Is Anterior Pelvic Tilt Causing Persistent Running Pain?

My blonde bombshell mother was a model. When she’d drop me off at school, she wanted me to treat the journey from the curb to the door like a catwalk, shouting “booty out, chest forward, Kitty-cat!” from her 1980 Chevy Suburban.

Her intentions were good but the booty-popping, arched back posture she shamed me into adopting later wreaked havoc on my body when I chose running shoes over the acting classes my mother primed me for.

After a decade and thousands of dollars in physical therapy, my booty pop—or as professionals say, my anterior pelvic tilt—slowly transformed to a more neutral stance. With the tilt gone, persistent injuries faded and I ran faster paces far more efficiently.

A few months later, one of my clients told me she was frustrated by running injuries that I realized were similar to the ones I experienced before I corrected my anterior pelvic tilt. After analyzing a video of her running gait and a photo of her standing relaxed, I saw she suffered from the same thing.

In this article, I want to take a look at hip position, specifically pelvic tilt.

What is Anterior Pelvic Tilt?

To understand how a booty pop posture enables running injuries, picture the pelvis as a bucket full of water. Anterior pelvic tilt causes the muscles in the front of your body (anterior) to pull tight on the pelvis, making the water spill over. When you stand straight, an anterior pelvic tilt arches your back and makes you slump your shoulders forward, spilling the water from the bucket, so to speak, when you run, walk or just stand up.

Muscular imbalances are the primary cause of anterior pelvic tilts and while they sometimes result from training injuries, they’re typically caused by lack of movement during non-training hours of the day. Running magnifies the pelvic rotation. When you spend a long time in a seated position, you likely have some degree of inactive glutes, inactive deep core muscles, tight lower back muscles and tight hip flexors, all of which contribute to an anterior pelvic tilt.

Pelvic Tilt and Running

When mid-run fatigue sets in, it’s natural to sink and let the pelvis tilt forward, spilling water out of the bucket. This increases the arch in our lower back or our lumbar spine and increases the risk of distributing impact in places that aren’t equipped to absorb the load of pavement pounding.

The discs between our vertebrae act like shock absorbers for our spine. But they can only do so much. When we’re pounding into the ground on a run, we need to reduce the impact on them. Our glutes help spread the result if they are in a position where they can be engaged.


If you have an anterior pelvic tilt, you may notice that the muscles in the front of your pelvis and thighs are tight while the ones in the back are weak. Your glute and abdominal muscles may also be weak. According to Boulder, CO physical therapist Jim Heafner, symptoms of anterior pelvic tilt can include overactive calves or hamstrings, plantar fasciitis, Achilles tendonitis, sciatica and piriformis syndrome.

What Can We Do?

The anterior-tilted pelvis is a perfect storm of tight lower back muscles, tight quadriceps, and tight hip flexors. A two-fold approach is needed to remedy this. First, begin to loosen the tight muscles with self-massage or active release. Second, begin to strengthen the muscles that counteract the tight muscles, which include the hamstrings, glutes, and the deep core muscles.

In next week’s article, I’ll share the best strengthening exercises to correct and anterior pelvic tilt.