1. Pelvic Tilt & Lower Crossed Syndrome

2. Hips and Pelvis Structural core of the body Contains center of gravity
Innominate Bone = Ilium/Ischium/Pubis
Sacroiliac Joints
- moveable eg. walking, running, breathing
- supported by strong ant./post. ligaments

3. Sacroiliac Region and Ligaments
Anterior Posterior

4. Pelvic Tilting Common causes: - acquired postural distortions
- muscle imbalances (weak/tight)
- leg length inequality

5. Pelvic Tilt Assessment
Anatomical Landmarks
ASIS, PSIS, Iliac Crest
Normal posture = No tilting
Innominate bones rotate:
PSIS > ASIS anterior rotation
ASIS > PSIS posterior rotation

6. ANTERIOR PELVIC TILT

7. Anterior Pelvic Tilt Forward/Anterior rotation of the pelvis
PSIS higher than ASIS
Most common type of tilt
Corresponding hyperlordosis

8. Anterior Pelvic Tilt ASIS lower than PSIS by >= ½” Contributes to:
- SI joint dysfunction
- vertebral dysfunction
- decreased spinal shock absorption
- altered biomechanics
Causes hyperlordosis

9. Anterior Pelvic Tilt May be asymptomatic due to compensation
or may cause symptoms elsewhere
Unilateral (one sided tilt)
= R or L anterior tilt

10. Anterior Pelvic Tilt Muscular Causes
Short &Tight
Rectus femoris
Iliopsoas
Erector spinae
Lengthened & Weak
Rectus Abdominus
Biceps Femoris

11. Anterior Pelvic Tilt Muscular Attachments
Rectus femoris – AIIS
Iliopsoas – lesser trochanter
Erector spinae – indirectly into pelvis
Rectus abdominis – pubic bone
Biceps femoris – ischial tuberosity

12. Anterior Pelvic Tilt - Assessment
ASIS vs. PSIS height
LBP due to - muscle hypertonicity
- facet joint compression
Hyperlordosis / prominent gluteals
Hypertonic QL, RF, ES
AROM: trunk flexion
hip extension (tight psoas)

13. Anterior Pelvic Tilt - Assessment
Anterior Innominate Rotation Test - positive if ASIS > I cm lower than PSIS

14. Anterior Pelvic Tilt - Assessment
Modified Thomas Test
Hip flexed 45 degrees.
Observe opposite thigh.
- hip flexion = tight psoas
- knee extension = tight
rectus femoris

15. Anterior Pelvic Tilt - Treatment
Massage, Stretching & Postural
reeducation
Manually release hypertonic muscles
Stretch tight muscles
Strengthen weak muscles

16. Three sacral angles and corresponding lordosis

17. POSTERIOR PELVIC TILT

18. Posterior Pelvic Tilt Backward/Posterior rotation of the pelvis
ASIS higher than PSIS
Corresponding hyporlordosis