Clinical Measures of Pelvic Tilt in Physical Therapy

Abstract

Pelvic tilt refers to the spatial position or motion of the pelvis about a frontal horizontal axis on the rest of the body in the sagittal plane. It is relevant for several musculoskeletal conditions commonly seen in physical therapist practice, particularly conditions affecting the hip and groin. Despite the relevance of pelvic tilt identified in biomechanical studies, and the historical precedence for assessing pelvic tilt, there is a lack of clarity regarding the utility of clinical measures that are practical in a rehabilitation setting. There are several options available to assess pelvic tilt which are discussed in detail in this commentary. All of these options come with potential benefits and considerable limitations. The purpose of this commentary is to provide an overview of the relevance of understanding pelvic tilt in the pathology and rehabilitation of conditions affecting the hip joint, with a focus applying evidence towards identifying clinical measures that may be useful in the rehabilitation setting and considerations that are needed with these measures.

Acute Effects of Ice Hockey on Hip Range of Motion, Strength, and Pelvic Tilt in Competitive Male Players

“…3,7 Static pelvic tilt was assessed in a split stance position on the right side for all subjects utilizing a caliper-based inclinometer with the posterior caliper on the posterior superior iliac spine and the anterior caliper on the anterior superior iliac spine (PALM, Performance Attainment Associates) as described previously. 25…”

“…An anterior pelvic tilt is identified when the posterior superior iliac spine is more vertical than the anterior superior iliac spine, and this position can be quantified in a reliable and valid manner. 25 The amount of pelvic tilt has been correlated with hip and groin symptoms and can directly impact the available hip ROM. 9,31 In particular, having a larger degree of anterior pelvic tilt is associated with lower total hip rotation ROM and earlier impingement at the femoroacetabular joint when moving into an internally rotated position by approximation of the anterosuperior acetabulum to the head of the femur.…”

A New Clinical Examination Algorithm to Prescribe Conservative Treatment in People with Hip-Related Pain

“…Changes in pelvic tilt have been correlated with various musculoskeletal conditions related to the lumbar spine [ 108 ], pelvis [ 109 ], and knee [ 110 ]. There is controversy in studies investigating changes in pelvic tilt posture in hip musculoskeletal pathologies [ 111 ]. Hip ROM is influenced by the position of pelvic tilt; several studies, using different methodologies, have shown that an increase in anterior pelvic tilt results in a decrease in hip flexion and internal rotation ROM, while an increase in posterior pelvic tilt increases hip flexion and internal rotation ROM [ 63 , 65 , 112 , 113 ].…”

Functional analysis of postural spinal and pelvic parameters using static and dynamic spinometry

“…For this reason, researchers and clinicians have developed clinical tests to detect functional deficits of the spino-pelvic complex [ [ 13 ]]. These functional tests are often highly dependent on the clinical experience of the examiner and have low interrater reliability [ [ 14 , 15 ]].…”