Low back pain is one of the most common musculoskeletal diagnoses in the world. The low back is typically considered the lumbar spine region, but it is also important to remember the pelvis and the hips influence motion at the low back. After an injury or experiencing pain in this region, motion in this area can get, ‘out of whack’ and you may feel like your alignment is off or your pelvis is tilted too much. This can lead to changes in body awareness and as a protective mechanism, the body may move in a more rigid pattern, thus less dissociation from joint to joint. This can lead to someone having difficulty with performing and controlling pelvic tilting. In these scenarios, you have to go back to the basics to retrain the foundations for healthy movement and improving body awareness. This article describes exercises that will help you fix your pelvic tilt!

 

Intro To Pelvic Tilting

The lumbar spine articulates with the sacrum and pelvis, which collectively is the lumbopelvic region. Learning how to dissociate movement in this region via pelvic tilting can really help someone with body awareness as well as someone who is experiencing low back pain or discomfort. We always want to promote motion, but we want to learn to control that movement. Learning how to perform pelvic tilting can be challenging, but laying flat on your back is a great place to start. When trying to teach someone a new movement, you want to limit the degrees of freedom. Supine (laying on your back) is excellent because the upper body is supported and there are fewer moving parts. 

Supine Pelvic Tilt

Sample Low Back [P]rehab Program Video

  • WHY: This exercise will help you to learn low back and pelvic body awareness. Learning body awareness in these regions is important when trying to manage pain now and in the future. This exercise also promotes motion in this region and can help with stiffness and spasms.

 

  • HOW: Get set up laying flat on your back with your knees bent and feet supported on the ground. Place your hands on your hip bones to help with learning body awareness. Now perform a posterior pelvic tilt followed by an anterior pelvic tilt.

 

  • COMPENSATION: Do not overarch your lower back, after you perform the posterior pelvic tilt let your low back naturally move into an anterior pelvic tilt by relaxing your muscles. The movement should come just from your stomach and hip muscles, not your low back!

 

Master Pelvic Tilting With Our Low Back [P]rehab Program

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The pelvis and our lumbar spine must work with one another for optimal movement. Our low back program can help you synchronize movement through these two important areas of the body. No matter how long you have suffered from back issues, it is never too late to start feeling better. We get it, we have dealt with low back issues too! The Low Back [P]Rehab Program is a physical therapist-developed, step-by-step program that blends exercise science, current evidence, our clinical expertise, and our personal experiences to provide you with the ultimate solution! Learn more HERE! 

 

Fix Your Pelvic Tilt: Cat Cow Exercise

The cat cow is another great way to feel the proper movement of the pelvis and spine in a quadruped position! We will talk more about the quadruped position next.

Cat Cow

This exercise will help with learning back and pelvic body awareness as it promotes the global mobility of these regions. This exercise also provides the opportunity for your back to get comfortable with moving in and out of your spinal flexion and extension range of motion. Get set-up on your hands and knees. While keeping the rest of your body still, round your entire back followed by slowly arching your entire back. When you round your back, you should feel like you’re pushing your chest away from the ground by pushing through your hands. You should also be performing a posterior pelvic tilt with rounding your back, thus your back looks like an angry cat. When arching your back, you should feel like your chest is dropping towards the ground, but you don’t want to bend at your elbows, keep your arms straight. You should also be performing an anterior pelvic tilt by arching your back, thus your back and head make the shape of a camel. Follow the video for other cues and tips.

How To Fix Your Butt Wink

Butt winking with squatting may be a result of poor lumbopelvic movement coordination. Is butt winking ok? What are ways I can fix it? Watch our youtube video to learn the answers to these questions!

 

Quadruped Rocking

The next progression for pelvic tilting is moving to a quadruped position on your hands and knees. This is also a great exercise prior to squatting as it limits the degrees of freedom at the ankle and knee. This will promote optimal motor learning directed at maintaining the right pelvic tilt position prior to standing squats. To learn more about motion at the ankle, which also influences the squat depth in a great way, read this article below on ankle dorsiflexion. 

READ: THE IMPORTANCE OF ANKLE DORSIFLEXION FOR SQUAT DEPTH

ankle dorsiflexion the prehab guys fix your pelvic tilt squat depth

 

The focus here is to move through hip joint range of motion without excessive pelvic motion. It is important to know anatomy and lifestyle will influence how much motion someone has in this area. This may be influenced by structural anatomy, learned movement strategies, or previous injuries. In this video, we are EMPHASIZING keeping the low back still! Appreciate the movement in the first two demonstrations, followed by excessive posterior pelvic tilt and excessive lumbar extension.

