What is Anterior Pelvic Tilt?
The Anterior Pelvic Tilt (APT) is where the pelvis is in a forward rotated position.
- Forward tilt of the pelvis
- Pronounced lower back arch
- Glutes that stick out
- Protruding stomach
Is Anterior Pelvic Tilt bad?
As the pelvis is the foundation of your spine, it is common for a poorly positioned pelvis to drastically affect your whole posture.
If the pelvis is in a sub-optimal position, your whole posture may be out of position as well.
It could be the one reason why you have so much pain and/or tightness in your body.
What are the potential complications for a person with an anteriorly tilted pelvis?
(Having an anterior tilt of the pelvis does not necessarily mean that it is the sole cause of the following issues, however, it could play a significant factor!)
- Lower back pain
- Degenerative Disc Disease
- Snapping Hip Syndrome
- Tight Erector Spinae muscles
- Lumbar Hyperlordosis
- Hip Impingement
- Disc bulge/herniation +/- Sciatica
Test for Anterior pelvic tilt
Try this simple test to see if you have this postural issue.
- Stand up.
- Locate the following land marks:
- (See above image for the points.)
- Anterior Superior Iliac Spine (ASIS) = Pointy bone at the front.
- Posterior Superior Iliac Spine (PSIS) = Pointy bone at the back.
- Compare the relative heights.
Interpretation: If you have an Anterior Pelvic Tilt, the ASIS will be significantly lower in comparison to the PSIS.
How much pelvic tilt is normal?
It is normal for the pelvis to have a slight forward tilt of about ~5-10 degrees.
(This is what I refer to as a “neutral pelvis”).
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What causes Anterior pelvic tilt?
In my opinion: The main cause is excessive SITTING!
Excessive sitting causes certain muscles that control the position of the pelvis to get tight, overactive, weak and/or inhibited.
As a result, there is a muscle imbalance around the pelvis causing a net force to tilt forwards.
What muscles are involved with Anterior Pelvic Tilt?
The following muscles will be need to be specifically addressed in order to fix the position of the pelvis.
- Tensor Fasciae Latae
- Rectus Femoris
- Anterior Gluteus Medius
- Erector Spinae
- Spinalis, Longissimus, Iliocostalis
- Quadratus Lumborum
- Thoracolumbar Fascia
- Latissimus Dorsi
- Anterior fibers of the Adductors
- Gluteal group
- Abdominal group
Exercises for Anterior pelvic tilt
Note: As you become familiar with the Anterior Pelvic Tilt exercises and the effect they have on your pelvis, you will find that you will need to spend more time on certain exercises, and not so much on the others. Focus on the exercises that are giving you the best results.
1. Can you tuck your pelvis?
If you CAN NOT tilt your pelvis back into a neutral position whilst standing without excessive compensation of your torso and/or legs: Focus more time on the Release and Stretch exercises.
If you CAN: Focus more time on the Strengthening and Control exercises.
The tight muscles that are holding the pelvis in an anterior tilt will need to be released.
a) Lower Back
(Target muscles: Erector Spinae, Quadratus Lumborum)
- Place a massage ball underneath the muscles of the lower back.
- Apply the appropriate amount of body weight over the ball.
- Do not place the ball directly over the middle of the spine.
- Duration: Continue for 3 minutes on each side.
Note: A small amount of bruising can be normal after the first few times doing these self releases.
b) Latissimus Dorsi
- Locate the Latissimus Dorsi muscle.
- Place a foam roller directly under these muscles.
- Apply an appropriate amount of body weight onto the foam roller.
- Roll your body in an up/down motion.
- Do NOT hold your breath.
- (Ease off the pressure if you are tensing up.)
- Make sure you cover the entire muscle.
- Duration: Continue for 2 minutes on each side.
c) Hip Flexors
- Locate the tight Hip Flexors:
- Rectus Femoris
- Tensor Fasciae Latae
- Anterior Adductors
- Anterior Gluteus Medius
- Place a foam roller underneath these muscles.
- Apply the appropriate amount of body weight over the foam roller.
- Duration: Continue for 3 minutes on each side.
3. Anterior Pelvic Tilt Stretches
Before you can start to strengthen any of the weak muscles, you will need to stretch the tight muscles which are locking your pelvis in the wrong position.
a) Hip Flexor Stretch
(Target muscle: Iliopsoas)
- Assume the lunge position as above.
- Perform a Posterior Pelvic Tilt:
- “Tuck your tail bone underneath you”
- Keep your glutes contracted.
- Lean your torso away from the side you are stretching.
- Aim to feel a pulling sensation at the front of the hip.
- Hold for 30 seconds.
b) Rectus Femoris
- Stand up right.
- Pull your ankle behind you as to bend your knee.
- Stay up right and keep your knees in line with each other.
- Tuck your tailbone underneath you.
- Drive your hips slightly forward.
- Aim to feel a stretch at the front of your thigh.
- Hold for 30 seconds.
Would you like to see more stretch for Rectus Femoris, check out this post: Rectus Femoris Stretches.
c) Tensor Fasciae Latae (TFL)
- Assume the kneeling lunge position. (see above)
- Keep your feet in line with each other.
- Proceed to lunge forward.
- Tuck your tail bone underneath you.
- Lean your hips to the side whilst using your arm on a support to keep your balance.
- Aim to feel a stretch in the front/outer side of your hip.
- Hold for 30 seconds.
- Repeat on other side.
For more stretches: Tensor Fasciae Latae Stretches
d) Groin Stretch
- Sit on the floor with your back against a wall.
- Assume the position as shown above.
- Sit up at tall as possible.
- Try to create an arch in your lower back.
- Slowly push your knees down towards the ground.
- Aim to feel a stretch in the groin.
- Hold for 30 seconds.
e) Lower Back Stretch
- Sit down on a chair.
- Push your knees out to the side.
- Lean all the way forward.
- Aim to feel a stretch in the lower back.
- Hold for 30 seconds.
For more stretches: Erector Spinae Stretches
f) Latissumus Dorsi
- Assume the position above.
- Hold onto a door frame with your hand.
- Whilst anchoring your legs as shown, aim to bend your mid section as much as possible.
- Use your body weight to sink into the stretch
- Twist your pelvis away.
- Aim to feel a stretch on the side of your torso.
- Hold for 30 seconds.
- Alternate sides.
For more stretches: Latissimus Dorsi Stretches.
g) Quadratus Lumborum
- Lie on your side on an exercise ball.
- Support your feet on a wall to maintain balance.
- Reach over with the arm on the upper side.
- Aim to feel a stretch on the upper side.
- Hold for 30 seconds.
- Alternate sides.
For more stretches: Stretch the Quadratus Lumborum.
4. Improve hip Rotation
If you lack rotation in your hip joint, this may prevent your pelvis from achieving a more neutral position.
How much rotation do you have?
Depending on the shape of your hip joint, you should have approximately 30-45 degrees of external and internal rotation. (See above image)
To improve INTERNAL Rotation:
a) Posterior Hip release
- Place your gluteal region on 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.
b) Posterior Hip Stretch
- Sit down on the edge of a chair.
- Place your ankle on the top of the knee of the other leg.
- Sit as tall as possible as to create an arch in your lower back.
- Whilst maintaining this arch, pull your knee in the direction of the opposite shoulder.
- Hold for 60 seconds.
- Repeat on other side.
c) Strengthen Hip Internal Rotators
- Lie down on your side with your knees slightly bent.
- Keep your knees together throughout the exercise.
- Lift up your ankle from the other ankle.
- Make sure that you do not move your pelvis.
- Don’t cheat! Only the leg should be moving.
- Aim to feel a contraction in the side of your hip.
- Hold for 3 seconds.
- Repeat 20 times.
- Repeat on other side.
For a detailed blog post on how to increase Internal Rotation in the Hip
See post: Hip Internal Rotation Exercises.
To improve EXTERNAL Rotation:
a) Stretch Groin
- Sit on the floor with your back to the wall.
- Place your feet together.
- Sit as straight as possible.
- Push your knees down.
- Aim to feel a stretch in the upper groin area.
- Hold for 60 seconds.
b) Strengthen External Rotators
- Lie on your side with your knees bent at 90 degrees.
- Whilst keeping your ankles together, lift up your upper leg as high as possible
- Make sure that you do not move your pelvis.
- Don’t cheat! Only the leg should be moving.
- Feel your External rotator muscles (aka your butt) activating.
- Hold for 3 seconds at end range.
- Repeat 20 times.
- Repeat on other side.
5. Strengthening exercises
Now that your tight muscles have been stretched and released, the next step is to address the muscle weakness that has lead to an Anterior Pelvic Tilt.
Target these weak muscles:
- Gluteal group
a) To strengthen your GLUTEUS MAXIMUS:
- Lie on your back with knees bent and feet on the floor.
- Engage your glutes to tilt your pelvis backwards into a neutral position.
- This should flatten your lower back onto the ground.
- Engage the core muscles.
- Drive your hips upwards
- Aim to feel the contraction of your glutes AND hamstrings.
- Lift your hips as high as possible whilst keeping a neutral spine.
- Do not over arch your lower back.
- Hold the end position for at least 30 seconds.
… Can’t feel your glutes working?
Check out this post: How to activate your Glutes.
b) To strengthen your HAMSTRINGS:
- Lie on the floor.
- Place your feet on the wall with your hips and knees bent at 90 degrees.
- Dig your feels into the wall and lift your tail bone off the floor.
- Tilt your pelvis backwards.
- This is to flatten your lower back onto the ground.
- Feel the tension in your hamstring muscles.
- Hold for 30 seconds.
- Repeat 3 times.
- Progression: Alternate lifting your feet off the wall without compromising the pelvis position.
c) To strengthen the ABDOMINALS:
Your abdominal muscles are connected to the top portion of the pelvis at the front. They play a vital role in rotating the pelvis back into the neutral position.
- Lie on your back with both of your knees bent in the air.
- Engage your core and abdominal group by gently drawing in your belly button.
- Keep your pelvis rotated backwards throughout this exercise.
- This is to flatten your lower back.
- Slowly lower the opposite arm/leg.
- Lower the better! (… but only if you can keep the lower back FLAT!)
- Repeat 10 times.
- Assume the 4 point kneel position.
- Tuck in your tail bone to rotate your pelvis backwards.
- Engage your core muscles by drawing your belly button in.
- Exhale all the air in the lungs as you form this position.
- Hold this for 5 seconds.
- Repeat 10 times.
Need more Core exercises?
See post: Core Exercises for Anterior Pelvic Tilt.
6. Finding neutral pelvis
By now – you should be fairly familiar with the stretching and strengthening of the muscles that contribute to your Anterior Pelvic Tilt.
The next step (… and in my opinion the most important) is learning how to take control of your pelvis position throughout the day.
If you can’t control your pelvis, the problem will continue to manifest! (… no matter how many exercises you do.)
- Achieve a neutral pelvis in various positions and
- Gain an understanding of what neutral pelvis FEELS like.
a) Pelvic Tilting (4 point kneel)
- Assume the 4 point kneel position.
- Hand under shoulders.
- Knees under hips.
- Find the end range of pelvis movement:
- Tilt your pelvis all the way forwards.
- Tilt your pelvis all the way backwards.
- The neutral pelvis will generally be the midpoint of these two positions.
b) Sitting Pelvic Tilts
- To position your pelvis in neutral while sitting, you will need to “Sit on your SIT bones”.
- To find your sit bones, place your hands (with palms up) underneath your buttocks whilst sitting on a chair.
- Feel for a pointy bony prominence.
- (This is your Sit bone!)
- Think of these bones as upside down TRIANGLES.
- The goal is to distribute your body weight between the tip (aka the pointiest part) of the triangle (as opposed to the side) and your anterior pelvic floor muscles.
- This will place your pelvis is a more NEUTRAL position.
- Whilst standing, place your fingers on the ASIS and PSIS.
- They are the “pointy bones” that stick out the most.
- To position your pelvis in neutral, you will need to tilt your pelvis in a backwards directions until the ASIS and PSIS are approximately in line with each other.
- Keep in mind, it is normal to have a slight anterior tilt of 5-10 degrees.
7) Strengthening Exercise (with Neutral pelvis)
The following exercises involve maintaining the pelvis in a neutral position.
a) Hip Extension
- Assume the 4 point kneel position
- Place your pelvis in a neutral position.
- Engage your core and glute muscles to lock the pelvis in place.
- Whilst maintaining this alignment, lift your leg as high as possible.
- Do not let your lower back sink in.
- You should not feel the lower back contract significantly.
- Aim to feel the contraction in your glutes.
- Alternate between sides.
- Repeat 10 times.
b) Over Head Reaches
- Stand up right.
- Place your pelvis in a neutral position.
- Activate your core and glute muscles to achieve this.
- Whilst maintaining your pelvis alignment, raise your hands over your head as far as possible.
- Do NOT let your ribs to flare outwards.
- “Keep the ribs down”
- The lower back should not arch.
- Repeat 10 times.
- To progress: Perform shoulder presses (with weight) in the standing position.
c) Pull Downs
- Whilst standing with a slight forward lean, pull the resistance band downwards.
- Lock your pelvis in a neutral position.
- Activate your core muscles.
- Slowly let your arms recoil to the over head position.
- Your torso and pelvis should not move during this exercise.
- Do not let your lower back arch backwards!
- Pull the resistance band back to starting position.
- Repeat 10 times.
- Get into the plank position. (see above)
- Position your pelvis in a neutral position.
- Engage the core and glutes to stabilize the pelvis.
- Make sure your lower back does NOT sink in.
- Hold for 30 seconds.
e) Strengthen hip flexors
Wait a minute… Why would you want to strengthen the hip flexors?
In my experience, I find that most people are very weak in these muscles.
(In fact – The hip flexors may be tight as a compensation for being WEAK!)
- Whilst sitting with your pelvis in a neutral position, raise your knee as high as you can go.
- Do not lean backwards.
- Aim to feel a contraction in the front of your hip.
- Hold this position for 5 seconds.
- Repeat 10 times on each leg.
- Apply leg weights to your ankles.
- Lie down at the end of a bed with your legs dangling.
- Hug one of your knees towards your chest.
- Allow the other leg to drop off the edge of a bed.
- Keep your lower back completely flat throughout the whole exercise.
- Keep your other leg straight.
- Slowly lower and raise this leg.
- Allow the leg to drop towards the floor as far as you can go.
- Aim to feel a stretch and contraction at the front of your hip.
- Repeat 10 times.
f) Hinge pattern
- Whilst standing with a neutral pelvis, hold onto an appropriate amount of weight.
- (… it should be a moderately heavy weight that you can control)
- Keep your lower back neutral throughout this exercise.
- Slowly lower the weight by hinging at the hips.
- Aim to feel a pulling sensation in the upper hamstring region before returning to the starting position.
- Keep the weight close to your body.
- The knees should bend slightly.
- This lowering phase should take 3-5 seconds.
- Perform 10 repetitions.
- Note: The pelvis should stay neutral relative to the spine throughout the movement.
8) Maintaining neutral pelvis
Make an effort to maintain a neutral pelvis in your daily activities such as standing, walking, sitting and hinging.
- Maintain the neutral position of the pelvis throughout movements.
- Remember to lightly engage the gluteal and abdominals as you are performing any movement/exercise.
- Avoid excessive amounts of quadriceps and lower back dominant exercises until you can maintain a neutral pelvis.
- Remember your body’s default setting is to go back into your Anterior Pelvic Tilt. You need to train your brain as much as you need to work on your body to fix this.
The end goal is to maintain your neutral pelvis as effortlessly as possibly.
Do not force your posture!
9) breathing and Anterior Pelvic Tilt
Inefficient breathing patterns (such as breathing with Flared Ribs) can result in the anterior tilt of the pelvis.
Here’s a breathing exercise:
(This exercise will help to engage the Diaphragm muscle in a more efficient position.)
Set up position:
- Lie down on your back with your legs in a bent position. (see picture)
- Ensure that your lower back is completely FLAT on the floor.
- Your lower ribs should not be flared.
- Keep your neck and shoulders COMPLETELY RELAXED throughout the whole exercise. (use a pillow if required)
1. Inhalation phase:
- Take a deep breath of air through your nose.
- Imagine a ring around the lower portion of your rib cage expanding in a 360 degrees manner.
- FEEL your lungs and ribs expand.
- Your lower back should not arch up as you breathe in.
- Do not flare out your ribs.
- Keep your neck and shoulders completely relaxed.
2. Exhalation phase:
- After you reach maximum inhalation, start to slowly EXHALE through slightly pursed lips.
- Continue to exhale until your lungs are COMPLETELY empty.
- Your lower ribs shoulder flatten towards the floor.
- The abdominal muscles should start to engage as you do this.
- Maintain this end position as you take a breath in again. (Inhalation phase)
- Alternate between inhalation and exhalation phase for 3-5 cycles.
10) Other areas to consider
Have you persisted with these Anterior Pelvic Tilt exercises… and still can’t seem to improve the position of the pelvis? You may need to address other areas of your posture!
a) Thoracic Kyphosis (Hunchback)
If you have a hunched upper back, the pelvis will compensate by going into an anterior tilt of the pelvis.
This is your body’s attempt to keep your head and torso in a more up right position.
For more information: How to Fix a HunchBack Posture
b) Lumbar Hyperlordosis
If your lower back has an excessive arch (Hyperlordosis), it may be locking your pelvis in an anterior tilt.
For more information: How to Fix Hyperlordosis
c) Flat feet
If you have flat feet, it can cause a domino effect which will end in the pelvis tilting forwards.
Here’s the best exercise for you:
- Sit down on a chair with your feet on the ground.
- Whilst keeping your toes relaxed, proceed to scrunch the under-surface of your foot.
- If performed correctly, you should be able to feel the muscles under your foot tense up.
- Hold this for 10 seconds.
- Repeat 30 times.
- Progress this exercise to a standing position.
For a complete blog post on how to fix this issue
See post: How to Fix Flat Feet
11) Other tips
Here are some simple tips to help you maintain a more neutral pelvis.
a) Reduce Abdominal Size
Any extra weight in the region of the belly will pull the pelvis into a forward tilted position.
This usually effects:
- Pregnant women
- People who are obese
- Bloating issues in the gut
b) Reclaim Full Hip Extension
It is important to have full hip extension without having the need to arch the lower back.
When walking – Make sure that you can feel your glutes contract as the leg extends behind you.
I recommend allowing more time for your leg to glide further behind you before lifting it up for the next step.
c) How to Fix Anterior Pelvic Tilt while Sitting
When sitting – make sure that your hips are slightly higher than your knees.
This will reduce the amount of hip flexion whilst in the seated position.
The aim of this is to minimize the likelihood of the hip flexor muscles from getting tight.
12) Common Questions
If you have any other questions that you would like to ask me, feel free to leave me a comment.
a) How long to fix Anterior Pelvic Tilt?
This is a very difficulty question to answer as there are many variables to consider!
Generally speaking – I would persist with the exercises for at least 6 months to see if the exercises are helping.
b) What exercises to avoid with Anterior Pelvic Tilt?
Care must taken with any exercise which encourages the hyper extension of the lower back and forward tilt of the pelvis.
This might include exercises such as:
- Superman extensions
- Over extending whilst deadlifting/kettle bell swinging
- Lumbar spine hyper extensions
- Over head exercises such as shoulder press
- Planking without core activation
- Squatting with hyper extended lower back
(Note: You can still perform these exercises as part of a general exercise program, however, make sure that the main focus is on your postural exercises.)
c) How should you sleep with an Anterior Pelvic Tilt?
If you sleep on your back: Place a thick pillow underneath your knees as this will tilt your pelvis backwards into a more neutral position.
It will also help reduce the amount of excessive curve in your Lumbar Spine.
Be persistent with your exercises!
Please note that these are general guidelines to address your Anterior Pelvic Tilt.
As with any rehabilitation program, it needs to be individualized to cater for your unique presentation.
All the best!
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!
About Mark Wong:
Mark is a Physiotherapist who has been helping his patients fix their posture for past 11 years. He created the Posture Direct blog in 2015 with goal of helping people fix their own posture.
The content presented on this blog post is not to be used as a substitute for professional advice, diagnosis or treatment. It exists for informational purposes only. Use of the material provided on this blog post is at your sole risk. For more information: Medical disclaimer.
919 thoughts on “How to Fix Anterior Pelvic Tilt (Best Exercises)”
Hello Mark, I’m a 27 yr old male that’s been having back pain for a while now. I’ve come to realized that I have apt and my lower back is much more curved in than it should be, as well as having hunchback and forward neck posture. I’m already working on losing weight, and would like to being lifting weights once I have my weight down, but have a few questions on how to best tackle my posture issues first.
You mention that the apt should be fixable if the spine isn’t fused, would it be likely that mine would be, or is that something more older patients would worry about?
Should I try and work on all the postural issues at once or just focus on the apt until it improves and then move on?
and finally, would changing my sleeping position greatly help? I’ve always slept on my stomach.
Thank you for your help
It is very rare for the lumbar spine to be completely fused at the age of 27 in the absence of any spinal condition.
In regards to what postural issues to tackle first – I generally suggest working on the hunchback posture first as this can help improve forward head posture and anterior pelvic tilt. If you are able to commit more time to the exercises, there is no reason why you can’t address the other areas at the same time as well.
I am not a huge fan of habitually sleeping on your stomach as it’s effect on the shape of the spine. If you must sleep on your stomach – I would at least consider performing stretches of the spine on a daily basis.
I’ve just came across your site after recently watching a youtuber called Will Tennyson in which he released a video regarding knee pain. Almost all those exercises I cannot complete.
