The spine and pelvis are the foundation of the body. The pelvis attaches to the bottom of the spine and these two together are the attachment point for many different muscles in the body. When the pelvis is in a neutral (ideal) position, it helps support a healthy position of the spine. When the spine and hips are in proper alignment, the spine is shaped like a slight "S" from the lateral view and should be moveable, flexible, and functional. However, it is important to note that because everyone's body is different, the proper neutral position could vary a bit for each individual (1).
Because it is common for Americans to sit for extended periods of time and lead a sedentary lifestyle, many people suffer from a pelvis that is out of alignment from their ideal neutral position. Three common alignment issues are anterior pelvic tilt, posterior pelvic tilt, and lateral pelvic tilt.
Anterior pelvic tilt is when the pelvis tilts forward. The misalignment can create a visible excessive curve in the lumbar spine which presses the butt out and protrudes the lower abdomen. Although there is some question around all the muscles that are involved in anterior pelvic tilt (2), tight hip flexors combined with an imbalance in the posterior muscles surrounding the pelvis and core are considered to be contributors to (3).
Posterior pelvic tilt is not as common as anterior pelvic tilt but is just the opposite of anterior pelvic tilt. The pelvis becomes tucked under which creates a flat lumbar spine and buttocks region. Like the anterior pelvic tilt, it is thought to be caused by an imbalance in the anterior and posterior muscles surrounding the core and pelvis (2).
Typically, when one hip is higher than the other, an individual has lateral pelvic tilt. Like the other two pelvis tilts, this can be caused by a muscle imbalance but it can also be a result of scoliosis or a difference in leg length.
An individual can have one or a combination of these, which could cause a variety of issues.
The pelvis plays an intricate role in posture, movement, and athletic performance.
A pelvis that is out of alignment may contribute to:
back pain (especially in the lumbar region)
knee and hip pain
protruding stomach (lower belly)
irritation of the sciatic nerve
other problems throughout the kinetic chain
As fitness professionals, it is important to help guide clients back to alignment within the scope of practice or refer them to someone that can. Yoga can be an effective way to help them do that.
Yoga has been around for thousands of years and one of the reasons it remains today is its many benefits to the human body.
Yoga can help individuals become aware of their thoughts, emotions, breath, and body. The presence, stillness, and focus required for many yoga postures can help clients tune in to how they move, where they hold tension, and where they have pain. Seeing and feeling the imbalances in posture and movement can initiate correction much like passing a mirror and noticing hunched shoulders can help trigger a conscious posture correction. The body is great at telling us what it needs, we just need to do a better job of listening.
Many times, imbalances in the body are caused by imbalances in opposing muscles. One muscle is typically tight (shorter in length) and the opposing muscle is stretched (longer in length). To help combat this, typically the lengthened muscle needs to be strengthened and the tighter muscles need to be stretched.
Many people think yoga practice is just stretching and flexibility. However, yoga is an incredible way to not only help increase flexibility but also increase strength. As a fitness professional, helping clients with the appropriate postures to help them stretch tight muscles and strengthen weaker muscles can help their body shift back into alignment.
When the position of the pelvis is altered, it can cause pain in a variety of different areas of the body. Because so many muscles are connected to the pelvis and spine, any imbalance in that region has a domino effect on the rest of the body. The body adapts to repetitive movements and postures. For example, the more an individual sits the likelier it is for them to have tight hip flexors. If the individual sits for long periods of time, the hip flexors are in a shortened position for most of the day.
Sometimes the slightest postural deviations can cause pain in other areas of the body which can make it difficult for someone to associate with the root cause. This means that the pain an individual feels is not always where the actual problem lies. For example, if one hip is higher than the other, this could cause uneven shoulders. Over time, this compensation can cause pain in the neck and shoulders.
Imbalances in the body are often a precursor to injury. A compressed spine is many times a concern with pelvic tilt. The spine helps absorb shock and when the spine is compressed, it reduces the range of motion and can put increased stress on the vertebrae and surrounding tissue (4). If the body is in an altered position and weight is added, speed is increased, or additional stressors are added even the smallest imbalance can turn into a significant issue.
When working with clients, it's important to help them understand that the goal is not to see how far they can stretch. The goal is finding alignment within the posture and stretching or holding in the correct position. The postures that will be most beneficial to a client will depend on their current pelvic alignment. However, there are many yoga postures that, when done correctly, can help support pelvic alignment.
Here are a few to consider:
Mountain Pose - helps the client find neutral pelvic alignment
Warrior Pose - helps open the hip flexors
Pigeon - helps relieve tension by stretching the hips and buttocks
Child's Pose - helps stretch the ankles, thighs, and hips
Pelvic tilt and muscle imbalances occur in many clients these days. Yoga has many benefits that can help guide clients to better alignment so that they can move, function, and perform better. And remember, it isn't just doing the yoga pose that supports alignment, it is important to do the yoga pose the right way.
Are you interested in learning more about yoga and how you can incorporate it with your clients? Check out ISSA's Certified Yoga Instructor course. The course is designed specifically to help personal trainers, group exercise instructors, and other fitness professionals learn more about yoga—its benefits and how to teach it to your clients.
Preece SJ, Willan P, Nester CJ, Graham-Smith P, Herrington L, Bowker P. Variation in pelvic morphology may prevent the identification of anterior pelvic tilt. J Man Manip Ther. 2008;16(2):113-117.
Takaki S Ms Pt, Kaneoka K PhD Md, Okubo Y PhD Pt, et al. Analysis of muscle activity during active pelvic tilting in sagittal plane. Phys Ther Res. 2016;19(1):50-57. Published 2016 Nov 29.
Lowe, Whitney. Hip and Pelvis chapter in Orthopedic Massage (Second Edition), 2009
Sahrmann S: Diagnosis and treatment of movement impairment syndromes. New York: Mosby, 2002