Pelvic Tilt & Lower Crossed Syndrome
Pelvic Tilt & Lower Crossed Syndrome
Hips and PelvisHips and PelvisStructural core of the bodyContains center of gravity
Innominate Bone = Ilium/Ischium/Pubis
Sacroiliac Joints- moveable eg. walking, running, breathing- supported by strong ant./post. ligaments
Sacroiliac Region and Sacroiliac Region and LigamentsLigaments
Anterior Posterior
Pelvic TiltingPelvic TiltingCommon causes:
- acquired postural distortions- muscle imbalances (weak/tight)- leg length inequality
Pelvic Tilt AssessmentPelvic Tilt AssessmentAnatomical Landmarks
◦ASIS, PSIS, Iliac Crest
Normal posture = No tilting
Innominate bones rotate: PSIS > ASIS anterior rotation ASIS > PSIS posterior rotation
ANTERIOR PELVIC ANTERIOR PELVIC TILTTILT
Anterior Pelvic TiltAnterior Pelvic TiltForward/Anterior rotation of the
pelvisPSIS higher than ASISMost common type of tiltCorresponding hyperlordosis
Anterior Pelvic TiltAnterior Pelvic TiltASIS lower than PSIS by >= ½”Contributes to:
- SI joint dysfunction- vertebral dysfunction- decreased spinal shock
absorption- altered biomechanics
Causes hyperlordosis
Anterior Pelvic TiltAnterior Pelvic TiltMay be asymptomatic due to
compensation or may cause symptoms
elsewhereUnilateral (one sided tilt) = R or L anterior tilt
Anterior Pelvic TiltAnterior Pelvic Tilt Muscular Causes Muscular Causes
Short &Tight
1.Rectus femoris2.Iliopsoas3.Erector spinae
Lengthened & Weak
1.Rectus Abdominus2.Biceps Femoris
Anterior Pelvic TiltAnterior Pelvic Tilt Muscular Attachments Muscular Attachments
Rectus femoris – AIISIliopsoas – lesser trochanterErector spinae – indirectly into
pelvisRectus abdominis – pubic boneBiceps femoris – ischial
tuberosity
Anterior Pelvic Tilt - Anterior Pelvic Tilt - AssessmentAssessmentASIS vs. PSIS heightLBP due to - muscle hypertonicity
- facet joint compressionHyperlordosis / prominent glutealsHypertonic QL, RF, ESAROM: trunk flexion hip extension (tight
psoas)
Anterior Pelvic Tilt - Anterior Pelvic Tilt - AssessmentAssessmentAnterior Innominate Rotation Test - positive if ASIS > I cm lower
than PSIS
Anterior Pelvic Tilt - Anterior Pelvic Tilt - AssessmentAssessmentModified Thomas Test
Hip flexed 45 degrees.Observe opposite thigh.- hip flexion = tight psoas - knee extension = tight rectus femoris
Anterior Pelvic Tilt - Anterior Pelvic Tilt - TreatmentTreatmentMassage, Stretching & Postural
reeducationManually release hypertonic
musclesStretch tight musclesStrengthen weak muscles
Pic of three sacral angles and corresponding lordosis
POSTERIOR PELVIC POSTERIOR PELVIC TILTTILT
Posterior Pelvic TiltPosterior Pelvic TiltBackward/Posterior rotation of
the pelvisASIS higher than PSISCorresponding hyporlordosis