#24 – Alexander’s Anterior Pelvic Tilt Problem

In today’s episode, we answer an Upright fan’s question about his stubborn anterior pelvic tilt.

To see our DIY training program to help you with your anterior pelvic tilt, check out the Fix Anterior Pelvic Tilt program here.


Matt: Hey, everybody! It’s Matt Hsu and welcome to the 24th episode of the Upright Health Podcast. I am sitting here with a tall, good looking guy. Would you please introduce yourself?

Josh: How’s it going, guys? I’m Joshua Hash. Happy to be here.

Matt: So Josh Hash, you guys have probably seen on the YouTube channel. I have finally wrangled him in to join on an episode of the Upright Health Podcast. So you’re in for a special treat. He normally would be at home, sleeping in his bed, curled up. (laughs)

Josh: (laughs) Reading a book, maybe. But let’s make this happen.

Matt: All right. So, today’s episode is about Alexander’s Anterior Tilt Problem. Specifically, it’s Alexander’s Anterior Pelvic Tilt Problem. He sent us an email. I think it was a couple weeks ago. And he has been watching our YouTube channel for quite a while and has been doing a lot of things to try to help correct his Anterior Pelvic Tilt and he’s got questions about it. So, Josh, actually, before we go any further, can you give people an idea of what Anterior Pelvic Tilt is?

Josh: Yeah. Anterior Pelvic Tilt is basically just a postural issue when the pelvis kind of tips forward too much. So if you think of the pelvis maybe like as a bowl containing water or any liquid of your choice, and if that liquid would spill forward, that is essentially what Anterior Pelvic Tilt is. And now, this kind of just messes with what else is going on in your body because it causes your lower back or your lumbar spine to over extend and it can create some issues.

Matt: Perfect explanation. So that’s what Alexander is facing. So has been doing some of our stretches and he is wondering about how to maintain his posture during the day and also at night. So he says that his gut sticks out a lot. And sometimes it gets to the point where it looks like he’s in the early stages of pregnancy.

Josh: (laughs)

Matt: That’s a direct quote. I’m reading that the email. That’s a very vivid picture. So anyway, he says he’s usually able to maintain posture during the day by bracing his core whenever possible, pushing my hips forward and forcing my neck back. However, it’s at night that I experience the most problems. He’s tried sleeping with pillows under his knees to try to get his spine in neutral. But then as he sleeps, he ends up lying on the side and the pillows are kicked off on to the floor. He also noticed that head posture is affected during sleep. So he says, “Whenever I rest my head on a pillow, I feel as if my head is unnaturally forward. And I suspect it has something to do with my Lordosis because when I brace my core, my upper body naturally moves forward and so does my neck. And when I sleep, my core is not braced, so perhaps my natural head position is effected by this. I’m not sure.” He says, “I was just wondering if you had any advice from me. In addition to these sleep issues, I find that whenever I fix my Kyphosis by pushing my neck back, this increases my Lordosis. And when I brace my core to fix my Lordosis, my head comes forward. I’ve tried to do both at the same time but the ever need to do this is impossible for me to sustain for more than a minute.” So a lot of stuff going on here. So, Josh, any ideas? What can Alexander do? What does it seem like he’s missing?

Josh: Well, the first thing that kind of jumped out at me was that he says he’s able to kind of keep an okay posture by forcing his hips under him and bracing his core really hard. Which is a good idea, right? You wanna be aware of what your posture is doing. But that word “force” kind of tells me that maybe he’s having to do these things too hard and they’re not coming naturally to him. And I think that doing more training,  basically, in the gym will help you get to into that posture a little bit more naturally without having to really kind of like exert your force to get there. Does that make sense?

Matt: Yeah. It’s something I think that we talk a lot about is kind of tricking the body to do the right thing and training really helps do that. You know, if get your body to do the right thing multiple times in a situation where its controlled, where you have resistance, when you take away that resistance, it’s a lot easier for the body to just handle the naturally good position. Okay? So that’s one thing is definitely some more training because it seems like that’s going to be probably more helpful for him.