I’m a 27 active weight lifter who attends 4-6 times a week and have been going on and off for about 11 years due to health complications. I have APT and duck feet as I am admittedly a competitive gamer since I was 10, meaning even up until now, there are periods where I sit 12+ hours a day. I’ve also been a tip toe walker since I was about 4 years old and unfortunately this was not addressed. In my teens I have been given stretches to do and heel raises as theres a slight 2cm difference between may legs at potentially a hip position level according to a physiotherapist I saw back then.
Skimming through the comments, I see you have blog posts addressing both these issues. My question is, how would I address both of them? Should I exclusively complete exercises in your ATP blog then the duck feet one? Will some exercises from one post negatively affect the other?
This has been an issue for me for over a decade, I’m not able to stretch my arms back enough to hold an Olympic bar for a squat which, along with other issues, limits what I can do at the gym as well as the fact that I cannot walk properly since a young age. Any help would be greatly appreciated and I’m glad I’ve stumbled across your site.
Prolonged sitting can lead to tightness in the psoas muscle. This a major driver of the anterior pelvic tilt. The psoas is also a hip external rotator which can rotate your hip outwards and cause your feet to point out wards.
Walking tip toe also tends to shift your center of gravity forwards which can encourage an anterior pelvic tilt.
If you have both, I would generally address the pelvic tilt first. You might find that addressing the pelvis may actually partially/completely corrected the duck feet posture. Once you find that your pelvis is more neutral, re-assess the position of your feet. If you still have a prominent duck foot posture, you’ll need to follow this protocol.
If you can’t stretch your arms over head, you may need to consider following this protocol: Exercises to help lift arm over head. In context of your APT, I would look out to see if you had lat tightness (as this muscle tends to be tight as well with APT). If your lats are tight, check this post: Lat Stretches.
Let me know if you have any questions.
Your post and dedication to your clients and fans is admirable. I have two questions for you if you’re willing to entertain them.
1 – Weak/elongated muscles are tricky, because as I understand it, they can be tight because they’re trying to shorten themselves. How can I tell when a muscle needs to be strengthened vs stretched? I’m quite hyper mobile and I tend to have an anterior pelvic tilt and my legs are quite laterally rotated. I’m working on the tilt and wonder if when I stretch my hamstrings I’m doing more harm than good. I can comfortably touch my toes standing up and if I spend a minute I can get my knuckles on the ground. Often I sit up in bed cross legged and slouch forward which feels like it stretches my lower back. I just wonder if I should be avoiding stretching of my glutes and hamstrings all together?
2 – have you tried the “better back” tool? I wonder if it would be a useful tool…
1. Good question. Indeed – Weak and elongated muscles are a bit tricky, but are best addressed with strengthening.
To determine if your hamstring muscle needs to be stretched, you’ll need to determine if it is actually concentrically tight (shortened). You can check this by performing the passive straight leg raise move where you are lying on your back. If you have less than 70-90 degrees of movement, this suggests that your hamstring is tight and will benefit from a stretch. If you have more movement than 90 degrees, I generally would not advise stretching them as Stretching a lax hamstring will likely make your Anterior Pelvic Tilt worse.
2. I have not used it myself but it seems like it would support the lower back arch when sitting. (Ideally – It is better to rely on your own muscles to maintain the arch.)
Thank you for your in-depth article with such useful advice, and thanks for answering all your comments- that’s very kind!
I’m 29, and have anterior pelvic tilt, slight knee valgus which isn’t noticeable at all unless you know what you’re looking for. I don’t have flat feet but I do have overpronation and feet that grow wider with bunionettes and toes kindof taking a funny direction (I wear orthotics).
I have all the classic tightness you would expect, pain in back, occasional knee pain and if I ever try to run I get bad calves and shin splints immediately. So I’m very much trying to fix it now while I’m young.
I have two questions- one is that when I do the stretches for the quads and hip flexors, it is painful in a way that feels as if I’m really working the muscle. Sometimes they are tight/ stiff the next day as a result- is this normal? It’s just not what I would expect from stretching! Also is a foam roller essential or is stretching enough?
My second question relates to my back- when I try to put my pelvis in a more neutral position and straighten my spine, a bone in the middle of my spine protrudes visibly, and I get pain in this area. Have you come across this before? I have a long torso for my body.
Maybe the pain and the bone are unrelated- it could be that I’m rounding my upper back as I try to straighten my lower back.
Thanks for your questions.
1. The stretches should not cause more tightness. Although – it is possible to relatively over-stretch them causing them too tighten up afterwards.
Try to stretch them at a lesser intensity and see if that helps things.
If you find that you get the same response, I suspect that you will likely need to follow up the stretch with some sort of muscular engagement of the core and/or glutes to take reliance off the hip flexor.
2. Yes – The level of the protruding bone may be where your spine is hunching forward the most. If your upper back curves forwards as you correct the pelvis position, it is likely that you will need to address the thoracic spine curvature as well. See post: hunchback posture.
Hello Mark, I have a doubt, my most pronunciated symptom of apt is the stomach really sticking out (i’m lean and I don’t have much gas), my pelvis isn’t very tilted, it’s kinda neutral tbh, with that in mind, is there a more specific area that I should focus? Thanks!!
Is it possible that you may have sway back posture? This is where your pelvis is pushed forwards. This can give the illusion of a stomach that sticks out.
Hey Mark, thanks for the reply. I don’t think i have sway back posture and my pelvis doesn’t really seems to be forward rotated, but my lower abs sticks out very much although i’m fairly lean, and i almost don’t fart/burp (assuming these are indicators of bloating /digestive problems) . Could it simply be a matter of weak abdominal muscles?
It could be due to weak abdominal muscles. If that is the case, here are some exercises for you to have a look at: Core Exercises.
Hi Eduardo and Mark, for me (36 fit, but slightly overweight) I found that while I was doing many core exercises I was missing engaging an important muscle because I didn’t know what it felt like to engage it. The transverse abdominis is a corset like muscle that I learned to engage once I started practicing the stomach vacuum. It helped me to feel what it was like to engage so that I could consciously bring it into all of my other exercises. You can see a difference when it’s engaged when you keep your lower back and feet on the ground and do a slight sit up or crunch position. For me, when it’s not engaged, my belly peaks in the middle like it’s being squeezed from the sides, but if it’s engaged, my belly is flat. I’m not a professional, but I just thought I’d share part of my journey. Thank you Mark for the excellent article.
Thanks for the contribution, Rick.
Can’t go wrong with a strong core!
Thank you for sharing all of this information.
I have constant dull pain in my left lower back that’s been going on for 6+ months now. It seems to be near the QL area (deep under the erector spinae). When I try to get to the source of the pain with my fingers, it feels quite tender and painful to touch. My left erector spinae muscles are much bigger than the ones on my right side – the protrusion is quite obvious to see.
Im a stay-at-home dad with three small children. I wonder if all these years of holding them on my preferred right side may have caused this..? On top of that, I tend to sit a lot in my free time. The pain is there from the morning, and gets worse with bending, lifting, etc. It seems like my left side does all of the work and feels like it’s never relaxed. My right side has no pain.
I had an MRI which indicated a slight curvature in my spine, bending towards the left side where the pain is. I also suspect I have slight anterior tilt. I’m at a loss of what to do. Should I aim to strengthen my right erector spinae muscles to balance the load (even if the left side sometimes takes over), or should I aim to fix the curvature in my spine with stretches? I’m currently working on strengthening my core and glutes.
I’m living in a foreign country at the moment, and sometimes I find it hard to convey all of the information like I have done above. If you could help with a quick pointer or two, that’d be great!
I wonder if all these years of holding them on my preferred right side may have caused this..?
Yes – this is certainly a possibility! Especially if you are already loading the left lower back.
If your Left lower back in hurting, I usually find that goes together with a pelvis that is rotated towards the right. Check to see if this relates to you. (See post: Rotated Pelvis). If the pelvis is rotated towards the right, this tends to make the left lower back compensate.
Try to avoid aggravating your pain. If you need to bend your back, try to get your hips and knees bending as much as possible to keep the lower back in a more neutral position. Continue with your core exercises.
You might benefit from stretching/releasing the left lower back area. Then following that up right lower back activation/strengthening exercises.
Once your symptoms are under control, you can consider address the spinal curve directly. (See post: Scoliosis Exercises)
Legend. Thanks for the advice!
Would a “wedge cushion” put on my desk chair, improve anterior pelvic tilt?
it would make my hips higher than my knees.
A wedge cushion can help improve general sitting posture, but it won’t specifically address an anterior pelvic tilt in the standing position.
Dear mark, is there a realtionship between the gluteus maximus and ic adductor Magnus? Meaning the Ischiocondylar part? Do they work together or does the Ischiocondylar help the maximus some how? I know its odd to get so deep into muscles but there is always this idea that the hamstrings quads and adductors may compensate for weak gluteus maximus but the Ischiocondylar portion isnt exactly adductor and not really hamstring although it seem to attach to the ischial tuberosity
What are your thoughts?
I know from some of your blogs that the hamstrings quads or adductors may compansate for weak glute but the Ischiocondylar portion of the adductor Magnus is a odd
I believe that Ischiocondylar part of the adductor magnus is more so involved with hip extension (and hip stability) which is a shared role with the gluteus maximus.
1: does the hamstrings also help with hip stability or is it just the this part of the adductor and gluteus maximus?
2. Which exercises i can do that bias this ischiocondylar portion of the adductor Magnus?
I left a post on FB a week ago but never heard back but I know you have many people posting and asking questions. I thought I’d come here and ask. I was diagnosed with spondylolithesis L3-4 with stenosis and some degeneration. I originally pulled my left ql muscle in December riding my indoor bike. I remember doing a hard hill climb while being in an extended position. Not sure why but my ql tightened up and I haven’t been able to get it to release for an extended period of time. I had X-rays which showed left hip hikes and anteriorly rotates while left internally rotates. Right left appears to be shorter than left. I’ve seen everyone and had every therapy and no one has helped. I was seeing an online corrective exercise specialist but I stopped. My pt said I need to find the root cause. I had anterior pelvic tilt which I think I’ve fixed. I was told to put a heel lift in my right shoe but I’ve read when the pelvis rotates it can appear to be shorter don’t put lift in. I’m working on rotating pelvis back to neutral and have made significant process but I’m still in pain in my ql if I forward flex or bend down. I know my left psoas is causing some issues. It’s very tender to tough but no one will release it. I did have right hip labrum repair with acl and meniscus. Tore left too but didn’t need surgery. I can’t lift or cycle without pain. Not even body weight. I’m only doing lots of core work and breathing. I’ll take an suggestions. Thanks. PS my shoulders are even and so are glutes. Hips feel level but sometimes they feel off. It depends. Thanks
Injury to the QL during bike riding is likely related to either your torso bending from side to side and/or the pelvis tilting laterally. Keep in mind – The QL can be injured in the shortened and/or lengthened position.
I am guessing the anterior pelvic tilt may have predisposed you to the spondylolisthesis.
From what you describe, it sounds like your pelvis has a high left hip with a right pelvis rotation? This could habitually place the Left QL in a shortened position which may have predisposed you to injure it during your cycle.
If it is indeed tight, you might need to stretch it out first. See post: QL stretches. (Stretch #9 is my favorite). Only take the stretch to a point where you can comfortable tolerate. Pushing it too far may cause the QL to strain.
You’ll likely need to strength it as well. You can try side bends towards the right side whilst holding on to an appropriate weight in the right hand.
Once the QL is asymptomatic, addressing any associated postural issues would be the way to go. If the pain is only on the left, I feel that you’d benefit from either addressing the pelvis rotation or lateral pelvic tilt.
See post: Lateral Pelvic Tilt
See post: Rotated Pelvis
(I usually would address the rotation first.)
Hey, i m too much concerned about my posture😓my physical deformity couldn’t showed in any medical report, my left pelvic bone is twisted to front, i m suffering from flat feet on right leg, left rib flare, left side jaw dropped & right jaw, ear pain, left side stomach pain in mid section on middle abs where flared ribs touching my internal organs, my head is automatically tilt & twists to right side my left dide is high than right side of body, i m confused & concerned how can fix all this symptoms which slowly creates neurological disorder in me, not a single doctor belive me when i tell them to diagnose my pelvic/sacral joint they are misaligned & tilted to right & this pain increases day by day my daily living & working gets affected because of my physical deformity, please mr.Mark help me to get neutral posture, & i also cannot able sleep on my back always feel uncomfortable when i m sleeping on my back my left rib couldn’t touch the floor it goes high hence i need to sleep on stomach for peacful sleep, hey mr.Mark plz… Help me to get neutral posture, i saw various post on u r website to correct posture but don’t know what part should i treat first plz… Help me by reply my cmnt what to do ? & From which body part should i start to workout, Thank you🙏🙂
If you would like to know which area to start with, you can try starting with the Rotated Pelvis. It sounds like your pelvis is rotating towards the right.
See post: Rotated Pelvis.
This may explain why you have a higher left shoulder, left rib flare, jaw shift etc.
About the abdominal strengthening, basically from what I understand is that we need to strech the hip flexors to have better glute and hamstrings activation like when i squeeze the glute when doing glute bridge i also feel the hip flexors strech so i get it bit when it comes to the abs strengthening its weird because dead bug also squeeze the hip flexors as well with the abs so how is it helps the situation, also about the other exercise it rounding the upper body and spine but the problem is in the pelvic and sacral and lumbar spine so why would i do movement that doesnt effect the issue it would probably just round our body over time , i feel like the abs are wierd in this apt issue , but the glute max and hamstrings are definitely a huge problem….
For the dead bug exercise, it is true that you will engage the hip flexors whilst lowering and lifting the leg. This is completely fine in regards to addressing an anterior pelvic tilt as long as you are not losing your neutral pelvis position (or perhaps even posterior pelvic tilt position). You still want strong hip flexors even if you have an anterior pelvic tilt.
I exercise 5-6 days a week (mix of cardio, strength, sports) for about an hour at a time and that is all I have time for. I noticed that doing all of these exercises takes around the same amount of time. Would you recommend I stop doing my normal exercise schedule and replace it with PT or is there a way to combine the two? Further, is there a form of cardio that is best for those with APT? I was thinking that walking would be a good choice. My APT causes me daily lower back pain/discomfort and is limiting my athletic performance. However, I am able to put my pelvis in a neutral position without help from the torso or legs. Thank you for your time, I look forward to performing at my best again soon.
I would advise you to keep up with your usual exercise routine.
If you feel that your APT is significantly impacting lower back pain and limiting your athletic performance, perhaps replace 1 day with the APT exercises. Keep in mind – it is not likely that you need to do absolutely all of the exercises recommended on this blog post all the time. There will likely be a handful that give you the most benefit. I would focus on those more so.
In terms of cardio – any exercise is fine providing that it is not reproducing any of your symptoms. As you learn to control your pelvis and spine, you will naturally hold a better posture as you perform your cardio. Some (not all) people with APT tend to report lower back with higher impact movements such as running, jumping, hopping etc so perhaps avoid those for now if it is problematic for you. Walking is a great option!
If you are able to place your pelvis into a neutral position, you will not need to focus on the release/stretches as much. This might free up some time to focus on the core and pelvis control exercises.
I just wanted to say big thanks for sharing all this valuable information, this website is a gem and you are my hero! :)
Thanks so much for the comment!
Let me know if you have any questions. More than happy to help you.
HI Mark can scoliosis cause apt and if yes is it fixabale?
Lateral bends in the spine is more likely to influence a lateral pelvic tilt.
Keep in mind – you can have an APT with scoliosis as well.
You will be able to improve your APT as long as the joint in your lower back are not fused.
Hi how can I tell if my joint in my lower back are fused.Thanks for responding
I have mild scoliosis,winged scapula,hyperkyphosis,hyper lordosis and anterior pelvic tilt.So you think these exercises can fix my posture or my posture problems are structural?
And last how much height do you think I lost from these postural problems.Thanks for helping and replying
I have these issues confirmed:
– APT (anterior pelvic tilt) -> Resulting in Lordosis
– Forward Head posture
– Knee Valgus
I probably have but don’t know for sure:
1.) How can I tell if my bones are fused or something like that and I can’t fix my APT?
2.) All of these things must have some cumulative effect on height, which ones are the most impactful? I’m guessing Knee valgus + Kyphosis?
1. If you can round your lower back out of the extended position, then it is not fused. If the lumbar spine is not fused, then you can correct your APT.
2. Hyper Lordosis and Hyper Kyphosis would be the main ones.
I came across your blog a while ago and have been circling back to it again. Long story short I experienced an injury (pop noise) when I was in a side crow arm balance yoga pose 5 years ago. Torso was twisting to the left, pelvis twisting to the right. Next day could not walk, was in extreme pain in mid back and pelvis and could not bend forward at all. For the next couple years saw many PTs and Chiros some who helped and some who caused more pain. It has now been 5 years, 6 PTs and 7 Chiros later and still no solution, answer. I was told it was a pelvic imbalance and have rehabbed everything possible with PTs. Currently I have dysfunctional throughout my whole body. And still a lot of pain and it is hard to do any form of exercise than walk. I was an extremely active yoga teacher and now have to change the way I do everything.
Current situation – Pain in right SI joint and popping when going from sitting to standing or sitting to laying down. Sometimes cannot sit for extended periods of time. Right buttock pain. Right pinching in hip sometimes. When I hike I always get injured on the front on my right thigh and can hardly walk for days and have to lift my leg in and out of the car. Low back pain. Tight erector spinae muscles (did get active release technique for years ago but still tight a little.) Lack of core strength. I have tried strengthening core and it goes right back to feeling weak. Would have to do it every day. Feeling like I am leaning forward in my low back often. Left knee pain and injury often. Left foot pain. Right shoulder pain and clavicle popping. Right shoulder is lower than left. Right side neck pain, feels pinched. Right side muscles are tight – rotators, under arm pit. Hard to sit at desk on computer. Using mouse tends to start to bother my right shoulder and neck. Mid back muscles and traps are usually tight. Any rows or exercising them makes things worse. Pinching on left side under shoulder blade. Neck is completely straight with some mild forward head. (seeing chiro currently to try to correct this – 2 years so far and nothing) I have honestly tried everything and have thought about rehabbing myself but it all seems so complicated. Seems like no one really understands pelvic imbalance and how to correct it. Would appreciate any help at all! I have seen a spine dr as well. Everything came back “normal” for besides a small herniated disk from years ago.
Also went I lay down and put my legs straight up in the air my right leg is significantly shorter. When I sit on the ground, legs straight out and together they are the same length.
Have you been assessed for a rotated pelvis?
See post: Rotated Pelvis.
It sounds like you may have pelvis that is twisted to the right. (which is also the position it was injured it by the sounds of it)
If there was a popping noise when you injured it (and scans have ruled out lumbar spine pathology), this would make me think that is something to do with laxity in the Right SIJ. Instead of core exercises, have you tried strengthening the right glute muscles? Hip external rotation (clam shells) on this side might help stabilize the SIJ. You could also try taping the SIJ to stabilize it.
If your pelvis is rotated to the right, your right hip is also in a position of INTERNAL rotation which can predispose you to anterior hip impingement (especially when you are hiking up hill).
If the pelvis is locked facing on direction, this will have a compensatory effect throughout the whole spine which can involve uneven shoulder heights and asymetrical distribution of pain.
Of course – this is just me speculating. You could even have a left rotated pelvis and the injury was due to an anterior innominate! Have a look at the blog post and try the tests.
My dr is having me do a stretch like this. Lay on belly. Put Bolster under knees. Bring knees to head. It’s best if you gets someone to hold your legs. D ok you have anymore insight on this? What muscles it’s dealing with etc.
I’m not too sure what stretch you are trying to explain. However – if I were to guess, it sounds like your doctor is trying to stretch your hip flexors?
Hey Mark is this comment accurate? Pertaining to regaining height and apt?
He states what height you gain by correcting your apt is offset by khyposis or something? Is this true or is he wrong? Thanks
It is my experience that exaggerated lumbar lordosis leads to stiffening and straightening of the thorax. As the lordosis is corrected, the upper back regains a healthy and flexible kyphosis not shown in this video that tends to balance off any height gain. Another consideration is that excess lordosis is almost always a compensation for hyperextension through the knees. The flexibility we can regain in our upper back depends greatly upon our capacity to move with our knees unlocked which will also balance off any height gained from lumbar extension.
This locked knee and upper back coordination is part of the parasympathetic freeze reflex initiated by the dorsal vagus nerve, which also for deterrent purposes attempts to make us look as tall as possible. Most people in modern society are locked in a mild freeze reflex as a matter of habit. The opposite, being activation of the sympathetic chain down the anterior thoracic spine, will kyphose the thorax and compress the front of the body. Caricatures of these extremes would appear tall and narrow with long neck for overly parasympathetic, and short and squat with thick neck for sympathetic. The former is a spring stretched to its maximum with no potential energy, while the latter is a spring coiled and ready to explode. Healthy posture is not locked in either of these extremes, but bounces within a healthy range as we move. A big part of achieving this neurological health involves psychologically letting go of the need to appear as tall as possible and allowing our back to round without the head falling forward which would initiate a slouch.
It’s as simple as this: as we extend the lumbar spine we widen the body as we engage lateral fibers beginning at the lumbodorsal aponeurosis, such as the lats and tva. This widening comes at the cost of height: the same height that is gained by extension at the lumbar and cervical. I can all but guarantee you that if someone gained 2 inches through correcting their posture, it was due to placing the head properly over the shoulders, not through extension of the lumbar spine. Of course improving spinal health in general will tend to correct forward head posture so there is a correlation, but it is not causal.
