Transcript Pelvic Tilt & Lower Crossed Syndrome

Pelvic Tilt &
Lower Crossed Syndrome
Hips and Pelvis
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Structural core of the body
Contains center of gravity
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Innominate Bone = Ilium/Ischium/Pubis
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Sacroiliac Joints
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- moveable eg. walking, running, breathing
- supported by strong ant./post. ligaments
Sacroiliac Region and Ligaments
Anterior
Posterior
Pelvic Tilting
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Common causes:
- acquired postural distortions
- muscle imbalances (weak/tight)
- leg length inequality
Pelvic Tilt Assessment
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Anatomical Landmarks
◦ ASIS, PSIS, Iliac Crest
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Normal posture = No tilting
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Innominate bones rotate:
 PSIS > ASIS anterior rotation
 ASIS > PSIS posterior rotation
ANTERIOR PELVIC TILT
Anterior Pelvic Tilt
Forward/Anterior rotation of the pelvis
 PSIS higher than ASIS
 Most common type of tilt
 Corresponding hyperlordosis
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Anterior Pelvic Tilt
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ASIS lower than PSIS by >= ½”
Contributes to:
- SI joint dysfunction
- vertebral dysfunction
- decreased spinal shock absorption
- altered biomechanics
Causes hyperlordosis
Anterior Pelvic Tilt
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May be asymptomatic due to compensation
or may cause symptoms elsewhere
Unilateral (one sided tilt)
= R or L anterior tilt
Anterior Pelvic Tilt
Muscular Causes
Short &Tight
1. Rectus
femoris
2. Iliopsoas
3. Erector spinae
Lengthened & Weak
1. Rectus Abdominus
2. Biceps
Femoris
Anterior Pelvic Tilt
Muscular Attachments
Rectus femoris – AIIS
 Iliopsoas – lesser trochanter
 Erector spinae – indirectly into pelvis
 Rectus abdominis – pubic bone
 Biceps femoris – ischial tuberosity
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Anterior Pelvic Tilt - Assessment
ASIS vs. PSIS height
 LBP due to - muscle hypertonicity
- facet joint compression
Hyperlordosis / prominent gluteals
Hypertonic QL, RF, ES
AROM:
trunk flexion
hip extension (tight psoas)
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Anterior Pelvic Tilt - Assessment
Anterior Innominate Rotation Test
- positive if ASIS > I cm lower than PSIS
Anterior Pelvic Tilt - Assessment
Modified Thomas Test
Hip flexed 45 degrees.
Observe opposite thigh.
- hip flexion = tight psoas
- knee extension = tight
rectus femoris
Anterior Pelvic Tilt - Treatment
Massage, Stretching & Postural
reeducation
 Manually release hypertonic muscles
 Stretch tight muscles
 Strengthen weak muscles
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Pic of three sacral angles and corresponding
lordosis
POSTERIOR PELVIC
TILT
Posterior Pelvic Tilt
Backward/Posterior rotation of the pelvis
 ASIS higher than PSIS
 Corresponding hyporlordosis
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