What to Do with Anterior Pelvic Tilt AND Disc Herniation!
Welcome back!
Pelvic Tilt Measurement
A common email question I receive is about measuring pelvic tilt. The best way to measure pelvic tilt is with a specialized set of calipers that were developed by neuromuscular therapist Paul Chek. These can be quite pricey, and are only usually found in the offices of skilled therapists.
The other way to measure pelvic tilt, which is quick, cost-free, and easily done is home is by looking at your belt line in the mirror. Usually, the front of your belt line rests either slightly above, or slightly below the Anterior Superior Iliac Spine, which is the small bony protuberance just above your thigh. The backside of your belt line usually rests again just above or below the Posterior Superior Iliac Spine, which are found about 2 inches to the side of the spine.
When you look in the mirror at your side view, you will look at the angle of the belt line. For men, the line should be parallel to the ground, with neither the front or the backside higher than the other, with normal measuring 0-5 degrees. For women, the angle should be slighter lower on the front side than the backside within approximately 7-10 degrees being normal.
It is important to note, that these are the “textbook” normal values for pelvic tilt. It should not be the ONLY evaluation for normal function and balance of the core muscles. You should also evaluate the range of motion and strength of all the associated muscles in order to really test total function of this area. You do NOT have to be perfect, but close enough to be out of pain!
Sam Visnic–
Massage Therapy…Relax Your Way To Relief!
One of the back pain relief methods that I subscribe to most is definitely massage therapy. Massage has a very nice list of benefits to your back, including:
1. Improving circulation throughout your body.
Massage can reduce ishemia (lack of blow flow), which improves the endurance of your muscles, and thus their job of stabilizing your lower back. Move blood flow and endurance equals less pain!
2. Reducing or eliminating adhesions and scar tissue.
Both adhesions and scar tissue in muscles cause decreased blood flow and decreases strength. Massage therapy is an effective method for reducing these that may be found in your back muscles.
3. Improving muscle imbalances.
Massage therapy, when applied to your unique muscle balance, is very effective. When you relax your “tight” muscles, such as the psoas (hip flexor) and quadriceps (front of thigh) can reduce anterior pelvic tilt.
Bottom line…..Massage Therapy = Less back pain!
–Sam Visnic
How To Measure Anterior Pelvic Tilt and Posterior Pelvic Tilt
How To Improve Lower Back Stability
The term “stability training” has been thrown around quite a bit in the last couple of years, as the fitness community has gone core training crazy. The problem is, however, most of the gimmicks being used for this so called stability training are simply entertaining at best, and unfortunately do not produce the kind of results that they are believed to.
The Issue of Stability:
Lower back stability, as well as stabilization of all joints in your body, is dependent first of all on optimal muscle balance. When muscle imbalances are present, meaning one muscle is stronger than its antagonist, the joint involved becomes distressed as it fights to maintain its homeostasis.
For example in the lower back, two muscles that have a relationship include the abdominal muscles, and the back extensors. The abdominals have the job of flexing the spine, which flattens the lower back, while the extensors extend the spine, creating an arch in the lower spine. More often than not, the spine has an excessive arch due to the prevalence of anterior pelvic tilt, particularly in the back pain population. This leaves the abdominal muscles in a “lengthened” state, and usually test weak.
In this situation, the lack of balance between the muscles that flatten and extend the spine creates a potential state of “instability” in the spine. It is a relative state, in that you may be stable picking up the newspaper in the morning, but when it comes to more intense efforts, such as playing a pickup game of basketball, or tennis, the instability becomes much more of an issue.
Correcting this stability issue involves identifying the weak muscles, which in this case would be the abdominals, and identifying the tight muscles, which again in this case may include the lower back muscles, and providing appropriate corrective procedures such as exercise and stretching.
The actual selection of exercises to do this would include the ones that work best to strengthen that muscle. If the abs are weak, then performing variations of the plank and/or crunch, will serve to strengthen them, and thus reduce the imbalance relative to the lower back muscles.
Corrective procedures must follow some form of flow, and make sense. Something more therapists need to be aware of, before starting to jump on the “core stability bandwagon”.
–Sam Visnic
Why Do So Many More Back Pain Sufferers Have Anterior Pelvic Tilt Than Posterior Pelvic Tilt?
Without a doubt, there is MUCH more anterior pelvic tilt amongst back pain sufferers than posterior pelvic tilt.
Why you may ask?
Well, because your body operates in such a way where it has groups of muscles that operate together when certain factors are present. Say, for example, when you go into “fight or flight”, your chest sinks as your upper abs tighten, the back of your neck and upper shoulders tighten, all with the purpose of protecting vital organs.
