Anterior pelvic tilt has been written about on strength training websites for well over 10 years.

It was once taken as an article of faith that the seemingly tight muscles associated with the anterior tilt were also the cause.

But through the work of the Postural Restoration Institute, we now know this was a complete misunderstanding of the situation.

Quite simply, the hip flexors, in particular the psoas, are not the muscles that cause the anterior pelvic tilt!

However, they do tend to get over-active when an anterior tilt is already there.

But this over-activity is compensatory activity brought about by the position that the pelvis is already stuck in.

Once the pelvis is forced into a position that it can’t get out of, muscles are bound to get overactive. These muscles are often the hip flexors and lower back muscles.

But again, these muscles don’t cause the tilt.

It is the overwhelming size and strength of the right diaphragm, compared to the left diaphragm, that causes an anterior pelvic tilt.

The pull from the stronger right diaphragm, 23,000 breaths a day, over time rotates our lower spine to the right.

This starts the process of the pelvis getting stuck anteriorly.

As the rotational force from the right diaphragm continues unabated, the left side obliques, that should provide opposition, are not able to do so because they have less help from the smaller left diaphragm.

When support for the left side of the pelvis is reduced from above, the left hamstring also gets challenged from below.

At some point the muscles that support the left side of the pelvis in the stance phase of walking can no longer stabilize it or move it posteriorly.

Thus it gets stuck in an anteriorly rotated position.

The video below shows how the larger right diaphragm puts you into the anterior pelvic tilt, which is called the left AIC pattern.

The Diaphragm, Psoas, Illiacus, QL Connections

The traditional answer for how to fix an anterior pelvic tilt has always been the same old refrain.

Stretch the hip flexors, strengthen the hamstrings and abs. And by hip flexors, it usually meant the psoas.

Sometimes people would get lucky and get some relief through stretching.

Yet the strategy rarely worked long term. I was one of those people that had some success in the short term but nothing seemed to stick in the long term.

The following video should demonstrate why trying to address an anterior pelvic tilt through stretching a psoas is usually ineffective. You can fast forward to 2:08 in the video and hopefully discover…..

  • The illiacus (a hip flexor) is continuous with the quadratus lumborum. The QL, considered the most posterior abdominal muscle though often thought of as a lower back muscle, is often overactive and painful in both anterior and lateral pelvic tilts.
  • Pay particular attention to the fact that the psoas and the diaphragms (plural) are completely inseparable. They are essentially the same muscle. As the anatomist pulls on the psoas, the diaphragm moves, too.
  • So the psoas, illiacus, QL, and diaphragm are all basically one functional unit. I find it ironic that only the first three muscles are talked about in anterior pelvic tilt, yet it’s the diaphragm that actually causes it! Virtually no one, besides the Postural Restoration Institute talks about restoring proper position and function of the left diaphragm. But that’s what needs to be done.

The Solution

The real solution, the only thing that truly lasts, is to treat an anterior pelvic tilt like the total body issue that it is.

That means you don’t try to isolate one muscle, such as the psoas, and try and massage it or stretch it.

Muscles don’t exist in isolation. Muscles move and contract with other muscles. Proper pelvic position is established by chains of muscles working together.

The only thing you can do is re-orient and strengthen the position of your pelvis into Left AF/IR……..

WHILE integrating proper breathing to regain your left ZOA. 

Fortunately virtually all PRI exercises are designed to restore proper position of the pelvis through exercises that re-set neurological, muscular, and respiratory activity.