Any book on back care that has been written in the past dozen or so years almost certainly includes the pelvic tilt in its list of ways to alleviate back pain. Though it’s scarcely a panacea, for the thousands of back pain sufferers it’s been a blessing indeed. So what more is there to say about it? Actually, quite a lot.
The “tilt,” if you’re as yet unfamiliar with the term, positions the pelvis with the bottom pressed forward in order to elongate the lower back and minimize excessive arching. One reason this arching, or swayback as it’s commonly called, causes pain is because the muscles in the lower back become fatigued from the weight of the upper body “sitting” on them, and fatigue in any muscle causes discomfort.
Tired or weak muscles aren’t the only cause of pain. With no relief from the downward pressure, the vertebrae become compressed, pinching nerves in the spinal column and compounding the discomfort. This can now lead to serious trouble, for prolonged compression of the vertebrae can result in disc degeneration and even surgery. So the pelvic tilt, by alleviating pressure to the lower back, can only be a good thing.
There are many ways throughout an ordinary day that you can make use of the pelvic tilt. In fact, anything that encourages the lower back to be less arched is useful. Putting your feet up on a low stool while sitting in a chair will do it. The same goes for resting one foot higher than the other on a low railing when standing at a bar, for example. And exercises that bring your knees over your chest when lying supine on the floor have the same effect. A common suggestion is to stand against a wall and, with your knees slightly bent, flatten your back against it. All of these “remedies” allow your lower back to stretch out and lengthen.
This is all well and good. However, we spend a good deal of our time either standing where we can’t put one foot up – in queues, waiting for a bus, etc. – or walking. How do we then maintain the pelvic tilt? In a word, we don’t. It goes back to the position it’s accustomed to being in and which is natural for it; if you have a swayback it will go back to being swayed, and with too much weight on it.
So while the remedies stated above are helpful, they’re at best only temporary and alleviating ones. They don’t eliminate the problem of a swayback and its subsequent stress on any permanent basis. For this to happen, we have to learn how to “straighten” our pelvis and lessen the arching of the lower back. This is a more comprehensive task than “tilting” the pelvis, which, commendable as it is as a means of relief and as an exercise, falls short of being a permanent solution to back pain. Let’s see why.
In all of the suggestions given above, the knees – whether it’s one, or both – are bent to one degree or another. You can’t, for example, flatten your back against a wall unless your knees are bent. Now, some authorities recommend that you should always keep your knees slightly bent, or slack, when you’re standing or walking, and that’s because bent knees keep the lower back lengthened to some extent.
This brings up three points. First, we are the most developed of upright creatures and bent knees don’t make us fully upright. Perhaps we’re not fully evolved yet but why not aim in that direction? Second, keeping the knees slack at all times only serves to shorten the hamstrings, which in most people are too tight as it is. Third, do you really want to walk with bent knees? There’s something psychologically demeaning, not to mention physically unsupportive when we don’t stand and walk at our full height, whatever that height might be.
So, despite the acclaimed benefits of the pelvic tilt, we need to know how to tilt the pelvis and elongate the lower back without bending the knees. For that it will help to understand what causes swayback in the first place.
The reason the pelvis tips forward is because the abdominal muscles, which are meant to contain the intestines in the abdominal cavity, are not doing their job; they’re either too weak or they’re simply not being used. Consequently, the innards “fall out” and the weight of the all-too-common stomach bulge pulls the pelvis off its centre of balance.
When the pelvis stays in this position over a long period of time, the muscles attached to it become set in their lengths. In the forward tilted position the muscles from the mid-back down through the back of the pelvis become shortened, as do the thigh muscles and those that attach the thighs to the bottom of the pelvis.
To change the position of the pelvis to one that is “straight,” meaning that the waist is brought back over the tailbone, these muscles need to be gradually stretched so the adjusted position becomes the normal, or accustomed position, and this transition can take a long time, especially when it’s begun in the adult years. This is why it’s important to begin flexibility exercises early on in life.