Alexander also mentioned that he’s done some stretches and they helped a bit. So one of the questions I would have for you, Alexander (and if you’re somebody out there like Alexander) is you know, what stretches specifically are you doing? Are you doing the ones that seem to directly affect that Anterior Pelvic Tilt for you? If stretches aren’t doing it… if you are doing good stretches, if you’re doing like quad stretches, if you’re doing hip flexor stretches or doing things like that and they aren’t seemingly affected, well, then, I think it’s just hopeless, I guess. Right, Josh?

Josh: Yeah, go home.

Matt: Yeah.

Josh: But don’t sleep.

(Both laugh)

Matt: But seriously, if stretches aren’t helping then you definitely want to be looking at more activation exercises. And what’s what Josh is getting at is, you know, how are you training your body to move? If you’re not doing anything in terms of abdominal training, you might not have the strength even to stabilize your pelvis. If you’re not doing hamstring training, glute training, you may not have the strength to hold the pelvis in the right spot. And no matter how much you stretch, it’s just not going to do anything.

Josh: Yeah, just to go off that, I would definitely say to continue trying to find something out of those stretches and maybe do that before you do your training. But then definitely, like Matt said, you should be visiting things like core exercises and you know, we’ve just recently put out a few like deadbugs and heel taps. So these are really simple things can just put you in that better position and train your body to be stronger in that position. So like we said, it can carry over into everyday life, right? So you do not think about it as much. But yeah, the big muscles are going to be your core muscles, your glutes, your hamstrings, right? I’d say go after those every day, if you can.

Matt: yeah. So, training, training, training. This stuff about the sleeping, anything you want to mention there, Josh?

Josh: I’m going to let you dive in there first. (laughs)

Matt: (laughs) Okay. So it’s funny because this thing about pillows under the knees, that’s a trick that I’ve found really helped me… actually back when I was in high school, just to try to get my back to calm down. But pillow under the knees is really not like a wonderful, long-term solution as you’re finding for first, the fact that you will kick the pillows off every single night. And unless your strap them to the back of your knees, it’s just never going to work. Even if you did that, you still have… you’re going to not be addressing muscular imbalance issues, so it’s just not going to be a good long term solution to it.

The thing that really gets my attention though is this… you mentioned the pillow pushing your head unnaturally forward. I’m glad you’ve noticed that. It’s actually something that I think a lot of people should pay attention to. Especially if you’re a back sleeper, if you have a really thick pillow, your head is in an unnatural position. It’s definitely being pushed forward.

I actually worked with one of my coworkers back in my twenties, back when I was doing other things in an office. Had really bad neck and shoulder pain and she was telling me that she would stack pillows, like, ten pillows (laughs) to try to relieve her shoulder and neck pain. And so she showed me her sleeping position and it would just be with her head just clocked at a 90-degree angle.

Josh: (laughs)

Matt: And you know, when you actually touch her neck and shoulders, it was tight. (laughs)

Josh: Yeah.

Matt: And it’s no wonder when you put your head and neck in a funny position, that everything’s gonna be uncomfortable and just annoyed and just yell at you, like, “Hey, something is wrong!”

So if you’re a back sleeper, definitely, you wanna look the thickness of the pillow and make sure it’s not really, really thick. Anything more than even, like, four inches is probably going to be too thick. And it should also compress enough to let you feel like you’re being… I don’t know what we’re looking for when we’re sleeping… but feel like you’re being cradled in the arms of God (laughs) I don’t know, but also not pushing your head and neck forward.

If you’re a side sleeper, you know, it’s the same deal; you just wanna make sure that your head is not being cricked, right? It’s not turning at a funny angle because of the pillow. You definitely don’t wanna have your pillow determining what your head and neck do; you want your head and neck to determine what your pillow does. While that doesn’t directly address your Anterior Pelvic Tilt question, hopefully it helps you just sleep better in general and doesn’t annoy your head and neck.

Josh: Mh-hm. Yeah. I mean, I think you just wanna try to get a neutral neck position. And also, to add about the Anterior Pelvic Tilt is we have to remember that the spine does having a natural lordosis curve in the lumbar spine, right? So to think that you’re going to sleep in like posterior pelvic tilt all night, it probably isn’t realistic, right? Obviously, you don’t wanna be in a huge Anterior Pelvic Tilt but I think as you train your body more to naturally be in that position, you’ll just be in a better sleeping position and your body will kind of know what to do.

