Posterior pelvic tilt (PPT) occurs when your pelvis is tilted backward instead of maintaining a neutral alignment. Milder cases of PPT may go unnoticed, but in more extreme cases, the abnormal alignment of the pelvis can contribute to back pain and other musculoskeletal problems. Physical therapy is one way to help correct PPT.
1. Lifestyle Changes
Many issues of PPT that are not congenital or caused by disease or injury can be attributed to lifestyle. Living a sedentary lifestyle, especially spending long periods sitting, can contribute to changes in pelvis alignment. Committing to being more active each day may help correct some cases of PPT. In the beginning, you can spend five minutes each day walking and trying to maintain good posture as you walk. Over time, you want to increase your walking to 30 minutes, most days of the week. Another change that can be helpful is improving your posture while you are seated. Make sure you have chairs that are conducive to better posture, such as those with adequate back support. Generally, chairs that reach mid-back are preferred over high-back chairs.
An imbalance of tight and weak muscles also contributes to PPT. Regular stretching can help relax tightness in the glutes and hamstrings. Many of the exercises to help stretch your glutes can be cumbersome and difficult to perform if you do not have adequate flexibility. As an alternative, you might consider foam rolling your glutes to help with stretching. Stretching your hamstrings is a little easier. While lying down on your back, bring one leg up toward the ceiling. You can use your hands to help hold your leg up. Depending on how close you bring your leg up, you should start feeling a stretch in the back of your thigh. Repeat the stretch on the other leg.
The weaker muscles seen in PPT are the quads and psoas, but there may be some weakness in the lower back muscles. Different variations of the squat are frequently used to develop the quads. When you are just starting, you can simply use your own body weight. If you have issues with your knees, use a chair for support. Pretend that you are sitting in the chair normally, but as soon as you touch the chair, return to the standing position. As you build strength, you can try squatting low enough that your knees bend to a 90-degree angle and eventually add resistance, such as weights. Your psoas muscle helps you pull your knee toward your chest like when you go up a staircase. Using a stair climber is one way you can strengthen your posture, or you can simply mimic the motion while standing. Holding on to a chair or wall can help you with balance.
In many cases of PPT, making lifestyle changes so you are less sedentary, combined with exercises that specifically target certain muscles will improve PPT. Contact your local outpatient physical therapy clinic for more information.