How to Fix Posterior Pelvic Tilt – Exercises + Follow Along Routine

Posterior pelvic tilt doesn’t get as much air time as its more popular cousin anterior pelvic tilt, but it still impacts a lot of people.

If you suspect you have a posterior pelvic tilt that might be giving you trouble, fear not:

This guide is designed to help you out.

We’re going to take a DEEP dive into exactly what a posterior pelvic tilt is, how to properly identify it, and some key posterior pelvic tilt exercises to help you address it moving forward.

Let’s get started.

If you have any questions at all, hit me up in the comments section below or on Reddit. 

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What is a Posterior Pelvic Tilt?

A posterior pelvic tilt is essentially a loss of the natural curve (lordosis) in the lower back, due to a change in the resting position of the pelvis.

Essentially, the front of the pelvis rises up and the back of the pelvis drops down.

The result?

Instead of natural lumbar extension, the tailbone tucks under and we end up with lumbar flexion.

An analogy I often use (via my expertly drawn crappy diagrams) is to imagine your pelvis as a bowl of water:

Neutral Pelvis Bowl of Water

When the pelvis is in a neutral position (or a slight anterior tilt of 5-10 degrees), all is well and the water is still. 

 

Anterior Tilt Bowl of Water

With an anterior pelvic tilt, the lordotic curve is exaggerated, the lower back is extended and the water spills out of the front.

 

Posterior Tilt Bowl of Water

The tailbone tucks under with a posterior pelvic tilt and we see lumbar flexion. The water spills out of the back of the bowl.

 

Posterior Pelvic Tilt Symptoms and Signs

Some of the most common signs and symptoms of a posterior pelvic tilt include: 

  • A flat lower back from the loss of lordotic curve.
  • An apparently flat bum.
  • A protruding belly.
  • Discomfort in the lower back.

But that’s not the whole story:

In some cases, as well as being rotated, we find that the pelvis shifts forwards.

As we can see in the level 2 diagram below, along with the flat lower back, we see hyperextension at the hips and the knee joint and that classic ‘sway back’ posture: 

Posterior Pelvic Tilt Level 1
Posterior Pelvic Tilt Level 2

Posterior Pelvic Tilt Causes

The causes of posterior pelvic tilt often come back to postural habits, including:

  • Slouching Whilst Sitting. Perhaps the most common culprit. If you tend to lean back and slouch whilst sat at a desk or in the car, it encourages flexion in the low back and rotates the pelvis accordingly. 
  • Poor Standing Posture. Posterior tilting whilst sitting can sometimes mean you adopt the same position whilst standing.* The pelvis is shifted forward from overactive hamstrings and glutes, and you end up ‘hanging’ on the iliofemoral ligaments.
  • Front Sleeping. This one can go either way. If you tend towards an anterior pelvic tilt, I’ve found that front sleeping can exacerbate it. But similarly for a posterior tilt – some find that front sleeping makes it worse.
* This isn’t always the case. Interestingly, there are also plenty of examples of people who adopt a posterior tilt sitting and still have an anterior tilt standing. 
Posterior Pelvic Tilt Sitting
Posterior Pelvic Tilt Neutral Sitting

Why is Posterior Pelvic Tilt Potentially Harmful? 

Here’s the thing:

When we’re looking for a posterior pelvic tilt fix, it’s important to note that faulty positioning doesn’t always = pain or discomfort. 

The human body is extremely resilient.

That being said, there are a few things that you may be more susceptible to if a posterior pelvic tilt is your default resting position:

  • Lower Back Issues. Our natural lumbar curve helps to effectively distribute load through the body. When we lose that curvature, we can experience excess pressure through the spine, potentially increasing our risk for disc injuries and nerve issues (or general back pain) from simple everyday tasks like lifting things up and bending over.
  • Breathing Mechanics. Results from a 2018 study suggest that pelvic positioning can have a significant impact on lung function. Peak expiratory flow and forced expiratory volume were lower in both anterior and posterior pelvic tilts compared to a neutral pelvic position. Granted, this is an isolated study. But breathwork is something I’ve taken a dive into recently, and it’s interesting to see how breathing mechanics, stress resilience, and positioning all seem to tie in. 
  • The Domino Effect. When the pelvis strays away from neutral, problems upstream and downstream often get exacerbated. So this might mean excess thoracic flexion and faulty neck + jaw positioning, and even issues at the knees and ankles.
  • Athletic Performance. It’s not that having a posterior pelvic tilt automatically means you’ll struggle to perform as an athlete, but any strong deviation away from neutral usually isn’t ideal. Your pelvic positioning impacts your squat, hip hinge, running mechanics and more. In a posterior tilt, we often see more stress on the knees and the lower back compared to neutral. 