Matt: Yeah. There’s two really good things to touch on there. I think one is if you’re training better, sleeping is easier, right?

Josh: Mh-hm.

Matt: That’s definitely true. That’s something we say a lot here.

Josh: And we’re going to make a YouTube video on that on how to do that.

Matt: (laughs) Yeah, let’s make that YouTube video. And the other thing that you kind of sparked in my mind was, if you have a really soft bed, it will also tend to make your Anterior Pelvic Tilt more dramatic. When you are sleeping on a soft bed, it will deform the most and compress the most where you’re heaviest. And if you think about where you’re heaviest, it’s going to be at your pelvis. The surface area that’s the weight of the legs are spread out on is so big, that your legs don’t really sink that much on the soft bed. Your rib cage also doesn’t sink that much, your shoulders doesn’t sink that much, your head doesn’t definitely sink that much. It’s going to be the butt that’s sinking down. And because you already have a natural lumbar curve, that lordosis, it’s going to basically exaggerate that. As your butt sinks lower, your Anterior Pelvic Tilt is going to get more severe. So if you are in a bed that’s super soft, that’s going to make it more difficult for you to maintain a better position — even if you do train well. And I think about that because I’ve been in some beds that are softer. Air mattresses tend to, even though…

Josh: (laughs) That’s a great point, right.

Matt: Right? (laughs) So even though I don’t have any problems sleeping normally and maintaining good pelvic position now, I used to, back in the years ago. And even now, if I sleep on a really crappy bed that’s really, really soft, I will still have problems with the Anterior Pelvic Tilt and I will get up feeling stiff and uncomfortable and will wish that I were at home sleeping instead, so.

Josh: Yeah, true. And you know, I’ve read books where people tell you to just sleep on very firm surface, even the ground. And I mean, I’m not as extreme as that. I wouldn’t suggest that, but you know, I think you could be on to something there. I think a little firmer surface definitely makes sense, yeah.

Matt: I’m definitely not that extreme. I’ve tried that before and it’s really uncomfortable. (laughs) I think even when I ended up with Anterior Pelvic Tilt, it’s just…

Josh: Leave that for the Yogis. (laughs)

Matt: Yeah, I’ll let the guys who are meditating 24 hours a day figure out how to make that comfortable. But yeah, something that’s maybe like or something firmer and then with an extra pillow or something can sometimes be helpful. So, couple of ideas there for you to think about, Alexander.

So you know, that pretty much covers it. Is there anything else you wanna add on this topic, Josh? I don’t think there’s much else I wanna talk about.

Josh: No. Take care of that pregnant belly, though, for sure.

Matt: Yeah. The pregnant belly (laughs) that’s actually…

Josh: Get that thing out.

Matt: (laughs) get it delivered…. We’re not trying to make fun of you, but that’s a big sign of your abs being pretty weak.

Josh: Yeah, no I’m not trying to make fun of him. That’s really funny actually, I like to say that too, “You got a big man belly,” or whatever.

(Both laugh)

Matt: But yeah, it’s definitely a sign of weakness. So if stretching is not doing it, then you wanna figure out how you can pull that belly back in. Deliver the baby. It might be painful, painful labor, painful delivery. But yeah, get that dilated and then just get it through and then start keeping those abs on so that you can maintain that proper pelvic position.

So yeah, that’s it. Alexander and everybody else out there who’s got Anterior Pelvic Tilt issues, hopefully this was helpful for you. In the future, we are planning on releasing the Fix Anterior Pelvic Tilt program on brainfood.uprighthealth.com, so you can keep your eye out for that. And in that program, we’re going to talk about different exercises you can do, how to sequence things that you’re doing, how to sequence exercises and stretches so that you get the most bang for your buck. So definitely keep an eye out for that if you are dealing with Anterior Pelvic Tilt is a question we see a lot of, so we definitely wanna have that program ready for you as soon as possible.

But yeah, that’s it for today for Episode 24. Alexander, good luck! And I hope you remember that pain sucks…

Josh: …life shouldn’t!


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