Pelvic tilt

1. Pelvic Tilt

2. DEFINITION
• The pelvic motion along with the hip
and the vertebral column makes the
normal sinusoidal curve in the Gait
cycle, these pelvic motions are called
as “Pelvic tilt”.

3. • These pelvic tilts may occur due to some
pathological problems also.
• The pelvic may be inclined tilted in below
mentioned ways:
• 1. Anterior pelvic tilt
• 2. Posterior pelvic tilt
• 3. Lateral pelvic tilt
• 4. Pelvic drop
• 5. Pelvic rotation.

5. ANTERIOR AND POSTERIOR
PELVIC TILTS
• Anterior and posterior pelvic tilts
occur in the sagittal plane and the
coronal axis.
• Anterior and posterior pelvic tilts can
be measured by the following ways:

6. Lumbosacral Angle
• The angle made by the line parallel to the
ground and the line along the base of the
sacrum.
• Normal lumbosacral angle should be 30°.
If it is increased said to be anterior pelvic
tilt and if decreased called posterior
pelvic tilts.
AT > 30° > PT

8. Pelvic Inclinometer
• One arm of the pelvic inclinometer
placed over the pubic symphysis and
another over the PSIS.
• In normal pelvic tilt, it is 30° change
in which said to be anterior or
posterior pelvic tilt.

10. Vertical Line
• The vertical line drawn from the ASIS
to the pubic symphysis aligns in the
same line, the alternation in which
said to be anterior or posterior pelvic
tilt

12. Anterior Pelvic Tilt
• ASIS moves anteroinferiorly and down
wards.
• Pubic symphysis moves posteriorly and
moves closure to the femur.
• ASIS aligned horizontal with the PSIS and
vertical line with the symphysis pubis in
normal aligned pelvic, it changes in the
anterior tilt.

13. • Sacral angle increases and the lumbar
lordosis and thoracic kyphosis also
increases.
• Abdominal muscles and the hip extensors
muscles are responsible for preventing
the anterior pelvic tilt.
• Contraction of the hip flexors and spinal
extensor results in the anterior pelvic tilt.

14. Posterior Pelvic Tilt
• ASIS moves posteriorly.
• Pubic symphysis moves away from
the femur instead of femur moves
from the pubic symphysis.
• Spinal extensors and hip flexors are
responsible for preventing the
posterior pelvic tilt.

15. • Contracture of the hip extensors the
spinal flexor results in the posterior
pelvic tilt.
• Sacral angle decreases and the
lumbar lordosis also decreases

16. Anterior and Posterior pelvic tilts

17. Muscles responsible for pelvic tilt

18. LATERAL PELVIC TILT AND DROP
• It occurs in the frontal plane and the AP axis.
• Both the ASIS aligned in the horizontal line in
the normal pelvic.
• If any changes occur in these alignment said
to be lateral tilt or drop.
• Possible during the unilateral as well as
bilateral stance.
• In unilateral stance one hip is fixed and
another is freely moving and results in drop or
hike.

19. Hiking
• In normal person the hip hiking occurs
while clearing the foot from the ground.
• This is needed from pressure relief
during prolong sitting.
• Also it is helpful when the patient walks
with the long plaster cast or braces.
• This movement support to clear the foot
from the ground during swing phase

20. • During hiking ASIS moves upwards
and medially.
• Spine goes for flexion in the same
side.
• Hip goes for abduction in the hiking
side.
• Hiking occurs due to the contraction
of the quadratus lumborum and the
spinal side flexors

21. Hip hiking and pelvic drop

22. Dropping
• ASIS moves inferiorly and medically.
• • Spine goes for opposite side flexion.
• • Hip goes for adduction in the drop side.
• • Pelvic drop occurs due to the opposite hip abductors
weakness. This sign is called as Trendelenburg’s sign.
• • Both the sides abductor paralysis leads to wadding
type of gait otherwise called as “Duck walking”.
• • In the bilateral stance, if the weight is transferred to
the right side, dropping occurs in the same side. During
the right side dropping the hip goes for adduction in
the tilted side and abduction in the opposite side.

23. PELVIC ROTATION

24. • Pelvic rotation occurs in the transverse plane
and the vertical axis.
• Pelvic rotation occurs when the swinging leg
moves forward and backward on the
supported or stance leg.
• Examples:
• In normal walking the forward motion in the
right side leg results in the right side pelvic
forward rotation, left side upper limb swings
forward and the stance or weightbearing hip
goes for medial rotation.

25. • In case of backward motion of the right leg
results in the backward rotation of the pelvic,
right upper limb swings forward and the
stance hip or weight-bearing hip goes for a
lateral rotation.
 There should be a combination of the pelvic,
hip and the spinal movements to maintain the
proper gait and the proper sinusoidal curve.
 So, during the normal walking itself there is
anterior tilt, posterior tilt, lateral tilt, drop and
rotations present to propel the body forward.

26. • These tilts are altering the body segment
during the normal walking and making
convenient or easier the walking pattern and
reducing thestrain in the weight transmission.
• If any pathological disturbance occurs there
will be
• marked and visible tilts seen.
• These pathological tilts or drops can be cured
by the proper treatment that is by the regular
strengthening or stretching program.