What does ‘Anterior Pelvic Tilt’ look like?

​Anterior pelvic tilt (ATP), excessive lordosis, is a noticeable curving inward of the spine. APT can be easily assessed by observing a persons posture while standing or during a squat assessment. If the individuals’ torso pokes out and butt perks up (creating a rounding/dip in the lower portion/lumbar spine) then this is an sign of excessive lordosis. This position can possibly effect an individuals squat technique due to muscle weaknesses and tightness or in some cases can involve a combination of under and over active muscles along with not having learned proper squat technique.

It should be noted that many people have ATP naturally and it does not cause them any pain or issues. To a slight degree ATP is a natural anatomical position of the human body. The purpose of this article is to analyze and address this position if you or a client are experiencing side effects or strength performance and output discrepancies due to an excessive arch of the lumbar spine and hip flexion.

​I love the illustration of visualizing your pelvis as a bucket of water with the goal of not letting it spill. The optimal position to aim for is a neutral spine, keeping the bucket (or pelvis) balanced. Therefore, if your pelvis is a bucket full of water that you don’t want to spill, then you can’t tip your pelvic too far forward (anterior pelvic tilt) or too far back (posterior pelvic tilt).  This info-graphic below by Eugen Loki (Instagram: @pheasyque) shows this visual cue fantastically. 

​Assessment

The Overhead Squat Assessment (OSA) is a go-to for coaches when evaluating a new client. Its purpose is to help find abnormalities in movement patterns, muscular imbalances, and assist the coach in implementing the right interventions in their clients program to correct any of these possible issues.
During an OHSA, APT can be identified if the details previously mentioned (excessive flexion of the hips and extension of the lower back) are observed and interventions can then be used to help correct this dysfunction.
The OHSA is also a great tool to come back to after using interventions to see potential progress in a previous dysfunction(s) or to analyze if any other abnormalities are occurring. 

​What muscles are short/over-active and long/under-active with APT?

APT causes a number of over-active muscles as well as weak muscles. If your spine is not acclimated to maintaining a neutral position then there will be muscles involved in pulling it into that position (short/over-active) and opposing/antagonist muscles that are long and under-active (weak) from being under utilized.
The muscles that are too tight from being in an excessive position are the muscles involved in lumbar extension and those make up the hip flexors. Muscles that become lengthened and weak from excessive lordosis are core/trunk flexors and hip extensors. 
Among the reasons this dysfunction is an issue worth correcting is it negatively impacts posture, athletic performance, and force production; it increases back pain and/or causes low back fatigue; and it causes pain and discomfort in tight muscles. 

*For full list of muscles involved check out the first source at the end of this article 

​Cues & Progressions

​There are a number of ways a coach can go about implementing cues and progressions to help their client(s). What it ultimately comes down to is being able to communicate in a way they understand what is going on, what they are trying to achieve, and providing them the simplest of cues that they can visualize and feel to achieve the desired outcome.
The cues and progressions I will be going over and are examples of what I typically use on my clients who exhibit APT in a fashion I feel as their coach is needed to be addressed. These exercise selections and progressions have helped correct my APT clients whether they be a beginner needing slow progression and closer attention to detail, or advanced lifters needing just a warm up into more optimal movement patterns for their mechanics before performing main lifts.
Band or PVC Pipe Overhead Box Squat (Start with a parallel box and progress to slightly lower then parallel), Band/PVC OHS

  • Cue client (or self) to keep band over shoulders behind head and simultaneously pull belly button in and tuck butt in.
  • Have client keep this position throughout the decent and accent of OHBS, reminding them at the box to clinch their core and glute in so it remains in position as they return to standing position.
  • At the bottom of the squat, tell client to push hips forward out of the squat rather than lift them up.
  • Once clients technique improves in the box variations, apply same principles and cues without a box. This variation may initially cause them to reflexively resort back to old habits due to not having a box for reassurance, so stay patient and continue to give them cues where needed.
  • Make sure to limit repetitions at first as fatigue will also cause client to lose both form and focus.

Once the parallel box squat then low box squat are completed with good technique and the client understands what to feel for throughout the movement they can progress to the next exercise.

Goblet Parallel-Low Box Squat, Goblet Squat

  • Keep same cues in mind while coaching client through a goblet box squat followed by goblet squat.

Adding load to the front will be an easier first progression than going immediately to a back loaded squat due to tendencies in arching the lower back during back squats. Fixing these tendencies and reflexes will be far more achievable the more simple and gradual the exercises are until APT isn’t nearly as (if at all) prevalent.

Banded Good Morning
I love using a banded good morning as the next progression before introducing the client to deadlift variations. In this exercise the client has to perform a hip hinge without arching their lower back.

  • Have client stand in front of a bench or box just under the height of their knees.
  • Instruct them to engage their core and glutes just as they have practiced in previous progressions.
  • Tell them to now sit back pushing their hips toward the wall behind them and explain that their knees should remain vertical to their ankles (purpose of the bench or box being placed in front of them -to prevent their knees from going past it), unlike a squat when their knees drive slight forward after the break at their hips.
  • To come back to the initial standing position, cue client to squeeze glutes and drive them forward through the same path they took to get into the hip hinge, as they drive their chest up toward the ceiling.


DB Farmers Carry

  • Instruct client to focus on keeping trunk and glutes engaged envisioning a neutral/straight spine, as well as rotating their shoulders back and down to activate their lats (a prime muscle involved in lumbar extension) as they walk down the room or on a treadmill holding a dumbbell in each hand.

This exercise will help reinforce a neutral spine and pelvis during standing and gait/walking.

The remaining progressions can follow those listed above as you or your client show signs of maintaining a neutral spine during standing, gait (walking), and performing the squat and hinge movement patterns.
Hinge Progressions:

  1. Kettlebell Conventional Stance Deadlift from Low Box
  2. Single-Double KB Conventional Deadlift
  3. Barbell Conventional Deadlift

Squat Progressions:

  1. Time Under Tension Goblet Squat Variations: Tempo, Pause, 1.5, etc.
  2. Barbell Parallel-Low Box Squat
  3. Barbell Front Squat
  4. Back Squat
​As mentioned, depending on the extent of the dysfunction, progressions can be taken slowly to focus on executing technique in both strength training and functional movement skills in day to day life, or if the client is more advanced, selecting a few progressions to be used as a warm up to reinforce correct movement patterns before the lifter begins their main programming. 

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