A Program to Help Fix Your Anterior Pelvic Tilt
When I graduated college, I thought I knew a little bit about training people. I had my NSCA-CPT and had just passed my CSCS. I spent the better part of the past year and a half working with D1 athletes and actually programming for several of the teams there. The people that I had worked with got great results, and I read stuff all the time. All the top fitness blogs, Men’s Health, you name it, I devoured it.
And then when I got my first training position in Dayton, Ohio and I was instructed to write a training program for a general population client (as I mentioned, I had really only worked with athletes), I was all over it. I simply drew from my experience at Evansville and went to town. This will be cake, I thought.
Boy, was I in for a lesson.
Even though I had done everything above, I had never been tested with this population when it came to program design. I didn’t know how to program for someone who has multiple movement impairments, much less how to work with an older person. I didn’t have many tools in my toolbox for when someone DID NOT pick up a movement pattern within minutes.
Suffice to say, things did not go according to plan. Sure, no one died, but let’s just say it could have been WAY better.
Right then and there, I realized a very important lesson, one that’s reinforced to me time and again.
You can have all the theoretical knowledge and certifications in the world, but if you don’t know how to apply that knowledge with efficient and effective programs that get people results, then it doesn’t really matter!!
For example, while the CSCS is a great certification, that by no means says you know jack about writing programs, because you don’t have to write one on the exam! You simply answer a bunch of multiple-choice questions, look at a few videos, and you’re done. They are tough questions, don’t get me wrong, but at the end of the day, a series of letters does not mean you should be qualified to teach high-level athletes. I would rather see someone in action than what’s on a resumé.
Your ability to write a great program and coach it effectively is what makes you a living, not having a bunch of letters behind your name that says you should know a lot about it.
Anyway, you have to be diligent about programming in your own self-study, using both your own experience and what you pick up throughout your studies.
I try to take in anything I learn in my continuing education and think about how it applies to client X’s program.
Can I use this immediately?
Or do I have to test it out for a bit first, or wait until they have a better skill-set?
So I will do my best on this blog to back up anything I present in-depth with how that information would look in a proper personal training program. I still feel lost with program design most of the time, so I’m sure I will laugh at parts of this down the road, but that’s the GOAL. I’m willing to face some criticism and get some dialogue going. That’s what makes us better.
To kick things off, I promised I would deliver a sample 1st mesocycle for someone that has a pretty wicked anterior pelvic tilt.
What makes a program like this individualized? How does that influence the exercise selection?
Let’s check it out. This is a program I wrote for a female client who had a noticeable anterior tilt (females present with this more than males, in case you were wondering) who got a 14 on her FMS (1 on the pushup, 1 on rotary stability…coincidence?). She was able to demonstrate more-than-adequate mobility, she just needed to reign that pelvis in to give her a solid foundation of alignment and stability.
I will list what we did and then BRIEF cues/reasoning behind it that make it specific to this case. I won’t delve into set/rep rationale, but feel free to ask questions below.
The Program (3x/week)
Goal: Open hip flexors and adductors, fire the glutes, get warm, and be efficient.
The coaching starts now! Especially with the hip flexors and adductor rolls, don’t let the lumbar sag excessively. At no point, should their anterior tilt be exacerbated under your watch. If the anterior core isn’t engaged with these, then the full benefits won’t be experienced.
Just because these did not limit her in the ASLR, doesn’t mean they aren’t stiff
This is often mistaken for rolling the IT Band, however, we are not lying directly on the side with these. Instead, you are torqued slightly facedown. This will make sure you are effecting change in the muscle and soft-tissue, and not just the tendon sheath that is the IT band. With a tendon, you can’t really change it’s length, so there isn’t a ton of benefit to rolling it aggressively.
As discussed in Part 2, the adductors are a major player with anterior tilts and need to be taken care of. Since the hip flexors don’t seem to be a huge issue, you can bet these are. And that assertion proved to be true, based on the grimacing test (the way a client’s face contorts when rolling a particular muscle)
As Mike Boyle says, you can’t have too much t-spine mobility. She sits at a desk consistently.
