Why Hip Position Matters, Part 1: Posterior Pelvic Tilt
Updated: Aug 31
Ah, the hips. Where would human movement be without them?
Sitting right at the crossroads between the upper and lower body, the hips do far more than simply move your legs. They play a central role in how forces travel through the body and how we organize movement from the ground up.
Every time you walk, squat, climb stairs, run, or simply stand upright, your legs, pelvis, and spine have to work together. The pelvis serves as an attachment point for muscles coming from almost every direction. Some connect it to the spine, others to the femur, and still others to the rib cage. As those muscles pull on the pelvis, they influence its position and, consequently, the position and mechanics of the joints above and below it.
Pelvic tilt itself is completely normal. Your pelvis should be able to tilt forward, backward, rotate, hike, and move as you move. Problems begin to arise when the pelvis becomes chronically biased toward one position and the rest of the body repeatedly has to organize itself around that position.
In other words, where the pelvis goes, the rest of the kinetic chain follows.
In this three-part series, we’ll look at what happens when the pelvis becomes chronically biased toward different positions, starting with the posterior pelvic tilt.
Posterior Pelvic Tilt
Let’s start by tilting the pelvis backward.
A posterior pelvic tilt happens when the front of the pelvis rotates upward while the back rotates downward. An easy way to picture this is to imagine tucking your tailbone underneath you or gently pulling the front of your belt buckle up toward your ribs.
As the pelvis rotates backward, the lower back follows along and its natural inward curve begins to flatten. Because the pelvis and lumbar spine are mechanically connected, a change in pelvic position inevitably influences the position of the spine above it.
None of this is inherently bad. Posterior pelvic tilt is a normal position that the pelvis should be able to move in and out of. The problem starts when the pelvis spends so much time there that the muscles surrounding it begin adapting to the position and movement in the opposite direction becomes more difficult.
Muscles Involved in Posterior Pelvic Tilt
Several muscles can contribute to posterior pelvic tilt depending on the position of the body and which structures are fixed. Some of the major players include the abdominal wall, including the rectus abdominis and internal and external obliques, as well as the hamstrings and gluteus maximus. Portions of the adductor group and other muscles surrounding the hip can also contribute depending on the position of the body and how the pelvis is being loaded.
Over time, the muscles can begin adapting to the positions in which they’re repeatedly held. The muscles held in a shortened position can become chronically short, while the opposing muscles held in a lengthened position can become chronically long. As these adaptations develop, the posterior tilt can become increasingly difficult for the body to move out of.
How Chronic Posterior Pelvic Tilt Affects Movement
Once the pelvis becomes chronically biased toward a posterior tilt, the issue is no longer limited to the muscles surrounding it. Remember, the pelvis sits between the spine and the legs, so changing its resting position changes the starting position of the joints connected to it.
Above the pelvis, the natural curve of the lower back becomes flatter. Below it, the hip sockets rotate along with the pelvis. As the pelvis tilts backward, the hip sockets become oriented more upward and backward relative to the femurs. This changes the relationship between the hip sockets and the heads of the femurs, giving the hips more room in some directions while taking room away in others.
The body will still find a way to move, but it may have to borrow movement or redistribute force somewhere else to do it. Over time, these compensations can place additional stress on joints and tissues that weren’t originally responsible for the pelvic position.
This can contribute to low back discomfort, restricted hip movement, and persistent tension through the hamstrings and glutes. Depending on how the body compensates, symptoms can also appear farther up or down the kinetic chain.
The posterior tilt itself was never the problem. The problem develops when muscular adaptations make that position chronic and the rest of the body has to continually compensate around it.
The Bigger Picture
Understanding these relationships gives us a much better picture of why an ache or restriction may involve more than the area where we actually feel it. When the pelvis changes position, the effects don’t necessarily stay at the pelvis.
In Part 2, we’ll flip the pelvis in the opposite direction and look at anterior pelvic tilt, the muscles that contribute to it, and how that position can affect the body when it becomes chronic.
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