So I’ve started doing these exercises for a couple of weeks now and they take a really long time so they’re hard to fit into a daily routine (even though I totally skip releases and only do each stretch two times since I can tilt my pelvis) . Then I saw that you recommended doing the Forward Head Posture 2-3 times a week but I can’t find any such recommendation on this page.
But can I do these exercises 2-3 times a week as well or won’t I have any progress if I do? Sorry if this is a silly question, I’m new to exercissing and really want to fix my posture after sitting infront of the computer everyday for half my life.
Thank you for your time and for making this website.
In the early stages – I would encourage you to do all of the exercises as you will eventually find out which exercises help you out the most.
From here – you can focus on a few exercises. (You do not need to do them all.) But they only way that you’ll know which ones are great for you is by trying them out.
You can do these exercises 2/week if that is more practical for you.
Hello Mark – I have forward head posture, rounded showers, visible kyphosis of the upper back, lordosis of the lower back, anterior pelvic tilt and flexed legs.
Where do I start? I’ve read your guides and I’m wondering if I’m best focusing on a couple of things initially such as forward head posture and rounded shoulders?
You can start anywhere.
But the one that I would encourage you to start early is the thoracic spine.
Addressing this area will likely help with the forward head posture, hyperlordosis and anterior pelvic tilt. (But it is also one of the hardest to change)
What if we have anterior pelvic tilt on one side?
This might be due to a pelvis rotation. See post: Rotated pelvis.
Hi Mark, thank you for all this valuable informations and advices that can be found here. I have two questions.
1. I have never before used foam roller and massage ball. What density is best for this purpose? I guess that i should start with soft but to me it looks like it can’t provide adequate pressure. Is it ok to start with medium? What about texture, should i use smooth or textured?
2. Someone asked if it was ok to do this exercises every day and you answered that it is ok as long as the body is able to tolerate it. Assuming that i can tolerate it, would i see better(faster) results doing it every day(or almost every day)? Or is it a better option to take a day off?
1. Go fairly firm, but also good to have a bit of give as you apply your body weight on top of it. I prefer the smooth texture personally.
2. If nil issues with the exercises, you can perform them daily in which should translate into faster results.
Thank you so much for this blog.
I’ve been doing lateral pelvic tilt exercises for almost 2 months now and it’s almost normal. I am so happy about it. But after reading your other posts I realized I have so many issues. I have mild scoliosis and flared ribs where the left rib sticks out more. So, I think I have a twisted spine.
Also, I realized I have anterior pelvic tilt and probably rotated pelvis too because my left hip joint pops/snaps when lowering the leg from a raised position.
At this point I’m kinda overwhelmed. So, can you please tell me which issue should be addressed first?
Thank you so much for putting together a very thorough guide to relieving common issues.
I have an anterior pelvic tilt and am working on trying to get it balanced. can an anterior pelvic tilt also create tightness in the shoulder/trap area? I am right handed and work at a desk so use my right arm a lot. Does an anterior pelvic tilt have a direct impact on any trap/shoulder stiffness throughout the day? I probably lean to the right while i sit throughout the day, which I’m sure is one of the causes but can issues lower down (pelvic tilt) also play a factor?
Your pelvis position can definitely impact the position of the shoulders.
Sometimes by addressing the pelvis, you might see some improvement in your shoulder.
Is there a way to measure progress?
There’s a few ways:
– You should be able to feel the muscular contractions better when the strengthening exercises
– Stretching should become easier.
– You can use the same assessments mentioned on this blog post to see if your pelvis position is improving. You can measure angles if you would like.
– A reduction in your symptoms.
– Improved function: for example, able to stand for longer with less pain.
Hi Mark. Is it ok to do this APT program everyday, especially the strengthening portion, i.e glute bridges, hamstrings and dead bugs? Thanks
This is fine to do as long as the body is able to tolerate it. If you find that you are quite sore after your strengthening exercises, you might need a day in between .
Thank you Mark. I figured it would be an “ok, but listen to your body” type of answer, makes total sense. Had to ask because we were always told not to train the same body parts everyday. The core is probably the exception and it’s not like we are crushing the muscles here in this program, just using them everyday to build them back up. Appreciate you so much, you help so many who can’t find local help to put them on the right track!
I’m wondering what would cause bilateral adductor origin Tendonopathy, and what could I strengthen to prevent it or help it
Adductor tendinopathies tend to occur when you place more stress on the tendon than what it is used to.
Have you started anything new recently that would place pressure on both adductors?? Sport? Exercising? Work? Etc.
To strengthen the adductors, I would start with an Isometric Adductor squeeze exercise from varying degrees of hip abduction.
Can I accommodate weight training exercise’s along with corrective exercise mention above ( I’m working only on arms chest and back )?
Can you suggest some good cardio exercises that can be done regularly along with above routine.
You can pretty much do any cardio exercise along side the mentioned routine.
Running, cycling, skipping and swimming are all fine.
Many thanks for such a thorough guide on ATP.
I have lower back pain, duck feet (due to hip external rotation), ATP, rounded shoulders and forward head posture. Are all of these connected somehow? Is there an efficient exercise routine I can do to address all of these problems?
I’m thinking posterior hip release, posterior hip stretch, strengthen hip internal rotators, strengthen glutes, stretch quads, strengthen abs, strengthen hamstrings, thoracic extension mobility, face pulls.
I’ll aim to do this once a day.
Does this sound fine?
All the best
It is quite common for the mentioned postural deviations to be connected. (Domino effect)
I generally advise people to address one area at a time as this will minimize feeling overwhelmed.
If you want to address multiple areas at the same time (which is not an issue), you will want to tackle the main exercises (for your individual presentation) for each postural issue.
It is fine to do the exercises mentioned, however, don’t be afraid to add/remove exercises as required.
Hey Mark, is it necessary to do all of the releases, stretches, and exercises mentioned in this blogpost? I’m feeling overwhelmed by all the things I’ll have to do to fix this. Is there a truncated routine?
Definitely not 100% necessary.
If you aren’t tight, then you can just skip straight to the strengthening exercises.
i have been battling with lower back pain for years and although its gotten better with stretching and strength training anytime I am standing or sleeping for long periods of time my QL’s immediately go back into this extremely tight condition. My Left QL (posterior) is farrr worse than my right and I have slight scoliosis (convex left, <5 degrees around L3-4-5).
When i wake up my QL's are exceptionally bad (i sleep on a somewhat firm mattress and on my side with pillows supporting). I notice they are worse when i sleep more in the fetal position so i try my best to stay elongated.
When i first wake up, its as if i have a hard time supporting my weight above my hips when bending, i have almost zero core strength or the ability to activate my core. I then have to crack my pelvis (basically rotate hips) for things to go back into place and to get some range back.
My left hip range is far worse than my right, as too is strength. Often when my pelvis is out of alignment (every morning after sleeping), my thoracic is locked up as well.
By the way, this website is fantastic.
Thanks Mark! Glad you find the blog helpful.
Sounds like your QLs do not like staying still for a long period of time. I suspect this might have something to do with the quality/strength/flexibility of the QLs.
If this is the case – you are on the right track with the progressive strengthening program!
If you are particular symptomatic when you wake up, consider doing simple warm up stretches such as lumbar rolls, pelvic tilts, knees side to side etc. I have some basic stretches here.
With the left side worse, it could be related to scoliosis. If so – these exercise might help. See post: Scoliosis Exercises.
You mentioned that your pelvis is out of alignment. Are you referring to it being twisted to one side? If so, see post: Rotated pelvis.
But I think continue with your strengthening exercises for the lower back. Once symptoms have subsided, you can start to address scoliosis and/or rotated pelvis.
I’m so glad I found your page! I am actually laying on my side with a pillow between my knees to sleep, and realize I am in severe APT when I do that? Until I get that under control with your exercises, should I sleep on my back as you recommend with the pillows raising my legs. I can correct the tilt while awake but will just drop back into it when asleep. I hope I can do better, but i also have a scoliosis curve in that direction, and your understanding and explanation of posture has helped me a lot! Thanks!
If you feel your sleeping posture is contributing to your anterior pelvic tilt, you can still sleep on your side but just brings your knees up higher. This should automatically place you in a posterior pelvic tilt.
Alternatively – you can also sleep on your back with pillows underneath the knees ( if it is comfortable for you).
Ps. here are some exercise for scoliosis: Scoliosis Exercises.
Hi, I have a Psoas Syndrome with a Snapping Tendon on one side. I have APT and a forward twisted pelvis on that side. My Psoas is weak on that side and all other hip flexors (espec. TFL, Part of adductors) overactive. My hamstrings feel like glued on that side.
Do you recommend doing the APT exercises? Can I do the dead bug as well or better different core exercices?
Thanks so much!
I have a blog post for you: Snapping Hip Syndrome.
Hope it helps!
Can I do burpees to loss my tummy n overall weight along with apt exercises.
This should be fine. Of course – listen to your body.
There shouldn’t be any increase in your symptoms.
Hi mark I wasn’t sure which blog to post on so I choose this but my problem is I’m wanting to know why my rec fem qaud muscle is so big and powerful on myself both sides but my vastus medialis and vastus lateralis are like tight and tucked away and when I train my quads my vastus medialis and lataralis fatigue super quick and my along with it my calfs muscles feel tight and tucked away aswel even though I stretch them heaps
It could be related to an anterior pelvic tilt which places more pressure on the quads and calf muscles. (Which I assume you have as you are commenting on this blog post).
Are you involved with any particular sport?
Hey Mark here is the article I was referring to a few weeks ago. Warning it may be a bit long, but interesting when you have time let me know your opinion
I had a quick look at the post you sent.
Basically – I agree with most of it.
You can’t blame APT 100% for lower back pain. There are many people with an APT and have nil symptoms whatsoever. At the same time, there are people with lower back pain with no APT.
Addressing APT is actually one of the last things I address when dealing with someone with lower back pain. It is more important regain the patient’s full movement, control/strength and confidence in their lumbar spine.
Do I think APT may be a factor in a certain amount of people with lower back pain? Yes. Do I think APT will always end up with lower back pain? No.
If you have APT and a facet joint problem, the extra lumbar spine extension could actually be causing more pain. In this case – I would be more inclined to address the APT sooner. If someone has a posterior disc bulge and APT, I would give the posterior disc bulge priority in terms of treatment. I tend to use to extension-based exercises to address posterior disc bulges. See post: Bulged Disc Exercises.
My belief is that if your lower back lives in extension (as related to the APT) in standing, then it is likely your back will be weaker/not accustomed to flexion. So when people to inure their backs, a good majority will injure their back in flexion.
Thanks for taking the time to read the article I sent you. I have another question that confuses me it’s from Esther Gokhale, she lists 5 tips to fix posture, one of them is rolling back shoulders and another tip is this…
Don’t sit up straight! “That’s just arching your back and getting you into all sorts of trouble,” Gokhale says. Instead do a shoulder roll to open up the chest and take a deep breath to stretch and lengthen the spine.
Whats your opinion on this? How should we go about sitting as we know you have a method as well? Thanks
You do not want to over extend your spine when sitting. The goal is to remain as elongated throughout the spine. You can think of it as it someone is gently pulling your head up towards the sky.
Is it ok to do reverse crunch for core strengthening?or it does it affect apt badly.
Completely fine to do reverse crunches.
You help a lot of people. I appreciate it. Thank you very much!
I read a lot of post in this website. My problems are:
anterior pelvic tilt (also I have hyperlordosis)
lateral pelvic tilt
scoliosis (cobb angle is 4.2 according to the x-ray).
Which problem should I address first? I tried to address APT for 4 months. But results are not that good. (I discovered your website recently. So I couldn’t try your exercises yet.) Maybe I thought that I should focus on my another problems first but I can’t decide where should I start from.
You can start in any area.
Perhaps try out the mentioned exercises in this blog post for the next 6 weeks and see if there is any change.
If not – you might need to target a different area.
Is it possible to practice these exercises with age?
Generally – it should be fine but always consult with a professional before commencing any new exercise program.
Hey Mark sorry I left thought I left a link in the last article, unless this website maybe blocked it as spam?, not sure but it was another opinion on apt and I wanted to know your opinion on the article.
It’s this one
It’s from msk neurology called really assess lumbar lordosis
If not it’s cool be safe!
Sorry about that – all links in comments are disabled.
Any chance you could go a very brief summary of the post for me?
I have a Anterior pelvic tilt doing exercises I feel that the tendons are tight especially when using exercises hip flexor and Gluteals
Tightness in these muscles can definitely be part of the anterior pelvic tilt presentation.
can I do free squat exercise 15repx3 daily along with apt exercises to strengthen my glutes and hamstring. also can I do med ball slam for core strengthening?
does it affect my apt badly or its booster to other apt exercises ?
Hey Kane, Completely fine to do these exercises.
Hi Mark, I hope you have a good holiday!
I’m worried about my posture because I want to start exercising but I don’t know if it will be safe since my posture is so bad. Should I wait until after I fix my posture or is it ok to start lifting weights now? I’m discouraged because I want to get in shape, but with such bad posture, I don’t know if I will be able to start lifting yet, or if it will take a long time to fix my posture so I can start lifting. It could take years to fix my posture, and then even more years to get in shape, but I don’t know if I’ll live long enough for that, haha!
What do you recommend for me if I have multiple posture issues at the same time? I have (I think) forward head, rounded shoulders, flared ribs, anterior pelvic tilt, hyperlordosis, flat feet, and duck feet (on one side). So I was confused whether I have to do exercises from the 7 articles for each issue, or if there’s a way to just do a few stretches that will fix most of these issues at the same time.
By the way, this is a really great website! Thanks for making everything so specific, it’s very helpful!
In my opinion, you could probably do both at the same time. Exercising has so many health benefits!
The main thing is that you perform all the exercises with good lifting technique and without any pain.
If your body is locked into bad posture, you might need to modify a few exercises so that you can perform it to the best of your ability.
In regards to having multiple postural issues, I would generally recommend people to pick one area and just focus on that. Get the most out of the exercises, and then once you feel you’ve taken them as far as you can, move onto the next area.
Addressing all areas at once is doable, but very time consuming. Once you know what specific exercises help your individual postural issue, you can concentrate on the few that will give you 90% of your results.
All the best!
Hey Mark, what’s your opinion/feedback on this article?
Would love to hear your opinion, thanks and happy Thanksgiving!
Had a quick look at the post. Was there a specific question you wanted to ask?
can I do free squat exercise 15repx3 daily along with apt exercises to strengthen my glutes and hamstring, does it affect my apt badly or its booster to other apt exercises ?
This is a great post, so thank you.
I have an anterior pelvic tilt that I am working on. After working on the glutes they are much stronger. I have poor hip extension which I am also working on, especially in bridges etc. I have spent nearly 3 years after having a baby trying to tighten up my abdominal region, specifically the lower abs. I hardly ever feel any burn after a good deal of core work. My friend mentioned that maybe my abs were over lengthened from too much yoga post baby and alignment. Are there any exercises that you would recommend to fix abs that have been over stretched? Thanks!
Not too sure who Jay is but I assume you mean me ! :)
Any exercise working on the core (eg. dead bugs and its many variations) and posterior pelvic tilts (eg. reverse curls) will help with the over-lengthened abdominals.
I would also recommend addressing flared ribs (if you have them).
I have hyperlordosis, anterior pelvic tilt, a military neck – loss of curve in cervical spine.
i have really bad digestion / indigestion issues…i have seen doctors who have done various tests and found nothing. i have had it for 6 years, it’s ruining my life.
i get indigestion, food sits in stomach, i have to force burps out, i can’t take deep breaths in, i can’t yawn, it lasts a few days, goes, then come back. i get it after eating only
i did some research and then my chiropractor also told me, nerves in your spine can affect digestion.
I found T6 is responsible for stomach issues. is there a way i can re-align this verterbrae myself? it’s ruining my life
also, when i use a massage ball on my traps they are as tight as hell…which verterbrae is this and which posture related issue is this from?
sorry for long email, but i really need help. i know you can’t diagnose health issues, but it seems like it’s not one, but a posture / spinal / alignment issue
Many thanks. i hope you can help
Hey Mark hope everything is well, I have a few more questions.
My quads are so tight that when I try and put my pelvis in a neutral tilt I have to literally bend my knees.
My question is how should I go about walking normally? Do I walk around with my knees bent? Lol or do I just try and stand tall as possible?
Do I squeeze my glutes at all how should I focus or my walking posture?
Similar to yoga mountain pose?
If your quads are locking your pelvis in an anterior pelvic tilt, you will need to work on lengthening them.
Do not force the pelvis to change when walking. (especially if the tightness has not been addressed)
Many thanks Mark. By wearing shoes while doing them, I can fit the anterior pelvic tilt tasks into the best place in my overall list of exercise items, some of which I do wearing shoes, and others barefoot. By the way, I started doing over a dozen of your anterior tilt tasks a couple of days ago, and they are brilliant!
Great to hear the exercises are helping you out!
Hi again Mark. I have just started many of your tasks from this web page for anterior pelvic tilt. In the photos of you demonstrating each task, you are doing them barefoot. Is it OK for me to do them wearing my usual trainers?
That is completely fine to do.
(I don’t like wearing shoes)
Love your site!
I have a question can tight adductor muscles cause back pain because I have super tight adductor muscles and back pain and I can’t seem to get to fix either of them any idea on what could be going on?
Hard to say without an assessment.
Do you have knee valgus? See post: How to fix Knee Valgus.
This potentially could place more pressure on your lower back from the addutors being tight.
Hello Mark. I just love how your site has a page for every common postural issue. I believe I have anterior pelvic tilt on one side leading to a slightly rotated pelvis as well as a winged scapula on the opposite side of the APT. I can move my pelvis to a neutral position like you said in the page which means I should focus on strength more than stretches. However, with a less common case like mine where APT exists on only one side, wouldn’t it be more likely that only one of side of the pelvis is tilted due to tight muscle(s)?
It sounds like you might need to follow the Rotated pelvis exercises.
However – If only one side is truly tipping forwards, you may have a lax Long dorsal sacroiliac ligament on that same side. This would likely accompany tightness in the muscles such as the quadriceps and lower back erectors on one side.
Thanks for the reply, Mark.
I was previously doing your routine for a right rotated pelvis, but I do believe it is anterior pelvic tilt on one side after examining the pelvis from both sides. It is ironic that you mention tightness in the quads and erectors (if the issue stems from a lax long dorsal SI ligament) because my quad is extremely tight on the side with APT, and I have had tightness in the lower back on the same side. Assuming it is a lax long dorsal SI ligament, how would I go about fixing the problem? Just doing stretches and releases for the tight muscles? Also, do you accept donations? I have been extremely grateful for your help, as it has been more beneficial than my chiropractor and physical therapist visits in the past.
I would start by releasing the tight quads and erectors at the back.
Follow that up with some glute activation exercise.
Then onto Core exercises.
The glutes (and hamstrings) and core will help hold the pelvis in the right position.
I would also recommend trying out this exercise here to help reposition the anterior rotated pelvis.
Lie on the floor with your foot onto a wall. (see above)
Place your knee in a position where you just start to feel a pinch in the hip.
Drive your heel into the wall for 10 seconds as hard as you can.
Aim to feel your glutes contract as you do this.
Drive through your heel.
If able – try to move closer to the wall as to increase the amount of hip flexion.
Repeat 5 cycles.
I have a donations page which can be located here. (Many thanks in advance!)
Honest and fair answer thanks mark. I too am concerned with the my current posture and “hyperlordosis” I don’t want back problems in the future when I’m older. Mobility is really important when you get older. I’ll continue maintaining good posture standing, sitting and working out.
My hip is pointed so far down it looks so bad almost as bad as trumps “apt” lol. Lots of confusion and research and opinions among physiotherapist and chiropractors.
For example one guy at msk musculoskeletal neurology says squeezing the glutes and pushing the hips forward to neutral pelvic tilt is bad as people usually have thoracic instability and that’s usually gets confused for apt.
How do you suggest I move forward just keep it simple?
Squeezing the glutes/hamstrings and driving your hips forwards is what I personally refer to as a sway back posture.
If you have tight muscles such as the hip flexors which are driving your anterior pelvic tilt, I would start addressing these first.
If there is no true tightness, I would assume you would have a control issue which might be related to poor core and trunk control. The core exercises mentioned in this blog post 9esp. the dead bug) is a great place to start.
Also check to see if you have good thoracic mobility.
Hey Mark I’m back lol, long story short here we go
Had a free consultation to see a chiropractor so I went. The chiropractor didn’t do a physical examination we sat down in the doctors office and I asked questions about apt and hyperlordosis.
I told him I think I had apt/hyperlordosis and told him about the research I did online and the different tests I did like the wall test and the floor test etc. He said those tests were 50/50.
He then told me everyone has a different range of apt they can have and used examples of dancers. He said as long as I can function with it it’s fine maybe do some core work and stretch the hip flexors.
I was like ok but when I do these tests my whole arm fits behind the curve in my back. He said again as long as there is no pain and I can function and maintain good posture habits don’t worry about it.
He suggested doing some core work, but I was like ok but when I stand in the mirror my pelvis is tilted so far down and my back is curved and my butt sticks up etc. He then said by looking at me sit he says he could tell I have tight hip flexors and a slight hyperlordortic curve. He said in popular culture women with really big behinds usually have hyperlordosis and apt is in a range.
It was a bit disappointing tbh, he did recommend seeing the spine specialist as they are better versed with that.
Now I’m wondering if I should work on my apt/hyperlordosis or just leave it as I have no back pain. He did mention to practice good posture habits and simple 5 to 10 minutes stretches but as long as I’m not hunched over it’s not a big deal.
What do you think should I get a 2nd opinion or maybe I should have seen an actual physical therapists as opposed to a chiropractor?
