Fixing Anterior Pelvic Tilt (“Butt & Gut Syndrome”)

August 6, 2018Dr. Grant Radermacher

How to correct anterior pelvic tilt (SIT happens!)

Your pelvis is essential in allowing you walk, run, and lift weights. It’s also incredibly important for proper posture.

Anterior pelvic tilt (in which your “hip” bones tip forward and your tailbone tilts up and back) is by far the most common posture problem I see at Ascent Chiropractic in Brookfield, and it’s a problem that affects almost everyone who spends much of their day sitting. It leads to poor exercise technique and increased risk of knee pain, lower back pain/injuries, and other musculoskeletal disorders.

Wondering if you have anterior pelvic tilt?

The easiest visual clues to look for are a forward tipped pelvis, increased lower back curve (sway back), and a “bulging” (not necessarily fat) abdomen.

Let’s take a look at the average person’s profile. Many people will find that their head is jutting forward, or their shoulders are slumped forward coupled with a hunchback posture, or that their lower back is so arched that your stomach protrudes forward, giving them “butt and gut syndrome”. These are all effects of anterior pelvic tilt.

People are often under the mistaken impression that the solution to correcting posture is simply doubling down on their workouts, but let’s make one thing clear: what you do in the gym only cements what you have. If you have bad posture, heavy lifting will make it even harder to correct. If you have good posture and alignment, lifting makes it better.

Fixing the “keystone” of the spine

So we’re going to focus on correcting problems in the lower torso and extremities to improve posture, but what’s going on in the lower body will absolutely affect postural changes in the upper body. Stabilizing the spine, like building a skyscraper, requires a good base to start from. But first, a few important points:

• A slight anterior tilt of the pelvis is normal and optimal because it puts the glutes and the hamstrings in a slight stretch, which optimizes force production through those muscles. So don’t fret if you have a slight degree of an anterior tilt; between approximately 15-24 degrees is considered normal. What we’re discussing correcting here applies to moderate to bad cases.
• It’s usually safe to lift weights with anterior pelvic tilt. Just be sure to extend through the hips, push through the heels and avoid overarching the lower back when doing compound movements like squats. That being said, listen to your body: pain isn’t normal! If you’re experiencing pain while lifting, stop and see your chiropractor first!
• Stretching tight muscles and isolating weak muscles, while helpful, is rarely enough to fix anterior pelvic tilt permanently. Seeing a chiropractor who can not only adjust correct misalignments contributing to anterior pelvic tilt, but can also treat soft tissue to help release tight and shortened muscles and ligaments (which is exactly what we do at Brookfield chiropractor Ascent Chiropractic). Your chiropractor needs to be your partner in correcting anterior pelvic tilt once and for all.

The classic problem muscle groups in APT (anterior pelvic tilt) are tight hip flexors coupled with tight lumbar erectors (lower back), along with weakened glute max (butt muscles), hamstrings and the abs (mostly the rectus abdominus and external obliques). Most people think that the hamstrings are tight in this position and go wild with stretching them, but the hamstrings are actually in a lengthened state – stretching them will only make it worse. Due to something called antagonist dominance, the glute max will not fire to its maximum capacity and to pick up for this slack, the adductor magnus and the hamstrings will be forced to step in. This leads to hamstring and groin strains.

Correcting this dysfunction takes some daily work:

1. Lengthen the hip flexors. Foam rollers are perfectly designed for hitting the hip flexors, but the lunge stretch works great too. To do it properly, make sure that you’re moving at the hips and not the lower back. Squeeze the gluteus of the leg that’s behind you. To enhance this stretch, raise the hand of the stretched hip to the ceiling. If you can’t “feel” your glute contracting, try tapping it with your fingers.
2. Activate and strengthen the glutes. The quadruped hip extension gives the most activity in the gluteus max (you can add simultaneous core activation by extending the opposite arm in front of you; ie the bird-dog). Glute bridges are also a good movement to relearn the hip extension pattern.
3. Avoid traditional flexion stretches like toe touches. These types of stretches put excess pressure on the spinal discs and can make a bad back worse. Cat/cow stretches are the most biomechanically-friendly stretches for the lower back. It’s important to not force these stretches; gradually increase their intensity.
4. Strengthen the core. Don’t do crunches/sit-ups/v-ups, which put stress on vulnerable structures in your lower back. Instead, opt for bird-dog and plank exercises for core strengthening. Once you can hold a plank for 60 seconds, move to more advanced variations such as “stirring the pot” with an exercise ball. With planks your posture should be perfect and your knees should have a very slight bend in them. Your abs should be tight with a slight arch in the lower back and your glutes should be squeezed. Torso stability during planks and other isometric exercises is incredibly important in preventing injury.

Warming Up Before Working Out

Using any or all of these stretches and warmups will get you warm, get you used to moving, and activate the correct muscle groups before you hit the gym.

1. Foam roll the quads and hip flexors
2. Rectus Femoris (hamstring) stretch – 2x20seconds each leg
3. Glute bridge with neutral pelvis – 2×15
4. Leg swings (front and back and side to side) – 1×12-15
5. Fire hydrants – 1×10 each side both directions
6. Yoga plex or reverse lunge with posterolateral reach – 1×8 each side
7. Plate loaded front squat or goblet squat – 1×8-12

Do This During Your Workout:

1. Lower ab and external oblique work: Planks, side planks and dead bug progressions will do the job.
2. Hip extension/hip hyperextension work: This includes lunge variations and front squats. These all allow you to reach complete hip extension.
3. Stabilization work: Anything that forces your body to stabilize through the torso (planks, pallof presses, and unilateral work) are all good choices. Make sure to include these in your training.

Brookfield Chiropractor

This is a great start to correcting anterior pelvic tilt on your own, but studies have shown that the most reliable way to stabilize your pelvis long-term is through a combination of both targeted exercise and chiropractic care. Need a Brookfield chiropractor? At Ascent Chiropractic we correct problems in the spine and pelvis using a gentle, low-force adjusting technique that’s both safe and effective for patients of all ages ranging from children to seniors. To make an appointment at Ascent Chiropractic, call 262-345-4166 or schedule an appointment with our online scheduling app.

About the Author

Dr. Grant Radermacher

Dr. Grant Radermacher is a Brookfield, WI chiropractor providing unmatched results through gentle, evidence-based chiropractic care. Our mission is simple: get you out of pain so you can get back to being you, only better.

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