Relationship between Muscle Imbalance (anterior and posterior thigh muscles) and pelvic Tilt.

Relationship between Muscle Imbalance and pelvic Tilt.

Relationship between Muscle Imbalance (anterior and posterior thigh muscles) and pelvic Tilt.


Pelvic Tilt:
Pelvic tilt means the positioning of the pelvic in relation to the body.
● Pelvic tilt is a common contributor to lack of stability, mobility, postural, and motor control.
● If pelvic was out of positioning, then it is usually tilted one way and can cause many other disruptions in the kinetic chain.

Muscle imbalance is considered the leading cause of movement dysfunction.
In a lot of pelvic tilt problems, the hip flexors and extensors are heavily influenced. Because these muscles attach to the pelvis and lower back.

**These muscles include but are not limited:
● Psoas major
● Rectus femoris.
● Quadratus lumborum.
“These muscles directly affect the lower back region and contribute to either good or poor posture”.

Weak core stabilization causes pelvic tilt?

Weak core muscles can lead to the degree of anterior pelvic tilting and increase the degree of lumbar lordosis.
● Some of the main causes of having an anterior pelvic tilt is poor posture and a sedentary lifestyle, especially one that involves prolonged sitting.

Types of Pelvic Tilt Issues:

There are three most common types of pelvic tilt disorders.
● anterior.
● posterior.
● lateral pelvic tilts.
Hint: Each type of pelvic tilt indicates the direction that the pelvis is fixed in.

  1. Anterior pelvic tilt:” APT” when the front of the pelvis rotates forward and the back of the pelvis rotates upward. For example, the APT occurs when muscles of hip flexors shorten and the hip extensors lengthen. This is called “lumbar hyperlordosis”
  2. Posterior pelvic tilt: “PPT” when the front of the pelvis rises up and the back of the pelvis drops down. For example, PPT occurs when the hip flexors lengthen and the hip extensors shorten, specially the gluteus maximus muscle, which is the primary extensor of the hip.
  3. Lateral pelvic tilt: “ LPT” it’s tilting toward the side, either right or left, and it’s is associated with scoliosis or people who have length leg discrepancy (one hip is higher than the other). It can also occur when one leg is bent, while the other leg remains straight, “in that case the bent side’s hip can follow the femur as the knee lowers towards the ground and leads to unilateral muscle imbalances throughout the body. 
type of pelvic tilt

Common Causes of Pelvic Tilt Issues:

Pelvic tilts developed through movements and some inactivity.

  1. Anterior Pelvic Tilt indicate:
    ● Tight hip flexors.
    ● Weak hamstring.
    ● Weak glutes.
    ● Weak core.
    • APT results of tight hip flexor muscles.
  2. When a muscle tightens, it shortens.
  3. When hip flexors muscle shorten, hip extensors will lose up or lengthen.
  4. Hip flexor muscles such as the iliopsoas, sartorius, and rectus femoris that attach to the pelvis and the lower back.
  5. Mechanism of Anterior Pelvic tilt:
  6. Due to the origin and attachment sites of the muscles, they play a role in bending the hip.
  7. Excessive sitting and poor posture can keep the hips in a flexed position for a prolonged time. Bending at the hips will rotate the front of the pelvis forward, and the back of the pelvis to rotate upward. This body position mechanism may make the person prone to an anterior pelvic tilt. Common during pregnancy and considered essential for delivery.

  1. Posterior Pelvic Tilt indicate:
    ● Tight glutes.
    ● Tight hamstring.
    ● Weak anterior chain.
    Mechanism of Posterior Pelvic Tilt.
    PPT happens when tight hamstrings and glutes pull the bottom of the pelvis underneath the body when the front of the pelvis tilts up and back. Tightness in the abdominal muscles will pull the pelvis up, while weak lower back muscles do not respond.