This is the big topic debate in the posture realm.
I would tend to go with addressing posture with the goal with minimizing any potential issue in the future.
However, on the flip side, why fix something that is not broken? If you are moving effectively, have good flexibility, strong in all movements and have no pain, is there an immediate need to address posture? Perhaps not straight away, but over time, postural related issues can eventually arise.
I am not sure what a spine specialist would do for you if you have no symptoms however.
I saw you posted my other question about surgery but didn’t reply so I guess that means you don’t know, thanks anyway.
But I have a question about massages today. I know everywhere tells you if you have anterior pelvic tilt DO NOT stretch your hamstrings because it will make it worse, but every massage therapist I’ve seen has said I should get them massaged. I know stretches and massages are a lot different but some places online says don’t touch your hamstrings period some do. So I was wondering what is your opinion on massaging hamstrings.
Also if it IS BAD to (massage not stretch) your hamstrings with APT is it also bad to massage BOTH glute mediuses and Both QL’s when you have Lateral pelvic tilt? I read your lateral pelvic tilt page so I know which side to focus on in massages if your not supposed to do both.
Thanks for any help.
I’ll try get to your other comment soon! (I get a lot of comments and so little time to answer, some comments get missed)
It is perfectly fine to stretch/massage your hamstrings if you have APT. (But it shouldn’t be the only thing you are doing to the muscles around your pelvis)
(Same opinion for the glute medius and QL with lateral pelvic tilt).
I doing free squat n kettle bell swing for hamstring strengthening ,can you suggest few more hamstring strengthening exercises?
Variations of the dead lift are perfect for the upper hamstring.
If you would like to target the lower hamstring, exercises like the nordic hamstring exercise will be great.
is it advisable to do standing march exercise for core ????
That is fine to do.
Hey Mark awesome informative site, thanks for your work. I scrolled through the comments to see if I could find answers to my questions. And I did find most of them, but I have a few more.
1.I have APT and hyperlordosis, I was wondering if I can still lift weights or jump rope or do some sort of kettlebell, yoga or elliptical machine while doing these stretches? Pretty much which exercises are the safest?
2.Can the exercises be done more than once a day? Or just once a day 3 to 7 days a week?
3. How much height can be regained is 1 1/2 to 2 inches possible if its severe?
4. Can I mix it with other stretches from different youtube videos like a quick 10 minute morning stretch?
1. You can do all of the exercises that you have mentioned. Try to keep your core engaged throughout.
2. Yes – it depends on how much your body can comfortably tolerate.
3. Yes – I wouldn’t be surprised!
4. Of course! More the merrier.
Hey Mark excellent website
I have a few questions
First I would say I think I have pretty bad APT I did the floor and wall tests and can fit my whole arm behind the curve of my lower back. Luckily no pain so far. assuming I have apt or lordosis due to failing many self assessment tests I was wonder besides fixing my posture health does fixing apt and or hyper lordosis regain or”increase” lost height? I heard it can be and is an added bonus to fixing apt/lordosis. Generally is it possible? Have you seen it happen? If so generally how much an inch on average? Inch and a half? I’m really curious. Some websites say it’s up to 2.5 inches, what’s the most you seen? Thanks appreciate it
It depends on how severe the APT is in the first place.
2.5 inches is quite a bit, but I would not be surprised if one reclaimed this amount with a severe APT.
I am having difficulties in the iliopsoas, rectus femoris and lower back stretches. The first two I feel more on my knees and the lower back I barely feel the lower back stretching (the butts come out from the seat). What can I focus on?
I also have trouble getting the lower back to the ground on the diaphragmatic breathing without using too much strength from the abs or my legs – sometimes even stressing neck. How can I approach it correctly?
Stretching is all about a game of angles, so if you feel that you’ve tried every angle and still can’t find that stretch, the next best thing would be to focus on the massage ball releases.
If you find it hard to flatten your lower back whilst doing the breathing exercise, try bending your hips to ~90 degrees and rest the back of your calf muscles on a chair.
I’m wondering I have a problem with upper back pain my tspine just feels locked…
I’ve got good rotation through my hips and spine when I rotate to the left but when I rotate my hips or my trunk to the right it’s super tight and doesn’t want to rotate any idea what I need to do?
Do you have a twisted spine?
Or perhaps even a rotated pelvis?
This may influence the amount of rotation that you can do towards the right side.
I can’t figure out if I have APT, Hyperlordosis or flared ribs (or all of them). In this case, do you suggest doing the exercises for all of them? If so, how often should I be performing the exercises for optimal results?
Thanks for all your hard work, it’s much appreciated,
It is very common to have more than one postural issue.
In terms of where to start: I would just suggest starting on one area and see how the body responds. Once you feel you have achieved as much as you can in this one area, move to the next.
If you APT, hyperlordosis and flared ribs, I suggest working on the APT first as the other 2 may just automatically correct with the APT correection.
Oh and to add onto my last comment I just posted i forgot to add this. I have so many issues around the same area that when I try to fix one issue it hurts / impedes me from trying to fix the other. For example I think on top of all that i may have a rotated pelvis. And when I try to do ANY QL/ Oblique stretch it hurts the other side of my body and everything feels uncomfortable and I have to stop almost instantly…. all I can do is massage the area… which doesn’t help completely with the issue because Massages mainly help with mobility, all studies show that it doesn’t help with flexibility like stretching does and I can’t stretch. Just like I can’t stretch my upper body.
I have a tight chest possibly giving me rounded shoulders. But when I try to do any chest stretch my delt feels like it’s going to bust, and also my scapula feels like it’s stuck and starts to hurt because I have like 3 different issues in my shoulders. Everything impedes me from fixing the other. And while I’m slowly fixing a few of my issues it’s spreading throughout my entire body and now my entire body is tight and pulling me a different way. And it’s extremely affected my sleep I can’t sleep. So I get constant headaches because I’m very headache prone always have been. So between around 12 different posture problems I’m having I can’t sleep, and every issue is causing me a problem on fixing the other issue. So if you know anything about surgery or if theirs some type of posture surgery i would highly appreciate it.
Hey I was here a long time ago doubt you remember me. I have Anterior Pelvic tilt and Lateral pelvic tilt, winged scapula, a lot of shoulder issues. And since then my issue has progressed, while I’ve been strengthening my muscles and I have been noticing some progress my issue continues to spread, I know have Diastasis recti(Poor TVA control) also what causes Anterior Pelvic tilt) I now also have forward head posture, which also messes with my shoulders. And more posture issues i don’t feel like typing. My entire body from head to toe is tight. I’ve had Anterior pelvic tilt for about a year now while it’s gotten better and i work my ass off it just work fix. I workout weak muscles, stretch, get massages and see a chiro for adjustments
And everything is spreading and just getting worse despite how much I’m doing.
So before I just give up i was wondering if you know if theirs any surgery for posture that will fix atleast just a few of my issues. Like surgery for anterior pelvic tilt and my shoulders.? I know theirs surgery for diastasis recti. But if I keep anterior and lateral pelvic tilt and poor TVA control my abs will most likely spread again so getting surgery for just that will most likely be pointless.
So I’m 100% set on wanting surgery or just giving up. I’ve gave it all i had for a year for nothing to fix, just spread. Spent money I don’t have on Chiro appointments, massages, etc. Are there any surgeries to help with Posture/ my issues. My entire body is tight and constantly pulling on me I’m done
I am also a physiotherapist but in a different posture management role. I deal with 24 hour posture management of the complex patient and make recommendations for seating and lying equipment as well as custom contoured seating. Ironically, I have terrible posture!!!
I have VERY tight hips, very anteriorly tilted pelvis and very weak core. I also have hypermobility syndrome and so tend to hold on with all of my longer muscles. I am developing a thoracic kyphosis and left lateral curvature. My pelvis is oblique (up on left) and I experience a lot of tension on my left side as well as a lot of left hip pain. Other areas of pain are thoracic and neck. I have been advised that it will be difficult for me to stretch due to my hypermobility.
I am struggling with trying to find a good starting point as it seems I have to work on all aspects of my posture. I can just about reach a neutral pelvic tilt, but that is difficult.
Any advice would be very much appreciated.
Glad to see a fellow physiotherapist here.
If you have a hypermobility syndrome, I would caution the use of stretches. However – if you know that you have tight hip flexors as per Thomas Test, you may be relying on these (likely in conjunction to other muscle groups) to maintain your posture. Strengthening the weak muscles will be important! (esp. anterior abdominal group, hamstring)
You mentioned that your pelvis can reach a fairly neutral position, is this the same with your thoracic spine kyphosis? These 2 postural presentations tend to influence one another and most likely both need to be addressed.
In terms of a good starting point – if you specifically have left hip pain, I would perhaps recommend addressing the pelvis tilt first.
See post: Lateral pelvic tilt. (If you are not tight in the muscles I recommend to stretch, go straight to the strengthening exercises)
Once your left sided symptoms have settled, you can now tackle the anterior pelvic tilt or the thoracic spine.
Thanks Mark. I’ll take a look at that page. Thoracic kyphosis seems to mostly flatten in supine although shoulders remain protracted. It’s very hard to maintain good natural spinal curves in sitting.
Hi Mark, I have bad apt, and I have been doing hip flexor stretches for long period but my psoas length hasnt changed over time when i test it with Thomas test (my leg dont drop on table) , and my apt is almost the same from the beggining. I learnt how to properly stretch so that shouldnt be the problem. I have noticed that when I lift my leg, im little shaking in that leg, but I can hold it more that 30 sec without drop (i dont know is that weakness of hip flexors). I have very bloated abs. I dont have fused joints, I can reverse spine. I wanted to know, why my posture isnt changing? I need to tell that I dont sit all day, and im trying to maintain neutral spine through the day.
I would be grateful.
Are you able to perform a posterior pelvic tilt to neutral pelvis position?
If not, your hip flexors may indeed still be very tight.
It sounds like you may be relying on your hip flexors to hold up your posture. How does the rest of your posture look like?
Hi Mark, thank you for answer.
My whole posture is bad. I have forward neck and winged scapula. But apt is my biggest problem so I wanted to fix it first.
I cant rotate pelvis in neutral position.
If you feel that you have done everything that you can do for the pelvis, I would recommend addressing other areas of your posture that might be influencing the pelvis to tip forwards.
Any hunchback posture?
When I lift my right leg up to my chest whether I am standing up or lying on the floor, I hear a “clunk” sound come from around my hip/pelvic area. If I move my leg outwards and lift the leg again, I don’t hear the sound. It feels as if a bone is rubbing against another bone but I’m not too sure. There is no pain, but do you know what this might be? I also have patellar maltracking which is not resolving itself by strengthening the VMO and glutes and I think this may be linked. I also sit during the day more than most people. I wonder whether I have anterior pelvic tilt. Thanks!
It could be an issue called Snapping hip syndrome. It’s where the tendon flicks over a bony prominence in the pelvis.
This is actually the next blog post that I will be covering. Make sure to follow me on facebook to be notified when it is posted.
Last year I had APT, a lot of back pain, neck pain…
I decided to fix my self.
I learnt about anatomy and did a lot of stretching exercises, and a lot of yoga.
All of my problems fixed except one of them “Back pain when sitting” .
Now I have a geat posture when standing. I am pain-free when standing or walking. I have no more neck pain.
I feel like I can’t control my pelvis to don’t rotate anteriorly during sitting.
I stretch my Ql, psoas, quads, hamstring, lats, traps, and erector spinae BUT I can’t see any improvements….
I have a friend who have PPT but he don’t have any back pain. I saw him and I figured out that he can control his pelvis smoothly when he is in sitting position.
( also “lying pelvic tilt” exercise is very painful for me)
Can you help me? ?
Hey Mark, I few days ago I figured out that the problem isn’t in my back.
I found one pose/exercise/… That helped me a lot.
“agni sara” was it’s name.
My back pain approximately eliminated.
Thank you for sharing informative content.
I have been dealing with an APT for quite some time and I’m wondering if these exercises can do good for me even if I sit at a computer all day at work ?
Yes – they can still help you even if you sit all day at work.
I also suffer from plantar faciitis along with the hip/anterior pelvic tilt. My podiatrist prescribed Vionic sandals/shoes which have helped the pronation in the feet (somewhat) but when I change to any other type of shoe my BACK/lower glutes immediately feel excruciating PAIN. This has been an alignment problem for the past 2 years. Can you help me?
It is extremely painful to stand and walk with this condition.
If you are an over pronator, it might be an idea to try to do exercises targeting the feet.
If you find the vionic shoes help with the lower back pain, strengthening your foot arches may also help.
Check this post: Flat feet exercises.
Thank you for your reply. My podiatrist claims I have high arches. The heels are my problem causing me to walk on my toes. When I step down it feels like spikes going from my heels to my lower back/glutes. I have an extremely tight hip flexor and groin. PAIN is a constant condition. Have been unable to stabilize my anterior pelvic tilt either.
When you say, “When I step down it (heel strike) feels like spikes going from my heels to my lower back/glutes”, this automatically makes me believe that there may be an issue with the nerve from the lower back/glute to your heel.
If this is the case – you will mostly like need to address the flexibility/sensitivity of the nerve that runs down the back of your leg.
If you look up “Sciatic nerve stretch”, you can try out some of the suggested exercises there.
It might also be an idea to get a scan to the lower back to see if the nerve is being impinged.
Can’t thank you enough for posting this information.
I have been suffering 2 years with pain in my hips, hamstrings and BACK!
Have been unsuccessful reaching a permanent neutral alignment when I stand and walk.
Sitting is much easier. Physical therapy, podiatrist, chiropractor, MRI – I am hoping these
exercises will help me overcome this horrible misery.
Thank you again.
Is there any type of pelvic tilt belt that will help correct/support my back. Standing and walking are so painful.
Can I do standing n prone hamstrings curl with ankle weight for hamstrings strengthening?
Yes – you can. But it won’t specifically be to address the Anterior pelvic tilt.
Thanks so much for all of your articles, they seem far more comprehensive than anything else I’ve found online. I just have one question. You mention here, and in some of your other posts, that focus should be placed on releasing/stretching before moving on to strengthening. Is there a rough time period that should be spent on releasing/stretching before moving on to strengthening? And also, when we do move on to strengthening, should we stop doing most of the releasing/stretching exercises, or do these still need to be incorporated?
Thanks for your help,
It depends on how tight you are. Naturally – if you are very tight, you need to focus more time on this.
(In people who do not have tightness, they can skip straight to the strengthening exercises.)
If you find that you are no longer tight and focusing on the strengthening exercises instead, it is completely fine to skip the stretches.
However – if you are still standing with an APT, I would assume your muscles will eventually get tight again.
So you might need to do both for some time!
Hope you’re well.
I’ve being doing a mixture of these exercises for some time. I have improved my plank from 30s to 2 mins max hold (I average about 1 min, 40 secs) and do planks daily. My hamstrings and glutes are quite fired after doing glute bridges and hamstring raises against the wall (I also run 5ks few times a weeks and squat / deadlift when gyms were open).
I still have APT. I’m thinking this is mostly due to my lows abs and hip flexors being weak. As you stated, hip flexors being tight due to being weak is true for my case I think as a do stretch and foam roll multiples times a week to release the muscles.
My question is, can I start incorporating situps too strengthen my hip flexors and my lows abs? Even though I can hold a plank for 1min 40s, I can’t do a situp without anchoring my feet (weight on top) and working my hip flexors; which may need strengthening so why not? Also, I have tried anchoring behind my heel for hamstring activation but my low abs are so weak that they can’t pull me up.
Thanks for your time.
In terms of addressing your APT: I would recommend reverse abdominal curls instead of sit ups to bias the lower abdominal region.
If you feel you have weak abdominals/hip flexors and want to strengthen them, then sit ups are fine. (Or crunches)
Sir i have anterior pelvic tilt one side, that is left side. How do i correct it?
This sounds like a pelvis rotation: How to fix a Rotated pelvis.
I don’t know if you’re still reading your comments but I hope you do!
I’ve been experiencing hip pain for quite a while and after reading your posts, I’ve found out I have a Lateral Pelvic Tilt (left hip hiked up, right shoulder higher) but also an Anterior Pelvic Tilt. Furthermore, my right knee seems to go inwards, does this mean I have a rotated pelvis? Which problem should I address first?
I always answer comments! (over 8000 and counting!)
You can start with any postural issue. You will just need to monitor how your body responds.
Also depends what is hurting in your hip?
Perhaps these other blog posts will help with that:
– Hip Bursitis exercises
– Hip Impingement exercises
Right knee that goes in wards would be knee valgus. However – this could be influenced by a rotated pelvis as well.
Thank you so much for all your work!
I’ve done the self tests, and it doesn’t seem like Hip bursitis! It seems more closer to hip impingement. My right TFL cramps up quite a lot when I rotate my legs inward (if that makes sense?).
The TFL can act as an internal rotator (rotating leg inwards).
Is it possible to have ATP more on one side than the other? Or one side needing more stretching than the other? In other words, can I do these exercises asymmetrically? I also have a rotated spine (to my left) and the left side of my body is far weaker than the other. So my right side has bigger but also tighter and more engaged muscles from head to toe. Suggestions?
If you have one side of the pelvis more forwards compared to the other, you may actually have a Rotated pelvis.
Check out this post: How to fix a Rotated Pelvis.
Thanks for your work. I am trying to correct my anterior pelvic tilt . I work as a gardener so I guess I tilt my pelvis (and upper body) forward when I am on my knees bending over a flower bed. Also many tool handles are relatively short so I find it’s difficult to bend your back forward whilst maintaining a neutral pelvis. Have you any tips on this please? Is it best to rest the bottom on the feet whilst kneeling? Thanks, Paul
There are going to be some movements/positions where you can not keep a perfectly neutral pelvis. (and this is completely normal)
You will just need to be careful if your lower back is sensitive in this pelvis position.
If you would like to keep a more neutral pelvis whilst gardening, I would encourage you to learn how to HINGE at the hips. (essentially a dead lift motion)
Just curious on your opinion,
When I was 15 I tore my right Rec fem muscle in my qaud playing footy and never had it repaired as the surgeon said it most likely won’t cause you any problems if you aren’t in pain from it which I wasn’t and I’m still not in pain in that area I’m not sure if this is contributing factor To my muscle imbalance or not That I’ve developed and had for the past 2 years I’m now 25… Here it is,
My right side of my trunk i.e my QL, rectus abdominal, obliques, serratus anterior and pec are super tight and short and my right shoulder sits lower and on the left side I feel week or inhibited through the abs, obliques, serratus, pec and my lower back and upper spinal muscles are very tight on the left side and my left rec fem Muscle fatigues and feels like it’s working over time when I’m putting my body/legs under load I notice, so one side of my trunk and pelvis feels like it’s doing the opposite to the other And ever since I’ve developed this muscle imbalance in my body I’ve noticed my breathing has been affected could you direct me in the right root to treating this as I’ve failed to get help from any physio or chiro in Perth
Do you think you have a rotated pelvis?
Check out this post: How to fix a Rotated Pelvis.
The pelvis position can affect the torso position, which then may explain some of your said symptoms.
I’ve just got a quick question I was hoping you might help me with.
I’ve got a combination of 3 problems – anterior pelvic tilt, rounded shoulders and hunched posture.
I’m pretty desperate to find a way to work through and resolve each of these – where do I start?
Is there an preferable area to work on first or do you work through a broad range of motions targeting all of these problem spots simultaneously?
Ive been doing Pilates for 2 months now and I’m really starting to feel and understand how my posture is effecting form and movement.
Any advice you could provide would be amazing.
You can start where ever!
However – in most people, I find that the thoracic spine is the hardest to correct.
Perhaps you can try focusing on the hunchback posture for now and see how the body responds.
Ok I was just finding it hard to figure if I had pelvis rotation which way I was rotated it’s hard to tell, I also forgot to mention my torso has shifted to the right and I got more weight going through my right leg would that suggest I have a pelvis rotation still?
The torso can shift to the right, which potentially could make you place more weight through your right leg.
Do you have any side bends in your spine? See: Scoliosis exercises.
In regards to pelvis orientation, a shifted torso will not dictate which way the pelvis would rotate towards.
Thank you for this post! I did some of the stretches and I already feel like my anterior pelvic tilt has gotten better. I’m bookmarking this page so I can come back. May God bless you in Jesus name! Take care
That’s great to hear!
Keep up the good work.
Thank you so much for this info. I’m 22 and have suffered from chronic back pain for three years now. I hope this can help. Quick question though. I can’t easily tuck My hips under my body which is indicative of apt. However,I was a football kicker in college so my Hip flexors I feel like are stretched out well. Really tight low back and thoroacolumbar pain. Could it be sway back?
Check out this post: Sway Back Posture
I’ve been looking for a resource like this for months. This is comprehensive, easy to understand
and so well done. Only caveat is it feels like a lot of things, and I can only do some of these
exercises at any given time.
Well done. Thank you!!!
Thanks for the comment.
As there is no way to know what exact exercises each individual that reads my blog specifically needs without an assessment, the only way for this blog to be helpful is to show every exercise possible.
From here – It is then up to the reader to try the exercises out, experiment to see what works, and focus on the ones that give the best results.
hey i have a problem to put socks on if i stand.it is hard for me to lift my thigh to my body. is it because of weak or tight hip flexors?
Out of the 2 options – I would say weak hip flexors.
Hello Mark! Thank you for all your hard work I really appreciate it. You helped me more than you may think you did! I have been doing your exercises, sleeping as you say and standing in chair again as you say and I finally can get a good rest and work throughout the day. My only question is if it is normal to feel, when you go to sleep and stay on the back a bit of “crawling” sensation and movement in the lower back. Thank you.
