What causes an anterior pelvic tilt?

The pelvis develops an anterior pelvic tilt for a couple reasons. Our body has a knack for finding the easiest way to get the job done. For instance, ideally we will keep our knees slightly bent and use our thigh and rear-end muscles to stand.

This creates an ideal environment for proper pelvic orientation (i.e. , a neutral pelvis). But these muscles can become fatigued during long periods of standing.

Conversely, resting on our joints by straightening our knees uses minimal muscular effort. So instead of using proper biomechanics, people often lock their knees in a straightened position and stand on their knee and hip joints. This is an energy efficient way to stand, but unfortunately, it also pitches the pelvis into a slight anterior pelvic tilt.

Muscles in the front of the pelvis, the tensor fascia latae (TFL) and rectus femoris, tighten to accommodate this new position. This habitual muscle tightness creates a permanent anterior pelvic tilt, which means the spine also permanently increases its lordotic curve (the natural inward curve of the lower back). The increased curvature stresses tissues such as bones, disks, ligaments, nerves, and muscles that attach to the vertebrae.

The same goes for sitting. Most of us sit forward in our chair when we work on the computer because this is more energy efficient. But this posture makes your pelvis rock forward into an anterior pelvic tilt, which consequently creates an increased lumbar curve (lordosis).

Unfortunately, other tissues such as the muscles described above adapt to this posture over time, which contributes to back pain and injury. Not all anteriorly tilted pelvises are due to a tight TFL or quadriceps. Sometimes people just have a very mobile pelvis that slips into an anterior tilt.

Because those key pelvic muscles aren't tight in these people, they instead must focus more on their habits and abdominal strengthening to fix their excessive lordosis. Pregnancy can also cause women's pelvises to develop an anterior pelvic tilt. The weight of the fetus pulls the stomach and pelvis forward, and the spine must extend backward to offset this stress.

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