"We started to realize that those who were hitting the biggest roadblocks had a unifying thread: they all spent a great deal of time sitting."

How to Perform a Posterior Pelvic Tilt Test

A posterior pelvic tilt is fairly straightforward to identify by eye: 

Using a mirror or taking a photo, from a side on view, you’ll typically see that loss in the natural curve of the lower back. 

If you want to go hands on to double check, you’ll need to find two bony landmarks:

  • The Posterior Superior Iliac Spine (PSIS) at the back of the pelvis.
  • The Anterior Superior Iliac Spine (ASIS) at the front of the pelvis.

Neutral pelvis: We typically see a slight decline from front to back (an anterior tilt of between 5-10 degrees).

Posterior Tilt: If you discover the angle between your PSIS and ASIS is close to horizontal, you’re likely dealing with a posterior pelvic tilt.

Posterior Pelvic Tilt Exercises Side View

Michaela demonstrating a posterior pelvic tilt with an anterior shift (pelvis rotated back and shifted forward). 

Posterior Pelvic Tilt Muscles Involved

In general:

If we’re looking to correct posterior pelvic tilt, it’s important to have at least a basic understanding of what’s going on structurally down there. 

So here’s a simplified version of the musculature typically involved:

Tight/Overactive Muscles:

  • Glutes
  • Hamstrings*
  • Rectus Abdominus (Abs)

Weak/Inhibited Muscles:

  • Hip Flexors
  • Lumbar Erectors (Lower Back)

Or if we look at it from a movement or positional perspective, we usually see:

Too much:

  • Lumbar flexion
  • Hip extension
  • Knee extension

A lack of:

  • Lumbar extension
  • Hip flexion
  • Knee flexion 

*I mentioned above that the muscular balance model is oversimplified. This is especially true with the hamstrings. In many cases with a posterior pelvic tilt, the mid to upper hamstrings are under tension. BUT, if the knees are in hyperextension, the lower hamstrings are lengthened. I’ve taken this into account with the exercises + routine.   

How to Improve Posterior Pelvic Tilt: Step By Step

After assessing your pelvic positioning, here’s a step by step process for fixing posterior pelvic tilt:

Video: Follow Along Posterior Pelvic Tilt Routine

You can follow along with the whole routine with the video below, or scroll down to view each posterior pelvic tilt exercise in more detail.

Posterior Pelvic Tilt Exercises

Scroll down for six posterior pelvic tilt stretches + release drills, and three key strengthening exercises to improve posterior pelvic tilt

Exercise 1: Seated Hamstring Release

1-3 minutes per side 

Hamstring Release 1
Hamstring Release 2
Hamstring Release 3

Why?

This is a great drill for calming down the nervous system and releasing some of the tension that often builds up in the mid to upper hamstrings from a PPT. 

How?

  • Grab a mobility ball and place it on a stable surface underneath your hamstring.
  • Start at the top of the hamstring (under the sits bones) and work our way down to the mid to lower hamstring.
  • Apply downward pressure into the ball, breathing slowly in and out through the nose. 
  • Scrub your weight from side to side, and play with flexing and extending at the knee.
  • If you reach a particularly sensitive area, take a deep breath in through the nose, hold that breath for 5-10 seconds as you contract into the ball, then slowly exhale through the nose (10-20 seconds).

Exercise 2: Standing Hamstring Stretch

20-30 reps per side

Hamstring Stretch
Hamstring Stretch 2

Why?

Once we’ve relaxed the tissues with the hamstring release, it’s nice to follow this up with a deep stretch. I prefer this standing version to a seated hamstring stretch or forward fold, as it’s easier to encourage your pelvis into a more neutral position. 