Hey Cristian Michael,
Happy to hear the exercises are helping!
In regards to crawling sensation: Do you mean tingling/pins and needles?
If so – this is generally a nerve issue symptom. Try placing a thick pillow underneath your knees and see if that makes any difference.
Thank you very much for the response. Even after one day of sleep and exercises I feel less tension down there and also 80% of the spasms are gone, but I have been dealing with another thing now. I have a stingy feeling right now in my left shoulder and dorsal area. May it be a “recovery” feeling?
Thank you again. Benjamin.
In general – Other areas shouldn’t be getting worse.
This may mean that when you address your anterior pelvic tilt, you might be making your shoulders worse.
If that’s the case, doing the exercises on this blog post might help:
How to fix Rounded shoulders.
Hey Mark, I’m back again
1. I need to cut a little weight for my 8 pack to show up good, I know ALOT of people including me who have Anterior Pelvic Tilt their stomach gets pushed out more making them look fatter, and their waist bigger. The problem is since my waist gained a few inches from this the “US Navy Body fat test” which has been seen to give VERY accurate results is off and says i have way higher body fat % then i do, so i don’t know how much to cut, so my question is, by any chance do you know how many inches on average Anterior Pelvic Tilt adds to your waist.
2. On PC on your website you have to scroll through like 300 comments all the way to the bottom of the page to post a comment just a tip/question have you thought about putting the post comment on top so you don’t have to scroll through so much.
1. Hard to say. But I don’t feel it would be a significant amount. With an anterior pelvic tilt, the abdominal region is lengthened and pushed out, but at the same time, the lower back is pushed forwards as well.
2. I thought I had limited the comments to display 30 only. I will double check this. Thanks for teh feed back!
Hello, thank you very much for everything. Just a question if I may. I am obese and I really want to start losing weight. With everything that is going on right now I have decided to actually start my journey, but my journey is pretty hard since I have this problem as well. Are there any specific exercises that I need to do since I am overweight? (I am talking about 115kg at 1.79m). Thank you.
Hey Benjamin Mark,
Losing belly fat may actually help correct your anterior pelvic tilt!
The most important exercises that I would be focusing on is the core exercises.
It is a good idea to learn how to stabilize and control your lower back. (esp. if you want to increase your physical activity).
The dead bug seen on this blog post is a great place to start. If you would like more core exercises, check out this post: Core exercises.
I fixed my APT after couple of weeks and doing a lot of exercises.
my pelvis looks great when I standing.
but when I sit down ( specially when I lean backward, my pelvis rotate anteriorly and my lumbar spine goes to the hyper extension position, thus staying at this position for just 15 mins causes pain in my lower back)
I did a lot of erector spinae, abs, glute, hamstring exercises and i believe my muscles are not “weak”.
what should I do?
Great to hear your anterior pelvic tilt looks better after the exercises.
I feel you might need to address a possible Hyperkyphosis in the thoracic spine
Check this blog post: Hunchback posture
Hey Mark, thanks for answering.
Yesterday I did some groin stretches and after it, I felt my legs want to go further than me!
I hadn’t balance, I fell down one time and my problem when sitting improved.(today i sitted on my computer chair for 2 hours without pain)
Do you know what my problem is?
I have also problem lunges( I think my hamstrings causes the problem)
Thank you very much for your prompt reply. It is really helpful.
Just to be sure, if it is my left thigh that is more forward, is it a left rotated pelvis or a right one? My pain mainly occurs on the right side.
And don’t you think I have also an anterior pelvic tilt since my right ASIS is lower?
You’re right, my left knee is more bended (towards the front) while my right one is more extended (towards the back).
Regarding my right hip, you’re still right. It feels tighter when I’m walking (actually all the leg). When I stand up straight, the upper part of the femur comes out (towards the front) more than on the left side, while the iliac bone seems slightly projected towards the back on this side.
A relatively bent left knee will make the left thigh more forward even if your pelvis is rotated to the left. Based on the other pieces of information you have provided, it sounds more like a left pelvis rotation.
It is possible to have an anterior pelvic tilt AND a rotated pelvis.
Hope you are keeping safe during these unprecedented times! I would love to ask your professional opinion on my back situation!
I think i have a apt looking back for most of my teenage years (now 22) and recently went to see a physiotherapist, he pointed out I have mild scoliosis and my rib cage is slightly dropping on the right side. In relation to that, my chest sternum pops each morning and sometimes i have the signs of costochondritis as i get chest pains on the left side of my chest
I go to the gym and have a good build. I have trained more on my legs (hamstrings, glutes) i always stretch my hip flexors a lot however I am not seeing any progress. I might see if i started strengthening the hip flexors this might help lengthen them out (as they might be weak af)!
I am losing hope with getting my bodymechanics back on track and with so many things to do with all of my problems, I would love to know what your honest thoughts are! Is it a serious problem I have going on with everything?
Many thanks mike!
Mild scoliosis is fairly common. The question is – is it related to the symptoms you are experiencing?
A lower rib cage towards the right may suggest this is related to the scoliosis. (side bend to the right)
In regards to your chest popping, this may be influenced by the same of your thoracic spine. (ie. flat vs kyphotic)
Strengthening the hip flexors may help with your APT if you’ve already tried stretching them.
Thanks for the reply Mark!
My upper back is just super tight are sore, i think its not helping the rib situation. What exercises should i do?
Also after hip flexor strengthening exercises should I stretch them after?
Will deadlifts and squats help strengthen them?
If you a tight thoracic, check out these exercises in this blog post: Thoracic spine exercises.
Dead lifts and squats will recruit the hip flexors, however, I would start of the activation/strengthening exercises mentioned on the blog post.
Thank you for your useful blog. Hope you are well during this crisis.
I really need some help to understand which kind of pelvic tilt I have and then perform correct exercises. I have seen many doctors and therapists who are helpless for now. This issue started a few months ago and has led to L5-S1 disc disease.
I noticed that I have :
– a lower right anterior superior iliac spine
– the right hip as projected forward and blocked (upper femur)
– the left thigh more forward
– a leg length discrepancy (not structurally), the right one longer than the left one
– stiffness in the right leg when I walk generating pain in the knee (going inward), ankle and foot arch.
Could you please tell me what you think?
Many thanks for your help.
Based on what you have said, it sounds like a left rotated pelvis.
If your left thigh is more forward, you might have that left knee slightly more bent (or the right leg more extended?)
When you say your right hip is blocked, do you mean it feels tighter than the left side when you let the right leg go behind you when you are walking?
Hi Mark! I have a rather unique case of ATP from childhood that has wreaked havoc on my body developmentally. I’ve had dozens of health issues because of it throughout my life but only discovering the cause now at 32. I’m under the care of a neurologist and a physical therapist, but they’re treating other symptoms and neither seem to fully comprehend what’s going on with the mechanics of my body. I discovered your site a few months ago and it has made a huge impact on my understanding of muscles and imbalances. Its allowed me to understand just a little about what’s going on with my body right now. I’m at a point now where my pelvis has been pivoting upward since September 2019 (on its own!) and the changes in the rest of my body are almost unbelievable. It hit me just two weeks ago that my spine is elongating and I need to see someone who better understands what’s happening. I was hoping to just share some of my symptoms and experiences and see if you could provide any insight. Thank you for all of the great work you do as if appears to be helping countless people. Hope you’re staying safe during all this craziness.
When you say the pelvis is “pivoting upwards”, are you referring to an anterior pelvic tilt?
Hi Mark. Yes, my pelvis was pulled forward so much that my pelvic crest was facing almost entirely forward (as of Sep. 2019). Its correcting itself and pulling every muscle in my body from my toes all the way up to my face – i’m developing ab muscles entirely on their own! I think I really need to see a physiotherapist or kinesiologist. In light of recent events I don’t think that is a possibility right now. I was hoping to see if you’ve ever heard of what I’m experiencing and if you can help explain it. I’m not exercising or stretching, but my body is continuing to move and change every day.
What is the reason that you are seeing a neurologist if you don’t mind me asking? Is it related to this issue?
Also – what happened in September 2019 that lead to this said issues? Or did it just start out of no where?
It sounds like your body is compensating and changing the whole posture!
I went to a neurologist because I had been experiencing dozens and dozens of neurological symptoms that tormented me for a year and a half. I was at the Mayo clinic for a month and they couldn’t figure it out. This particular neurologist “diagnosed” my problem by discovering that my traps were large and raised and I had a pretty bad winged scapula. I was sent to a PT in Sep. 2019 and he started loosening my suboccipital muscles. Ever since he loosened those up my body started changing on its own. This has been a discovery process…much more than a winged scapula. My hips are still pivoting up, my legs are rotating inward and my hamstrings appear to actually be unraveling from my groin. My arms are also rotating outward and my biceps and triceps are unraveling from my armpits…and my pelvic floor is literally being dismantled at the moment…there’s so much happening to my body right now. I’m using muscle relaxers and medicinal marijuana to cope with the muscular and neurological pains, but everything appears to be improving as my body continues to literally unravel. I also think I’m getting taller as my spine is starting to elongate. I’m just trying to understand what’s happening and why…and what could’ve caused this. I’m almost positive I’ve had this since at least 5 years old. I’ve had unexplainable health problems my entire life and now its all starting to make sense. I’m just trying to get a grasp on what’s actually happening to my body. Thanks for all your help!
Hey Michael, So this all started after your Sub-occpitals were released?
Sounds like something changed in the relationship between Occiput, Atlas C1 and/or Axis C1 (craniovertebral joint).
It is believed that if these are not in the right position, it can make the whole body compensate.
Have a google search using the search terms and see if it can explain any of your symptoms.
I have a successful posture fix experience.
How can i share this experience with you? Do you have email?
Feel free to send me a private message on the facebook page.
1. Your site has been a huge help while i cant go to my chiropractor, i donated a small bit wish i could of done a-lot more but the Corona virus might make some of us lose our jobs in my house so I have to be careful right now. Ty for all the help.
2. My pec minor was 100% WAY tighter on my left, but it doesn’t seem like thats the main cause as it didn’t help at all. Even tho it didn’t help i will be stretching it from now on, i guess i will have to wait till my next appointment IRL to find the cause :(
3. My final question, What are your opinions on using Physiotherapy/ Manual therapy before my chiropractor appointment to loosen up/release all my tight muscles and then getting everything adjusted at the chiropractor would it make the adjustments work better? Or should i do it after a chiropractor appointment? Or use them on opposite days? Would doing both at the same time help/expedite all this in your opinion? (I’m talking about my Lateral+Anterior pelvic tilt And mild scoliosis not my shoulder issue)
1. Thank you very much for your donation. There are only a handful of people that have donated and I appreciate it a lot!
2. Might need to give it time. A tight pec minor can take awhile to release ! (think about how long it has been tight for)
3. I feel a physiotherapist and chiropractor (of course- it really depends on the individual practitioner) can provide all of the treatment. Keep in mind – some physios do manipulations as well!
I have been seeing a good chiropractor which is helping, but i have a few questions. I am having a very hard time because i have SO MANY tight mucles, I have Anterior and lateral pelvic tilt, and mild scoliosis. (I think i got scoliosis from the pelvic tilts)
1) When i try to walk with good posture my lower back IMMEDIATELY starts to hurt.
2) I noticed this when trying to do an Overhead Press, I cant take my left shoulder to 90 degress, when i do and try to point my arm upward to do the press a muscle at the bottom of my shoulder blade hurts, and my arm leans forward it wont go straight up. Also when i do Front Raises a muscle in my left shoulder pops. Is this because of lateral pelvic tilt, this IS the side my hip hikes up on, or just coincidence. Please lmk what my issue is called or things it could be if you know
3) For someone with A lot of tight muscles from Anterior and lateral Pelvic tilt, and mild scoliosis, would you recommend Physio Therapy or regular Physical therapy. My main problem is tight muscles, and i am so tired of stretching that i pretty much only stretch like 2x a week now because theirs so many that its extremely tiring to do. I can do the muscle strengthening myself at home. So regular Physical therapy or Physio Therapy.
Hi there Tommy,
1) If you have anterior pelvic tilt and it hurts when your try to walk with good posture (which I assume you are trying to be more up right?), my assumption would be that you are extending your lower back too much. Make sure you do not have a rib flare when you are walking. This should take some pressure off the lower back.
2) Sounds like you are either lacking shoulder External rotation +/- have an anteriorly tilted scapula. Make sure you know how to perform a posterior tilt as indicated in this blog post: Rounded shoulders. You need to think about TILTING (not pulling back) the scapula backwards. A lateral pelvic tilt can certainly affect how the shoulder is working… but I would start at the shoulder first)
3) Physiotherapy and Physical Therapy is the same health profession. (Just different names in different countries). I strongly advise everyone to see a health profession in person as they can do a much more detailed assessment on your body.
1. I think this is correct, I push my lower back forward and squeeze my glutes a little, I must be pushing too far forward bc when I walk without squeezing glutes or trying to fix lower back I can walk for ages and it doesn’t hurt at all. Ty for this.
2. I am tilting. But the bottom of my scapula or a muscle starts to hurt and won’t go farther. Is this because of a tight muscle? I’m trying to learn to use my left hand as much as my right and when I went to brush my teeth with my left hand today when I brought my arm up and started brushing left to right my shoulder was popping constantly. When I lower my arm and pretend like I’m brushing my stomach left to right it’s completely fine. So it’s when my arm is up. But with my arm low I still can’t tilt it 90 degrees. Does this narrow it down at all? If not that’s fine, your tutorial has been very informative and helped me a lot.
My guess would be a tight pec minor that is resisting the tilting. This could possibly cause a muscular strain at the base of the scapula.
You can try releasing/stretching this muscle (in the Rounded shoulders blog post) and see if it helps!
Hi Mark, I discovered your page few days ago and I absolutely love it! I have been having postural pain for year, and I had to give up my piano career because of that.
Long story short, I have a hunchback. Recently I have been trying to fick that through foam roll exercise. It actually works magic and I can stand straighter. However I notice that, when I stand or even sit straighter for some time, I start having pain on my mid back! (red area in the picture at the bottom). Obviously my mid back is now taking all the stress my upper back was taking before.
However I am not sure how to solve this. I don’t think I have a clear case of tilted hips. Or do I? What do you think I should do? Strenghten my hips? My abs? Exercising the lower back? The mid back?
Please help, I would really appreciate any help! ?
Hi there Valerio,
It might be a case of just letting the body get used to the new posture. Strengthening your mid back in this case might be helpful.
If you are getting some pain, I would recommend that you actually ease off then amount of correction that you are doing by 10% and see how that feels.
For hunchback posture, I would recommend this blog post.
It doesn’t seem like you have an anterior pelvic based on the photos provided.
Hi mark,I had a rounded shoulders for 10 years and I do exercises for 2 weeks and my posture become so great,but after 4 days I noticed APT become to me!!! I really want to know why this happend???
I’m so sorry my grammar wrong
If you improved your rounded shoulders but then it made you have an APT, it is likely your lower back may over extended whilst your were bringing your shoulders back. This is compensation.
Try to pull your shoulders into a better resting position without arching your lower back.
Hi Abdo, I think I had a similar problem, read my post! I started getting the pain on the lowerd/mid back associated with APT. I am doing some stretches for now and during the exercise I am being really careful to NOT arch the lower back.
Hi Valerio, I have your problem 100%
Did you strength your middle back or just doing exercises without arch the lower back??
Hi again Mark, I was just wondering if it would be okay to train lower abs with weight (so i can implement progressive overload) or will that cause the hip muscles to take over?
This is fine to do.
Hey Mark, when doing bench press, its a common thing to make an arch in your back to lift more weight (this is indeed proper form).
Is this a bad idea with APT?
Actually I’m not sure if its “proper form”, but it is used by most people and does effectively help you push more weight and thus gain more hypertrophy.
You should squeeze your shoulder blades tight and achieve arch through thoracic extension not lumbar extension. This may be a problem if you lack mobility in thoracic are. But if that’s the case bench press could also cause shoulder problems.
Abs and glutes should be tight and maintain normal lumbar arch.
Hope this helps.
I personally don’t cue the excess arch in the lower back when bench pressing and especially would not encourage it if you are specifically addressing an APT.
For anterior pelvic correction should I do internal hip rotation exercises or external hip rotation exercises or both?
I would do both!
However – from what I have seen, majority of people with a prominent anterior pelvic tilt tend to lack internal rotation.
So Mark, in addition to doing the exercises, is physical manipulation by a chiropractor something that could be useful and worthwhile? I originally went simply to get the X-ray and a professional’s diagnosis, but now I’m considering staying for weekly treatment to fix my tilt as much and as quickly as possible. Is there any benefit to this?
Yes – I would always encourage to be guided by a health professional to make sure that you are on the right track.
Main thing is to make sure they are prescribing you with exercises otherwise the treatment affects may only be temporary.
Hi Mark, I have APT, forward head, rounded shoulders, flat foot, protruded torso and excessive knee pain specially right knee. Where do I start from?
I would focus on your knee first to see what exactly is wrong with it. You may need to do exercises in the knee specifically to strengthen it.
From here, you can address any of the said postural issues.
My advice would be to address one area, see how your body responds, and adjust from there.
Thank you for comprehensively addressing these issues! Your site is such a valuable resource.
I am dealing with a left hip hike and anterior tilt on the right side, which I assume the combination is causing my pelvis to rotate to the left. I’m sure I have had some degree of these issues for years (or decades) but they have become worse after having kids and now are becoming a bit debilitating.
I am a cyclist and I’m now noticing the issues so much more when I ride. I can feel the difference in power output on each side and also the different tilts of my sit bones on the bike seat.
I feel like the right anterior tilt is the first issue I should address as there is not enough time to do all of the exercises for each of the 3 issues. Would you agree that this is the best plan of action? And if so, should I really do each exercise on both sides if the tilt is only on my right side? The hip hike exercises are specific to the side hiked and dropped but these are not.
Lastly, do you think cycling could be contributing to these issues and would you advise that I stop or take a break? Or, is there anything i can do from a posture standpoint when I’m riding to help correct the issues or at least not make them worse?
Thank you again!!
If you feel that the “right anterior tilt” is the main issue, this area would be a good place to start.
If your right side is tilting forwards, the left side will be tilting backwards. (unless you have some major instability issues in your SIJ ligaments)
For this reason – you need to address both sides.
For you- I would recommend you doing this protocol instead for a LEFT rotated pelvis : How to fix a Rotated Pelvis.
If you are sitting with a tilt + rotation in the pelvis whilst cycling, you are likely re-enforcing this pattern.
Try to keep the sit bones balanced as you are cycling. Do not push pass fatigue so that you can control your technique.
Thank you, Mark. Just a few points of clarity:
1. I believe the anterior tilt is priority because I think this is causing the most imbalance when sitting and cycling since my “sit bones” are not in alignment. My right sit bone is further posterior/higher up due to the anterior tilt, which I believe makes me lean a bit to the right when sitting/cycling. I feel this imbalance is reinforcing the other alignment issues because I can’t sit straight/evenly on my sit bones until the right anterior tilt is fixed. That is why I believe this to be priority. Does this make sense and/or do you agree?
2. I am 100% sure that the anterior tilt and rotated pelvis were caused by the lateral tilt/left hip hike, which I’m sure I created after carrying my kids primarily on my left hip for the last 4 years. I also think the right anterior tilt happened during the later stages of my last pregnancy when my hip joints were loose from pregnancy hormones. I think I remember when it happened I just didn’t know what was happening at the time – only that my right hip was slightly painful and odd feeling and clicking a lot all of a sudden. This info is just FYI in case it helps in your understanding of my issues.
3. You recommend that I do the exercises for the left rotated hip “instead”. I did most of these yesterday and I do think they were helpful, but did you mean to only focus on that regime instead of anterior or lateral tilt exercises (for now at least), or did you mean to focus on that in addition to either the anterior tilt or lateral tilt regime?
I am truly so grateful for your blog and advice. I have been to so many physical therapy appointments, chiropractors, and even an orthopedic surgeon, and have really not had much success aside from radiographic confirmation of the issues I’ve described. The Ortho at last appointment told me to use a heel lift to correct my lateral tilt even though I do not have a true leg length discrepancy, only a functional one. I can’t help but think this would make things worse, and have concluded that I need to take my treatment into my own hands. What I’ve learned from you in a week is 10x more than months of treatment from others! I will certainly be donating to your cause and would love to make an appointment for an in person assessment if our geographies ever permit. I’ve searched your blog and FB page and can’t find where you’re located?
1. Sounds like addressing the right anterior tilt via doing exercises for the Left rotated pelvis is a good place to start for you.
2. Based on this information, you could also address the lateral pelvic tilt if the above does not seem to be working for you.
3. I would just do the rotated pelvis for now. Try not to do too many things at once as it will be hard to determine what exactly has helped you or made things worse.
I am not too keen on the heel lifts for functional leg length discrepancy as it does not really address the underlying cause.
Where are you located?
Also Mark, is it true that exercises that induce hip flexibility (like leg raises for abs and leg extension for quads) are bad for fixing anterior pelvic tilt?
They aren’t bad as long as you are also doing other exercises to address this issue as well.
Hey Mark, I forgot to add this question in my last post: also, are using the hip adductor and hip abductor machines at the gym okay? (Doing this mainly to combat knee valgus, but I want to make sure it won’t negatively affect anything else.
It is completely fine to use these machines.
Hey Mark! I’m back again for another question! I’ve decided to forego squats for now because I don’t trust myself to have proper pelvis form while Ike doing them. However, I still intend to implement some quad strengthening in the form of seated leg raises and leg press. Also I’ve stopped doing lat exercises. What I wanted to ask though, is: does increasing muscle strength or hypertrophy lead to tightness and or shortening? Cuz I do want to get stronger and bigger, but I also don’t want to make my posture worse by tightening the muscles that need so be stretched. Maybe stretching AND exercising them would be a good compromise? Lemme know what you think!