½ Kneeling Positional Drills
She needs stability and length through her hip flexors, so I got her on one knee to see what she could do. It was quite the balancing act the first time! But in a few weeks, she was dropping down and killing it. Biggest thing with this is cueing the ribs down and down glute tight. No rib flare!!
Split-Stance Adductor Mobilizations x 6-8 each side
We got some stiffness out of these muscles with the foam roll, now it’s time to create some length. Cued a bit of flexion on the way back to get her out her arch.
Glute Bridge x 10
Gotta get the glutes firing. I brought her back into half-kneeling a few times after doing this. Cued the tilting of the pelvis back to the chin to prevent excessive lumbar extension.
Inchworm to Walkout x 6
Done mainly to bring up her pushup. This also puts the lumbar in more of a flexed state, which is what we are after with this case. When she reaches the pushup position, I cue her to engage glutes and get solid alignment. This will be harder to manage since gravity is acting straight down, but that’s why we did the other drills first.
A1) Rolling Pattern x 5 each side
When talking about building a foundation of stability, this can’t be done if the person can’t access a solid rolling pattern. I like this especially for anterior tilters, because it encourages a significant posterior tilt.
A2) Tall-Kneeling Cable Chop x 8 each
While half-kneeling was appropriate in the warmup, with load I want her in tall-kneeling to prep her for the stability needed for the bilateral deadlift. This is a great chance to teach getting “stacked” from shoulders to knees, getting glute engagement while the core has to reflexively stabilize. Chops are the bomb.
So are dowels. Use them lengthwise on the spine and have an anterior tilter flatten their low back against it. Boom, you now have core engagement. In the beginning, the more external feedback you can give, the better.
B1) Kettlebell Deadlift x 8
Ummm…of course!! What are deadlifts not good for? With these, the main cue is making sure she doesn’t over-extend at the top, instead focusing on keeping the ribs down and squeezing the glutes. Without that, the hip flexors stay shortened and the low-back takes more of the load…you might not get hurt with type of position bodyweight, but with a load, you have to really careful.
B2) Split Squat x 8 each side, 301 tempo
Single-leg work is legit for fat-loss and gaining stability. I recently started teaching this bottoms-up (start in a half-kneeling hip flexor stretch and stand up), but at the time, I got her set-up so that she could descend and keep the back knee under the back hip. Hands were held at chest, fists tight, to help keep ribs down. You can also hold the arms out front, pressing one hand on top of the other for more core engagement.
C1) Incline Pushup x 2 x 5
She needs to bring up her pushup, so using an incline is a great way to get there. I used a dowel for 4 points of contact from head, upper back, lower back and glutes to help her find the positioning. If she lost it, I reset her between reps. No point in repping anything out if it doesn’t look good.
C2) TRX Row x 2 x 12
A user-friendly intro to rowing patterns. She sits a lot and needs more upper back strength, in general, (who doesn’t?). Keep the elbows out at just below a 45-degree angle to really fry the rhomboids. Focused on the rib flare coming up, got her to lock-down and squeeze glutes.
Noticing a theme??
D1) Versa-Climber x 3 x 45 seconds
Some metabolic work to close the day. Even though this is not a resistance-training exercise per say, that doesn’t mean you still can’t cue the ribs down. The more this is reinforced, the quicker you will see a change!!
A1) Rolling Pattern (see above) x 2 x 5 each side
All about the frequency when it comes to improving motor control!!
A2) Birddog x 2 x 6 each
Start with one-leg extensions and then one-arm extensions. Cued a neutral spine and getting full glute engagement when the leg achieved extension. This 2-point quadruped posture is going to be very challenging for someone in lordosis, so it wasn’t a surprise when this took a lot of focus to do properly. If you allow someone to fly through this and use their lumbar to extend, then they won’t feel jack, except for their down shoulder starting to burn.
B1) Prisoner Squat x 3 x 8
The deadlift’s brother. The quicker you can get someone squatting and deadlifting well, the better. I like to teach it on a separate day from deadlifts to minimize confusion. On the descent, an anterior tilter will want to exacerbate that arch, but cue them ribs down and this will help bring everything into alignment. They should also feel more powerful coming out of the bottom when doing this. I cue to also get a big inhale before each rep to help create that intra-abdominal pressure and prevent the lumbar “tuck” at the bottom.
