Anterior Pelvic Shift: How do I fix it?

What is an Anterior pelvic shift?

anterior pelvic shift

It is the forward position of the pelvis (relative to the ankle joint) as seen in the standing posture.

The Anterior pelvic shift is also referred to as:

  • Forward hip shift
  • Hips pushed forwards
  • Anterior hip shift
  • Forward pelvis position

Note: It is NOT the same as an Anterior pelvic TILT.

 

How do I know if I have an Anterior pelvic shift?

Instructions:

  • Take a side profile shot of your standing posture.
  • Locate the land marks: (see above)
  • Draw a vertical line starting from the lateral malleolus.

Result: If the Greater trochanter is significantly in front of the lateral malleolus, then you have an Anterior pelvic shift.

  • The more forward the pelvis is, the more pronounced the postural deviation.

 

Why is it an issue?

The most efficient and optimal standing posture is where the pelvis is directly stacked on top of the ankles.

With Anterior pelvic shift: To prevent the body from falling forwards, your body is forced to recruit certain muscles to pull the rest of the body back over the base of support.

… this can eventuate into painful muscles and joints!

 

What are the different types?

There are 3 different pelvis positions that can occur in conjunction with an Anterior pelvic shift:


  1. Posterior pelvic tilt (most common)
  2. Anterior pelvic tilt
  3. Neutral pelvis

1. Posterior pelvic tilt (+ Anterior shift)

(also known as “Sway back posture”)

Characteristics:

  • Ankles in dorsiflexion
  • Knees in hyperextension
  • Pelvis shifted forwards in front of ankles
  • Pelvis tilted backwards. (Posterior pelvic tilt)
  • Torso shifts rearwards
  • Upper lumbar flexion
  • Increase load on Thoracolumbar junction
  • Lower ribs depressed

“Where is the tension felt?”

As a response to the Anterior pelvic shift, the pelvis will tilt backwards (posterior pelvic tilt) and the torso shifts rearwards.

This will cause excessive tension in the lower glutes and upper lumbar spine.

 

2.  Anterior pelvic tilt (+ Anterior shift)

(also known as “Military posture”)

 

Characteristics:

  • Ankles in dorsiflexion
  • Fore foot loading
  • Pelvis shifted forwards in front of ankles
  • Pelvis tilted forwards. (Anterior pelvic tilt)
  • Prominent lumbar spine arch
  • Flared ribs

“Where is the tension felt?”

As a response to the Anterior pelvic shift, the lumbar spine will hyper extend to bring the center of mass over the base of support.

This will cause excessive tension in the lumbar spine.

3.  Neutral pelvis (+ Anterior shift)

Note: Since the femur (upper leg bone) is already angled forwards in an anterior pelvic shift, a neutral pelvis RELATIVE to the slanting femur would mean it would already appear with an anterior tilt.

 

Characteristics:

  • Ankles in dorsiflexion
  • Fore foot loading
  • Pelvis shifted forwards in front of ankles
  • Neutral pelvis (relative to femur)
  • Torso shift rearwards
  • Increased load of lumbar muscles.
  • Lower ribs flared

“Where is the tension felt?”

As a response to the Anterior pelvic shift, the torso shifts rearwards.

This will cause excessive tension in the lumbar spine.

 

 

 

How to tell which type you have:

Instructions:

Results:

  • Anterior pelvic tilt (Red) : The line will be significantly slanting forwards.
  • Neutral pelvis (Orange): The line will be moderately slanting forwards
  • Posterior pelvic tilt (Green): The line will be slanting backwards, horizontal or even slightly forwards. (depending on the degree of posterior tilt)

Please note that this is an approximate method to determine the pelvic tilt as it is really dependent on the degree of forward lean.

Exercises to fix Anterior pelvic shift


Image courtesy of Master isolated images at FreeDigitalPhotos.net

 


Note: These exercises are to be conducted gently and pain-free. If you have any doubts, please feel free to contact me on the Facebook page.