In the pelvis, the muscles that shorten and increase tone when you are under stress include:
1. The Psoas
2. The Quadriceps
3. The Adductors (groin muscles)
All 3 of these muscles contribute to anterior pelvic tilt! Now, interestingly enough, a smaller percentage of the population goes the OPPOSITE direction when they get stressed! They actually go into posterior pelvic tilt.
So, what is the difference between the two? What makes someone go into anterior versus posterior pelvic tilt, particularly when stressed? In my experience, postural imbalances are HIGHLY correlated with psychology, and particular characteristics within that realm.
But…thats another blog post!
–Sam Visnic
The Best Back Pain Relief Exercise
One of the very best back pain relief exercises involves one the most commonly underdeveloped muscle groups.
Which muscle group would that be?
Your GLUTES!
That’s right…those huge lumps of muscle that most of us sit on all day long. You know, I was thinking, maybe thats why there is SO MUCH back pain out there…
Our butt muscles are starting a civil war with our backs because we sit on them all day!
lol…maybe not! 
Anyway, squeezing your butt muscles together may very well be the best back pain relief exercise available. This helps alleviate back pain mostly because the majority of the population has an excessive anterior pelvic tilt. If you remember correctly from my previous posts, this postural imbalance involves the pelvis tipping too far forward, and involves too much tension in the psoas and quadricep muscles. Alternately, the abs, hamstrings, and glutes are thereby “weakened”.
So, if your back is bothering you when standing, put a little squeeze in your glutes (don’t worry, no one will notice unless they are staring at your ass!), and that may bring you some relief!
By the way, you don’t need to squeez the life out of them to get relief, just about a 25% squeeze will do the trick!
–Sam Visnic
The 3 Major Body Centers That React To Pelvic Tilt
Excessive pelvic tilt, whether that be anterior or posterior, is by far the most destructive imbalances that can happen in the body. It can create imbalances as far down as the feet, and as far up as the neck and even eyes.
The cool part is, MOST of the time, correcting just the imbalances in the pelvis will improve other far reaching problems in your body, however, sometimes, you need to look elsewhere.
The 3 major body centers that exist include:
- The head-neck-jaw complex: These three structures are essential for human survival. Think about it, if you lived 10,000 years ago and could not keep your eyes or ears level with the horizon, you would not be very efficient at escaping predators. Just as important, if your jaw was out of alignment significantly, you would not be able to chew, and that would certainly lead to death.
- The pelvic complex: The pelvis and the hip joints work together to create stability and balance to the center of the body, as well as generating movement. Based on what the head-neck-jaw complex is doing, this area will reflexively coordinate with it. The pelvis is far lower on the survival needs list. With a dysfunctional pelvis, one could live to perform daily functions.
- The foot-ankle complex: This area provides essential information to the brain about ground forces, how to react, and other key reflex features. When the foot and ankle is imbalanced, ground forces cannot be distributed correctly throughout the body. It is well known in therapeutic circles that imbalances in the feet may contribute strongly to unresolved neck and pain.
Sam Visnic–
Question: Pelvic Pain
How Your Abs Affect Lower Back Stability
You hear it time and time again….
“You have to strengthen your abs to get rid of pain in your back.”
I think thats pretty good advice…BUT…NO ONE tells you exactly how to do that! I’m going to let you in on a little secret:
DOING CRUNCHES WILL NOT HELP YOU OVERCOME BACK PAIN!
Yep. Thats right. Why? Simple.
How do most people, including those with back pain, stand? You guessing it, with pretty crappy posture. The chest is sunken, complete with forward head posture, and a pelvis that has a massive anterior pelvic tilt.
When the chest drops, and the shoulders round, commonly called a “upper cross syndrome”, then the upper portion of the abs are shortened, and usually tight. The lower portion of the abs, are usually weakened. (Yes, you do have lower abs, but not how you think, the muscle is separated NEUROLOGICALLY). The external and internal oblique muscles are usually the ones taking a nap. These muscles are responsible for the posterior tilt of the pelvis, which goes hand and hand with flattening the curve of the lower back.
If you look at the position you are in during a crunch, and and stand up from there, what do you get? Exactly…shitty posture. Sunken chest, etc. What I am saying is that performing crunches for the majority of the back pain suffering population will make MANY people much worse off.
What you NEED to focus on is strengthening the abdominal muscles which are primarily responsible for posteriorly tilting the pelvis, which are the obliques.
So…you may be wondering, “how the heck do I do that?”
Learning pelvic tilting, of course!
I’m going to shoot a few short clips with my cool little Flip video recorder this weekend, and I’ll post them up in a few days.
–Sam Visnic
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"Having someone like Sam to refer my patients to who is as comprehensive, brilliant and caring as he is makes my job so much easier!! I feel assured that my patients are in good hands and are going to get the results they so desperately want. I highly recommend Sam to anyone who is looking to resolve their back pain easily and effectively!”
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HealthSource Chiropractic and Progressive Rehab