Lateral Pelvic Tilt and Back Pain

September 8, 2011

in Fixing Your Hips

Lateral Pelvic Tilt, an often unnoticed yet pervasive source of back pain. Click on the picture for a closer look

Lateral Tilt

Neutral Pelvis

I had the intention of using my “Summer of Back Pain 2011″ as a way to conceptually explain:

1. What can go wrong in the human body without anyone noticing.

2. The source of pain is often difficult to discover.

3. Why you, or your doctor, must think globally instead of locally. Basically, if I had treated my SI joint pain as SI joint dysfunction (or simply “lower back pain”), I never would have fixed myself. Rest and anti-inflammatory might relieve you of the pain temporarily, but unless you address the underlying issue, the treatment only serves as an temporary bandage.

I’m going to skip most of that stuff and get straight to the physical problem.

Lateral Pelvic Tilt

Looking at the diagram above, I’ve documented what is often associated with a lateral pelvic tilt.

1. Tight abductors (glute medius, TFL, glue max) on the low side that could be exerting a downward pull.
2. Lengthened and perhaps weak abductors (especially glute medius) on the high side.

note: This is a typical situation found everywhere in the body. When one side is short and tight, the other side is often lengthened and weak. It’s so common and widespread that it should be taught in high school (insurance companies would save a lot of money on needless doctors visits).

3. Tight lower back muscles on the high side of the pelvis
4. Possibly tight inner thigh (adductors) on the high side. Just another example of the short and tight/lengthened and weak pattern. This one centers on the high side hip joint.

In my case, the only thing I could definitely feel was a tightness in my lower back muscles which often felt like a spasm. Other times it was more of sharp pain. I was also having generalized lower back pain–more of a dull ache–and acute SI joint pain. Life was miserable.

All this is unsurprising because the pelvic tilt caused the back muscles to be overactive and my spine to curve as a compensation (as seen in the diagram) so that I could remain up straight. This curved spine put extra compression forces on my vertebrae.

The Solution

At this point, I’m done speculating on how I ended up with a pelvic tilt. It was probably the way I stand or sit in the car. Adaptive postural distortions are one of the main sources of non-acute injury pain; in other words, the type of pain that just sneaks up on you. And don’t think that just because you lift weights and stay in shape means that pelvic shifts–lateral or anterior– won’t happen to you. It’s quite common in both sedentary and more athletically minded people.

What I did to fix the tilt was very high-tech: I put the insole of my Nike Frees into my Chuck Taylors. This raised the low side of my pelvis so that my pelvis is now neutral. The relief was virtually instantaneous and I can happily say that today is the first time I lifted weights since July 12!

From now on, I’ll be careful to make sure I do my foam rolling, dynamic warmups, and stretches so that I am balanced on both sides of my body. It’s hard to notice that muscles might be getting a little out of whack until the pain lets you know. This is why a well balanced program is so important.

Update: As this post seems to get a lot of traffic and questions, here is my most recent post on the subject.
My Twisted Pelvis It discusses how the real root of my problem was a twisted pelvis and provides a resource that may be helpful.

PS. I drew the diagram at the top of the page by myself. Took me hours. Hope it’s helps illustrate the problem.

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