Such a great website. Can’t believe this is all for free, really thank you so much!
I have a question regarding the glute bridges. I feel like I can engage them a lot, but there’s said to repeat them 2-3 times and hold as long as we can. I think I can manage to do 1 minute just fine of a really heavy squeezing to the point where they burn a lot and it feels good. However, wouldn’t it be better to move up to a harder progression? I never really feel the glutes after working out, I thought there was supposed to be at least some soreness, maybe even the day after haha :)
Is there any list of yours where I can find harder progressions? I can never gauge at what point can I move to more difficult variations (of exercises in general) – maybe you could give me a hand in this?
Thank you so much once again! :)
Thanks for your comment!
Here are some great ways to progress the bridges:
– Do them 1 leg at a time.
– Hold a weight on top of your hips. (I personally rest my upper back on a bench, feet on the floor, knees bent, with the bar bell across the front of my pelvis)
– Do them with your feet in a more higher position
In terms of changing the pelvis position, you don’t need too much resistance. However – if you would like stronger glutes, the above progressions are a great place to start!
Hope this helps you.
I’m having incredible amounts of trouble locating the ASIS and PSIS, and even if what I’ve located is actually the ASIS I still have no idea where the PSIS is because there doesn’t seem to be any notably sharp bones anywhere on my backside
If you are unfamiliar with the pelvis anatomy, it is best to get a health professional to show you.
In the guide on how to find your “neutral pelvis” you say it should be in the middle of the largest posterior tilt you can do and anterior tilt you can do… But in the middle of these two is just my regular pelvic position (which is anterior)… Please help!
Hey Mark. Im back AGAIN. Just to say, I dont really understand how your supposed to have a “neutral pelvis”. If you have apt, I understand that if you flex your lower abs and glutes you can put yourself into posterior pelvic tilt which combats your anterior pelvic tilt. However, you mention in multiple responses that you can do exercises like deadlifts and squats if you maintain a “neutral pelvis” so I’d very much love to know how to accomplish this.
You have a lot questions! I like it.
When I say neutral pelvis, this is referring to the relative position of the pelvis to the spine.
When your pelvis is neutral, the lumbar spine will maintain its normal arch.
You will need to engage the abdominals/glutes to reposition the pelvis if you have an anterior pelvic tilt.
Hey Mark, I left another comment but I forgot to add this other question. When it comes to abs, I know your supposed to train LOWER abs to fix apt. My upper abs already appear more bulky than my lower ones (then again maybe thats just because I havent lost enough fat to fully see my lower ones). So my question is should I eliminate/reduce upper ab training and focus on lower ab training? Or should I continue to do both?
I’m worried that I have a muscular imbalance in my abs because I can do very high weights on the ab crunch machine at the gym but I cant do leg raises with anything more than a 17.5lb dumbbell between my legs. (P.s. I have since stopped these exercises in favor of other ab exercises with less hip flexor involvement).
Lower ab training (such as reverse curls) are a nice way of tilting your pelvis backwards.
If you have been doing crunches, it is likely you will have developed upper abdominals. On top of this, if you have a thoracic kyphosis (hunched back), you are likely quite tight in this upper region.
You can still do crunches, just make sure you prioritize lower abdominal training.
Hey Mark, thanks so much for posting this! I’m 17 and have gotten tired of people saying I have a big butt, and I want to correct these issues before I start bodybuilding so I have a good foundation. Ive scheduled a consultation with a chiropractor and I’m going ALL OUT to fix this stuff. Unfortunately I think I suffer from just about all of the postural deficiencies listed (flat feet, apt, hunchback, forward neck..) But I saw in an earlier response of yours that it is okay to work on all of this stuff at once if you aren’t overwhelmed so I wont ask about that. Instead, I’m wondering about this: I know that apt means you have tight quads, tight lats, and tight hamstrings. Im pretty sure that the hamstring tightness is to compensate for weakness, but how do I know whether the same is true for the quads and lats? Ive recently cut out quad work and lat work from my workout routine, so is there anyway to know for sure if that will be effective? Or is the only way to know for sure by failing and crawling back? XD
You can still train your quads and lats. You just want to perform those exercise from a neutral pelvis position as best as you can.
You want strong quads and lats, but you don’t want them tight that it holds you into a APT.
Thanks Mark! Hopefully I can find out more about what it means to be in neutral pelvic position when I go to a chiropractor for the first time on Friday!
But I still want some clarification here:
Since I want strong quads and lats, but I don’t want them tight, should I work them out AND foam roll/stretch them? I was under the impression that working out a muscle shortened it (and made it tighter). And I also thought that foam rolling/stretching kind of deactivated a muscle, and well… stretched it. (which would mean that strengthening and foam rolling/stretching would be having conflicting effects?)
So if you could tell me:
1. Where I’m going wrong in my thinking
2. Whether I should be stretching or not along with my strengthening
that would be great!
I would like to start out by saying I love your stuff! But I’m getting quite frustrated because I have a great of issues. I have anterior pelvic tilt, my upper hamstrings are super tight and My back is tight. My knees also face outwards and my calves are always tight no matter what I try to do. I am a serious swimming and train up to 8 times a week for 2 hours a day so I’m always working out and would think that this is probably a tightness issues rather than a weakness in my muscles. But if not then I would like to know where I should try and attack first because I’ve had minimal success when it comes to self treatment. Thanks :)
Anterior pelvic tilt + knees that face outwards usually means you have very tight external rotation fibres in your glutes.
Anterior pelvic tilt can also place more pressure on the fore foot which can make the calf over active.
It can also place more tension on the upper hamstrings.
Based on this – it might be an idea to start addressing the anterior pelvic tilt.
However – if you are a swimmer (esp. if you do freestyle and butterfly), you may have a thoracic kyphosis.
Check this blog post: Hunch back posture.
This can also lead to anterior pelvic tilt
Great article! Thank you very much!
Cheers Igor! Hope it helps!
Hello mark! It has come to my attention that I have both ATP and knocked knees. I try correcting both but as I try to correct one with the any of the exercises provided on your website, the other prevents it so I can’t perform the movement necessary. What should I do?
Hey Isaiah, if you have both ATP and knock knees, remember that knocked knees start due to APT and flat feet. If you focus on improving your pelvic tilt and your flat feet (if you have!), you can fix your lower body posture. This article is very good to describe APT but tightness of hip flexors is a very big issue which can be overwhelming during tightness. I am linking an amazing hip flexor program to fix anterior pelvic tilt. You should check it out here:
I have forward head+ hunchback (forward shoulder) + apt
Can i do one day for apt and one day hunchback forward head /shoulders
So this means 3 days per week for apt and 4 days for fhp/shoulder and hunchback ? Or i should do my best to do both daily <its hard both btw
Hey there Morse,
It is perfectly fine to do that.
The main thing is that you will need to monitor how your body responds to the exercises and adjust accordingly.
Hello mark! I’ve come to the realization I suffer from both anterior pelvic tilt and knocked knees, be it the anterior pelvic tilt is most likely causing the Knock knees. Your information on how to correct both are useful but I have a problem. When utilizing the exercises on fixing the APT the knocked knees prevent me from performing them. Same goes for me performing the knocked knee exercises the ATP throws me off balance and makes them less easy to do. What can I do to address this problem? Thanks
If both make each other worse, you might need do address a little bit of both at the same time.
Was there specific exercises that you can’t do?
If the relative heights between PSIS and ASIS is significant high when I relaxing my abs, but it become alright when I tight my abs. Do I have an Anterior pelvic tilt?
It sounds like you have an APT when you are relaxed.
The good thing is that you are able to correct it.
I have been doing these exercises for last 5 months 6days a week and once in month full body oil massage.but I don’t see any difference why ?
I would say that you might need to focus on other areas such as the foot and/or the thoracic spine.
These areas may be affecting the position of the pelvis.
If unsure – I would strongly suggest getting assessed by a health professional who can see you in person.
My throatic spine is straight n foot are normal then what could be the reason
Have you had much experience w APT and congenital scoliosis? I have an S curve that was fused at 7 months back in 1978. I’ve been fairly fit and active my entire life but having a shortened torso causes some issues with working out and staying limber. I just recently realized my hips were tilted forward after battling w tight hamstrings the past 6 months and finding any remedies that would help relieve the pain.
My back muscles are already working hard to keep me straight from the S curve as well as my legs keeping upright. Any suggestions or advice would be great.
The pelvis can often compensate for a stiff torso. As a result – It’s not that uncommon for the pelvis to go into an anterior pelvic tilt.
If you have fusion at certain levels throughout your spine, there will be a limitation as to how much the spine will be able to move.
If this is the case – you will want to get your pelvis as strong and as mobile as possible to handle the excess load.
If you are not fused throughout the whole spine, you can do some exercises to help regain as much spinal movement.
Check out this blog: Scoliosis exercises.
I have apt with tummy
Does the pelvic tilt to normal only after tummy flattens out?..
Hello – a protruding stomach related to the pelvis position will correct/improve as you get the pelvis in a better position.
Do you have any suggestions for pelvic torsion where one side anterior rotates and the other posterior rotates? My right side anterior rotates and my left posterior rotates. This has caused a significant leg length discrepancy, making my right longer & left shorter, and walking is very difficult and impossible at times. I think I have tried every exercise, stretch, and release technique on the internet! I’m also going to a chiro 2X a week. This problem just seemed to “happen” about 7 months ago…before that I was going to cross fit, walking & riding my bike with no problems. I have had no accidents or injuries. I don’t know what could have caused such a severe muscle imbalance and I’m at my wit’s end to fix it.
Generally speaking – a good place to start is to release/stretch the areas that are holding your pelvis in that region.
– right anterior hip region
– left upper hamstring
– left abdominal region
– right lower back
If you have pelvic torsion, you most likely have some sort of pelvis rotation. Addressing the rotation usually corrects the torsion.
Check out this post for more information: How to fix a Rotated pelvis.
Hi Mark! Next year i will be starting dance so i have been trying to gain flexibility. I was wondering if stretching my hamstrings and just stretching in general may have a bad effect on my posture?
If you have an anterior pelvic tilt, I would be careful just stretching the hamstrings out.
In this particular pelvis position, then hamstrings are relatively in an elongated position and can give a sensation of tightness.
This may lead to more imbalance and further the tilt.
Hello Mark ! Can the habit of keeping the knees hyperextended when standing contribute to anterior pelvic tilt ?
It can definitely be a factor. (But not necessarily the only one)
I have been doing these exercises for last 3 months but I don’t see any major difference in tilt . Initially when I stretch my hip flexors I could feel the stretch but now I don’t feel the stretch at all , should I intensify hip flexor stretch, could u suggest me some other intense hip flexor stretches . How long does it take to fix my tilt.
Your hip flexor might not be so tight now.
The next step would be strengthen the muscles to help rotate your pelvis back to a more neutral position. ( Abdominals, hamstring, glutes)
Can I do squat like goblet or with barbell to strengthen my glutes n hams
To strengthen glutes n hams can I do variations of squat like barbell squat , goblet squat n barbell hip thrust etc ..
Hey mark! I think i have ATp as i dont stand on heel of my foot when i stand it seems that i am falling forward and i have protuding stomach and arched back and hups stick out but i think with gym its getting more stiff…i have one side hip hike too and one side if but and leg is rotated forward
Thank you for the exercises and your great explanations of them! I also have a question: I have a sort of desk rocking stool and suspect it may make my hyperlodosis worse. When standing “straight” I have an anterior pelvic tilt, and keep finding myself sitting with an arched tilt, either backward or forward. I’m quite sensitive to synthetics like plastics and so prefer natural materials like wood (it’s so nice to also be able to breath when in the same room as ones chair :)), which, though, makes the range of chair choices narrower. Anyway: which kinds of office chairs do you think would be best to encourage a healthier sitting posture? A big thank you in advance! Best regards Sue
I personally alternate between 3 different chairs
– Normal office chair
– Kneeling chair
– Exercise ball
Standing desks are fine too. But if you tend to standing with an anterior pelvic tilt, you might want to address that first.
First of all, your website is a Godsend. I’ve never seen so much info in one place. You go from describing the issue to very detailed how to fix.
I have been dealing with lower back pain my entire life. I’m also a super active. After giving birth to my first, my lower back pain increased and also became hip pain/SI joint pain.
I have an overextended lumbar spine (hyperlordosis) and also APT, flat feet. I also have a shorter leg on my left side, and tight psoas there. I respond well to chiropractor but I’m going to start working really hard on the exercises here.
Here’s my question: it seems like I have unstable hips – they keep shifting balance(hence the shorter right leg). Any suggestions for exercises for this? Can you possibly explain the correlation between imbalanced hips and APT?
Also, tho my leg is short on the right side, all my pain is on the left hip. Why is that?
Uneven hips is also referred to as a Lateral pelvic tilt. Is this what you mean by “unstable hips”?
If so, check out this post: How to fix a Lateral pelvic tilt.
APT is the imbalance of the pelvis from a front vs back perspective.
Imbalance hips (if you mean lateral pelvic tilt) is an imbalance between the pelvis in left vs right perspective.
Also – Pain does not always follow the side of the short leg.
One of my friend who is fitness freak suggested me to do goblet squat as it works on core , hams n glutes but its also works on hipflexors. My doubt here is, if it works on hipflexors , it makes it tight.In case of apt hipfexors should me stretched but it becomes tight in above case.So my question to you is should i do “GOBLET SQUAT”.
It is fine to do a goblet squat.
If you are concerned you will get tight in the hip flexors, follow it up with some stretches.
Can I do kettle bell swing with neutral pelvis position for posterior chain activation?
Do you have a post to correct a torso that twists toward the right? My left ribcage is anterior to my right ribcage. I don’t know how to take a measurement, though I guess the difference is 3/4 of an inch.
Thanks for your helpful information!
I don’t have a a post on torso rotation yet.
I generally tend to find a rotate pelvis with a pelvis rotation as well.
Check out this post: Rotated pelvis.
Addressing the rotation may help with the torso rotation.
I have apt with tummy,should I wait till the tummy flatten out before I could see any change in spine movement to normal
As your pelvis improves, the lumbar lordosis (arch) should also decrease.
Thank you so much for this! I’ve always been teased and called “duck” in school. I had scoliosis and surgery to correct it years ago. Now that my hips are correctly aligned I want to work on the anterior pelvic tilt. I had a baby last year as well and she was breech my entire pregnancy, and I attribute that to the tilt as I’ve heard posture is very important for a baby’s presentation…
Hi, Mark. Excellent stuff. I am in the process of fixing my rotated pelvis and then going to begin working on my anterior pelvic tilt and hyperlordosis. I also have some degree of kyphosis. My question is, if I fix these things, I know I won’t actually “grow” any, but should I stand taller than I am now? I know this varies along severity of each person’s issue but, if height gain is possible, what would you expect someone to “gain”? Thanks for all of your work, Mark!
My belief is that a lot of these postural deviations create a lot of COMPRESSION in your joints.
So from this, if you correct/improve your posture, you should be decompressing your spine in which in turn could help you grow taller.
How much height you gain is relative to how compressed you are.
Do you have any alterations for this program if my anterior pelvic tilt on affects one side? I have had PTs tell me my APT is only on my right side, and it causes significant discomfort. Curious about how I would change the above program in that event.
If you are referring to the pelvis being rotated, feel free to check out this post:
How to fix a Rotated pelvis.
Thanks a lot for this helpful blog.
I definitely suffer from atp, I find I have a lot of pain and tension in my neck which I think is related to my atp.
This doesn’t go away even after doing the exercises for atp.
Could you please help? My neck problem is really bothersome.
You might need to work on other areas as well.
The 2 things I would recommend:
1. Forward head posture
2. Hunch back posture
See how you go with that and see if that relates to you.
I have what looks like left pelvic rotation, right hip hike, and atp. I tried out exervises for atp on other websites and found it to be too hard. I started doing exercises for rotated pelvis on your website a week ago and have improved a good amount. And then i noticed i had lateral pelvic tilt and both of those posture problems look pretty obvious to me. I know i have had rotated pelvis and atp for a year or so but i went to a sports and spine clinic as it is called where i live and was told i had none of those things. Now im here feeling like crap all the time and could use some guidance on what to do. Should i continue doing exercises for lateral pelvic tilt and rotated pelvis or shoyld i add in exercises for atp from your website? Also is lumbar lordosis and atp the same thing? Looking at the picture for lumbar lordosis it looks exactly like the curve i have on my back but mine is a little worse than that i think.
Thank you for posting these exercises by the way and i truly appreciate the amount of thought put into these exercises as they work out well for me.
Also as a side note, um, my back KILLS me every day with fatigue. It is a huge mental struggle getting through this every day but even now that i am better than before and think a little bit better since my head is not so incredibly tense. I havevery hard time walking and i cant go much time throughout the day without feeling like my back is going to collapse but i tryvto fight it every day by trying to maintain the best posture i can. This may sound over dramatic but i this is how i feel and have been feeling. Again
Do you offer a personalized program for paying clients?
I am interested but would need some hand holding.
Not at the moment. (need more than 24 hours in the day!)
Was there a specific question that you had?
Great article!! Are your exercise demonstrations in the pic for a right or left anterior tilt? I have a dull aching pain in my right glute and lower back pain on my right side. My left side of my back is significantly more defined. Any suggestions? I do core exercises and glute work all the time.
You might have a Rotated pelvis. Check out this post: How to fix a Rotated pelvis.
That blog post might be more helpful.
I have apt with tummy,should I wait till the tummy flatten out before I could see any change in spine movement to normal
Thank you for your precious instructions. Could you please check my posture? I think I have anterior pelvic tilt, but I need to make sure.
Looks like there is some anterior pelvic tilt going on there.
Thank you for your response.
Do you have a youtube channel showing these exercises? I couldn’t find if you have it. I think watching exercises would be better than trying to figure out from the pics.
And although I entered my email address to get the free ebook, no email has been sent to me :/ How can I download it?
I have been doing these exercises for 2months now ,my flexibility has increased n tummy has reduced but I don’t see any difference in my tilt why?
One more thing I have been researching about runners lunge exercise some say it also stretches hamstrings which we shouldn’t in apt cause. what’s your take on that.
Hey there Kris,
You might need to address other areas that may be influencing your pelvis position.
I would check to see if you have:
– Hunchback posture
– Flat feet
It is fine to stretch hamstrings if they are tight, but generally people with APT will have relatively elongated hamstrings compared to the hip flexors. It would be better time spent trying to strengthen them.
I have no hatchback or flat fleet and I guess I have hyperlordosis
And these are the exercises i have been doing all this while :
Child pose Scorpion
Seated straddle stretch sideleg raise
Frog pose dog kick
Lunge1 Hip lift
warrior pose bird dog
Pigeon pose plank
Mark, thanks for all the great content. In addition to APT, I also have an imbalance between my left and right rectus abdominis and transverse abdominis.
Is there a way to tailor the dead bug exercise so that I can specifically work my left RA and TA without hitting the right?
I would check for uneven rib flares and pelvic rotations as they can cause asymetrical load to your abdominal muscles.
This might need to be sorted along side your APT.
Can you still have a anterior pelvic tilt when you have a supinated foot? I have extremely high arches (when flat on the ground you can see a big hole through the other side) and I tend to have trouble walking on the balls of my feet.
Is it possible to still have an anterior pelvic tilt? Seems like many articles out there say it’s more common for a flat foot which is the opposite of what I have. Thank you so much in advance.
100% you can!
If you don’t have structurally high arches (that is – that is how your bones/joints are positioned genetically), then you will need to learn how to pronate your foot.
On top of this – I would still do the exercises for addressing the anterior pelvic tilt.
I have been doing these exercises for a month or so. I do it 5days /week n take Sunday as my rest day. I’m getting soreness but not severe though , is it a sign of spine moving to its original position?
Most likely due to doing exercise that you are not used to doing.
It’s normal! Keep going :)
Is straddle exercise a good stretch exercise for apt.
Can I do bicycle crunches, bent knee crunches n
Superman exercise for apt and it is ok to do super cobra pose?
All fine to do, just don’t prioritize them over the other exercises as mentioned on this blog post.
by doing crunches does it worsen apt
Hey hey Mark
Just another quick one to run by you
My chiro tells me my left hip has a posterior tilt and right has a anterior tilt can you perform these exercises seperate
Is this different then a rotated pelvis ? Or are the rotated pelvis evercises a good place to start
If my left hip is posterior is that a right or left rotation
As always love your work
An left posterior tilt + a right anterior tilt generally couples with a LEFT pelvis rotation.
So exercises for a left pelvis rotation would be the way to go based on what you have told me.
Perfect thanks Mark ?
I have the same problem as Romana. And this problem has bothered me for the last 10 years after I stepped on a rusted nail into my left feet when I was 15years old. I was truly frustrated because I couldn’t find any help in China and I didn’t feel like being supported and understood from my parents. Your post has saved my life! Thank you Mike! I would do anything to express how gratitude I am now if I could. Now I have been following your post for a month, and feel much better Now!
This awesome comment makes me happy.
I am going to share this comment with my Facebook page :)
Been seeing my physio to help with the Fai in my right hip the side which has the anterior tilt and my left having the posterior tilt.
You say this is most likely a left rotation of the pelvis but it seems based on some muscle tests my right glute is pretty much not working and left is.
Is it possible in this situation to have a right rotated pelvis ? As everything on my right appears tight ql tft psoas hip flexors hamstring or is it possible the muscles in the right glute are so tight from overuse they appear weak ?
