Anterior Pelvic Tilt

The Influence of Anterior Pelvic Tilt on Hip Flexion Mobility

Several months ago I featured a couple of posts discussing the importance of hip flexion strength and how to assess and enhance hip flexion strength.  Since then, I have receive a lot of feedback from people saying that they have been working on their hip flexion strength but feel that they still don’t have good functional hip flexion strength when doing the step over FMS test or the functional hip flexion test:

There is one more reason that you may be struggling with this in addition to the lack of strength and dynamic stability that I previously discussed that centers around mobility.

If you look at the picture below of Janda’s lower body cross syndrome, what do you notice about the position of the hip?

Janda Lower Body Cross Syndrome

Because the pelvis is already anteriorly tilted, the horizon (your leg perpendicular to the ground) is not really 90 degrees of hip flexion.  You are starting the movement already in a position of hip flexion, so would naturally have less ability to flex the hips.  You may have the same exact amount of hip flexion as someone else, but if you are starting in a flexed position, you would have the illusion that you actually have less.

Simplifying this and the numbers to make it easy to understand, take a look at the picture below.  See how the hip is sitting in 45 degrees of flexion because of the anterior pelvic tilt.  That means if you raise the hip up 45 degrees, you are actually in about 90 degrees of hip flexion.

Anterior Pelvic Tilt

Many people have told me that they started to work hip hip stretches and even hip capsular stretches to increase their hip flexion.  One could argue that you actually wouldn’t want to do this.  If you don’t improve your pelvic tilt first, then you may actually be overstretching your muscles and joint.

Rather, focus on your anterior pelvic tilt by strengthen the core, glutes, and hamstrings while working on lengthening the hip flexors and back extensors.  This is a simplistic view of correcting an anterior pelvic tilt but a good start in the right direction.

This isn’t rocket science, but something to consider.  Sometimes we get in trouble by assuming that the body is perfectly aligned in neutral and that raising the leg parallel to the ground is 90 degrees when it isn’t always the case.

13 replies
  1. Michael C
    Michael C says:

    Good post Mike, if I may give you a plug? Readers with questions on how to maintain a neutral pelvis should check out Mike and Eric’s Functional Stability DVD. Really worth the time and money!

  2. Isaac Ho
    Isaac Ho says:

    Hi Mike,

    If you say people have started to work hip stretches to fix their length tension relationship in their pelvis but then say that you may be overstretching your capsule and hips but than say strength while improving length of hip flexors and back extensors are you saying they lengthen from reciprocal inhibition of strengthening or are there certain lengthening exercises you feel are better than others combined with a strengthening program?

    Thanks for the clarification!


    • Mike Reinold
      Mike Reinold says:

      Thanks Isaac, if I read your question right, I think you are asking about strategies to improve this.

      This too, is a large topic and I intentionally brushed over it in the post above.

      Think of it this way, if you have your pelvis in a poor position, let’s say anterior tilt for the sake of this discussion, and you just torque the leg into extension trying to improve this, you essentially are not addressing the alignment issue and just stressing the static stabilizers of the joint (i.e. the hip capsule).

      You may achieve more hip extension, but I wonder if you are doing this by sacrificing static stability of the anterior hip capsule, and potentially creating a bigger problem – an anterior tilted pelvis with ligamentous laxity anteriorly.

      The key is to first address the pelvic position, which is a large topic beyond the scope of today’s post… but to answer your question a little, I wouldn’t focus on as much stretching the joint in extension as I would on the soft tissue to allow, such as a psoas release vs. hip extension stretch.

      • Tim Holder
        Tim Holder says:


        Above you mention lengthening the back extensors. What is your preferred technique for this? Are you referring to the length gained by restoring a neutral pelvis or do you do specific forward bending stretches to lengthen the back extensors?

        Tim Holder MPT,OCS

  3. Kyle Bohanon
    Kyle Bohanon says:

    Excellent Post Mike.

    Do you seem to find this going both ways if an athlete shows an inability to fully extend the hip during a sprint, in regards to a reduced ROM in perceived extension from already present posterior tilt of the pelvis??

    • Mike Reinold
      Mike Reinold says:

      Thanks Kyle, this is definitely possible. Also, the shortened position of the hip flexor may limited the extension and a compensatory external rotation of the acetabulum on the femur may also limit the femur’s ability to IR on the acetabulum…. this is way more complicated, though, and a much bigger discussion But, to answer your question, yes!

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