PELVIC TILTING
B.VANDHANA MADHU PREMI
B.P.T 2ND YEAR
VAPMS COLLEGE OF PHYSIOTHERAPY
INTRODUCTION
• Meaning of pelvic tilting
• Pelvis : greek word,basin or bowl
• Formed by ilium,pubis,ischium,sacrum,and coccyx
• Tilt: slope ,incline, lean, bend.
DEFINITION
• Movement in the vertebral colum and at the hip joint
make it possible for the pelvis to be stabilized in a
variety of positions.
• Pelvic tilt is an antero posterior motion of the pelvis
around an imaginary axis in the frontal plane.
TYPES OF PELVIC TILT
• Three types of pelvic tilt
• Anterior pelvic tilt
• Posterior pelvic tilt
• Lateral and rotation of pelvis.
ANTERIOR PELVIC TILT
• Anterior superior iliac spine (ASIS) of pelvis moves
anteriorly and inferiorly and thus closer to the
anterior aspect of the femur as the pelvis rotates
forward around the transverse axis of the hip joints.
• The pelvic motion results in hip flexion and
increased lumbar extension.
• Muscle causing this motion are the hip flexors and back
extensors.
• If hip flexors through femur movement is the desired motion ,
the pelvis must be stabilized by the abdominal to prevent
anterior pelvic tilt.
• During standing ,if the line of gravity of the trunk shifts
anterior to the axis of the hip joints, the effect is an anterior
pelvic tilt moment. Stability is provided by the abdominal
muscles and hip extensor muscles.
POSTERIOR PELVIC TILTING
• The posterior pelvic superior iliac spine of the pelvis move
posteriorly and inferiorly ,thus closer to the posterior
aspect of the femur as the pelvis rotates backward around
the axis of the hip joints.
• This results in hip extension and lumbar spine flexion.
• Muscles causing this motion are the hip extensors and trunk
flexors (abdominals).
• An upward inclination of the pelvis from the point of
support is produced and maintained by the
contraction of the abductors of the hip of the
supporting leg
• Ifthe hip extensors through femur movement is the
desired motion, the lumbar extensors contact to
stabilize the pelvis.
•During standing the line of gravity of the trunk
normally falls posterior to the axis of the hip
joints creating posterior pelvic tilting.
•Dynamic stability is provided by the hip flexors
and back extensors and passive stability by the
ilio-femoral ligament.
LATERAL PELVIC TILT
• The pelvis may also be tilted laterally on one of the
femoral heads .
• When the femur on which the pelvis is tilted is fixed
as in standing on one leg , and the other leg is free
to move , the pelvis is tilted laterally to bring the
centre of gravity over the base and so maintain
balance by abduction or adduction in the hip joint
of leg which is fixed.
• When this occurs the lumbar side flexors on the
opposite side from the supporting leg work to keep
the trunk erect.
• When the weight of the body is transferred on to
one leg and the hip abductors are relaxed or
inefficient the pelvis is inclined laterally and
downwards towards the unsupported side by the
force of gravity.
LATERAL PELVIC TILT
ROTATION OF PELVIS
• It occurs around one lower extremity that is fixed on
the ground.
• The unsupported lower extremity swings forward or
backward along with the pelvis.
• When the unsupported side of pelvis moves
forward it is called forward rotation of the pelvis.
• The trunk concurrently rotates in the opposite
direction and the hip joint on the stabilized side
rotates internally .
• When the unsupported side of the pelvic moves backward,
it is called post rotation ,the hip joint on the stabilized
side concurrently rotates externally and the trunk rotates
opposite.
• Muscles causing pelvic rotation are the hip rotators
working in synergy with the oblique abdominal muscles,
the transversus abdominis and the multifidus muscle.
• When hip rotation through femur movement is the desired
motion, the pelvis must be stabilized by the trunk
musculature
MEASUREMENT OF ANGLE OF PELVIC TILT
• A) ANTERO POSTERIOR TILT: In erect posture the angle of
the pelvic tilt can be measured in a variety of ways:
• 1)The angle at which an imaginary line, drawn
trough the symphysis pubis and the lumbo-scral
angle, lies in a relation to a horizontal line can be
measured.
• The pelvic tilt is said to be normal in the standing
position when this angle measures between 50 to
60 degrees
• 2) the angle of pelvic tilt is said to be normal in the
standing positions
• 3)The angle recorded by a inclinometer, one of the
arms of which is placed over the pubic symphysis(PS)
and the other over one of the posterior superior
iliac spine(PSIS) is in the region of 30 degrees in the
standing positions when the pelvic tilt is normal
Maintenance of the normal angle of antero-posterior
tilt of pelvis: the angle of the pelvic tilt in standing is
stabilized either by the tension of the structures which
lie anterior to the hip joint ,which prevent the angle
from being reduced, or by the action of the straight.
Abdominal muscles and the hip extensors which
prevent it from being increased.
• Alteration in the angle of antero- posterior
tilt of pelvis: an increase in the angle of
pelvic tilt may be called forward tilting of
pelvis, and a decrease in the angle of pelvic
tilt may be called backward tilting of the
pelvis
Forward tilting of pelvis:
• Movement of the pelvis on the femoral heads to
produce a forward tilting is produced by the
contractions of the hip flexors muscles and the
extensors of the lumbar spine.
Backward tilting of pelvis:
• the pelvis can be tilted backwards on the femoral
heads by the contraction of the hip extensors and
the straight abdominals muscles.
POSTURAL RE EDUCATION THROUGH
PELVIC TILT
• Voluntary control of pelvc tilt teaches the patient to
recognize any deviation from normal and trains him
to be able to adjust
• Pelvictilt exercises introduce you to proper pelvis
positioning , and then may encourage you to
maintain the tilt while your legs. Unilateral
balancing exercises help you establish a proper
pelvic tilt while balancing on one foot.
• Crook lying: gluteal and abdominal contraction.
• Low wing sitting ,pelvis tilting and adjustment.
• Low wing standing, pelvis tilting and adjustment.