 

Step 1: Release the Tibialis anterior

A tight and/or overactive tibialis anterior muscle will pull the shin bone forwards.

Releasing this muscle will help allow the shin bone sit more perpendicular. In turn, this will make it possible for the hips to sit directly on top of the ankles.

Instructions:

  • Place the front/side of your shin on a foam roller. (see above)
  • Apply an appropriate amount of body weight.
  • Foam roll the whole muscle for ~1 minute on each side.
  • Additionally – you can follow up with a stretch to the tibialis anterior.

 

Step 2: Practice weight shifts

Instructions:

  • Whilst standing, sway your pelvis in the backward direction so that it is stacked directly on top of your ankles.
  • Focus on shifting your body weight onto the back of the heel.
  • The aim of this is to get you used to being in the stacked pelvis position.
    • … it is likely you will feel like falling backwards at first!
      • Hinge forwards at the hips.
  • Continue for 1 minute.

 

Step 3:


I have split the section into 3 main parts:

  • Posterior pelvic tilt
  • Anterior pelvic tilt
  • Neutral

Follow the section that is appropriate for your individual situation.


1) For Posterior pelvic tilt

READ THIS:

For a comprehensive and complete guide on addressing this issue, check out this blog post: How to fix Sway back posture.

(… I cover everything that you will need to know over there!)

For the purpose of this post, I have listed the 5 main exercises to get you started. 🙂

 

1. Hamstring release

Instructions:

  • Place your hamstrings on top of a massage ball.
  • Apply an appropriate amount of body weight.
  • Perform circular motions.
  • Make sure to cover the whole area.
  • Duration: 2 minutes each side.

2. Hamstring stretch

Instructions:

  • Whilst standing, place your leg in front of you.
    • For upper hamstring: Slightly bent knee.
    • For mid/lower hamstring: Straight knee.
  • Hinge forwards at the hip joint.
    • Keep your back completely straight.
    • Point your foot.
  • Ensure that you can feel the stretch in the back of your leg.
  • Hold stretch for 1-2 minutes.
  • Repeat on both sides.

Pro tip: Want to know more stretches for your hamstrings? Check out this post: Every hamstring stretch that you need to know.


 

3. Upper lumbar extension

Instructions:

  • Lie on your stomach.
  • Prop your torso onto your forearms.
  • Arch backwards as to feel pressure strictly in the upper lumbar region only. (see arrow)
  • Lift up your lower ribs at the front.
    • You may get a stretch around upper abdominal region.
  • Repeat 30 times.

4. Planks

Instructions:

  • Assume the plank position. (see above)
  • Keep your core engaged:
    • “Gently draw your stomach in.”
    • Do not tuck your tail bone underneath you.
  • Make sure that the pelvis does NOT droop towards the ground.
  • Maintain a straight line between the shoulder, hip and ankle joint.
  • Hold this position until fatigue.

5. Standing pelvic tilts

Instructions:

  • Stand with your hips stacked over your ankles.
  • Perform an anterior pelvic tilt
    • “Imagine your pelvis is a bucket and is tipping forward.”
  • Hold for 10 seconds.
  • Relax into a neutral pelvic position.
  • Repeat 30 times.

 


How to stand:

  • Stack your hips directly over your ankles.
  • Perform an anterior pelvic tilt to bring pelvis to neutral.
  • Lift lower ribs.
  • Extend the thoracic spine.
  • Retract and spread shoulder blades.
  • Retract and elongate neck.

2) For Anterior pelvic tilt:

READ THIS:

Before you read any further, I strongly urge that you check out this post: How to fix an Anterior pelvic tilt.

(… I cover everything that you will need to know!)

For the purpose of this post, I have listed the 5 main exercises to get you started. 🙂

 


1. Lumbar erector release

  • Quadratus lumborum
  • Thoracolumbar fascia
  • Paraspinals

Instructions:

  • Place a massage ball underneath the targets areas (see above)
  • Apply an appropriate amount of body weight on top of the ball.
  • Perform circular motions.
  • Duration: 1-2 minutes per side.