With the pelvis able to straighten, the job of keeping it straight falls to those lower abdominal muscles mentioned above. These muscles need to be strengthened so they can hold the bottom of the pelvis forward and contain the viscera. But they need to be strengthened in a particular way so they don’t simply tighten and press against the viscera but instead, lift them into the pelvic cavity and contain them with an easy hold, while allowing the rib cage to handle the breathing. Beyond this, relieving lower back strain involves supporting body weight, but as this article is mainly about straightening the pelvis, the topic of weight support will be left for another time.
Take a moment here to look at the drawings in Figures 1, 2 and 3 above. In Figure 1 you see the pelvis tipped forward producing the swayback and stomach bulge and, as normally happens with this posture, a corresponding backward pressure through the knees. Figure 2 shows the “pelvic tilt” with bent knees, and Figure 3 is the “straightened” pelvis with straight legs. As you can see, the lower back is elongated in both Figure 2 and 3, so the tilted and the straightened pelvis are, in fact, equally effective in relieving strain.
There are a number of exercises you can do that will help the pelvis to straighten, but here are three that will start you in the right direction.
TO STRETCH YOUR THIGHS AND GROIN MUSCLES
- Sit on the floor and extend your right leg forward. Bring your left foot in beside the buttock, as shown, and place your hands on the floor behind your hips. Lift your hips a little and tip back on your pelvis, then relax your upper body between your shoulders and rest your weight on your hands.
- Stay relaxed in this position allowing the thigh to stretch. You can increase the stretch by tightening the left buttock. To increase it even further, press the buttock forward into the hip joint as you breathe out.
- Lift the leg with your hand to bring the foot forward. Straighten the leg slowly and roll it gently in and out. (Photo #1)
TO STRETCH YOUR LOWER BACK MUSCLES
- Sit on the floor with your legs in front. Hold your ankles – or as close as you can reach – with a firm grip and take a breath in.
- Simultaneously breathe out through your mouth, pulling your abdominals in, then drop your head forward as you pull your body gently backward away from your feet. Hold the backward pressure for a few moments, then relax forward as you breathe in to repeat the stretch.
- After you do this movement 2 or 3 times, sit up and move your waist forward and back gently while rolling over the sit bones to help loosen the back muscles.
Note 1: Your arms need to be straight, so if you have long arms, you may need to hold the soles of your feet rather than your ankles in order to feel the stretch in your lower back. If you bend your elbows and pull on your legs instead of just holding them, you’ll transfer some of the stretch to your hamstrings.
Note 2: Although this stretch is primarily for the lower back, you may also feel a stretch in your upper back or shoulders, so just consider that an added benefit.
Note 3: Keep the pressure into your lower back gradual and gentle until you can assess how much stretch it can take. If you feel a twinge of sharp pain, use minimal pressure and don’t repeat for a day or two. If the sharp pain happens each time you go back to the exercise, you should have your back checked by a professional and /or have some deep massage work into that area to help loosen the muscles. Sharp pains are a warning signal of vulnerability, so exercise restraint! (Photo #2)
TO STRENGTHEN YOUR ABDOMINALS
- Lie with your back on the floor and knees drawn over your chest, hip-width apart. Take a breath in, then, breathing out through your mouth, pull your abdominals in so the back of your waist is pressed against the floor; at the same time, lower your feet toward the floor but only to the point where your lower back is beginning to lift. Hold this position for a few moments, then bring your knees over your chest as you breathe in to repeat.
- When you’ve finished, lower your feet to the floor one at a time.
Note: You may find that your back begins to lift almost right away. This is not unusual as the abdominal muscles in most people, as mentioned before, are weak. The important point is to keep the back of your waist pressed to the floor. This way, your abdominals will be strengthened without putting strain on your lower back. In other words, how close you get your feet to the floor is unimportant. (Photo #3)
The top two exercises will help to loosen the tight muscles that cause a swayback, while the third exercise strengthens the lower abdominal muscles to hold the pelvis straight. With the tightness freed and your legs moving easily in the hip joints, you will walk with a much longer and freer stride. It will feel great and you’ll look inches taller.