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Back Pain and Anterior Pelvic Tilt

(For video, please scroll to end).

Pressure on the spine from a rotated pelvis can cause pain in otherwise healthy individuals, due to muscles shortening and weakening. This video explains why, and shows how you can remedy it.

A common cause of back pain is something called anterior pelvic tilt, where the pelvis tilts 'anteriorly' – or forwards - and is mainly caused by being seated for long periods.

When you're sat down your back muscles, glutes and hamstrings are stretched out, which weakens them. The back muscles are prone to tightness when weak, which causes tension in them.

Meanwhile, the hip flexors, which are muscles that move the leg forwards, are in a shortened position. Over time they adapt, and become permanently shorter.

If you can't get both legs straight down towards the floor on this stretch then you've probably got tight hip flexors. (See video for actions).

Tight back muscles and tight hip flexors pull on the pelvis, rotating it forwards. Weak, stretched out glutes and hamstrings, combined with weak abdominals then make it harder to pull the pelvis back into the correct position.

The first step to addressing it is increasing flexibility through stretching.


Bend one knee, stick the other leg out straight, and pull your toes up to the ceiling. You should feel a stretch in the back of the outstretched leg. Those are your hamstrings.


Sit with one leg out straight in front of you, bring the other leg across that and then pull it in close to your body. You should feel a stretch in the muscles in your bum.

Hip flexors

You can use the quad stretch from earlier to stretch them (see video).

You can also do them by getting down on one knee, keeping the torso upright and then pushing your whole body forwards. Be careful not to start arching your back in order to try to get the hips further forwards. Try to keep the spine and hips in a straight line.

To increase the stretch you can grab your foot and pull that in towards your body.

Hold these stretches for 60 seconds on each side to increase your flexibility, or for 15 seconds if you're just looking to maintain your current levels of flexibility.

Getting a good stretch on the back muscles is hard as the human spine just doesn't bend far enough to allow it.

If you've got somebody who loves you enough to give you a massage give that a go. If not, but you've got a tennis ball that loves you enough try this.

Hold the tennis ball against the wall with your back and move up and down to massage the tight muscles. Try firmer balls against the floor if a great effect is needed. If you can get hold of a baseball they work brilliantly for this.

For strength you want to do exercises for what's called the 'posterior chain', which are muscles down the back of the torso and legs, including the hamstrings, glutes and back muscles, that are responsible for straightening you out, and that will have gone weak from years of sitting down.

King of the posterior chain exercises is the deadlift. The form is a lot trickier than it looks, requiring a very precise set up, so please consult with a fitness professional to learn the correct technique before trying them. Get it right and they're a fantastic exercise for back strength and training your body to bend correctly when lifting. Get it wrong and you'll make your back pain worse.

Kettlebell swings are another great posterior chain exercise, but again, please make sure you've learnt the correct technique. It's easy to put the focus on the wrong muscles to be effective, or start bending the spine by mistake.

That leaves the muscles on the front of the torso to strengthen up. Before getting into doing loads and loads of crunches and trying to hit the abs specifically, it's best to take a step back, and look at the torso holistically, and this is where core training comes into play.

The core refers to all of the muscles in the torso whose job it is to keep the spine straight while the arms and legs do all of the moving around. Everything from the tiniest muscles deep down by the spine itself out through the different layers to the larger muscles on the surface; everything that keeps your spine straight is a core muscle.

The best place to start with core training if you've done nothing before is with a plank.

For doing a plank you want your feet and forearms on the floor and everything else raised up and held in a straight line. It can be tricky to make sure you've got your body in a straight line, so one tip for that is to pop a broom on your back.

With a broom on your back you should feel 3 points of contact:

you should feel it on your calves,

on your pelvis,

and on your spine, somewhere halfway up your back, depending on how tall you are.

If you raise your hips too high, or drop them too low you won't feel all 3 points of contact with the broom.

Be careful with arching your back. It's easy to end up arching your back to keep your pelvis in contact with the broom but still not be in a straight line, so keep the spine straight, feel for all 3 points of contact and then you're doing a plank correctly.

Back and core strength, and flexibility, have a big, big impact on back pain. A personal training client of mine, Sam Wegrzynowski, struggled a lot with back pain until we started working on his strength and flexibility.

“Before training with James I used to suffer really badly from a lot of lower back pain. But when I focused on my strength and conditioning, and my flexibility training, I'm able to go to gigs and not suffer any pain and mosh to my heart's content, while all my friends are suffering from back pain.”

There are more tips and nuances than I can cover here, so if any of this affects you or if you have any questions, either get in contact or, if possible, leave a comment in the comments below and I'll get back to you as soon as possible.

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