Pelvic tilt exercises can be confusing for many lower back pain sufferers. Questions such as: which direction of pelvic tilting is right for me, how far should I pelvic tilt, should I pelvic tilt on one side or both, how frequently and how many repetitions of pelvic tilts are needed, and should I use extra resistance to my pelvic tilt exercises are all essential considerations before you start any type of pelvic tilt exercise.
This article will help answer these questions, allowing you to get the most out of your pelvic tilt exercises, and avoid harming your lower back from inappropriate pelvic tilting.
Begin by comparing how the arch of your lower back affects your discomfort. In the standing position, lower your pubic bone and raise your tailbone to increase the arch of your lower back. This is known as anterior pelvic tilting. Try different amounts of this movement (ranges of motion) to determine if any degree of anterior pelvic tilting relieves your pain. Next, perform the opposite motion, lowering your tailbone (or tucking it under the center of your legs) and raising your pubic bone. This will decrease the arch of your lower back and is known as posterior pelvic tilting. Again, try different amounts of this motion to determine if any degree of posterior pelvic tilting relieves your pain. The direction and degree (how far you pelvic tilt) that best relieves your pain is most likely exactly what your lower back needs. This finding should of course be confirmed by your treating doctor or rehab therapist.
To determine if you will benefit from pelvic tilting on your right side versus your left, stand with one leg behind you and one leg in front of you. Try different distances of leg position. If your lower back pain is worse with sitting, scoot your hips to one side of an armless chair and allow one leg to drop off the side of the chair so your bent knee is behind your hip. Try this on both sides. Finally, pull one knee at a time toward your chest while lying on your back. If placing one leg behind you standing or sitting relieves your pain, anterior pelvic tilting on that one side will likely be beneficial for your back pain. If standing with one leg in front of you or pulling your knee to your chest relieves your pain, posterior pelvic tilting on that one side will likely be helpful.
The easiest way to perform pelvic tilting exercises is to do them while you walk. This makes exercise consistency and results easy, since it is a daily activity that you are already doing. If you need anterior pelvic tilting on both sides, simply hold your anterior tilt position as you walk, emphasizing the amount of leg backward motion more than leg forward motion with each step. This means that you will be leaving each leg behind you for a slightly longer period and trying to increase the distance that the leg travels behind you with each step. This will cause your opposite landing foot to strike the floor more equally on the entire sole (mid foot strike) rather than the typical heel strike. If you need anterior pelvic tilting on one side only, emphasize the backward leg motion on that side only with your walking steps. Always use a comfortable range of motion and begin with only 10 steps at a time, repeated 2-5 separate times each day. Increase the number of steps gradually over several weeks to months until you can perform 5 minutes of walking 2-5 times per day.
If you need posterior pelvic tilting, hold your posterior pelvic tilt position as you walk, emphasizing the amount of forward leg travel with each step. That may be as simple as stepping forward an extra inch or two compared to your normal walking form. In this case you will wind up landing more on the back of the heel with each step. If you need posterior pelvic tilting on one side only, emphasize the leg forward motion on that specific side. Be sure to use a comfortable range of leg motion and follow the same training schedule as already described.
Following these techniques will help to strengthen your pelvic tilting muscles to hold better spinal and pelvic alignment, which over time will decrease the stress imparted to your lower back and help heal your back pain. Extra resistance can eventually be used to further strengthen these muscles by tensing your abdominal muscles with leg forward motions as you walk for posterior pelvic tilt needs, and tensing buttock muscles on the side the leg travels backwards for anterior pelvic tilt needs.
Dr. Michael C Remy, DABCO, CCSP is a chiropractic sports orthopedist who specializes in custom walking exercises for back pain and spine rehabilitation. His Walk Away Back Pain™ Program offers simple and effective back pain solutions through improved walking movements and techniques.
Disclaimer: The Walk Away Back Pain Program™ and all North Shore Health and Fitness Associates, Inc. ebooks, video series and courses are for general educational and informational purposes only and do not replace professional medical advice. This content does not establish a doctor-patient relationship. Always consult with your own doctor before starting this or any new exercise program, or changing your diet or supplements, as these changes may be harmful to your health. Exercise and changing posture and movement patterns carries a risk of injury. You perform these movements, stretches and exercises at your own risk. Stop immediately if you feel pain, numbness, tingling, dizziness or shortness of breath during any exercise. Modify or skip any movement that causes discomfort. The author and publisher disclaim any liability for injury, loss, or damage resulting directly or indirectly from the use of this content. Results vary by individual, and no specific outcome or cure for back pain or any other musculoskeletal pain is guaranteed.