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Suffering with ‘non specific back pain’? It could be your pelvis

Updated: Mar 27

Are you among the 80% of people that suffer with bouts of unexplained lower back pain? Medical professionals describe this type of problem as ‘non specific lower back pain’. It often has no clear cause e.g. accident or injury; or spinal condition, e.g. scoliosis and it just comes and goes.

Sometimes it comes on because a person has over-done it - in the garden or maybe moved a really heavy item. We have all experienced this. Rest is always advisable, together with some slow, controlled and supported movements. I saw a lady with this problem recently and helped her with some gentle practices to get some movement into her spine and hip areas. She said she felt much better afterwards.

This article will explain how some unexplained back pain problems are the result of pelvic tilting and it's well worth understanding what this means. It also goes without saying that if your back pains persist you should see a GP and seek support from an osteopath or chiropractor. Yoga is great but you always need to discuss your condition with someone qualified to diagnose the exact problem.

Gentle movement can be helpful

As the lady who came for yoga therapy experienced, careful, targeted movement can be a good way to obtain relief. It helps to lubricate the vertebrae with spinal fluids, promotes fresh blood supply and can alleviate symptoms of muscular tension, which then contributes to pain like sciatica. You always need to exercise caution when dealing with back pain but virtually all physical therapists will advocate trying to keep moving wherever possible.

In a lot of cases, this type of niggling lower back pain can be the result of weak rear core muscles and too much sitting. Strengthening practices, like bird dog, locust pose, heel beats etc. can be helpful in combination with regular spine stretching. Rotational practices like wind screen wipers, gentle knee circles, hamstring and quad stretching, and happy baby are all good options.

What about pelvic tilts and back pain?

Another often overlooked contributor can be pelvic tilting (anterior or posterior) and it is interesting to understand how this can impact your body.

The effects of an anterior pelvic tilt

This happens when the front of the pelvis tilts forwards which results in an exaggerated lumbar curve. It looks like you are sticking your bottom out too much! It occurs due to a muscle imbalance in the lower half of the body. A combination of weak and tight muscles pulls the pelvis forward.

Tight, overactive muscles that may contribute to anterior pelvic tilt include:

- Quadriceps muscles;

- Hip flexors in the front groin area e.g. psoas muscle.

Weak, underactive muscles that can cause an anterior tilt include:

- Gluteus muscles e.g in the buttocks;

- Hamstring group, the three muscles at the back of the thigh;

- Rectus abdominis, i.e. the six pack muscles along the front of the abdomen.

If you have been practicing yoga for a while you may have observed a natural tendency to use your quads and hip flexors a lot and maybe find it more difficult to activate the gluts. This can be an indicator and always bear in mind there is always a spectrum of tilting in individuals. An anterior tilt can be very subtle.

The effects of a posterior pelvic tilt

A posterior pelvic tilt is the exact opposite of the anterior pelvic tilt. Instead of the front of the pelvis dropping forwards, the pelvis rotates backward, causing the front to rise and the back to drop.

If you did gym workouts in the 80s and early 90s you might remember being asked to ‘tuck in your tailbone’. It was a very common thing, people would try to straighten up their backs by ‘tucking under’ and also reduce the amount their bottoms are sticking out. This action is posteriorly tilting the pelvis and it is flattening the natural lumbar curve.

The thing is, our spines are meant to be curved, this shape of the lower region is specifically designed to absorb shocks and provide strength and stability. If it is straightened out, it loses that capability and creates postural imbalances.

The posterior pelvic tilt can arise naturally due to a lengthening of the hip flexors and shortening of the hip extensors. In other words, the result of weak, underactive quads and hip flexors, together with tight and overactive glut muscles and hamstrings. These automatically pull the pelvis out of alignment.

Sitting is the enemy!

Posterior pelvic tilts can be very common in people who sit for long periods, maybe due to working at a desk constantly or driving long car journeys. If you have to do this, it’s good to be aware of the effects and take time out to move in your seat, get up and walk around, do some stretching and strengthening practices when you can.

Many people also tilt their pelvis habitually without realising, e.g. when standing for long periods. Some people also just have a very curved lumbar (lordotic spine), making them susceptible to aches in the lower back region if they don’t have a strong core.

How to help yourself

Being aware of pelvic tilting and the effects in terms of contributing to back pain is useful because it means you can explore how to help yourself with regular gentle stretching and strengthening. This is especially true for people with a very slight tilt as they might not be aware of why their back sometimes aches for no reason.

And regardless of whether you suffer with back pain or not, these are all good practices to maintain the core and lower body.

Which yoga postures can help to address pelvic tilting?

  • Great poses to strengthen your quads - Utkatasana the chair pose; Warriors 1 and 2, Goddess Pose;

  • Great poses to stretch quads - Half Dhanurasana the bow pose, Natrajasana the dancer pose, Anjaneyasana the crescent moon lunge;

  • Great poses to strengthen hamstrings - Trikonasana the triangle pose; Setu Banda the bridge pose;

  • Great poses to stretch your hamstrings - Prasarita Padottanasana the wide legged for forward fold, Supta Padangustasana variations - reclined raised leg stretches.

There are hundreds more other options too.

Hope this is helpful information!

Let me know if this article has been informative and helpful.

If you would like a one to one yoga therapy session to address your lower back pain, I can offer you targeted practices supported with a home practice.

Please do get in touch to discuss this in more detail.

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