Do you have poor posture? Do you suffer from knee pain after exercise? Low back pain/weakness? Is your low back always sore or in pain after exercise? Today I want to address Anterior Pelvic Tilt (APT). I want to talk about how it effects resistance training, specifically deadlifts and squats. This is a very common fault I see, especially in women.
Anterior Pelvic Tilt (the guy in the middle above) may be to blame for your aches and pains. I've worked with a lot of people on this issue, more so in women since they tend to be hyper-mobile (super bendy). It's crucial to address and correct, especially when exercising and lifting weights. There are a lot of factors that contribute to APT and they need to be assessed and addressed. For some people, a certain degree of APT is OK but an excessive amount leads to big problems - poor lifting technique and increased risk for knee, hip and back injury. Having APT isn't a huge issue on it's own but when you're lifting weights, you can get into trouble. If you can't organize your body correctly when you're not exercising, how will you keep it together while fatigued and under load?
How do you know if you or someone has APT? Here are some visual cues.
- If you look at them from a profile view while standing, their pelvis is tipped forward. Think of your hips as a pale of water. Tipping that pale forward or backward causes the water to spill. We never want the water to spill.
- They have an increased curve in their low back. This makes their butt stick out (stop trying to fake an ass ladies) and their ribs poke out in the front as well.This is very obvious not only standing but in their deadlift and squat.
- A bulging abdomen. I'm not talking about fat here.. people can be very lean and have a bulging stomach.
What can cause APT?
- Lifestyle. Years of poor posture and APT..leads to more APT. Sitting in a chair, at a desk leads to APT. Sitting shortens the hip flexors, stretches the hamstrings and deactivates/atrophies the glutes. Your butt can quite literally turn into mush. When your butt stops working as it should, your low back takes the load to make up for it.
- Poor movement patterns. A lot of people aren't aware they have APT and have no idea how to brace themselves. They lack motor control.
- Musculoskeletal dysfunction. This is usually a by-product of the first two. You spend day after day, year after year in bad positions and using faulty patterns. You then develop joint and muscular dysfunction. People with APT often display weak/lengthened hamstrings, glutes, rectus abdominis and external obliques. They also tend to have strong/stiff psoas, illiacus, erector spinae, rectus femoris and tensor fascia latae. In lamens terms, all of the muscles that control the position of your pelvis are either weak, over worked or not working properly.
- Lack of knowledge. Some people simply do not know how to lift properly.
How do you fix APT?
- Lifestyle changes
- Stretching and soft tissue work to unwind/address tightness and tension
- Breathing technique
- Correct motor recruitment pattern
- Strengthening and building stability in the abdominals, obliques and glutes
Starting with lifestyle changes, over the years people have become more sedentary. They sit at a desk all day long only to go home at the end of the day to sit some more. I know we all can't help to sit at a desk for work but there are things you can do to help unwind that poor position.
1- Do what you can to get a stand up desk. Buy one. Ask your employer to help. See if insurance will cover/help with the cost of if you've been suffering from low back pain. Get a doctors note. This is your health and livelihood! Budget for one - get your priorities straight. Sitting is the WORST thing we can do to our bodies. It throws everything out of whack. If it's not possible to get a stand up desk (fight for one and start a trend at your office!) then you need to get up and walk around as often as possible. Stretch out your hip capsule, quads and hip flexors. Do some air squats. Move! Get your hips warm.
Seated Hip Capsule Stretch. Keep the back flat and lean forward. You should feel a very isolated stretch on the outside of your hip.
Kneeling Hip Flexor Stretch. The key here is to flatten out the lower back (no arching!) by squeezing your glutes. You'll also fire the anterior core muscles (think about keeping your ribs down). Tilt the pelvis under (posterior tilt).
Get in some air squats! And make them quality, organized squats. You need to train your body squat the same way, regardless if you're doing an air squat or you have 300Ibs on your back. Don't worry about looking like a jackass to your coworkers. You want to function pain free, right? Take care of yourself. Maybe they'll catch on :)
2- Soft Tissue Work - Years of poor posture and bad habits have built up some tough tissues. It may be beneficial to find a qualified soft tissue specialist to help remove scar tissue and adhesions from the tissues that have been over worked and compensating for faulty patterns and poor positiions. More than likely, your hips and hip flexors could use the work of a soft tissue guru to restore healthy joint and tissue function.
