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Pelvic Tilt – The First KEY in Home Care of Back and Leg Pain

How many times have you heard someone say, “Hold your core tight”?  This terminology is thrown around all the time as if everyone knows how to do it. I consistently find that patients do not understand how to engage and tighten their core on command. Pelvic tilting is KEY in rehabilitation and prevention.

Why is a pelvic tilt so important?

  • It is the FIRST exercise we give back pain patients 
  • It opens our low back 
  • It protects our back with exercise 
  • It reduces the stress of daily activities 

Almost everyone can do a pelvic tilt, even when they are in acute pain. Most of our therapeutic exercises require you to engage your core and perform a pelvic tilt FIRST, then perform the rest of the exercise. Opening our low back reduces the effects of arthritis, stenosis and disc protrusions. Exercises are safer and more effective when we perform a pelvic tilt first. Lifting groceries, doing laundry and prolonged standing are all examples of activities improved when pelvic tilting.

3 positions to pelvic tilt – Learn them in this order of difficulty

  • Lying Supine – easiest
  • Standing – intermediate
  • Sitting – advanced

Position 1Supine Pelvic Tilts

The easiest way to learn a pelvic tilt is to perform them while lying on your back. 

Step 1. Lie on your back with your knees bent and feet about hip width apart. 

Step 2. To perform the tilt, you will tighten your buttocks and stomach while flattening your back to the floor. Think about pushing your belly button toward your spine. If someone had their hand underneath your back, you would be trying smash it. Relax your shoulders and neck and focus all the movement in the pelvic and stomach regions.

Step 3. Perform the exercise slowly. Try to really squeeze the lower abdominal muscles. Pause for a second and then slowly return your back to a neutral position. Start with 10 repetitions. Do this once a day. You can do it more frequently when having pain. 

Position 2 – Standing Pelvic Tilts

This is a more advanced exercise. Tilts are harder to do when weight bearing. It is an extremely important exercise because we do most of our activities in an upright position.

Step 1. Stand with your back against a wall to use as a reference point.

Step 2. While keeping your shoulders and buttocks against the wall, place your feet about 6-8” away from the wall. This makes it easier to tilt.

Step 3. Tighten your muscles just as you did with the supine tilts. Flatten your back against the wall. You will feel your bottom slide on the wall slightly as your pelvis rotates. 

Step 4. Again, perform this exercise slowly using a lot of control. Do 10 repetitions at least once a day.  

TIP: DO NOT bend your knees and DO NOT pull down with your shoulders or chest. This is much more difficult that it sounds. 

Position 3 – Seated Pelvic Tilts

This is an advanced exercise that we will cover at another time. 

Practical Application

Pelvic tilts alone are good for early treatment and the ongoing management of back and leg pain. 

Once you master the pelvic tilt in both supine and standing positions, then you can begin adding exercises such as pelvic raises and crunches, AFTER you tilt. Tilting in a standing position allows people to stand for longer periods. Tilting slightly and tightening the core prior to lifting groceries, laundry or children will protect your back and reduce injury. 

In future blogs, I will be showing you how to incorporate pelvic tilts into various activities.

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