on how my back is doing few weeks from now.

    Keep up the good work!!

    1. Also,

      One thing I want to bring to my attention. I injured my back 4 months ago doing squats and it felt like I pulled something. Due to that injury, I couldn’t move my body for a week and I couldn’t move my left leg due to extreme pain in my back. Even though I have fully recovered from that injury, I notice that my right leg is more dominant than my left. when I do any exercise which require balance of the lower body (Squat, dead lifting, Leg press, lunges. I notice my right foot is always placed ahead of my left one. If i am squatting, or doing stiff legged deadlifts, and stand normally (both feet are aligned) I do not feel comfortable, it does not feel normal to me, and i have to slightly move my right foot head to achieve normality. what would you recommend for that?

      Thanks in advance!

      1. Hi Ubaid,

        Without specifically assessing you in person, it sounds that you may have a rotated pelvis. (and possibly compensations up into your torso)

        You can quickly check this yourself. Close your eyes. March on the spot. Place your hands on your ASIS on both side (see below pic).


        (It’s those pointy bits at the front of your hips)

        Look down at your hands which are on your hips. Is one side a little but more forward compared to the other?

        If it is, it is likely due to an imbalance of the muscles in your body (possibly due to the injury that you previously had).

        Try that first. Let me know what you find.

        Mark

        1. Hi Mark,

          I am not exactly sure since its really hard to tell, maybe it is in my head but I do notice the left side being more pointy.

          Also when I do dead bug exercise shown, and as I am bringing my left leg down towards the floor, I feel this awkward movement in my back (almost like the cracks you hear if you have a tore ligament). However, I do not feel any pain.

    2. Hey Ubaid,

      Happy that you have found this article!

      I am positive it can help with correcting your anterior pelvic tilt.

      It takes time… but it will be worth it in the end when your posture is all good 🙂

      Please keep me posted!

      Mark

  48. Hi mark,
    I’ve been doing each of your excercises and stretches once a day each for about a week. I was just wondering if once a day each is enough. Thanks!

  49. Hey man,
    im a 19 year old male suffering from apt. The main thing i hate is that my stomach bloats even tho i have 6 packs. Can forward head and rounded shoulders can cause it ? Or i should keep doing hip flexor stretch and some strength movements ? And if so how long would it take it?im really really frustrated about this i look like a fat guy eventho my body is fit enough.
    i hope u ll reply
    Have a good day.

    1. Hi there,

      Although forward head posture and Rounded shoulders are related to Anterior Pelvic tilt (APT), I would still recommend continuing with the above exercises.

      You have had your APT for awhile now, and it is going to take some time to correct.

      One thing that you need to make sure is that you are doing other exercises correctly, especially if you do a lot of sport/go to the gym. Doing exercises in the wrong pelvis position will encourage pelvis issues.

      Mark

  50. Hi mark, I am pretty certain that I have apt, and have been doing these exercises for maybe 1 or two weeks.
    Ive asked questions already but I’ve come across more.
    1: How often should I do the excercises and stretches per day each?
    2: Am I doing the planks incorrectly if my back gets really tense while doing them?
    3: Is the propose of the chair stretch to stretch your back or your legs?
    4: Does apt cause fat around your lower stomach, butt and thighs?
    I found this website to be very helpful, I’m just looking to see if I can improve further.
    Thank you!

    1. Hi Jim!

      1: How often should I do the excercises and stretches per day each?

      At least 1/day. But I have had some very motivated patients who aim to do it 3 times. It depends on how severe your APT and how fast you want to correct it.

      2: Am I doing the planks incorrectly if my back gets really tense while doing them?

      You may be letting your pelvis dip too much towards the floor causing your back to arch a little bit. This commonly will make your lower back ache.

      Try to engage your core and lift your pelvis up slightly to maintain neutral spine.

      3: Is the propose of the chair stretch to stretch your back or your legs?

      Your lower back. Although – it can also hit your upper hamstrings (which can get tight if you sit slouched all day in a posterior pelvic tilt.

