Hi folks, I'm Bob Schrupp physical therapist, Brad Heineck physical therapist
I'm Bob Schrupp physical therapist, Brad Heineck physical therapist, together we are the most famous physical therapists on the internet, in our opinion of course
Once you kind of get off line it's hard to get back on again, we're going to talk about
Do you have fake anterior tilt, anterior pelvic tilt and how to fix anterior tilt in five steps, we're gonna do them for both!
We can do double duty. Right, is this like fake news Bob? Yeah. Sure just like fake news
No, it's not actually
there's a really good difference between the two and we're going to show you in just a little bit, a lot of people think they have
anterior tilt and they don't, right
So if you're trying to fix it, you know
Actually a lot of things we do today would fix even fake anterior tilt, right so it's a win-win situation
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There you go. And that's fake too, by the way
Let's first show what an anterior tilt is. So we're talking a real anterior tilt here.
We're taking about the pelvis, we're taking everything off Bob and showing just the spine and his pelvis here and
the pelvis can rotate this way or this way, I'm gonna go along with you Brad, go ahead and do it again. So if we go back,
Let's go together, anterior tilt, posterior tilt, anterior means forward, tuck that in little bit Bob
We have our blue here. We have a blue thing there to try to emphasize the line
That's a good anterior tilt. Move that arm. Thank you. And now let's do posterior
So it's you know, some people may not know this but as a therapist
This is something we're looking for all the time, it's like
Oh we're gonna
Right cuz a lot of times when I do lifting I try to do an anterior tilt to kind of keep my back as
straight as possible and you can't start going down here. And otherwise you want to be kind of in the neutral zone. Sure
You don't want to be anterior or posterior
And I think one of the biggest issues as therapists
we see is many people do not have awareness of where their pelvis is
Whether it's anterior or posterior because you're just not aware, it's not like your arm or your legs
What I see with a lot of people lifting is
they're actually posterior tilted they're tilted like this and they're lifting like this and their back rounds out
So if they tilt it this way, they got a good arch in their back and their back is supported
Let me show the fake one Brad. Okay, so right now my pelvis is level, see that does it look level? It does
If I just lean back like this, my pelvis is still level
But now it looks like I have anterior tilt because I have an arch in my back
Normally I have to do this to get an arch in my back, you know, it does tilt forward
So fake anterior tilt and sometimes people just lean back and their posture is like this
Right, so they have a sway back going back and we don't like this either because look what it does to the neck
Head forward posture. We got a lot of stress in the lower--I'm locking in the knees.
I'm hanging on my ligaments is what I'm doing, I'm hanging on the pelvis. I'm hanging on the hips. Sure, so it's just, it's not a good thing to do
And like we said, the things that we do for the exercises and the posture corrections do luckily work for both of them in any case also, yeah
Let's show you how may want to first
do a pelvic tilt, right, so you kind of know where your pelvis is at, lay down
the best thing to do is to lay down and Bob's going to work a good exercise
And these are good core exercises, by the way
See he's doing a posterior tilt, now if I were to put my hand right here and this is what I do with patients
I say squeeze my hand with your back
And when you do that the abdominals contract, the pelvis posterior tilts
and the person is becoming aware of that motion if they're not already and typically if I work with some elderly people that
were physically active all their life, they really don't have this awareness, as well as other people, too
So yeah, you're learning how to do a posterior tilt
And eventually you can translate that to standing too, right. I mean, if you learn how to do it here
and even sitting learn to do it and then you can learn to do it standing
where you kind of keep again the pelvis in a neutral area when you're doing things, right precisely. Alright. Next thing is one of the things that can cause an
anterior tilt is tight hip flexion, right. And so we want to work some
exercises and some means to get those more flexible and pliable because when you sit a lot which almost
everybody does and if you think about it, because you're talking about driving time you're talking about when you're watching TV at night
Right, then, your hips are in this position here
So they're not getting stretched at all and they're gonna tighten up on you
Especially if you have your job then you sit all day too, and you know if you've heard about tight hip flexors
We're talking to muscles that are responsible
for pulling your hips into flexion or your femur up like this
when you sit a long periods throughout the day day after day month after month, etc
They stay tight and then they actually when you stand up they can help pull that anterior tilt
where we have it so if we stretch those muscles out we can get that
neutral position we're looking for. Yeah the thing I see to Brad is not only
the anterior tilt, they may even get bent forward a little, sure
After time they're like this and they can't even straighten up because the hip flexors are tight, right and that puts stress on the lower back as well
because they're connected to the low back. So one way to stretch them
Well should I do the laying down one first? If you're not that mobile and
you just want to stretch your hip flexors, one way you can do it
is actually just by starting off if you pull up on this one and you're really tight
This will probably stretch your hip flexor a little bit
You know if I push here gently
I'm not going to be aggressive, but that might help Bob
if he happens to be tight, if he does this and this pulls up you're really tight, right
So if I go like this, it's down flat
Then I go like this and it pulls up, that means it's really tight
Another thing you can do, if you start, you know again, don't fall off the edge of the bed
but you can go off the edge like this
There you go
And the same thing on this if I pull it up and it comes up like this
You're tight, right
And if you want to add a little more stretch, you can even pull the knee, the foot back a little bit like this
Right and that actually gets the rectus femoris another hip flexor because there's a number of hip flexors that work together
So that's being more complete, if you're a little more mobile you can get down on your knees
I throw a pillow down. I did this this morning.
