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)
    • Hip: Greater Trochanter
    • Ankle: Lateral Malleolus
  • (If you are unsure, check the location of these land marks on Google)
  • 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:

“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:

  • Take a side profile shot of your standing posture
  • Locate the:
    • Anterior Superior Iliac Spine (ASIS)
      • “Bony part at the front of pelvis”
    • Posterior Superior Iliac Spine (PSIS)
      • “Bony part at the back of pelvis”
  • (If you are not sure where these points are, check the location of these points on Google)
  • Draw a line between these 2 points.

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: The complete list of Glute exercises


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.


What to do next…

1. Any questions?… (Leave me a comment down below.)

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the exercises!

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

  1. Hey Mark,

    First of all thank you so much for such detailed post, best on the net I have found.

    I have a list of issues as follows:- 😁

    1. Lower back pain , due to gym, started 11 years back which developed into siactica on left side … And which was last year diagnosed as Pirformis Syndrome.

    2. A definite anterior pelvic shift and no so sure tilt, seems to be neutral to me.

    3. Severe tightness/ pain in legs post sleeping.

    I was also told last year I have hyper flexibility and very low strength (especially in core and gluteus)
    Since Last 1 year I am undergoing physio treatment – strength training.

    With hip stretches my Pirformis Syndrome pain has reduced significantly. Now I am facing 3 issues:-

    1. When I do your postural exercises – I feel extreme tightness in my left hamstring , developing into pain.I am using foam roller once in a week for hamstring – pain reduces but recurs.

    2. Recurring siactica pain Especially when I do core strengthening exercises.

    3. Pain on top part of gluteus medius when I do hip strengthening exercises ( reduces with massage ball but recurs pretty soon).

    I accept situation is bit complicated 😉, but I have full faith that I would get best advice from you.

    Thanks and regards

    Reply
    • Hey PATS,

      1. Which specific exercise do you feel is causing your left hamstring tightness? I would exercise caution if any exercise or movement is causing you any pain.

      2. If you are referring to the Dead bug exercise as your core exercise, this may cause increased sciatica if your lower back is sensitive to flexion. If this is the case – try to maintain a slight arch as you perform the exercise.

      3. Again- which specific hip exercise is leading to this?

      Mark

      Reply
    • Hey Thanks, for your response

      1. There is a general tightness – when I try to stand straight ( against a normal arched posture) , with weight sighting from front to compete foot – my hamstrings feel tightened.

      2. So you mean I shouldn’t try to straighten the lower back during dead bug and rather maintain slight arch?

      3. Squats , side lying hip abduction, even long walk cause pain in upper glute medius region, which eases with massage balls but recurs on exercising.

      Regards

      Reply
  2. Hi Mark, I’ve looked all your different articles but I’m still confused about what I have.
    I have my legs bending forward when I’m completely relax, which means I have an anterior pelvic shift, but it’s pretty difficult for me to determinate if there’s anterior or posterior pelvic tilt on top of that.
    What I know is that once I realign my pelvis to the level of my ankles, I have an hyperlordosis.

    Thank you for all your help !

    Reply
    • PS : And once I realign my pelvis, I have an anterior pelvic tilt, but when I don’t have my pelvis realigned, it looks more like a posterior pelvic tilt

      Reply
      • Hey Antony,

        If your pelvis can switch from a posterior tilt to an anterior tilt that quick, it is likely that you do not have a lot of tightness in this area.

        It sounds like more of a control issue. This would mean you need to focus on strengthening exercises. (as opposed to releases and stretches)

        If you default into a hyperlordosis + anterior pelvic tilt, I would feel you need to work on your core strength,

        Mark

        Reply

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.