People with a PPT often struggle to dissociate between the lower back and the hamstrings, but this variation can really help focus the attention on the right area. 

Note: I recommend maintaining a slight knee bend in the front leg. This helps focus the stretch nearer the high/mid hamstring, as opposed by the knee. As I touched on earlier, with a PPT, you can be prone to overextension at the knee and the attachment is lengthened. So traditional hamstring stretches with a straight leg might not help.

How?

  • Stand with your feet staggered, hips width apart.
  • Your front foot can be on the floor or on an elevated surface if you find it more comfortable. 
  • Keep a slight bend in the front leg.
  • Keeping your spine long and core engaged, hinge at your hips to lean out over your front leg. 
  • You can hold this position for 1-2 minutes or perform repetitions. 
  • Optional – hook a resistance band around the front of your hip to (potentially) open up the front of the hip capsule, or at least add another variable into the mobilisation.

Exercise 3: Seated Glute Release

1-3 minutes per side 

Glute Release
Glute Release 2
Glute Release 3

Why?

Great for releasing tension that’s built up in the glutes, which reinforces that ‘tailbone tucked under’ position. Interestingly, you’ll often find that after performing this drill it’s easier to fire your glutes in a hip hinge or squat.

How?

  • Place the ball on a stable surface and take a seat, positioning the ball above your sits bones.
  • Trace all the way to the outside of your hips and then across towards your lower back. 
  • Apply downward pressure into the ball, breathing slowly in and out through the nose, and scrubbing from side to side.
  • If you reach a particularly sensitive area, take a deep breath in through the nose, hold that breath for 5-10 seconds as you contract into the ball, then slowly exhale through the nose (10-20 seconds).

Exercise 4: Pigeon Stretch

15-20 reps per position

Pigeon Stretch 1
Pigeon Stretch 2
Pigeon Stretch 3

Why?

The pigeon is a great drill for opening up through the glutes and outer hip. I prefer teaching this variation as opposed to a seated glute stretch (where you hug the knee into the chest) for a posterior pelvic tilt, as it’s easier to maintain a neutral pelvis, as opposed to defaulting back into a PPT. 

How?

  • Place your front leg up on a chair or stool, with roughly a 90 degree bend at the knee.
  • To keep the ankle and knee safe, have the foot dangling off to the side of the stool and flex your toes up towards your shin.
  • If this position is a little challenging to get into, you can adjust the height of the raised surface, or place pillows underneath your front knee. 
  • You can hold the position for 1-2 minutes or perform repetitions – raising the hips straight up and dropping them down to deepen the stretch.

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Exercise 5: The Gut Smash

1-3 minutes

Gut Smash 1
Gut Smash 2
Gut Smash 3

Why?

I first stumbled upon this drill courtesy of Jill Miller at Yoga Tune Up (via Kelly Starrett). It’s an excellent way to release tight abdominals and free up the diaphragm. So we get a double whammy – sorting out our posterior pelvic tilt, and improving our breathing mechanics.

How?

  • Grab a soft ball like a kids football (bonus points for the Spiderman variety) place it on the floor and lie down on it.
  • Apply downward pressure into the ball, breathing slowly in and out through the nose. Let the ball sink deeper after each exhale, and gently scrub from side to side.
  • Anywhere on the front and side of the torso is fair game. You’ll likely feel some stiffness just below the sternum and the bottom of the ribcage.
  • If you reach a particularly sensitive area, take a deep breath, hold that breath for 5-10 seconds as you contract into the ball, then slowly exhale (10-20 seconds).

Exercise 6: The Prone Cobra

20-30 reps

Ab Stretch 1
Ab Stretch 2
Ab Stretch 3

Why?

The cobra is a nice mobilisation from the yoga world. I don’t personally get on with it that well as I tend towards an anterior pelvic tilt and super exaggerated lordosis. But for a posterior pelvic tilt and a loss of lordosis, it works great for opening up the rectus abdominus and restoring some lumbar extension.

How?

