Before we go on to talk about various tilted pelvis positions I want to first clarify the description of a ‘neutral pelvis’.
There are many ways in which a neutral pelvis position is described. Mostly it is defined as in between anterior tilted and posterior tilted.
It is not only the pelvis that is affected by the position it holds but also the rest of the body, for the reasons I set out next. Suffice to say here that pelvic position is important.
The main area affected by the pelvis is the spine. The spine is connected to the pelvis by two Sacroiliac joints, one either side of the lower lumber vertebrae.
We can imagine the pelvis and spine to be similar to balancing a stick on its end on the palm of your hand. Every move the stick makes has to be counteracted by the movement of the hand to maintain the stick’s upright position - the stick being the spine and the hand the pelvis.
If you have a rotated pelvis either posteriorly or anteriorly it will affect the natural curvature of the spine.
This then effects the load on muscles and joints throughout the body. This is so because the body will also need to keep aligned with gravity. So if one area sticks out to far, for example your abdomen region pushes too far forwards. To counteract this, another area will stick out backwards to maintain that alignment with gravity. For example the upper back.
The spine needs to have a curve in it to make it flexible and strong enough to cope with the demands of everyday live.
If these curves are too sharp or too flat we have adopted an undesirable posture and are putting various parts of our body into positions in which they were not designed to be, therefore increasing the risk of injury and pain.
Lower back pain is one of the most common complaints in the western world. This is largely due to how we go about our lives. Nowadays we pick a career and specialise in that one thing, and therefore do the same actions day after day for years and years.
This means we adopt habits. It is these repeated actions that form our blueprint for the postures that we hold. Therefore if we develop bad habits we will create a bad blueprint.
For example if we need to spend a large amount of time driving to work or as part of our work, then the seated position we adopt when we drive will start to develop part of our blueprint. The posture we need to hold to sit in a car and drive is far from ideal, and it is fairly common that we would adopt a tilted pelvis position. This means extra stress and strain on various joints and muscles within the body. These areas then get overworked and become stiff or aggravated and effect the posture we hold not only in the car but also when we get out.
So we must change our bad habits for good ones in order to form the correct posture and fend off or prevent the onset of chronic conditions such as lower back pain.
We start by making sure we haven’t formed a tilted pelvis position. If we can hold neutral pelvis then the rest of our body stands the best chance of also being in line.
The neutral pelvis position is generally agreed to be achieved when the spine has the correct and appropriate curves and is thus in good posture.
I personally like to be a little more descriptive, as I feel we need a more accurate way to know that we are in neutral pelvis. If you are not really sure what you are working towards then it is hard to achieve it.
To check for a true pelvis (neutral) we look to see if we have a(rotated) tilted pelvis one way or the other. To do this we use two reference marks on the pelvis and see if they are in a horizontal line.
These two points are the Anterior superior iliac spine and the posterior superior iliac spine.
It is possible to establish how the pelvis is sitting by drawing an imaginary line between these two markers and looking at whether the resulting line is horizontal, or indeed whether there is any tilt.
If we place our hands around our waist with the palms of our hands resting on the tops of the pelvis we can then feel the boney prominence at the front with our fingers and at the back with our thumbs.
If we then look in the mirror with a side view we can see if these two points are in a horizontal line which means a neutral pelvis. If the front point is below the rear point we have an anterior tilted pelvis and if the rear point is above the front point we have a posterior tilted pelvis.
A good way of finding neutral position when seated is to put your hand under your bottom when sat down and feel for the boney bits each side. Take your hands away and hopefully you should still have a sensation of where these bone parts are.
Now rock your pelvis forwards off the boney bits, then rock your pelvis backwards off the boney bits, then come upright and sit on the boney bits. This is neutral pelvis and will help to give the correct posture when seated.
We usually hold a tilted pelvis position because of excessive tension held in the muscles in and around the hips and spine area.
To help this condition we can use stretches to release the tension and help re-establish a more neutral pelvis position.