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’. 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 three exercises to help retrain low back movement and pelvic tilting.
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 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 less moving parts.
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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.
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.
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!
Learn More Low Back Exercises
Learn more low back exercises by visiting our exercise library, specifically click on tags including low back, core, paraspinals, and more!
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.