  • Laying prone, place your hands on the floor in line with your head, and your legs straight out behind you.
  • Leading with your your mid + lower back, lift your chest off the floor and stretch through the front body.
  • Keep the shoulders relaxed back and down, and avoid craning the neck.
  • Come up onto your elbows initially, and only if it feels safe on the low back, play with rising up onto the hands with the arms straight.
  • Hold for a few seconds at the top position, then slowly lower.

Exercise 7: Romanian deadlift

10-15 reps

Deadlift 2

Why?

The Romanian deadlift is useful for improving hamstring length whilst simultaneously building strength (through the eccentric portion of the movement). 

How?

  • Grab a kettlebell or anything fairly heavy (a shopping bag filled with cans or books can work).
  • To pick it up from the floor, engage the core and glutes by screwing the feet into the floor, hinge over at the hips and bend slightly at the knees. 
  • Keep that core connection and neutral spine as you pick the weight up to the start position. 
  • Start the repetition from this top position, again maintaining that neutral spine, shoulders back and down.
  • Think of someone pulling your hips back with a rope as you hinge over, initiating from the hips and letting the knee bend follow.
  • Lower the weight as far as you comfortably can without it touching the ground.
  • Reverse the motion to return to the top position.

Exercise 8: Hip Marching

20-30 reps

Hip March 1
Hip March 2
Banded Hip Flexor 1
Banded Hip Flexor 2

Why?

There are a few options we can use to strengthen the hip flexors, but prone hip flexor marches are a decent place to start. Over time, strengthening this pattern will help to pull the front of the pelvis down into a more neutral position. The drill can be done sitting to start with, but I find it’s easier to progress further with the lying version. 

How?

  • For the seated version, sit on a chair or stool and march one leg at a time off the floor.
  • For the lying version, lie down on your back, bring your feet off the floor and have your hips and knees at a 90 degree angle.
  • Slowly lower one leg down to the floor, then raise it back up towards your chest.
  • Squeeze for a few seconds at the top of the movement, then repeat for 10-15 reps, and swap sides.
  • You can use a partner or a resistance band hooked around your foot to increase the difficulty – making it harder for you to bring your knee towards your chest.

Exercise 9: Back Extension

20-30 reps

Superman
Superman

Why?

The back extension or superman/superwoman is a great way to strengthen the lower back and reinforce that natural lumbar curve. 

How?

  • Lie down on your front with your core braced and shoulders relaxed.
  • Engaging through the mid back, lift your torso off the floor as high as you can.
  • Pause at the top for 5 seconds, breathing into the mid back. 
  • Avoid craning through the neck, and keep the shoulders relaxed back and down.
  • Lower and repeat for 20-30 repetitions. 

4 Habits to Improve Posterior Pelvic Tilt

"Soft-tissue manipulation alone, without some form of postural retraining is unlikely to achieve a lasting effect."

Habit 1: Healthier Sitting

One of the biggest changes you can make to improve a posterior pelvic tilt is to alter your sitting position. 

Slumping down into your chair will no doubt feel like a super comfortable resting position, but it only reinforces that loss of lordosis. 

If you have to sit, try your best to avoid slumping and instead, rest on your sit bones. Think about a string attached to the top of your head, lightly lifting your torso upwards. This can reduce the feeling of being curled up like a prawn, dumping pressure into the hips and low back.

It’ll be challenging to maintain a neutral position to start with, so play around with a lumbar support to get into position, and take it away when you’re strong enough to stay there solo.

Habit 2: Keep Moving

Ideally, we want to minimise any prolonged sitting, regardless of the position. 

If you find yourself sat at a desk or in a car for a long slog, try breaking it up into half hour chunks, getting up for a walk or to do some of the above mobility exercises in between. 

Depending on your work environment, you can also alternate between sitting on a chair, standing, kneeling, and sitting cross legged on the floor. 

Mix it up, keep it fresh, and you’ll prevent your body from moulding itself into one set position. 

 

Habit 3: Learn to Hinge

As a general rule of thumb, if you’re picking something up off the floor or bending over to do something:

You’re going to be better off if you can initiate a solid squat or hip hinge – maintaining a neutral pelvis and an organised torso, as opposed to rounding down through the lower back.