I just go ahead and stretch like this. Give a little more stretch if you turn your foot out like this
I'm going to just get in front of you quick Bob
But I just wanna show the point Bob's got nice tall posture, if he leans forward with his trunk
Then it doesn't give you quite as aggressive a stretch
You may have to start that way, but you want to work up to this vertical posture. Right and look how well extended
I have the leg because I do stretch this out a lot
He's got pretty flexible hips so, he's a good demonstration for someone that's flexible
I'm a little bit tighter that way so I didn't want to do it
I appreciate that Brad. Okay, the other one we can use we can actually use a foam roller, right?
Right. If we want to, can you get that Bob? We're going to take advantage of this.
If you got a foam roller the 4 inch or the 6 inch will work
It depends on your body size, if you happen to have a 6 inch one use that one
Don't go out and buy another one for it. And what we're going to do is actually we've got blue on blue on blue here
Oh, oh my goodness. We can put the blackboard in there if that shows up
Okay, we'll get serious
I'm gonna roll to one side a little bit to get to my left hip flexor and I'm going to let all my weight go on there
It's a deep muscle so you're gonna have to work it
fairly aggressively, this one is a roll that is
a little more firm, might be advantage to it, but you could still use it, advantageous. Tthank you Bob. Yeah, because
this one's probably almost too soft isn't it for this, bring it close?
And plus you're not gonna do it on a soft bed, that's the problem, on a carpeted floor is best,
Right we don't have our mat out right now so we're not going to get into detail with that
but that's definitely a good option and then we're gonna go ahead and
we're gonna work on getting our posture right
especially if you have that posterior lean or if you are anterior tilted you can go up against the wall
and you can straighten yourself out here. You can go ahead and flatten your back up against the wall
Get the hand out where they can see that. There you go
You're gonna do it with your hands down there see how you flatten it you can, do that again Bob, there and that little bit of a movement is
significant in the low back and the pelvis and
and then I go ahead and bring my shoulders back and get everything all lined up and then I can walk away from the wall and
maintain that posture
There you go
So the other thing that you know you can do is I'm going to do that and I really like doing this because it really
feels good on my back
here and I'm going to do this and then shoulders too, right, and then we're going to maintain that with that chin because a lot of times
people can't get the head back
And right now my stomach is tight because I'm tightening up to get that posture to wherever we want to to get get rid of that anterior tilt
If you want to use some bands with that
that you happen somewhere to anchor to the wall like we have here, now if you want to strengthen your core a little bit
while you're keeping it in good position. You can go ahead and use some bands
So, there you go
And that actually works the core some more
while you maintain that posture that you found against the wall and you'll be amazed after you work this, you're gonna say oh geez
I was never aware of where my pelvis looked before and once you do it, it becomes part of your life, why don't you flip around Brad
Oh yes there you go
and then I'm going to try to
straighten that out again. This is a great posture exercise
So now he's got his pelvis in the right position, but he's also working on the upper back and
shoulders and this is going to help keep that posture correct
Which is the one that a lot of people do have difficulty with they get rounded up in those shoulders,
They get internally rotated and it's all a mess, it is but, what are ya gonna do, just listen to us, we're therapists
We're concerned about your posture, it's really going to help, Bob once again, we can fix just about anything
except for a broken heart, there you go, but we're working on it. Yep, we've got homework and stay up til midnight sometimes working on it. Thanks.