B2) Batwing Row x 3 x 10
Like the TRX Row, this functions as a user-friendly way to teach proper rowing. All someone has to focus on here is pulling the weight. One thing I notice with anterior tilters is that they will still try to use their lumbar as they fatigue, instead of their upper back. I cued her to sink her weight into the bench and keep the core and glutes braced, as well as to dorsiflex the feet.
C1) Tall-Kneeling 1-Arm Overhead Press x 2 x 8 each side
Going overhead is going to place a significant challenge on maintaining a stacked torso, which is why I started her in tall-kneeling. I prefer to start unilateral, so that the free arm can be placed on the ribcage. This way, when the ribs start to flare, they will know.
C2) Assisted Chinup Iso x 2 x 20 seconds (video shows pullup iso)
I progress someone to doing full chinups essentially by starting with isos (if they are capable and have symmetrical shoulder mobility screens), then eccentrics, then full pulls with various assistance, and finally full-on chinup madness. I have her hold for 20 seconds with a weight-assist.
Yeahhh buddy!!! One of my favorite tools. No one has ever said to me after training with a weighted sled, “I need more.” Amazing for fat-loss and just developing mental toughness.
A1) Tall-Kneeling Cable Chop x 2 x 8 each side
A2) Birddog x 2 x 6 each side
B1) 1-Arm Dumbbell Bench Press x 3 x 8 each side
I love these for helping teach and reinforce proper elbow positioning in a pushup (roughly 45 degrees). Plus, it forces the core to engage. Cue ribs down, so there doesn’t end up being too much separation of the lumbar off the bench.
B2) Reverse Lunge x 2 x 10 each side
For lunge patterns, I start reverse to place more of an emphasis on the posterior chain, which pretty much anyone could use more of. Not to mention, it is easier to teach the weight distribution of a proper lunge (heel-dominant) stepping backward, than stepping forward and having to control the knee going that direction. I cued her to step down, so that the back knee ended up under the back hip. The thing I had to watch for here was her tendency to extend through the low-back on the way up (this is also a theme). Ribs down and drive through the planted-side glute, making sure to keep that “planked” position at the top.
C1) Half-Kneeling 1-Arm Cable Row x 3 x 12 each side
Why not tall-kneeling?
Well, I just wanted her in half-kneeling, as I felt it would be easier for her to pick up the rowing motion in this position. It was still pretty difficult, so I’m glad I went with that.
That being said, tall-kneeling is often viewed as a regression to half-kneeling, but that is not necessarily the case. Speaking from my own experience as an anterior tilter, I feel much more comfortable in half-kneeling than tall-kneeling. Tall-kneeling exposes all of our weak links. It’s ok to start there for chop/lift variations, but the weight is coming across the body there and staying close to the center of gravity. In a row or press, the weight moves considerably farther outside of one’s COG, making it far more difficult.
C2) Hip Thrust x 3 x 8
Glutes, glutes, glutes. Cued core bracing and a strong exhale at the top. Also had to watch for excessive lumbar arching at the bottom. This is often-overlooked but the start determines the finish, so get them into more of a flat-back posture here. A big inhale helps too, it’s not just for the big lifts!
C3) Prone YT x 2 x 6 each
These are great for reinforcing proper good horizontal and vertical pulling, as they emphasize lower traps and tucking the scapula into the back pockets. These muscles don’t get a lot of love, so they are great to do at the end of a session.
I have been training this particular client for several months now, and she is becoming a machine (her program has obviously evolved since the above). Her posture is way better, and aesthetically, everything is coming together. Most importantly, she is able to feel her anterior core and glutes without much effort and her movement ability is night and day from when she started.
And again, this is just a brief example of a basic program. I wanted to throw it out there, so you can take it for what it is. Use what you feel is appropriate to get you out of your anterior tilt!
I get tired of saying this, but it’s the truest thing in fitness…EVERYONE IS DIFFERENT, so you can’t really judge someone’s program one way or the other without being in that person’s shoes.
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