It’s not that lumbar flexion is inherently bad… 

But if you already tend towards a posterior tilt and a flat back, at best it’s going to reinforce that position, and at worst it might open you up to disc and nerve issues.   

So whether it’s tying your shoes or picking a bag up off the floor, opt for a solid squat or deadlift over the Jefferson curl.  

Habit 4: Minimize Lumbar Flexion

As well as trying to limit spinal flexion when we pick things up in everyday life, when we’re addressing a posterior pelvic tilt, it also makes sense to limit flexion in a training environment too.

So as well as maintaining a neutral spine during our main lifts/movement like the squat, deadlift, and push/pull patterns, we might want to avoid things like situps, crunches and even Jefferson curls for a little while

Again, it’s not that these movements are inherently bad. 

But if we want to maximise our time in the gym and move our body to its full potential, we’re better off focussing on movements that allow us to adopt a more stable position. 

 

Posterior Pelvic Tilt FAQs

With an anterior vs posterior pelvic tilt:

In an anterior pelvic tilt, the front of the pelvis drops down. It’s often accompanied by tight hip flexors and lower back muscles, inhibition of the glutes and deep core musculature, and an exaggerated lordotic curve.

A posterior pelvic tilt is essentially the opposite. The front of the pelvis tips up, there’s a loss of lordosis, and we see tightness through the glutes, hamstrings and rectus abdominals, and inhibition of the hip flexors and muscles of the lower back. 

In a posterior pelvic tilt, we typically find that the hip flexors and lower back muscles are underdeveloped and can benefit from strengthening exercises. 

Yes. It takes time and patience to improve flexibility and make lasting structural changes. But with a combination of mobility drills, posterior pelvic tilt correction exercises and adjustments to postural habits, it’s entirely possible for you to correct posterior pelvic tilt and find a more neutral resting position. 

Most of us tend to slump into a posterior pelvic tilt sitting, and this can translate into a posterior tilt whilst standing too. Interestingly, we also see instances when people who posteriorly tilt whilst sitting, end up with an anterior tilt when standing. 

This is because in a seated position, both the hamstrings and hip flexors are in a shortened position. So when you then stand up, your pelvic positioning could go either way depending on the relationship between your femur and pelvis (and any ingrained movement patterns).

The short story – sitting isn’t ideal and can mess up your standing/walking mechanics in many different ways, so avoid or limit it as much as possible. 

Posterior pelvic tilt and back pain often go hand in hand. A posterior pelvic tilt results in a loss or lordosis, so instead of that natural curve in the lower back (extension) we see lumbar flexion. It’s not that flexion is always bad, but being in that position for a prolonged time period may lead to some issues, including disc damage, nerve irritation, inhibition of the deep core musculature, and a cycle of lower back pain. 

Over to you!

So there we have it – an in-depth guide and routine to help you correct posterior pelvic tilt. Give it a try and let me know how you get on!

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Luke Jones

Luke Jones is a Movement Coach, Wellness Enthusiast, Online Content Creator, and Founder of HERO Movement. Through articles, videos, courses, and online coaching, his big goal is to help people discover freedom of movement and create lives filled with well-being & adventure.

3 Responses

  1. Great stuff; anxious to get started; Have had posterior pelvic tilt for years, and decades of chiropractic, but nothing has worked. I see a program of recovery here!

  2. One of the best blog posts about fixing posterior pelvic tilt with attention to specific details like (lower – upper hamstring difference). Thank you!

    I would like to ask a question. I developed posterior pelvic tilt but only one side of my body (right) due to some movement restrictions and developing asymmetrical muscular imbalance (focusing right quads for months) which began after injuring my ACL and after the surgery. I tried nearly everything but still I have posterior pelvic tilt on the right side of my body. Hip flexor on that side is pretty weak but it seems rectus femoris compensates or took the role of psoas. Also due to the ACL surgery hamstring near the knee is very weak. Glute is severely tight. Question is whether I should do hamstring stretch (already have weakened) or instead can I do a single leg stiff deadlift variation to both strengthen and lengthen hamstring on the same side + maintaining arch.

    Asymmetrical postural dysfunction feels the hardest.

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