3- Breathing Technique - Most people don't realize that strength is a skill that is developed over time. Like any skill you acquire, it takes awareness and practice. Diaphragmatic breathing is crucial when creating stability. It is a skill you must master. I have an extensive blog post coming soon about this topic but for now, you can refer to this article.
4- Correct technique. Your breathing will aid in the correct movement pattern so be sure to read up on it. I want to focus on the deadlift and squat in this post. Many trainers harp on not rounding your back during these lifts, which is very important. But not enough trainers and coaches watch for (or even know) that lifting with excessive APT (and hyper-extended back) can be detrimental. The moment your pelvis tilts too far forward, you're essentially taking your glutes and abs out of the equation and placing sheer force on your lumbar spine (you're now hyper-extending at the low back). You're breaking at the spine instead of hinging at your hips. There is a very big difference. Trainers have developed an obsession of "reaching back" for squatting. Many people mistake breaking at the lumbar and APT for hip hinge. Whether you're squatting or deadlifting, I personally like the cue "keep your ribs down". This is done by firing the glutes and anterior core muscles.
Aside from this photo being ridiculous, I'd like you to focus on her spine (stay with me here). Do you see the excessive curve in her low back and her ribs poking way out in front? This is an example of initiating the squat with a hyper-extended lumbar spine and excessive APT. She's not just "reaching back" with her hips and hinging. She's placing the load on her spine, not her hips. This excessive APT and hyper-extension will become very apparent at the bottom and on the way up from the squat. This is dangerous. You're beating the crap out of your discs.
Same issue here with the deadlift. Another ridiculous photo but you get the point. Excessive APT and a hyper-extended low back. This is where being hyper-mobile (super bendy and flexible) is dangerous. You have no stability in these positions and it loads your discs excessively.
Ahhh :) Look at those neutral spines. Flat backs, everything is locked in place. Their hips are loaded and ready to extend. Ribs are down (meaning their abs and obliques are firing). This is how your spine should look during a deadlift and a squat (the back angle will vary based on the lift and squat variation -that's a whole other post).
In both the squat and deadlift, the low back should be as neutral as possible. Some people will have a slight APT and that's OK. But if you have a large curve in your back while lifting, it must be corrected. Get with me if you need help with lifting technique. I'm happy to help.
5- Strengthening and Building Stability- If you're well versed oh how to lift properly but you simply lack strength in the muscles that stabilize and move the pelvis, then you need to focus on building those up. Most people have weak abdominals (just because you're lean enough to see some abdominal definition, it does not mean they have the anterior core strength to create stability). They will also likely have a weak ass (or at least not know how to fire their glutes properly). Here is what I suggest you focus on:
- Master and build strength within the hip hinge. You can do this with PROPER kettlebell deadlifts, kettlebell swings (stop squatting your kettlebell swings, damnit!) and pull throughs. Focus on keeping the spine neutral, pushing the hips back and finishing the movement with squeezing the glutes. Keep a big chest without arching your low back.
- Build core stability with deadbugs, RKC planks and hollow holds. The key to ALL of these movements is to POSTERIORLY tilt your pelvis (tuck your hips under) and pull your bellybutton through your back (ribs are tucked). The glutes are firing and so are all of your abs. You should be trembling fairly quickly with these three movements. Get REALLY good at these exercises. They will make everything better- lifting, running, gymnastics, posture, etc.
- Glute bridges and hip thrusts are also great options to strengthen your booty- the key here is initiating with a POSTERIOR PELVIC TILT. You must flatten out your lower back when doing these two movements. Start with body weight and slowly add resistance as you grow stronger. Bret Contreras is The Glute Guy. He has a ton of great information and tutorials on direct glute activation and strength building here.
Again, I feel this is a big issue that is often overlooked by trainers and coaches. We not only need to be aware of spinal flexion (rounding) but we need to be just as conscious of spinal hyper-extension and APT.
Strength training is beneficial for eveyone. It aids in health, longevity, independence, sports performance, etc. If you need some guidance on how to get started, join us at St. Pete Strength and Conditioning.
Co-Owner/Trainer at St. Pete Strength and Conditioning, home of SPSC Crossfit