When you say your right glute isn’t working, what exact hip movement are you referring to ? (eg. external rotation or hip extension) Both are movements of the gluteal complex.
It is still possible to have a right rotated pelvis. I would go with what the physio has assessed in person as it would be more accurate.
Can I do lizard pose, fish pose and other hip opening exercise
Yes that is not an issue.
Can I do lizard pose, fish pose and other hip opening yoga poses
Sure – no issues with doing that.
Is it ok to do free squat 15rep 3 Sets for glutes strengthening
When doing the dead bug, I seem to feel a click in my inner thigh whenever I lower my left leg. What could the reason be?
Most common answer would be the tendon of the psoas muscle flicking over a bony prominence in your pelvis (AKA Snapping hip syndrome).
I tend to find people with this issue have a rotated pelvis as they drop the leg down.
Check out this post: Rotated pelvis.
how do these work. i fixed my posture
On the Bird/Dog position and the 4 point kneel I feel my shoulders engaging too much and they start to get sore. What can be pointed out about it?
Thank you in advance.
You may some issues around that area.
If the shoulders are hindering you, You can perform the same exercise, but just move your legs.
Hi Mark, I would first like to thank you for this website and all the incredible information you have provided.
Im a healthy 23 year old male, and over the past four years ive picked up multiple injuries that have stopped me from training in the gym and reaching my fitness goals. After finding this site, and seeing a posture specialist, its clear my posture is awful and more than likely the main reason I have so many physical problems. Im going to be completing a few exercise menus from you: Twisted pelvis, flat feet, shoulder impingement, anterior pelvic tilt and winged scapular.
I know ive got a lot of work ahead, and im willing to put in as much effort as necessary.
My question is, how often should i be doing these physiotherapy plans?
Many thanks again mark :)
With multiple postural issues, I would try to address 1 area at a time.
This will give you the best opportunity to improve your posture without being completely overwhelmed by the amount of exercises there are.
Start the exercises at a frequency of 2-3 times per week, monitor how your body responds, and increase as appropriate.
How long does it take to cure.?
Hi there, I’m a soccer player of 16. I think i’m having anterior pelvic tilt. And so confused what to do. Now a days my lower back started giving me pain my posture is just getting worse. Now it is impossible for me to have more movements on the field. Everyone says dude you have a big ass. They are irritating me. It is from last year plzzzzzz do help me.
These exercises will be perfect place to start :)
I have huge tummy with apt so along with exercises u have suggested ,can I do goblet squat to strengthen my core .
That is perfectly fine.
Try to maintain as neutral of a pelvis as you can.
Hi Mark, can I do backbends if I have APT?
It is fine to do as long your lower back has the capacity to do it.
While trying to do the stretches I noticed I could not keep the proper form. For instance when I do the b) Quad/TFL stretch in order to keep the knees aligned my back arches and my stomach sticks out alot. Is this okay? If you do make videos please make sure to add in things like “if you can’t get that far do this or stay at this position etc”
Hi there Jeremy,
If you struggle to keep proper form, it is likely that the muscle you are trying to stretch it pretty tight.
You can try to a smaller lunge stance in that stretch you mentioned. This will take some tension off the TFL.
Hi mark.. it would be great if you video demonstrate the exercises
I 100% agree with you.
It is something that I need to get around doing.
Hey Mark! Should I avoid doing the superman planks for the lower back extensors like you reccomended in your sitting with a correct pelvis post? Would that not make my anterior pelvic worse?
You can still do the superman exercise if you specifically wanted to increase the strength in your lumbar spine erectors.
If you are doing the other exercises mention in this blog post to keep good control/position of the pelvis, it is completely fine and won’t make your APT worse.
If Running daily with apt is only going to elevate the problem , can I walk for good 30 min or so ?and can I do saw exercise (pilates ) for core strengthening.
Sure – that is fine to do.
I recently went to a physio after enduring about a month of agonising pain in my glute that stopped me from walking and even sleeping. Simply looking up or left with my head triggers this glute pain as well and it is only on my left side. The cause for this was apparently pelvic tilt. My physio gave me no clue as to how long this condition takes to fix and how serious it actually is? I’m quite young and this has me very worried as I was involved in many sports before this and wish to continue. Will I fully recover?
Thanks for this great post Mark.
Is it ok to do these exercises everyday, or should I incorporate rest days?
Hi there Gemma,
It is fine to do the exercises every day as long as the body is able to tolerate that intensity.
However- I find that most people require a rest day in between.
Hi Mark, I have a grade 2 Spondylolisthesis at l5s1, with stenosis. Could this cause my duck walk gait? I also have extremely tight hamstrings. Will the exercises you have posted help or since I have the above condition not? Thanks!
Pain in the lower back can alter the way you walk. This is usually do the body trying to move without causing pain.
In regards to the exercises, they are specifically designed to address the anterior pelvic tilt.
If you have an anterior pelvic tilt and it is affecting your symptoms, then the exercises should be able to help you out.
If not – you will need to find exercises specific to your problem.
Not sure if my first comment posted correctly, so I’m just posting again.
Thank you for such an informative article, it’s nice to find something about APT that is so comprehensive (everything else seems to neglect the upper back and hamstrings). However, when I do the quadricep stretch, I get a sharp pain at the top of my knee (it’s only in my right knee). Is this normal when starting, or should I try something else. I know my IT Band is tight as a result of the level of pain I get from foam rolling, but I was just wondering if I should just press on with the quad stretch. Kind regards, Max.
Sounds like your patella bone is rubbing against the bone behind it.
(This can occur with full knee flexion + placing the distal quad in a stretch.)
Keep doing the stretch, but you might need to lay off the end range knee flexion and focus on tucking their tail bone underneath you (posterior pelvic tilt) as you perform the stretch
Thanks Mark, another question, I had a chiropractor a little while ago get me to do some abdominal hollowing exercises as a means of strengthening my core, and that seemed to work, but he didn’t get me to strengthen/stretch everything else mentioned in this article, does that mean I should be fine to lay off the ab work? I feel like it tightens my lower back further whenever I do, but when I do everything else, it feels fine.
If you already have good control and strength of your core muscle, then you can focus on the other areas for now.
Is it safe to do pigeon pose or 90 90 pigeon pose for glutes strengthening
Yes. This should be fine as long as it’s not making any other issue worse?
What did u mean by other issue , by doing pigeon pose I could feel it on my glutes, no issues though
I mean, as long as you aren’t causing any other pain/symptom whilst doing the pigeon pose, then it is fine to do.
Is it safe to do mountain climber exercise for Apt.
That is completely fine to do.
Just aim to keep your pelvis neutral whilst you are doing it.
And another thing, when I do the dead bug stretch, both of my hips make a pop noise as I lower them. Everytime. My girlfriend can hear it in the other room. Feels like a tendon or ligament is going over under a bone or something. Like a twang lol. Thanks again if you have any help for me.
Sounds like you have “Snapping hip syndrome”.
Don’t worry – it’s nothing to be concerned about.
It is basically a tendon flicking over a bony prominence.
If you twist your knee in a slightly inwards position as you do a leg drop in the dead bug exercise, does the sound go away?
And Mark, thank you so much for making this stretching information available to all. I’m going to try everything on here, I just was always nervous to try stretching before I narrowed down the issue in case it’s something that requires surgery and stretching prior to surgery would only cause more injury. When I try to touch my toes it feels like my vertebrae are separating. I’m definitely not using the parts of my body that I should. Is there such a thing as partial hip dislocation? It feels like my femoral head is not in the right position. Sounds crazy and maybe I am haha just I live in a small town and these doctors aren’t the best…
You can have a femoral head that is not sitting centrally within the joint space.
This could block certain movements of the hip which then could lead to your spine compensating.
Hi, I know it’s best for me to visit a doctor first. I’ve never been able to touch my toes. Probably about 6 inches away. 6’tall, 165 lbs. Skateboarder and snowboarded since I was 12. 31 years old now and my heels are killing me, poor balance and lower back pain. Waking up I feel like I got hit by a truck and just walking up the stairs burns in my legs specifically my knees. My legs are very skinny and look different than other healthy people. I’m thinking the problem lies in my hips but cannot figure it out. I am very flexible in some ways but not in others. I’m obsessed with researching this but cannot figure it out. Please help me.
Sounds like you would benefit from a full assessment to see what is going on.
But if you think it is coming from the pelvis, might be a good idea to check out these other posts
Lateral pelvic tilt
i have slouch with forward head posture with apt, which one should i address first and can i do reverse table pose with knee at right angle for apt
You can start on either.
There is no wrong area to start.
Yes – reverse table top is fine to do as long as you aim to keep the pelvis neutral.
If I have APT and lateral pelvic tilt, which one should I treat first?
You can start addressing either one first.
It might be an idea to match it with the symptoms you are experiencing.
I have hip pain on my right side. I felt a pop about two years ago followed by some extreme lateral pelvic tilt. (Right hip raised).
I have APT and at times lateral pelvic tile and a rotated pelvis. These are all different issues on your website. Is there one that I should be focusing on more than the others? (I.e. if I focused on solving the APT issue would it most probably solve/ help the other issues?)
Any other info you can give me about what I should be focusing on would be brilliant as I have been doing a mixture of the routines and I am not seeing a great deal of change.
Thank you for your help
With multiple postural deviations, you want to start on the area that can positively influence the others.
However, that being said, the only way you can really tell which pelvis position is driving the others is if you just start working on one and see how the other areas respond.
When I do stretches such as the quad stretch, the muscles to either side of my upper/mid spine stick out heaps, and make a very large curve. This also happens if I do exercises like press ups, planks, or the bird/dog exercise. It looks pretty bad, and I’m concerned it could be a problem.
I have only recently found your site, it’s really helpful so I’ve been doing the exercises for a week now.
How long will it take to fix my anterior pelvic tilt???
As long as it takes, my friend!
Have started following your exercises to try and sort out my bad anterior pelvic tilt and forward head posture. Is there anything linking these two posture problems? And if so is there anything i can do to combat both at the same time?
They are definitely linked!
But I would recommend addressing both.
If there are too many exercises, perhaps start with one and see how far you can take it.
From here, then you can start on the next area.
i’m also in the middle of my exam period which means i have to sit at my desk alot which seems to make the problems worse and increase the pain. im finding it hard to fit on my pointy bones Is there anything i can do?
You can use a pillow to help support your lower back arch.
Sit on a cushion to take some pressure off your back.
Use a more supportive chair.
Take regular breaks.
Perform pelvic forward and backward tilt to keep the pelvis/lower back moving.
This is really excellent. I teach pilates and this is a fantastic breakdown. Thanks for posting.
Thank you for your comment!
Can you help me, I dont know what to do, I will be grateful for any advice. I have truly thight psoas but I cant stretch him. I tried so many different stretches (engage gluteus and abs, pelvis posterior rotated) but nothing. You told me two weeks ago to try psoas release, maybe it will give benefit, but again nothing. Im doing your program for a while, maybe about year and my angle of hyperlordosis hasnt changed. For that time I stretched quads fully, for sure. I dont want to give up, but I know that without stretched psoas I cant get rid of apt and hyperlordosis. I have that problem more than 10 years for sure and now im 23.
I wish to thank you for all help.
If you are having a hard to stretching the psoas, you might need to eccentrically strengthening it.
Muscles tend to get TIGHT to compensate for the weakness. So – if you strengthen it, the tightness compensation will reduce.
I am 27, and I have Anterior pelvic tilt. I walk like a duck that decrease my self confidence and sometimes I fell pain in my feet. Does these exercises is enough for me. To correct my duck feet and Anterior pelvic tilt.
It will be the best place to start!
For your feet, check out this post:
How to fix Duck feet posture.
Firstly thank you for this amazing website! You’re really helping people across the world :)
I have two issues with my back at the moment and am struggling with pain after yoga, swimming and climbing.
My thoracic is flat and I have anterior tilt, I can’t do the lower back stretching (camel, cow pose, posterior line) on this page because it remains flat too, although I’m hyper flexible the other way (backbends). Is this due to tight pelvic muscles, bad hip flexibility and maybe tight abdominal muscles too? My upper abs are quite tense also.
What things should I be doing?
For a flat thoracic spine, check out his post:
How to fix a flat back posture.
(Focus on the exercises related to the thoracic spine only)
Hi, I have SI joint pain and a lot muscle tightness in the left low back. I stretch the QL and do other stretches. When I try to do prayer pose stretch or rounded back stretch, my left low back erectors tighten up. I also have anterior pelvic tilt, and my back hurts doing planks. What exercises are safe for si joint pain?
They are all fine to do, but you might need to reduce the intensity to a level where you are very comfortable.
Sounds like there’s a muscle in your left lower back region that may be holding you in an anterior pelvic tilt. Have you tried gentle massage in the area before doing the exercises?
I have been using your website for my anterior pelvic tilt, lordosis and flaring ribs. It’s been really useful, thank you.
When I try to stand with proper posture I have found I can now align my shoulder bone with greater trochanter and have a neutral pelvis.
The only thing I am not sure about is these two points are aligned with eachother but slightly in front the of the ankle bone. Is this still ok or am I missing something?
In line with the ankle bone or even slightly in front is completely fine.
Good job with your posture!
I want to know if there is any way I can fix my hollow body. You probably know that you have to stick your lower back to grand. The problem is that, when I’m trying to hold this position, after few seconds my lower back starts moving up. I don’t know if that’s because of my legs weight, maybe they’re too close to the grand, or maybe I bend my stomach not as much as I should. Could you please give me some tips to do proper hollow body position without “flying” lower back? Hope you’re still active and will give me a response.
Btw You did amazing job, keep it up!
Sounds like you lack some control of your core muscles.
You might need to make the exercises a little bit easier so that you can maintain the lower back contact with the ground.
You can do this by resting your feet on something in the dead bug position to begin with.
Many thanks for your work on this website it’s really helpful.
I have both anterior and lateral pelvic tilt and I am wondering which one I should prioritize and also how long should it take to start seeing progress.
Thank you very much
It doesn’t really matter which one you start off with.
If you have symptoms, then correct the one you think will have the greatest impact.
Im doing your program for a while and i dont feel any stretch in my hip flexors. I tried different metods of psoas stretch but again nothing (all stretches I did correctly). I want to know your opinion is my psoas fully stretched, because when i do Thomas test it say that i have tightness.
Any your advice will mean to me.
If your hip flexors are truly tight and you can’t get into a position to feel a stretch, you may benefit more from focusing on the releases first.
This might allow you to get into a position to actually feel a hip stretch.
Another thing that might help is to perform a posterior pelvic tilt as you do the stretch.
Thank you for help Mark :)
Do you have same advice how to release psoas ?
I tend to do it this way
Just make sure you stay off your guts! You don’t want to be applying pressure on your intestines.
Thank you so much Mark :)
I must confess I’m obsessed with your website. It’s great and you’re great!!!
I have an anterior pelvic tilt, forward head posture and a winged scapula (jackpot ?)
What do you recommend I work on first? Or can I work on all of them simultanously?
Do you recommend doing these exercises each day or alternating and giving each muscle group a little rest?
You can do them all at the same time, although, that could potentially be quite overwhelming!
If you can do it, do it. If not, it is also fine to pick one area to begin with, and move on to the next once you feel you’ve achieved as much as you can.
A couple of questions about the dead bug: When I lie down, my lower back is arched and does not touch the floor. My back only gets to be totally flat on the ground when I raise my legs and the pelvis tilts. Is this correct?
Also, my lower back starts to hurt as I do the exercise for awhile, even though my back is flat on the ground. Should I modify the exercise so that there is no lower back strain whatsoever, or is it normal to get a little strain in the lower back?
If you are unable to flatten your back whilst lying on your back, you either have:
1. Tight muscles (such as hip flexors) that may be preventing you to flatten it and/or
2. Poor control of the region.
If your lower back hurts during the dead bug exercise, it is likely that you are letting your legs drop lower than what you can properly control.
I would suggest modifying so that there is no tension in the lower back.
Thanks, I didn’t see your reply so I posted the same question again. Oops!
Hey Mark, just wanted to say thanks. This really is an amazing site, so helpful – especially these comments that you reply to. You are really helping people.
I was doing the dead bug for months before I read this, but my lower back always got sore. So now, I modified it as you suggested, but I can just barely touch my feet to the ground near my butt, or else I feel it in the lower back. My plan is to keep doing this and hopefully in time get better at the exercise. I try to think of my abdomen as I do the exercise now, and not allow the lower back to strain at all.
Thanks for the comment!
Yes! A lot of people perform the Dead bug exercise incorrectly! If anything, your stomach muscles are the one that should be getting tired.
Is swimming or stationary bike treats anterior pelvic tilt.
They are fine for general fitness but it will not address your Anterior pelvic tilt specifically.
I have anterior pelvic tilt and hunchback.
I have sciatica pain in my left leg and knee moves in ward, leg internally rotates, overpronation of the foot in my right leg.
Can the pelvis return to neutral position with these exercise Or I should do hunchback exercises first.
You can start at any part of the body.
However- if you have sciatica, this would be a priority before addressing your posture.
Hey great article!
How often should I be doing the stretches and exercises? Everyday?
Yes – If possible!
Thanks for all your help! :)
I have a question. I gather that there are muscles such as the glutes and hamstrings, in addition to the abs, that need strengthening, as their weakness is contributing to the imbalance and therefore APT. With regards to the other muscles, which are supposedly tight (Quads and Lower back), should I not exercise them at the gym? or should I still continue to strengthen and exercise them, whilst also building and strengthening the weak ones mentioned? I couldn’t find an answer to this anywhere online.. Thank you :)
I would recommend to continue to strengthen them, but making sure you do so in a more neutral pelvic position. (meaning, don’t let your pelvis go into an APT whilst strengthening your lumbar erectors/quads)
Once you can move in and out of APT easily, you can then focus on exercises that place your pelvis in an APT.
I really need your help.
I started doing dead bug exercise with as much as proper form as possible.And my abdominals felt quite engaged during the exercise.
But what happened after a few hours that my abdominals and the region slightly below the abdominals became so tight that it started to bloat and hurt a little bit.
Like I hurled if I laughed or got up from chair.
And the region became so tight that it lead to constipation.
What to do ??
I am a boy of 16.
I have got APT associated with wide hips.So it does not look good.
Can I stretch my TFL and IT band for my hips. It just should not worsen my APT.
I did not know the science thats why asking.
The TFL is a hip flexor so stretching this out should help with APT.
Thank you sir,
and what about that IT band
You can’t really stretch the IT band as it composed of very thick connective tissue.
Focus on the muscles to help restore neutral pelvis. This should help with any ITB “tightness”
Mark please can you tell me if bad posture can cause gynecomastia ?
I don’t believe it can as it is generally due to excess fat +/- hormone issues.
However, gyno can indeed lead to bad posture as on attempts to hide their chest with rounded shoulders.
Hi Mark, thanks for your help. I am going to start fitness. Can you tell me witch bodybuilding movements are harmful for Anterior Pelvic Tilt Posture?
There aren’t any “harmful” body building movements for anterior pelvic tilt as long as you are in a relatively neutral position.
Be extra careful with your pelvis position esp with dead lifts, squats, up right rows and military press.
Well I thought it was normal for my body to look with the arch because I have been doing squats for about 5 months now and thought I was getting what I wanted which was a rounder butt. Guess not! Now it looks as if I have a pregnant belly sometimes when I am standing. Would the squats be doing this or most likely it was like this before and just never noticed? Also my abs are shot! Have been since giving birth to my boys who are in double digits now! (I know…I should have been working on my core)
So should I do the workouts you have posted on this page before continuing my squats?
If you have been squatting with an excessive lower back arch (hyperlordosis), then that may have caused it.
You can still squat, just make sure you are “feeding your rib cage into the pelvis”. The ribs should be aligned with pelvis.
Thankyou for your article; it was very detailed and comprehensive.
I have quite pronounced hyperlodosis which is causing me alot of pain in the neck and back. Looking at my postore, it looks like I have APT.
I tend to Overpronate when I walk, but I don’t have flat feet. I have brachymetarsia (short metatarsal bone in the fourth toe)where my fourth toe is excessively short and kind of floats in the air.
Ive started the gym recently; is there any exercises I should avoid. ive heard situps leg raises should be
This is extremely helpful. Thank you very much!
Thankyou for your article; it was very detailed and comprehensive.
I have quite pronounced hyperlodosis which is causing me alot of pain in the neck and back. Looking at my postore, it looks like I have APT.
I tend to Overpronate when I walk, but I don’t have flat feet. I have brachymetarsia (short metatarsal bone in the fourth toe)where my fourth toe is excessively short and kind of floats in the air.
Ive started the gym recently; is there any exercises I should avoid. ive heard situps and leg raises should be avoided?
Also do you think the flat feet exercises will help me strengthen my foot, and help with the protonation?
Exercises that use of your hip flexors such as straight leg raise and sit ups can encourage your hip flexors to become more dominant. This in turn can make your lordosis/apt worse.
However – that being said, many tight muscles are actually really weak. So, it might be an idea to train them, but pay attention to how your body responds to it.
Every exercise must be comfortable! :)
The flat feet exercises will be great for your over pronation.
hi Mark, im 16 y/o and i wonder if because i have a anterior pelvic tilt, can i do squats and deadlifts? and when im doing some of this strecthes my lower back cant reach the ground because of my posture, should i still do these exercises? sorry for mispelled words and such, from norway
You can do squat and dead lifts even when you are working on your anterior pelvic tilt.
You will need to encourage a more neutral pelvis during these exercises if you are wanting to address your pelvic tilt.
If you are unable to (and your APT is causing you issues), I would focus on the rehab exercises before progressing to these compound movements.
