Confirmation of pelvic tilt

Discussions relating to Lower Back Pain.

Confirmation of pelvic tilt

Postby Pilch » Fri Dec 21, 2007 12:27 pm

Hello everyone

I won't go in to the history of my back problem, but in short, have gone down the route of chiropractor etc and now have hit a brick wall. I got some advice from a physio/PT who specialises in Pilates type rehab and his info was useful. I found this website and have bought the rebuild your back book and glad to see much of the advice is similar to that of the physio.

Anyway, I've started the exercises but wanted some clarification, if possible, on the alignment of my pelvis. Upon examination, I can't really confirm if it is tilted forward or not. The pain I have is in the area of my right SI joint. When I lie or stand, my right foot wants to point slightly further outwards, compared to my left foot. Stood in front of the mirror, my right shoulder is a fraction lower than my left.

Also, all of my t-shirts are slightly twisted - when I hang them on a coathanger, the seam down the right hand side (my right) hangs slightly to the rear, behind my back; and the seam on the left then hangs slightly to the front.

The question really is are these symptoms all related to pelvic problems and is it likely forward tilted?

I hope I've put enough information here for someone to help me out. If more is needed, I'm happy to expand.

Thanks very much.
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Postby Ron » Sat Dec 22, 2007 4:52 pm

Hi Pilch,

I'm not a doctor, but based solely on your description, it doesn't sound like you have any serious alignment issues. If you did, your physio would have noticed them right off.

One thing to keep in mind when doing the evaluations of your posture is that nobody is perfectly symmetrical. One arm is longer than the other. One foot is bigger than the other. We are all that way. It's completely normal.

I think what Dean is trying to get across in the section about Pelvic Tilt is to make you aware of extreme distortions. If your issues are so slight that you're not sure, then I think you can rest assured that you don't have anything to worry about.

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Location: Denver, CO

Postby Pilch » Thu Dec 27, 2007 2:20 pm

Hi Ron

Thanks for your comments. I guess you are right in the fact I don't probably have a serious pelvic misalignment, however I do definitely have a problem. The physio didn't really describe the exact condition, but did say I had an alignment problem that looked fairly familiar, and one that he himself had once suffered with.

Also, in the past, an osteopath has been able to correct the problem in one visit, but my most recent trips to see him resulted in going back several times and still suffering from some pain, thus my quest to find a solution and arrival at this website and the physio.

The discomfort has been less over the last few days, but I think that is more a result of not training in the gym or playing golf - obviously I'm doing the stretches in the book, but guess the problem is not exacerbated as I am not currently 'exercising'.

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Postby Bill P » Wed Jan 02, 2008 6:34 pm


You really should be examined by a competent PT to determine how much or how little pelvic tilt you have. It seems you have some other misalignment issues by the description of your shirt, shoulder, and your laterally rotated right foot. It is possible that work or sports has contributed or caused the misalignment.

In a male, the position of the pelvis is considered neutral or normal when the anterior superior illiac spine (ASIS) is 1/2 inch lower than the posterior superior illiac spine (PSIS). The ASIS is the very top and front of your pelvis which is easy to feel. PSIS is the top upper edge at the back of the pelvis. In a female, the difference between the ASIS and PSIS is 3/4 of an inch with the ASIS being lower.

Often, you can get a good idea as to the degree of tilt you have by performing a simple test. Back up to a wall so that your heels, backside, upper back, and head simultaneously touch the wall. If you have the correct amount of tilt, your flattened hand should slide between the wall and the base of your lower back at the beltline level. If you have to force your hand in by pushing the lower back away from the wall, then you have too little pelvic tilt. Incidentally, too little pelvic tilt is more often associated with back pain than is too much pelvic tilt. On the other hand, if there is a space between your hand and your lower back, then you have too much pelvic tilt. It is also possible to have one hip slightly higher than the other.

As for the other areas in which you may have an alignment issue, they need to be looked at in person by a competent PT, because a more thorough, hands-on musculo skeletal evaluation needs to be performed. This will allow for the appropriate stretching and strengthening exercises to be given to correct your alignment and muscle imbalances.

In short, the physio should have pointed out a corrective approach based on his/her exam of your overall posture; not solely the pelvis. Your treatment is totally dependent upon the quality of the assessment, for a good assessment will lead to a good treatment method.

Keep us informed, Pilch so we can follow your progress.

Bill P
Bill P
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Postby Pilch » Thu Jan 17, 2008 12:43 pm

Hello Bill,

Thanks very much for your response, and sorry for my pathetically slow one! I've actually just contacted my physio, who I saw for a series of 4 treatments a couple of months back, so do not see on a regular basis. His diagnosis of my 'problem' is, which I have been told before, is that of a twisted pelvis. His words were: -

"A twisted pelvis generally occurs when you one side of you lower back
(usually your dominant side) is much stronger and active. This tightening of one side causes a slight elevation of the hip, and is one reason why
physios, chiros etc tell us we have one leg shorter than the other. Because
of the alignment of the muscles, not only does one side of the pelvis
elevate, but a slight twist also occurs."

My discomfort is on the right side, around the SI joint. I am right handed. In terms of sport, I've played golf for 15 years, so perhaps the years of that, where one 'loads' the weight on to the right side during the backswing, could possibly have affected it? Or perhaps just doing general everyday tasks right handed.

When I tried your little test by placing a hand behind my back, whilst up against a wall, my hand slid in ok from the left side but was slightly more restricted when doing it from the right. If my pelvis is twisted with the right side being slightly backward of the left, would I be correct in saying this would then explain why my right foot then points slightly further out and why my t-shirt seam down the right side, is dragged slightly behind me at the bottom of the shirt? I'm guessing all the problems are linked. Incidentally, in terms of 'leg length', although I can barely notice a difference now, during the worst times, the right has appeared the shorter. Again, this ties in with the pelvis being twisted back and slightly up at the right side.

The guy I saw did give me plenty of exercises to correct this, including side bends and swimming, and others which appear in Dean's book. So, hopefully, with patience and time, I can correct this.

I hope this new information makes sense and I would be very grateful to hear your opinion on it.

Kind regards,

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Joined: Fri Dec 21, 2007 11:52 am

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