2. Lumbar stretch

Instructions:

  • Lie on top of an exercise ball with your stomach facing downwards.
  • Shift your weight onto your hands.
  • Make sure your legs are completely relaxed.
  • Aim to feel a deep stretch in the lower back.
  • Hold this for 1-2 minutes.

Pro tip: If would like to see more lower back stretches, check out this post: 12 ways to stretch out the Quadratus Lumborum.


 

3. Hip flexor stretch

Instructions:

  • Assume a deep lunge position as shown above.
  • Perform a posterior pelvic tilt.
    • “Tuck your tail bone underneath you.”
  • Lean slightly backwards.
  • Lean away from the back leg.
  • Aim to feel a stretch in the front of the hip.
  • Hold for 1 minute.

 

4. Standing Posterior pelvic tilt

Instructions:

  • Stand with your hips stacked over your ankles.
  • Perform a posterior pelvic tilt
    • “Tuck your tailbone underneath you.”
  • Engage your glute muscles.
  • Hold for 10 seconds.
  • Repeat 30 times.

Pro Tip: For a complete list of glute strengthening exercises, check out this post: Is sitting destroying your butt muscles?


 

5. Anterior core strengthening

Instructions:

  • Lie on your back as shown. (Position 1)
    • Keep your lower back completely flat on the ground.
  • Activate your core muscles.
    • Gently draw your stomach in.
    • Brace your abdominal region.
  • Lower opposite arm/leg as low as possible. (Position 2)
    • Do NOT let your lower back arch.
  • You should feel NO tension in the lower back. It should all be in the abdominal region.
  • Alternate between sides for 10 repetitions each.

Pro tip: For more variations of this exercise, I recommend reading this post: Dead bug exercises.


 

 


How to stand:

  • Stack your hips directly over your ankles.
  • Perform a posterior pelvic tilt to bring pelvis to neutral
  • Reduce lumbar arch by dropping lower ribs down.
  • Extend thoracic region
  • Retract and spread shoulder blades
  • Retract and elongate neck

3) For Neutral pelvis

READ THIS:

Since the pelvis is already in a neutral position relative to the femur, the areas of focus would be:

  • Ankles (see Step 1 + 2)
  • Reduce Lumbar extension

 

1. Lumbar erector release

  • Quadratus lumborum
  • Thoracolumbar fascia
  • Paraspinals

Instructions:

  • Place a massage ball underneath the targets areas (see above)
  • Apply an appropriate amount of body weight on top of the ball.
  • Perform circular motions.
  • Duration: 1-2 minutes per side.

2. Lumbar stretch

Instructions:

  • Lie on top of an exercise ball with your stomach facing downwards.
  • Shift your weight onto your hands.
  • Make sure your legs are completely relaxed.
  • Aim to feel a stretch in the lower back.
  • Hold this for 1-2 minutes.

3. Thoracic extension

Instructions:

  • Lie on your back with a foam roller under your thoracic spine.
  • Arch backwards as to feel pressure strictly in the thoracic region only.
    • Target the area where your back is rounded the most.
  • Keep your lower ribs down.
    • Engage your abdominal muscles.
  • Hold for 1 minute.

4. Anterior core strengthening

Instructions:

  • Lie on your back as shown. (Position 1)
    • Keep your lower back completely flat on the ground.
  • Activate your core muscles.
    • Gently draw your stomach in.
    • Brace your abdominal region.
  • Lower opposite arm/leg as low as possible. (Position 2)
    • Do NOT let your lower back arch.
  • You should feel NO tension in the lower back. It should all be in the abdominal region.
  • Alternate between sides for 10 repetitions each.

 


How to stand:

  • Stack your hips directly over your ankles.
  • Depress the lower ribs by engaging the abdominal muscles.
  • Extend the thoracic spine.
  • Retract and spread shoulder blades.
  • Retract and elongate neck.

Conclusion:

Having your pelvis/hips  pushed too far in front of its ideal alignment is not optimal posture.

