What it means
The front of the pelvis lower than the back, with a deeper lumbar curve and the belly pushed forward.
Where it comes from
Prolonged sitting shortening the hip flexors and switching off glutes and transversus.
How it is measured
It is measured on the side view, in the sagittal plane. The defining measurement is Pelvis tipped forward or back (Sagittal pelvic tilt), and it is reported as a finding from above 15°. The number is computed from landmarks on that photograph — not estimated by eye, and not compared against a stock example.
What the numbers mean
| Measurement | Grade |
|---|---|
| up to 15° | Within normal range |
| 15–20° | Mild anterior tilt |
| 20–25° | Moderate anterior tilt |
| 25° and above | Severe anterior tilt |
Source of the bands: Herrington L, Man Ther 2011;16:646-8 (mean anterior tilt ~7° men, ~10° women)
What is usually seen alongside it
- Sway back (Lumbar lordosis) — above 45°
None of these is a diagnosis on its own. Together they corroborate the finding; apart, they do not refute it — a measurement nobody took counts neither for nor against.
What confirms it
The Thomas test, for iliopsoas and rectus femoris shortness.
Anterior pelvic tilt — what most people without symptoms have
Anterior pelvic tilt is usually presented as a fault, and a great many exercise programmes are written to "correct" it. One simple measurement in people without symptoms changes that picture.
The figure worth knowing before judging anything
Herrington [1] measured pelvic angle in 120 healthy, asymptomatic people (mean age about 24, with a palpation meter, from the line between the anterior and posterior superior iliac spines). The result:
- 85% of the men and 75% of the women had an anterior tilt.
- Only 9% of men and 18% of women were neutral.
- Posterior tilt appeared in 6% and 7%.
In a population with no symptoms at all, anterior tilt is the majority finding, not the exception. Finding it in one person says nothing on its own about their pain or their risk.
And why comparison is hard
That same paper opens by noting how little normative data exists against which findings in a symptomatic population could be compared. Side-to-side asymmetry was also significant in the men of that sample.
⚠️ So a pelvic tilt number is not a treatment target on its own. What means something is reading it alongside symptoms, function and the rest of the movement chain — and that is an examination.
References
- Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Man Ther. 2011;16(6):646–648. PMID 21658988 · DOI 10.1016/j.math.2011.04.006
The evidence on this
Study summaries that measured this finding — with their numbers and their limits.
- Which exercise for chronic back pain, and how much — Systematic review and network meta-analysis, 24 randomised controlled trials
The exercise programme
Pelvic angle is the base of the whole chain. Until the pelvis reaches neutral, the low back and knee keep taking the wrong load.
The stages advance on a standard, not on the calendar:
- Stage 1 — release and wake up — weeks 1–4: Hip flexor release, Half-kneeling hip flexor stretch
Move on: When the movement is done without pain and without compensating, and the stretch is no longer what limits it. - Stage 2 — control — weeks 3–8: Half-kneeling hip flexor stretch, Glute bridge, Single-leg bridge, Dead bug, McGill curl-up
Move on: When the target muscle is felt through the whole range and the last set looks like the first. - Stage 3 — load and integration — weeks 6–16: Glute bridge, Single-leg bridge, Dead bug, McGill curl-up, Hip hinge pattern
Move on: When the corrected pattern holds in everyday movement and under fatigue.
Each session 15–20 minutes, 6–7 times a week, for at least 16 weeks. (from a study)
This example is for a moderate grade; each stage runs shorter or longer with the measured grade, and a person's own programme is written after assessment, around their other conditions and limits. If a movement causes pain, stop it and contact the clinic. Muscle colours in the animations: orange working, blue stretching, amber holding still.
Every number on this page is measured on the skin surface in a photograph. That is not the same as a measurement taken on a radiograph: it correlates with one and does not replace it. Wherever the decision depends on imaging, this page and the report itself say so.
What happens at the clinic
The assessment starts with three standing photographs — front, side and back. Every angle is measured on those photographs, the report prints the number and the grade for each, and the exercise programme is built from those numbers rather than from a template. Posture analysis explains the whole path, and the online assessment can be started from your own photograph now.
Frequently asked questions
At what point is anterior pelvic tilt reported?
When pelvis tipped forward or back (sagittal pelvic tilt) is above 15°, it is reported as a finding. That is where the "Mild anterior tilt" band begins. The bands come from: Herrington L, Man Ther 2011;16:646-8 (mean anterior tilt ~7° men, ~10° women)
Can anterior pelvic tilt be assessed from a photograph?
A photograph gives a number, which most assessments do not have. But it is a surface measurement and it does not replace imaging. The Thomas test, for iliopsoas and rectus femoris shortness.
What is the most severe grade?
The worst band in this table is "Severe anterior tilt". The grade is printed beside the measurement itself in the report, so it is always clear which number produced the word.