A common complaint physical therapists will hear from patients is pain with prolonged standing. While this can be caused by a variety of factors, one of the first things we will look at is standing posture.

 In this posture, sometimes referred to as “Lower Crossed Syndrome” Posture, the person is standing with their back hyper-extended and hips protruding forward. For many people, this is a comfortable standing position that requires less effort to maintain, but for some people over time this can lead to pain across the lower back. This standing posture can lead to increased tightness across the low back and may eventually lead to an increased curvature in the lumbar spine. 

There are several factors that contribute to the development of this posture. The protruding forward of the hips, or Anterior Pelvic Tilt, can occur due to tightness in the hip flexor muscles pulling the front of the hips forward. Hip flexor tightness is common in many people but can worsen from living a sedentary lifestyle. The prolonged sitting can cause these muscles to shorten over time and pull the hips forward creating the anterior tilt. Any excess weight in the abdominal region will further add to the anterior tilt. 

In order to combat the pulling forward of the hips, multiple muscle groups must fire to posteriorly tilt the pelvis back into a more neutral position. The main muscle groups responsible for performing the posterior pelvic tilt are the abdominal muscles and the glutes. Many people struggle to engage these muscles properly or lack the strength or endurance to maintain engagement when standing or exercising leading to poor posture.

The problems of an anteriorly tilted pelvis standing posture is multi-faceted with issues related to tightness in the hips and excess abdominal fat pulling the hips forward combined with the lack of muscle engagement and strength to counter this motion. Therefore, to best help correct this posture, all issues must be addressed. 

Building the Posterior Pelvic Tilt:

Improving abdominal and glute activation and strength:

This exercise shows how to properly engage the abdominal muscles in order to perform the posterior pelvic tilt. This exercise is an excellent building block in working on strengthening your abdominals and should be performed while performing any other ab exercises. As this exercise becomes more natural lying down, it can then be performed in standing to help correct the anteriorly tilted posture. 

This exercise is one way to learn how to properly engage and strengthen the glute muscles. As glute activation becomes easier to perform, it can then be performed in standing in addition to the abdominal bracing to help create a posterior pelvic tilt.

Reducing the Anterior Pelvic Tilt:

Perform this stretch to gradually improve the flexibility of the hip flexor muscles to reduce the pulling forward of the hips that creates the anterior pelvic tilt. 

Weight Loss most specifically at the abdominal region will also help to reduce the anterior pelvic tilt. 

If you are struggling with low back pain from prolonged standing, consider your posture. These exercises may help to improve your posture and reduce your pain. If symptoms are still present, consider an evaluation with a physical therapist to further evaluate.