It may lead to eventual injuries as it places increased loads on certain structures of the body.

To fix an Anterior pelvic shift: You will need to identify whether your pelvis tilts anterior, posterior or neutral as this dictates the specific exercises that will be required to be performed.

The exercises will help you stand with a posture of optimal alignment.

 

… Do you have any questions?

Let me know in the comments section!

Let’s fix your Anterior pelvic shift 🙂

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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15 thoughts on “Anterior Pelvic Shift: How do I fix it?

  1. Hi Mark, first of all I would like to thank you for dedicating your time to this website and helping others like myself. I am so so grateful I found this! I have been in chronic pain for 7 years now and wasted a lot of money on only treating the symptoms because I have never been given an answer or full explanation as to what was going on with my body. It wasn’t until I found this site that I finally came to understand.
    I now know I have multiple posture problems going on starting from my pelvis up to my head. I was wondering if you could help me with where to start? I have an anterior pelvic shift and tilt along with a lateral tilt. At the moment I feel as though my pelvic shift and tilt is causing the most pain. My psoas muscles get really tight and the pain that travels up my body is unbearable at times. Should I focus on each specific postural issue one at a time until I see improvement or can I do as many as I like?
    Also any tips on releasing psoas muscles? They are a tricky one to get into lol.

    1. Hi Casey,

      Thanks for your comment.

      Multiple postural issues can be quite overwhelming. This is quite common!

      My best advice to you without actually assessing you in person would be just to start on one area that you think might be driving the others, and see how you go. Once you feel you have achieved as much as you can, move on to the next.

      Psoas is quite deep so you will need to get the right angle and depth to release it properly. Any luck with a massage ball?

      Mark

  2. Hi, I noticed for the first time how you respond to all the comments and detail a list of adviced exercises. Thanks for providing all this information for us. I have viewed the website and many others to figure out what I can do for my posture which is steadily getting worse and more painful and more comments and more stares. To be honest, I am really scared. And it seems all the treatment options are unattainable to me. I was just shooting this out to see if you might be able to respond to an email with pictures, CT scans x rays, and more info. I have taken alot of notes. I have had successes. I fixed my flat feet. But, Forward head posture. Pectus excavatum. Flared ribs. Rounded shoulders. Thoratic kyphosis. I have to battle it. I just don’t know where to start. Hope you can help.

  3. The lumbar stretch is great! I’m always searching for more stretching options for my chiropractic clients. Thanks for this information!

  4. Hi Mark,
    I have been working on fixing a rotated pelvis and a flat feet on one side, and after I read this posting, I realized I have an anterior shift as well. (!!) And i think this may explain why I have developed so much front thigh muscles and “fake” calf muscles (meaning I actually don’t have much of them, but they look like they stick out) even though I’m thin.

    Though I have the neutral pelvis, do you think I can still work on some of the anterior tilt exercises to balance out my thigh/calf muscles?

    And I’ll second the comment below, you are defenitely reading lots of people’s minds and your postings are such hope-giving:’)

    1. Hi there Clare,

      Do you have a neutral pelvis in relation to your femurs?

      Or are they neutral when you compare the 2 bony land marks in standing?

      When you have an anterior pelvic shift, it makes measuring the pelvis position a little bit harder!

      Let me know 🙂

      Mark

          1. Cool, just what I was thinking.

            If you tend to place most of you resting weight on the front part of the foot, you will activate your calves and quadriceps excessively.

            This can lead to your symptoms.

            I would suggest you work on releasing/stretching the tibialis anterior muscle.

            Mark

    2. Hi, can you please help me has this gets me really down. Iv tried my doctor and they say there isn’t anything I can do it’s how I am but I cant just leave it as it upsets me. Iv never been able to show anybody my body as I’m to ashamed. I need to know if it can be straightened but I don’t use Facebook. Is there another way I can send you a pic please

  5. Hey Mark!!!!!!!

    Another FANTASTIC post!

    It’s like you are mind reading or something! Every post you submit is ME.

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