      4: Does apt cause fat around your lower stomach, butt and thighs?
      APT does not directly cause fat, however, due to the pelvis position, it can cause your stomach to pout out and your bottom to stick out.

      Hope this answers your questions!

      Mark

      1. Thank you so much! The only concern I have now is that when I do the chair excercise I don’t really feel much of anything in my back, yet I do feel some stretch in my legs. Is this ok?
        As always thank you for this great information! I don’t know what I would do without this site!

        1. Hey Jim,

          You want to feel it in your lower back.

          You might want to try a few variations:


          Stretching is a game of angles. So you might need to move your body until you get that desired stretch.

          If you still can’t feel the stretch, just focus on the massage ball releases to the area.

          Mark

  51. Hi Mark,
    Thank you so much for this wonderful article. I have APT since last seven years, its because of some of the reasons you mentioned above. I never used to any exercises. And my posture is very bad obviously with my belly tiers. And I don’t have good chest and arms. Now I wanna get rid of this APT posture and reduce my thighs as soon as possible before building my chest and arms. So how long it takes to get neutral posture?
    And please give some tips to reduce my thighs. Will be waiting for your reply.

    1. Hey hey Raju,

      It can take some time to get a neutral pelvis.

      In terms of exactly how long?… It varies from person to person so I can’t give you a definite period of time.

      In regards to your thighs, stretching the quads out is a good place to start to help reduce their dominance.

      Ultimately you will need to do all the other exercises as well 🙂

      Mark

  52. Hi Mark, great article…I believe my PT occurs on my right size. It feels like a very deep intense soreness/ache almost in the hip area. The slightest recorrecctive move amd it “slips back”. Then feels sore fir a day, then full relief. My hips and tailbone are very “poppy” meaning they Crack easily. Could good be a cause perhaps?

  53. Pingback: Prolonged Sitting: How Long Should You Sit For Before Your Back Hurts?
  54. Hi mark!! Crumbs! Brilliant article!! Very informative!! I wish I could personally have a one to one with you so you could diagnose what’s up with me! Basically I have had a tilted pelvis for years, I stand in a slouched position, hunched back when I sit, I am a 47 yr old female and have had 4 kids, have some diastase recti although not so bad, muscles a lot nearer than they were! But people do mistake me for being pregnant so my tummy is a bit on the large side! I also have slightly bow legs, I don’t seem to be flat footed, but high arches, although left foot is not as high. Basically my problem is this, for the last 3 months I have had a weird bad left knee, basically, pain on inside edge of kneecap, but sometimes pain travels around knee cap area, my quads sometimes twitch, I think I have weakness around my knee, I also had terrible sciatica (left side) when I was pregnant with my last 2 kids, (5 &8 yrs ago) from time to time I have pain in the sciatic area, also my shin are on my left leg also painful sometimes. Basically I am so down in the dumps about all this!! I have been reading on google like mad, taking up loads of time and just scared of what I am reading!! Surgery etc!! Oh mean to add, when to chiropractor and he said pelvis was out, on the right side, I think he said it was higher tan left, when to doctor a month later and she said she thinks it’s arthritis!! Gave me some exercise to do. It was very vague and didn’t say how often etc!! Please please please help me. I am desperate here, really worried invade I told I need surgery!!! Knee feels like dull ache most of time, then other days not bad, then few days later gets a bit bad again, sort of comes and goes, basically that’s my concern, the darn knee! Please help.
    Regards, Alison

    1. Hi hi,

      It sounds like you have an issue with your knee cap gliding in the wrong position.

      This has many causes! (… But also many solutions 🙂 )

      Arthritis is very common. And its presence does NOT mean you definitely need surgery for it.

      To fix your problem, you will need to find out WHY your knee cap is not tracking properly.

      If you want, you can take a photo of your posture (whole body) and I can assess it for you?

