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Anterior Pelvic Tilt Break Down (Workshop Snippet)
This workshop snippet provides a comprehensive breakdown of anterior pelvic tilt (APT), a common postural deformity caused by an incorrect alignment of the pelvis in relation to the spine. Through a series of guided exercises, participants will learn how to recognize and correct APT, as well as how to manage pain associated with the condition. This workshop is ideal for anyone suffering from chronic back and hip pain or anyone interested in learning how posture can improve overall health.
Transcript
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So how'd you do on your overhead
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squat? You did okay? Did everybody kind of get
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it? It's not all that complicated right? It's not like, 'oh my god I see 800
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things, this turn, that flex, that extension, ahh!'. It's not that bad. It's not that bad, at
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least in this area. At this level we need to set a foundation, we need to get
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good at seeing a few things, and then it's just like layers of an onion.
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Well add layers. Let's get good at one layer at a time though, you know, before
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we totally confound this thing to include a bajillion different joints and
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all of these different muscles, and all of these different things that can happen.
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Let's stick to feet turn-out, what's happening at the knees, what's happening at the hips, do we have an
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excessive forward lean, do the arms fall forward. You got that? Good.
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Now, the question is what we do with that information. You have seen this.
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Yes, this is your solutions table.
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Probable overactive muscles. What do we do to overactive muscles? Before we
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stretch them, what do we do them? Foam roll. We foam roll them. So you
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foam roll and stretch these. Then these are some exercises to help increase the
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activity of our long muscles. So, all it is, is short muscles on this side, long muscles
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on this side. Release and stretch short muscles, activate and integrate long underactive muscles.
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Does that make sense?
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Ok, so these are the short muscles we're going to stretch and release them. That
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makes sense, right? If a muscle is short we want to do what to it to get it to
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optimal length? We want to lengthen it. And if a
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muscle is long, we want to do what with it? Shorten it. Which we're going to do by
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increasing it's activity, by working it. Are you with me there? Now, I know this
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probably seems a little, what's the word I'm looking for...?
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It probably doesn't make a whole lot of sense just laid out in this format. This is
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the K.I.S.S. version. Anyone know what K.I.S.S. is? Keep It Short and Simple.
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Alright, so this is the Keep It Short and Simple version, you could memorize this
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and you would be well on your way to understanding corrective exercise, but I
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am going to take you through at least one or two solutions, to show you how the
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math works out, I don't want you to think this is rumor.
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There is a logic behind this. So,
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I'm going to show you how to work this out, then maybe you can work out a
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couple others on your own. Let's start with an anterior pelvic tilt:
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APT, Anterior Pelvic Tilt. The first thing we need to do is figure out what
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joints are involved in an anterior pelvic tilt.
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Hips and lumbar spine. So you've got your hips,
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and your lumbar spine.
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Now, next thing we have to do is we have to figure out what joint actions
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happen to get us from neutral
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to an anterior pelvic tilt. Are you with me? So when I went from neutral to
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anterior pelvic tilt what joint actions just happened? Let's start with the hip.
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Hip...
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Flexion, ok, so hip flexion.
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What happened at my lumbar spine? Extension. The hard part's over.
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Give yourself a big round of applause the hard part's over. If you can get that far
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the rest of it is just simple,
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I don't want to say math, because I know math scares people, but it's like simple
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fill in the blank. What are my hip flexors?
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Psoas. Keep going. Iliacus.
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You've got to two more and a group that's assisted with it. Not pirifomis, it's not on the right side.
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Adductors as a group can. What about the muscle in your quads? Isn't there
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a muscle in your quads that can hip flex. You all do
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do your quad stretch like this, right? No, like this right, you go into extension.
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The rectus femoris, and we're missing one other nasty little bugger.
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You'll probably foam roll it later. It uses the IT band as it's tendon. The TFL. Tensor fascia latae.
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Those are my flexors. What are my lumbar extensors?
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Your erector spinae, and one more big one that most people don't think of as a
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low back muscle, your lats, thank you.