Hi mark brother…i have this Anterior pelvic tilt problem…every i do 30 push up…it’s harmful??? please answer
That is fine to do.
Try to keep neutral spine by engaging your core as you perform your push ups.
I just measured my angle between my ASIS and PSIS and it stands at whooping 11.8 degrees :O
I am 30 years old and I have low back pain in the morning if I sleep on the back, now I can see why. I will do these exercises for the next 2 months twice a day and report the results. Cheers!
Awesome Cira! Best of luck to you.
should i stretch my hip flexors on top of strengthening them if i find out that they are weak or should i just strengthen them because stretching would make them weaker again?
I find most people are actually tight AND weak in the hip flexors
I would encourage you to strengthen them as well. (Perhaps try eccentrically first!)
I’ve just recently been put on the trail of APT by my chiro, and he sent me the link to your article, which is great. When we discussed it prior, I was confused about the matter that I still am now having read your article and some comments – how do I know what to do with my hip flexors?? The last thing I want to do is put time and effort into something I think is helping my chronic and acute pain then have to undo the work and do the opposite. Is it a little bit of a must-do trial and error though??
Thanks in advance,
If your hip flexors are tight or overactive, stretch them.
Although hip flexors are often tight/overactive, I personally find them quite weak in most people as well. If this is case – strengthen them in a neutral pelvis position.
what do you suggest for apt causing hyperextended knee and also internal rotation of femur and tibia
You can perform the same exercises mentioned in this post to address the APT.
If your Hip is still in internal rotation, then I would recommend performing more glute exercises to encourage external rotation of the hip.
The problem is watever i do my belly remains little protuded…i have done cardio,strengthening but still i couldn’t acheive my dream flat belly… After doing some research ,now i guess the belly problem may be due to APT…But i cannot rule out it….plzz help mee…I also have severe neck pain.
To fix APT is it a good idea to walk around with the glutes squeezed in everyday life or only during exercises?
You can engage the glutes, but don’t force the position as this will probably cause some other issue.
If I have flat feet due to genetics which can’t be fixed, is it still possible to correct my APT if flat feet can cause APT?
Although it may or may not be able to completely corrected, I am quite certain you can at least improve the degree of your APT.
Hello mark. I dont know if u remember me but we talked extensively on this page more than a year ago. (scroll back upto october 2016)You can scroll back up to I had an extreme case of APT. Since then ive been doing stretching and strengthening and foamrolling as u suggested. I have improved so much. I stand straighter now and im so much happier.
I still have some degree of APT left and also kyphotic upper back. Im working on it. Any new advices and also thankyou!
Hello mark. I dont know if u remember me but we talked extensively on this page more than a year ago. (scroll back upto october 2016)You can scroll back up to I had an extreme case of APT. Since then ive been doing stretching and strengthening and foamrolling as u suggested. I have improved so much. I stand straighter now and im so much happier.
I still have some degree of APT left and also kyphotic upper back. Im working on it. Any new advices and also thankyou!
What do you feel is limiting you from improving further? Is it tightness?Weakness?
I’m 17 and I think I’ve had ato for about 3-5 years now I’m gues because of surgery recovery or just play a bunch of videos games. I don’t feel back pain unless I try to straighten my back,my gut is also protruded and I have rounded shoulders, I wanna play soccer in a month but i don’t know if I can fix it by then? Any tips for faster results?
Thanks for the article mark. I am suffering from shoulder pain since almost a year now. Since last 6 months or so, my neck has also become an issue, it remains stiff most of the time. I’ve seen multiple doctors and physiotherapist , got IFT also for sometime but nothing seem to be working. Cervical Spine MRI shows everything normal. Off late, I am also feeling pain in my knees. I guess more than bones, it has to do with my muscles and nerves. I seem to be having anterior pelvic tilt as you have pointed in your article. Can this be root cause of my issues? It would be great help if you can suggest something which can help me to come out of this everyday struggle.
Thanks a bunch!
Hey there Monica,
If you have had treatment to your neck/shoulders and not getting anywhere, I would then start to look at other areas that might be driving your issues.
An Anterior pelvic tilt can definitely cause issues up into the neck/.shoulder region.
Thanks a lot for prompt reply Mark. Yes, I’ve got X-Ray, MRI done; took some medicines too as precribed by orthopedics and pain specialists but nothing has worked so far. I am 35 yo working in IT industry and my posture has not really been great all the while. Also, after delivering my second child over 2 years back, it seems my body is just not bouncing back and I feel lethargic most of the time. If you can recommend any specific exercise which may help my issues, it would be of great help. Thanks again for replying :)
It’s hard to give specific exercises without assessing you, however, if you believe you have done everything you can with your neck/shoulder, start with these exercises to address your anterior pelvic tilt.
This may cause a chain reaction up to your shoulders/neck.
Should we only do one set of the Bridge?
How many repetitions for the dead bugs?
It’s really as many as you can do properly.
If you can do more than 20 with perfect technique, you need to make the exercises harder.
You offer a real good plan of stretches and exercises. I am very grateful, however I am trying to work on my flat feet but it seems like I can’t perform the exercise at all. What do you suggest I do? Is there an alternative for this one exercise?
Check this out: Fix flat feet.
Are these mostly yogic exercises that I could learn by taking a yoga class at some point? I find it a bit hard to look at pictures because I am not sure if I am doing the moves right or not. It’s hard to just imitate pictures for me.
They are not specifically yoga exercises. But I guess you can incorporate it into some yoga class.
I have been APT since 5 years. But what I feel that my hamstrings are tight.While doing the Glute bridge I feel a cramp on my hamstrings and my hip flexors pain a little bit.
But it is said that in APT the hamstrings are tight.
So what to do??
Strengthen them or stretch them??
While doing the Dead Bug exercise, my belly boats( inflates) though my back remains flat on the ground. Is that normal?
I think it’s a sign of a weak core.
What’s your say??
You do not want to bloat out your stomach whilst doing the Dead bug exercise.
If anything, the belly should retract!
I have a natural pelvis position.My hamstrings are a bit tight as a result of which my glutes are not at all active. It is very loose and weak.
So nowdays i am aiming to fix it.
Also my abdomen protrudes a little bit( the region above the stomach and below the chest)
So is this a sign of weak abdomen or tight abdomen???
I’m 27 years old. I’m suffering with APT since my childhood, I even have some extra hair in my lower back. Is this common for APT ?
I’m pregnant now will my baby get APT, is it hereditary?
There may be some genetic predispositions when it comes to anterior pelvic tilt.
However – it does not guaranty that your baby will have it too.
I have titled pelvis on my right side and the exercise does not help much. The pain is unbearable. The pain shoot down my leg and in my stomach. I’m doing the exercise every day twice a day but not helping. Will this tilted pelvis also cause me to have pain in the knees where it hurt to bend. Any advice will help.
Sounds like you need to address your symptoms first.
If pain shoots down your leg, it may be indicative of a nerve issue.
If your nerve is inflamed, these exercise (well, any exercise really) will likely make your pain worse.
Consider reducing exposure to aggravating movements, anti-inflammatories, cortisone injection (try to avoid) and/or nerve medication (last resort).
Hi, great site, with a wealth of information, when reading through the different posts on your site, i’m starting to worry that i might suffer from everything to a varying degree, guess my desktop job have messed my body up good..
Is it normal that i can’t force my body in to good posture even for a brief moment, also i’m having a problem of flared ribs.
You don’t want to force the good posture as this will likely cause more tension in your body.
The aim of the exercises will try to make good posture as natural as possible so that you do not have to force your body into the position. (this takes time!)
You just want to correct your posture as best as you COMFORTABLY can for the time being. Also – remember to move! Don’t stay still for too long.
Hi John! Lots of good info here. I’m going to work on the stretches. I want to state that I believe my ATP is genetic. My mom, myself, and my 1 1/2 year old son all have this pelvic posture problem. I’ve had it my whole life. Assuming it is genetic, do all of the same practices apply?
Also wanted to ask: what is the average time frame to straighten the pelvis back to the normal position? (I know the answer depends on circumstances but I’m looking for a rough number here as an average)
I have a 10 year old daughter who is an active dancer. She, rather suddenly(in the last two months) has a new posture, APT. It’s throwing off her balance while dancing and she’s composing of lower back pain.
I’ve reminded her to correct her posture, but it’s all day. Any suggestions for a young, less than focused, child?
Working with kids’ posture is always a challenge.
You will have to emphasize the importance whilst she is dancing.
It is a bit strange how the posture changed all of a sudden though. Perhaps something learn in dance school?
Hi Mark great Article,
i have ATP and i did a lot of workout with that incorrect posture. Im suffering from chronic shoulder pain since 3 years, on the mris and x ray pictures are no visible structures that are hurt. I did a lot of shoulder stretching and strengthening but i couldnt fix this pain. Can my ATP be the reason for having this shoulder Pain? I noticed that i cant lift my arms straight above my head (180 degrees) they stop at like 140-150 degrees, but the more i tilt my pelvic back and stand straight the better my overhead mobility gets.
On top of that i have very limited internal rotation, without having an extra external rotation. Some doctors said they think the GIRD syndrome is possible. Is that connected to ATP in any way?
Thanks for Reading, hoping for an Answer. Keep up the good Work.
Limited IR may indicate tightness in the back of your shoulder. This is quite common with people with rounded shoulders which MAY stem from APT.
If your shoulder mobility improves by keeping the pelvis more neutral, then this would indicate your pelvis might be driving your shoulder issues.
Thanks for the reply Mark!
I have always got problems while walking.
I have got APT associated with hyperlordosis and some muscular imbalances around the scapular region. Well APT and lordosis have improved thanks to the exercises of yours.
But while walking and climbing up stairs my legs (shins) hurt.
So is it okay if I foam roll my shins and calves??
It is just that it shouldn’t contribute to APT??
Any other tips to improve a walking posture??
It is said that excessive sitting can be the root cause for APT. But I feel in my case it is because of my improper way of walking where hips are not in motion and body very stiff. Well the exercises have been helpful but are not able to resolve the problem as a whole due to my walking style.In the Earlier messages you said to be persistent with the exercises as to hold a nuetral pelvis while walking. But to be very personal i feel that I do not know how to walk properly. On trying to maintain a nuetral pelvis the posture becomes weird and leaves me worse off.( as said by people around me).
So i have read about your blog of ideal sitting posture which is very informative.And I request you to also make one on “standing” “walking”
as in my case I feel that because of that I ve developed a very poor posture since years of incorrect and uncomfortable walking.
This sounds like a great idea.
Thanks for your suggestion.
Hi mark, I am 17 years old and I do a lot of weight training, I’ve always had this problem ever since I can remember so I doubt the cause of it is the way I sit as I’ve had the issue since I was a small child (as has my father) I really want to fix this as it hurts my lower back to do shoulder presses in the gym which is one of my favourite exercises and also my belly sticks out a lot and I don’t like the way it looks. If I do these stretches and exercises will it fix my problem or are they only for people who have developed the problem because of the way they sit? Thanks.
These exercises should be able to help you.
I have APT. I have been doing the exercises mentioned. It’s been effective.
With APT I also have duck feet and knee hyperextension which makes my walking worse and fall into APT?
So how to deal with it?
Great to hear the exercises are helping with your APT.
The APT may be causing a chain reaction leading to your knee hyperextension and duck feet. Address the APT may help improve the others.
Duck feet posture blog post coming out this month. Stay tuned for that. (I’ll post it on the facebook page once I am finished with it.)
I am always in Anterior pelvic tilt while walking. My friends say it seems that I keep my upper body very stiff. I am not able to maintain a nuetral positioned pelvis while walking. So could you please give some tips for the same ?
You will need to focus on these exercises a bit more so it will eventually become easier to hold a more neutral pelvis whilst walking.
I am always in Anterior pelvic tilt while walking.
Unable to maintain proper pelvis position while walking. My friends say it seems that I keep my upper body very stiff and butts sticking out.
So how do I improve my walking posture???
While doing the kneeling hip flexor stretch, my knee hurts which stops me to do the stretch.
Also while doing a Glutes Bridge, on tilting the pelvis in a neutral position from APT, my knee hurts ????
What to do ???
You can do the same stretch but place your knee on a thick pillow.
Thank you Mark
What about the Brigdes??
It is one of the most important exercise I guess.
Thanks for all the great information. One question: As the pelvic tilt is corrected, do does the pelvis rotate to a new position as the lower back straightens? Or does the pelvis stay in the same position and the spine straighten? If it is the latter, does your height also increase as you fix your pelvic tilt?
The pelvis and lumbar spine will move together.
And yes – you can potentially grow taller with a correction.
While doing the Bridge Exercise, my legs pain and I cannot feel a thing in my glutes.I also have APT. Is it the result of tight hip flexors which need to be stretched???
Your tight hip flexors may be preventing you from allowing your pelvis to get into a position where you can efficiently contract your glute muscles.
You may need to work on stretching those tight muscles out first, then working on doing posterior pelvic tilts, and then performing the bridges.
For core strengthening is it ok to do reverse crunch or any other core exercises
That’s perfectly fine to do. As long as you gain control of your anterior abdominal wall.
I have been pouring over your website with all of it’s fantastic information. I don’t even know how I found you but I have been working on ITBS on my right side and somehow I pieced together that APT might be a contributing factor. I have a tight and painful left QL too. I’m a bit of a hot mess. Anyway, I am working on my APT using your recommendations and it is working wonders on my posture! Do you think there is a connection with my ITBS? Thanks so much for all of your fabulous information!!
I am happy to hear that the exercises are helping!
With ITB issues, I tend to find it is due to issues with the Tensor fascia lata, glute max and/or glute medius.
When you have an APT – it tends to place these muscles in a suboptimal position which may cause extra tension on the ITB itself!
Thanks for the reply! I totally agree that those muscles are in suboptimal position. I believe it makes it harder to both release and and strengthen the glutes and TFL while in the suboptimal position of APT. I think that is why I have never been able to defeat ITBS. So, this time around I am addressing the APT as part of my ITBS rehab. I hope it makes the difference! Does that make any sense??
On top of the APT, make sure you do not have knee valgus and flat feet.
These can also lead to ITB issues.
GOOD LUCK! I believe in youuu!
Hello sir ,
I must tell u your information is awesome.
I am a sixteen year old boy who has been in a bad posture since four years. I observe a protruding stomach and butts sticking out. Whenever I do the hip flexor stretch, the result has always been the opposite in spite of engaging the abdominals and flexing glutes. Whenever I sit down and try to maintain a proper pelvis position my body gets very stiff. I have always been very fat despite being very very diet conscious. Please help me Sir. I often get frustrated thinking of my body. Also with anterior pelvic tilt, I have got wide hips .
I have often been told by my friends that I walk in an awkward manner.
Please help me Sir.
I am a sixteen year old boy. I have been in a bad posture since 4 years and have always dreamt of fixing it. I observe a protruding stomach and butts sticking out. Whenever I do the hip flexor stretch, the result has always been the opposite in spite of engaging the abdominals and flexing glutes while doing it.After the hip flexor stretch , when I do the quad stretch I am no longer able to feel the stretch. And also while sitting when I try to maintain a proper pelvis my body becomes very stiff.while sitting my belly becomes like a balloon. I always look fat despite being very very diet conscious!
Please help me Sir. I get upset thinking of my body.I am not able to study at school thinking that my posture would make leave me worse off due to excessive sitting or rather sitting in APT.
Could you also text some foam rolling exercises to fix Anterior pelvic tilt.
THANK YOU FOR ALL THE SUPPORT AND HELP!
YOU ARE DOING A GREAT JOB HELPING PEOPLE LIKE ME.
PLEASE REPLY ASAP.
what does it mean to engage you core muscles? where are the core muscles?
The core muscles are essentially a group of deep muscles between your lower ribs and pelvis responsible for stability.
Check out this post and go to section 3: Breathing + Core.
This should help guide you to engage the core.
ok thnks so much
thank you so much! I went from physio to doc to physio to doc to physio to doc…
Until i found your Website. Which showed me how unbelievable unqualified most of our docs and physios are(im really pissed about that). Now i understand why everything feels so tight and why i have so much pain in my body(it even made me depressed). Thanks again! And thanks for doing it for free and giving me the hope to live a normal life!
I have two questions:
Do you have a guide which shows me how to correctly walk and stand with flatfeet/duckfeet/atp? I try to hold neutral pelvis, but because of my unbelievable short Rectus Femoris its not really possible. (FYI: I am using barefoot-shoes since some weeks)
Cheers from bavaria,
Hi Selli from Bavaria,
I’ve got some posts for you!
– How to fix flat feet
– Knee valgus
Have a read of those and let me know if it helps.
Hi! Love your website!!!
So I am 35 years old and a massage therapist (so feel free to speak in technical terms). I suffered from chronic neck pain for all of my 20s as a career student during those years. It was up to a point that I couldn’t do any athletic activity without any excruciating pain. Well finally (as I became a massage therapist and worked with a sports chiropractor) I have it under better control, but it’s not gone. About a year ago, I started gymnastics, intensive yoga training and crossfit. This has led me this year to discovering circus with a huge focus on hand/head balancing classes. I am currently doing 6 and a half hours of hand/head balancing classes a week. And have added2 hours of ballet classes a week with the intention of eventually getting into contemporary dance and acrobatics.
Anyway, here are my current issues. Though my posture has much improved, handstand classes are really showing that I have not eliminated my postural problems. This has caused me bicep tendon problems in my left shoulder (despite the fact that my scapula are no longer winged) my right lower back (inferior to my lowest rib) occasionally spasms. My own difficulty in maintaining my handstands seem to stem from difficulty squeezing in my rib cage (and I noticed when I am actually on my feet I have my rib cage flaring—which I just noticed. And I have an anterior pelvic tilt which refuses to correct itself after more than a year working on this stuff). I do most of the exercises mentioned on this page already, as they are part of my attempts to get into splits. I also work on wall angels and thoracic mobility and shoulder stretches for the handstands. I still fight forward neck posture as well. And rounded shoulders—though that one is much improved). I am surprised how much these problems are persisting despite all of my activities and the pretty strong core I have developed in the last year (I wouldn’t be able to do half of what I do with a weak core and abdominals.
So yeah, what I am struggling with:
* anterior pelvic tilt
* thoracic inflexibility
* mild rounded shoulders (used to be severe)
* severe forward head posture
* flaring ribs (flares more when I attenpt to shift my scapulae and pelvis into neutral in front of a mirror).
Not only are these issues hampering my progress in my sports, but they cause pain and make me prone to injury.
The first thing I would look at is your shoulder flexion mobility during the hand stand.
Lack of full shoulder flexion can lead to a pronounced arched lower back + rib flare + anterior pelvic tilt.
This is due to that the body is trying to balance the centre of gravity.
The muscles inferior to your last rib at the back are over worked to achieve this. If only your right side is giving you trouble, I feel that this may be due to some Left vs right asymmetries.
Hello Mark, I suffer with APT and rotated/lateratal pelvic tilt (I think). I have had problems since I felt my hip pop out of place whilst leaning to my right at a wedding. My right hip was much higher than my left for weeks.
My questions are;
1/ Can you have rotated and LPT at the same time and on the same side?
2/ Also when I lean forward my hips push out to the right hand side causeing a bend in my lower spine (it happens in almost a popping motion). I can force myself straight but it takes a lot of effort and I have to put my hands on my hips to help me stabilise. Also this couses a lot of discomfort in my lower back.
What is the reason for this as I a sure this is the key to my problems.
1/ Sure can! There are many combinations of postural distortions that people can develop.
2/ Where is this popping sensation originating from? (perhaps mark in on a picture so that I can have a look)
Hello Mark. Thanks you very much for your comments. How is beat to send a photo to you via email?
I can’t attach one writhing this comments box.
As soon as I send a photo you will see what I mean.
Many thanks Mike.
Facebook chat is the best way to go.
My abs are likely to come , but still I find my hips anteriorly rotated even if I tighten them .
I am Ronnie and suffering from APT too.
I also asked something to Mark but it went unreplied. I think he is not getting our posts .
Most patients we see are having a lateral pelvic til with symptoms more on the side of the hip hike. How do we ascertain the pelvic rotation component in such people?
What symptoms do you attribute to APT/PPT? Low back ache more in the centre? As one sided back pain (QL/ES) can be attributed to the LPT.
Generally speaking – Pure APT/PPT issues cause central or symmetrical issues.
One sided symptoms may be more indicative of frontal (LPT) and/or transverse plane (Pelvic rotation) issue.
I have three questions:
1) Is it necessary to warm up before stretches ?
2) Does foam roller help loosen up tight hips, and does it better than stretch ?
3) Can I do once a week quads, like leg press ?
1) It’s a good idea to warm up before stretching.
2) Foam roller is not necessarily better than stretching but it helps you cover all areas of the muscle that you might not get with stretching.
Thanks for the various descriptive posts. What is the difference between APT and Exaggerated Lumbar Lordosis? Also which condition is associated with the laterally outside bulging buttocks, usually seen in ladies, and how do we address them? Also the buttocks being protruded backwards?
APT refers to the forward tilt pelvis position.
The hyperlordosis refers to the arched shape of the lumbar spine.
They generally occur together.
In regards to buttocks that bulge to the side, this is characteristic of females as due to the structurally wider hips. Genetics, fat deposits and gluteal muscle size will effect it too.
I have APT all my life and I am now 22 years. I im doing your program about 8 months, but i dont see any progress. I found that i have motorical problem because i can get my pelvis in neutral position, and im doing much more abdomen exercises in hope that will help me fix it soon as possible. My abdoben stick out and i cant improve my planks more than minute and a half even if i doing them most of the day for long period. My abdomen have same shape from the beginning, nothing has changed.