      Mark

  55. Hey Mark,
    I’ve had lower back pain for 3 months or longer now. I recently found out that I have a pinched nerve due to one of my legs is longer than the other. Pain medicine doesn’t help and I’m not sleeping at night. My left leg also wakes me up at night with tingling, throbbing, numbing, and burning. I was also diagnosed with Premature Ovarian Failure this year which means I have no eggs. I guess I’m hoping for a small chance of something…Is there a possibility that if I align my back up that I could possibly have some eggs to drop. I just didn’t know if that affected something. I’ve been having a lot of pain in my lower back during intercourse too, but I assumed it was because of my Endometriosis, but the pain is different. It’s like a shooting pain that goes all the way into my butt. Is this due to my tilted pelvis as well?
    Thank you,
    Kimberly

    1. Hi Kimberly,

      When the nerve is involved with pain, it can make everything much more painful and sensitive. (especially at night time)

      Certain positions, movements, coughing/sneezing, and even intercourse can aggravate the nerve. With Anterior Pelvic Tilt, this pelvic position tends to close up the hole which the nerve comes out.

      Here are a few tips that I hope can help you out.

      Sleeping – If you sleep on your back, have your knees/hips bent. You can use a pillow(s) to support them. If you are a side sleeper, place a small pillow in the waist crease and one between the knees.

      Pain management – I assume you are taking pain medication and anti-inflammatory meds. If these are not sufficient to give you a good nights rest, you can consider taking “nerve drugs”. This is best to consult your doctor.

      Exercises –


      Gently bring your knees towards your chest. Make sure this does not make your symptoms worse.This helps open up the hole in which the nerve comes out of.


      This helps stretch out your nerve. Once again, it should not reproduce any symptoms. All you should feel is a firm stretch at the back of your leg.


      This will help stretch out your joints.

      On top of that, correcting your Anterior Pelvic Tilt will be beneficial too.

      Hope this helps!

      Mark

      In regards to the Premature Ovarian Failure – I think the main issue is with estrogen levels in your body (not that I am a doctor or anything). I personally haven’t seen this treated by adjusting the pelvis. But hey, there’s always a first for everything?

  56. I need to understand clearly the third part of this post. How I meant about the brain functioning about pelvic that what I would do each day to let my mind start to roll-over the neutral pelvic position

  57. Hi Mark,
    Brilliant article,I am not 100 percent certain if I have apt or if it is something else,although the symptoms do match apt.please could you help. Thank you.

    1. Hey Adam,

      Usually people get confused Anterior Pelvic Tilt with Sway back posture.

      The main difference is that the centre of the hip joints is in FRONT of the ankle joints. In pure APT, the hip joints are in line with the ankles.

      Feel free to post pictures if you would like me to have a look.

      Mark

  58. Hi Mark.

    Just subscribed to you as I need some major help. I’m a 26yr male and my Anterior Pelvic Tilt is what I call severe. Do you know how long it takes to correct ATP from doing all the exercises listed on your website please? I don’t really care how long as long as it’s fixed but would be nice to have a goal date to reach if you know what I mean.
    I have flat feet and my right knee down to my foot is twisted so my right foot always walks pointing outwards and I’ve had lower back pains for years as I didn’t really clock on to ATP until recently.
    Besides stretches is there medical help you know that I could receive? Each time I look in the mirror I feel depressed at how poorly I’ve looked after my body. I started running a while ago and now do between 4-5km per night for 4 nights a week though it doesn’t seem to help my ATP.
    Just feel at a loss really. Will ATP come back, even once corrected from doing the stretches? Or is it guaranteed success first time?
    Could do with some inspiration.
    Thanks man.

    1. Hey Stephen,

      The exercises can definitely help address your APT. It takes consistency and a whole lot of determination though.

      In terms of how long it will take – it can take anywhere from couple of weeks to months. But the more you focus on fixing it, the faster it will get there.

      If you strengthen and stretch the right muscles and learn to control your pelvis (… and continue to practice), the APT will not come back.

      You might want to be careful with your running though. If you keep running with an anterior pelvic tilt, you will just be encouraging your pelvis to sit in the wrong position.

      Mark

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