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Those are all of your short muscles. That's it. That wasn't bad, right? I mean
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how many of you did I just scare to death with functional anatomy, raise your hand? Let
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me make one more thing clear, because I want everybody to pass their exam,
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if you can't do that, if those muscles don't look familiar to
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you, you need to go home and study. You cannot pass the exam without knowing
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your functional anatomy. I'm not saying that to be mean, I'm saying that because I care.
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I want you to pass.
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Now,
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what are we going to do with these muscles that are short?
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We're going to release and stretch. The only discrepancies you see in
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your solutions table, come from things that either we can't release, like can
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you release your psoas and iliacus yourself? Can you foam roll your psoas
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and iliacus. No. Your psoas is underneath your abdominal wall, connected
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to your lumbar spine going down your lesser trochanter, your iliacus is on the
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inside of your pelvis. You can try to hit it with a foam roll, you're probably
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going to squish a lot other stuff though. Don't squish other stuff. Just write that down,
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don't squish other stuff. So when you see something like, you don't see - I'm sorry
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where are we here - low back arches, you see hip flexor complex, you don't
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really see individual hip flexors, it's because some of them can't be gotten. Can we foam roll
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our TFL? Yes. Can we foam roll our rectus femoris? Yes.
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Can we foam roll our adductors? Sure. When we stretch our hip flexors, how do we do it?
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The kneeling hip flexor stretch, you've all seen this before, like the NASM, everybody's like
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oh, this is the NASM hip flexor stretch. So that one knocks out a bunch of them. How do we stretch your adductors?
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What I'm saying is, when you get to your programming, and you see examples
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it's the same as this, don't get scared and think why did they put that, and not that? It's probably
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because they listed this out, but this they couldn't release, so they release what
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they could. They picked the stretch that hit all
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three of these, so we don't need to write them out individually. Are you with me? And
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then how do we stretch our erector spinae and lats? Our Child's Pose.
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It's just easier, it takes less equipment
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and you get a nice little back stretch out of it too. How many of you guys do yoga?
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Tell me Child's Pose just doesn't feel awesome?
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So, how do we get long muscles?
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How do we figure out what our muscles are that're long? It's the opposites. So, now what we're going to do
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is hip extension, lumbar flexion,
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then we have glutes,
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and we have, rectus femoris, you could
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put hamstrings up here as long for hip extension,
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but then what does lumbar flexion? Rectus abdominis. Who else?
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The obliques. And then just a little secret,
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how many of you have heard of your TVA?
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Anybody heard of their TVA? Draw-in,
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transverse abdominus activity. Anytime you have postural dysfunction that
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involves the lumbo pelvic hip complex, your TVA is going to shut down. It might
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not get long or short, so to speak, what would lengthening of the TVA look like?
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Abdominal distension.
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This is TVA lengthening, a very sexy look. So when you see abdominal distention that's
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lengthening of the TVA.
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What are we going to do with these muscles? Strengthen them. So we go over here, low
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back arch, and we see prone iso abs. Would that be effective for these? That's
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a plank, for those of you who don't know. Why we can't call prone iso ab at NASM
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a plank, I have no idea. But it's a prone position, isometric abdominal exercise,
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that everybody else know's about. So, prone iso ab with opposite arm leg raise,
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that would be good: hip extension, glute activity, takes a lot of stabilization, takes my TVA
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holding my lumbar spine segmentally in place.
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Bridges, what're bridges good for?
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Glutes. Hopefully more glutes than hamstrings. I will say this about
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hamstrings.
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Your hamstrings are long and overactive. That's weird, right? They should be
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long and under active, but they're not, they're long and overactive because
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they become synergistically dominant for an inhibited glute complex. You know what
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we do with long and overactive muscles? Nothing. They're confused. Will you stop
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being confused, hamstrings? I'll deal with you. You get what I'm saying? You can
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release them a little bit. If you want to foam roll because they're really
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sore, and they feel really neuromuscularly tight, fine. Don't stretch them
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though. And if you strengthen them, you're only going to make them more
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synergistically dominant. So don't strengthen them either. Leave them alone.
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Does that make sense how I got here? Kind of? I know some of you need to
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