 

Quadruped Rock Back

This exercise will teach you how to maintain a neutral or straight low back as your move your hips and shoulder. This is key as you get in and out of a chair, perform squats, and walk up and down stairs. Learning how to keep a neutral spine will help protect your back. Begin this exercise on your hands and knees in a tabletop position. First, find a neutral low back and pelvis, you can arch your back and tuck your tailbone to find a neutral position. While maintaining this neutral position rock back towards your lower body. Rock back as far as you can until you feel like your low back is rounding or your tailbone is tucking. At first, it may be beneficial to use a mirror as a visual cue to assure you are performing this correctly. This is a control exercise, and you won’t feel much. Your core muscles will be activated to maintain this neutral position.

LISTEN: How To Prevent Low Back Injuries With [P]rehab

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The Bird Dog Exercise

The next progression for lumbopelvic dissociation and pelvic tilting is learning to maintain a neutral spine while moving your arms and legs. The bird dog is a staple low back rehab exercise as it focuses on improving body awareness and strengthening the leg muscles and back muscles. Watch the video to see different variations of the bird dog and focus on quality versus difficulty. The goal is to be able to move your arms and legs without your back moving too much!

Bird Dog

Sample Low Back [P]rehab Program Video

Begin on your hands and knees. In this position, you will balance on the opposite arm and leg. The wider you are the easier to balance, and the more narrow the more challenging this will be. Bring the arm and leg up as high as you can towards the ceiling, slowly return to starting position and repeat on the other side. With the leg kicking out you will feel the muscles on the back of the hip working, with the arm that is punching out you will feel the muscles on top of the shoulder and back of the shoulder blade working. Avoid rotating the trunk, arching the back as you raise your leg, or shrugging the shoulder as you raise the arm.

 

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Bird Dog Progressions

Mastered the bird dog? Try these progressions! Each of these variations will challenge you to utilize your core stabilizers even more while maintaining a neutral spine.

 

Bird Dog – Band

 

Bird Dog – Foam Roller

Sample Low Back [P]rehab Program Video

 

Closing Thoughts

Does every single person really need to fix their pelvic tilt? This is a highly debated topic that we plan to cover more as it requires more discussion. Please leave comments for us to help us with what you want to learn when it comes to fixing pelvic tilt! We hope this article has provided you with exercise variations to fix your pelvic tilt. The key is to start with the fundamentals, and progress to other positions once you have mastered the basics! Do not be discouraged if it takes time for you to begin appreciating a pelvic tilt. Just like anything else, practice and many repetitions will help you master the movement!

 

Bulletproof Your Low Back Today!

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Rising rates of low back pain are keeping individuals sitting out instead of partaking in meaningful activity. This is not the future for you, the future for you consists of optimal back health by creating a rock-solid core, establishing hip mobility and strength, and overall confidence in your ability to move! Take ownership of your low back today HERE

 

REFERENCES

1. Pirouzi S, Emami F, Taghizadeh S, Ghanabari A. Is Abdominal Muscle Activity Different from Lumbar Muscle Activity during Four-Point Kneeling? Iranian Journal of Medical Sciences. 2013; 38(4): 327-333.

 

About The Author

Craig Lindell, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Content Officer

craig lindell the prehab guysCraig is a South Jersey native & Penn State Kinesiology Alumni. When the opportunity came, Craig packed his bags and drove to California to pursue his Doctorate in Physical Therapy from the University of Southern California. With [P]rehab, Craig oversees all digital content creation and multi-channel publication that reaches millions of people on a weekly basis. As a PT, Craig has a wide array of experience from working with various neurological conditions to working with collegiate & professional athletes across the Big Five in North American sports. Experiencing physical therapy first-hand as a soccer player in high school, Craig has a passion & special interest in adolescent athletic development working with young athletes to overcome injuries. In his spare time, Craig enjoys exercising, playing golfing, hiking, traveling, watching Philly sports, and spending quality time with his family.

 

 

 

 

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

About the author : Craig Lindell PT, DPT, CSCS

5 Comments

  1. Andrius March 10, 2017 at 9:09 am

    No comment, just 10×10 and I know who I talk…

  2. Risa Booze January 17, 2018 at 12:35 pm

    This was part of the Bird Dog explanation. I’ve never thought of multifidus and obliques as rotators. Can you elaborate? I’m not a PT so it may just be vernacular differences.

    “one must rely on their rotators such as Multifidus and Obliques to keep the low back aligned.”

    • Michael Lau February 24, 2018 at 11:31 pm

      Essentially those muscles also rotate the spine, specifically at certain levels. Just getting into the nitty-gritty is all!

  3. Alec December 31, 2018 at 5:41 pm

    This is great. I have difficultly performing the pelvic tilts supine. When would it be a good time to start progressing ? Wait till I feel confident with the pelvic tilts in supine I guess ? This helps my back pain as well. My pelvis has forgotten to move lol…which impacts higher level activities at the gym like deadlifts etc. Any tips to rehab this would be appreciated

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