Lower Back: Sit Comfortably for Days (Pelvic Tilt)

Lower Back: Sit Comfortably for Days (Pelvic Tilt)
4.2 Reviewer
Potential Relief3
Universality4
Ease4
Low cost4
Low time investment5
Comfort5
Summary
Learn to sit with a slight anterior pelvic tilt. This can relieve pain by engaging the ideal spinal curve, which gives a better foundation for relaxed upright posture if you also engage the abs slightly.
  • Potential relief: 3 - It often can relieve roughly half of symptoms. Direct self-massage, stretching, exercises, and/or other ergonomics are usually necessary in conjunction with (and to reinforce) this posture reset.
  • Universality: 4 - Helps most people, who slump with a flattened lower back.  Do NOT do if there may be a herniated disc.
  • Ease: 4 - No complicated contraptions required, but it can be tricky to get used to. You may want a towel to lift your rear, or to adjust your seat height or tilt if able.
  • Low cost: 4 - Free if you get it from online videos; otherwise, about $20 for Gokhale's book to learn completely.
  • Low time investment: 5 - Takes seconds to adjust.
  • Comfort: 5 - For most people who slump, this will instantly feel better.  If you get tired quickly or collapse into a slump, you need a more complete posture overhaul.

Detailed Instructions

“Sit up straight!”

We hear that all the time, right?  But HOW do you do that?

Specifically, how do you do that in a way that feels good on the lower back?

There are multiple pieces to that puzzle, but the main piece I find that helps the lower back is a slight “anterior pelvic tilt”.  Anterior just means forward.  What does it mean to make the pelvis is tilt forward a bit?

Imagine a bowl in your hands, and tilt it forward as if to pour water past your toes… Your pelvis is the bowl.  Put another way, it’s going to feel like you’re sticking your butt out slightly when seated, as with this first image.

Watch this 2-minute video to see clearly the full range of pelvic tilt, and where you should settle:

 

 

Who Won’t Benefit from Anterior Pelvic Tilt

You may have heard that anterior pelvic tilt is bad, and you must “fix” it. No!!!  Not when done properly.  Except for a small percentage of people with a very exaggerated forward tilt (second image of boy below), “fixing” anterior pelvic tilt is a total misidentification of where the posture problem is located.*

There’s a different, real problem with most people who already have anterior pelvic tilt.  Their problem is not the pelvis position, it’s exaggerated spinal curve.  Almost all of them have an exaggerated backward arch in their entire lower and middle back, a type of hyperlordosis (third image of boy below). That reflects disengaged core abs and over-reliance on back muscles, causing the whole back to be overused and upset.  I’ll review those solutions in future posts.

 

Who This Helps Most

However, I find that most people flatten their lower backs and round their midbacks in a slump, either slumping forward (toward a desk) or backward (rounded backward into the chair). If so, this posture correction is for you.

Furthermore, Esther Gokhale’s introductory video below recommends using a wedge, like a towel or a forward-slanting chair, to help with pelvic placement.  This lets your knees be slightly below the height of your hips, easily creating the mild anterior tilt.

Click for Gokhale’s Sitting Intro Video

Herniated Disc Warning

Do NOT do if you have ANY suspicion of a herniated disc in the lower lumbar spine.  Tilting your pelvis this way can pinch off the herniated portion of your disc, according to Esther Gokhale. 

 

Just One Piece of an Integrated Sitting Strategy

Sitting with your pelvis bowl tipped slightly forward is one simple piece of a full strategy to sitting comfortably.  For an integrated strategy that will help lock in perfect sitting posture, I STRONGLY recommend learning the multi-part “Stretchsitting” and “Stacksitting” methods from 8 Steps to a Pain Free Back.  It feels really good from head to toe, and takes only a couple seconds to get into once you learn it.  I’ve recommended this book to at least fifty people over the years, because it has changed my posture and life. Combined with exercise and some tennis ball muscle release, I’m now able to sit for hours with practically no back pain and much less fatigue.  So many people need that!

Like I mentioned above, if you find you already sit with your pelvis like this and you still hurt, it’s likely you have excessive backward arch in the upper lumbar / midback.  You’ll need a solution to correct it. “Stretchsitting” is one solution (official preview video here), along with engaging the abdominals including the transverse abs (some safe core exercises for beginners from Mayo Clinic).

 

*Controversy Note: “But My Doctor / Physical Therapist Told Me to Get Rid of my Anterior Pelvic Tilt”

The US medical view for decades has been that anterior pelvic tilt is a bad thing, like Upright Health’s video repeating that argument I don’t agree with.  On the contrary, ancient and modern world societies with pain-free backs universally have an anterior pelvic tilt (as documented by Esther Gokhale and others).  The problem is NOT that forward pelvis!  The problem is when an exaggerated arch backwards continues up through the upper lumbar and middle back, reflecting an imbalance between core abs and the back.

In Upright Health’s video, her explanation of “bad anterior pelvic tilt” and the over-reliance on back muscles is actually an example of upper lumbar hyperlordosis!  It’s misidentifying the problem.   If you follow that recommendation to tuck your pelvis (tilt the bowl backward), you will compress your lower spine, flatten the buoyant curve in your lower back, and have no stable foundation to keep your shoulders rolled back.  Her “recommended” tucked posture is frankly ugly, and for good reason.  It’s unnatural.  Slouching is inevitable with a flattened lower back, and more pain is likely.

Some people do get temporary relief by tucking their pelvis, but that’s because slumping the pelvis backward relaxes the back muscles, which are probably tight and hurting from doing too much work.  That will wear on the spine over time.  With slightly engaged core abs, and weight balanced on the ideally curved spine, you have the stability to not over-rely on your lower back muscles – plus a balanced base that gives long-term relief.

 

Posted in Lower Back.