  1. Lateral Pelvic Tilt indicates:
    Tightness in thr quadratus lumborum.
    LPT can make one leg appear shorter than the other, the quadratus lumborum is the main muscle responsible for creating and correcting a lateral pelvic tilt. 
    Mechanism of LPT:
    The quadratus lumborum muscle is deep within the abdominal wall and attached to the pelvis and lumbar spine.
    The main role of this muscle is lateral bending, “bending from side to side”. This will help in stabilizing the pelvis. When this muscle gets tightened on one side of the spine it will begin to pull the pelvis up on the other side, creating a lateral pelvic tilt.

Special Test for Pelvic Tilt

Test for anterior pelvic tilt:
Physical examination: includes having to bend over, lie flat on the back, and stand up straight. The doctor felt the spine and
pelvis as part of the initial exam.

Thomas Test:
The patient lies on his back on the examination table, the therapist assesses ability to stretch legs, one by one, alternating knees to chest, to see whether the resting leg touches the table.

The patient lies on his back on the examination table, the therapist assesses ability to stretch legs, one by one, alternating knees to chest, to see whether the resting leg touches the table.

**The degree of flexibility the patient has and the tightness of the muscle groups may give a positive (+ve) result for the Thomas Test.

Best Exercise for Pelvic Tilt correction:

1.Half kneeling hip flexor stretch :stretch Step your right leg out in front of you and lunge until your left knee is resting on the ground. Bring your pelvis forward by tightening your gluteus and abdominal muscles. Lean forward until you feel tension in the hip flexor and inner thigh of your left leg. Hold for 30 seconds. Repeat 5 times on each side.

Half kneeling hip flexor stretch

2. Bridging exercise: Lie on your back with your legs bent and your feet flat on the floor and hip-width apart, arms by your sides. Push your heels into the floor as you lift your pelvis up off the floor until your upper body and thighs form a straight line. Hold for 2 seconds, lower down slowly, and repeat 8 to 12 times.


3. Squatting: Place your feet shoulder-width apart, toes pointing forward. Lower yourself to a sitting position until your thighs are parallel to the floor. Keep your back in a neutral position. Push up to a standing position and move your pelvis slightly forward by tightening your gluteus muscles. Repeat 15 to 20 times.


4. Pelvic tilt: Lie with your back on the floor with your legs bent and feet flat on the floor. Pull your belly button in :oward your spine, pushing your pelvis up toward the ceiling. Tighten your gluteus and hip muscles as you tilt your pelvis forward. Hold for 5 seconds. Do 5 sets of 20 repetitions.

Pelvic tilt

Relationship between hamstring muscle and pelvic tilt

hamstring attachment with the pelvis?
The hamstrings connect to the ischial tuberosity, the small bony projection on the bottom of the pelvis, just below the buttocks.
● The hamstring muscles attach the back of the thigh.

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** The hamstring muscle stabilizes the pelvis in the sagittal plane by controlling the anterior pelvic tilt during dynamic posture and trunk forward flexion.

Can tight hamstrings affect the pelvic floor?

Hamstring muscles attach directly to the pelvis.
When they’re tight, they tug on the pelvis and tip it backwards into a posterior tilt. It’s difficult to achieve a neutral pelvis alignment if
the calves and hamstrings are wound tight.

**Pelvic drop, anterior pelvic tilt, and lack of hip extension all contribute to hamstring overuse.

Relaed books


  • ActiveCare Physio. (n.d.). Do you have a pelvic tilt?: Activecare physio. Ottawa. Retrieved January 3, 2023, from https://acpottawa.ca/do-you-have-a-pelvic-tilt/
  • ISSA. (n.d.). Pelvic tilt: What is it and how do you correct it? ISSA. Retrieved January 3, 2023, from https://www.issaonline.com/blog/post/pelvic-tilt-what-is-it-and-how-do-you-correct-it
  • Laura Jawad, P. D. (2021, March 31). Pelvic floor strength and function (from head-to-toe): Part 2. Laura Jawad. Retrieved January 3, 2023, from https://www.laurajawad.com/post/pelvic-floor-strength-and-function-from-head-to-toe-part-2/
  • bodycomplete. (n.d.). Hamstrings: Why you should be training them more. bodycomplete. Retrieved January 13, 2023, from https://bodycomplete.co.uk/hamstrings-why-you-should-be-training-them-more/

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