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Pelvic Realignment Exercises (Pelvic Tilts)

Draftmotor-control85%beginner⬤ moderate evidence
View FHIR resourceFHIR R4 ActivityDefinition — the interoperable form of this exercise

Positions & Range of Motion

Start
supine, knees bent ~90°, feet flat hip-width on the floor, arms at sides, one hand optionally under the lumbar spine
End
pelvis returned to and held in neutral (lumbar spine lightly touching the floor) for three breaths, after cycling through full posterior and anterior tilt
Range of Motion
lumbopelvic tilt through full available anterior-to-posterior pelvic rotation (~10–15° each direction), rocking about the hip sockets

How to Perform

Supine pelvic tilt exercises for lumbopelvic awareness and motor control. Patient alternates between anterior and posterior pelvic tilts, then practices holding neutral. Part of pericapsular soft tissue and realignment (PSTR) approach. Significantly improves pain (NRS) and function (Harris Hip Score) in hip OA. Enhances lumbopelvic awareness and reduces hypertonic guarding in low back pain.

Watch on YouTube↗

Opens a YouTube search for “Pelvic Realignment Exercises (Pelvic Tilts)”

Starting position: supine

Coaching Cues

  1. 1

    Slow, segmental rocking — pelvis rotates around the hip sockets

    (verbal)
  2. 2

    Flatten the lower back into the floor, then arch it away

    (verbal)
  3. 3

    Find the middle position and hold it for three breaths

    (verbal)
  4. 4

    Hand under the lower back feels pressure come and go

    (tactile)

Evidence-Based Dosing & EMG Data

Recommended Dosing

3×10-15 reps each direction; find neutral and hold 10 seconds

Muscles Involved (5)

Primary Movers

Rectus Abdominis— Posterior pelvic tilt
Gluteus Maximus— Assists posterior tilt

Secondary Movers

Erector Spinae Group— Primary during anterior tilt only
Iliopsoas— Assists anterior tilt

Stabilizers

Transversus Abdominis— Core control during both directions

Easier Variations ↓

1

Seated Pelvic Tilts

Perform on a firm chair or stability ball. Rock the pelvis forward and back. More functional position for some patients.

Harder Variations ↑

1

Pelvic Clock

Imagine a clock face under your pelvis. Tilt to 12, 3, 6, 9 o'clock and all positions between. Builds multi-directional control.

2

Standing Pelvic Tilts

Perform against a wall, then freestanding. Transfers lumbopelvic control to upright functional positions.

Target Movements (2)

Lumbar FlexionLumbar Intervertebral Joints
Lumbar ExtensionLumbar Intervertebral Joints

Why This Exercise Matters

Everyday activities this exercise helps you do — essential means it directly trains the capacity the task needs:

Posture MaintenanceWalkingGetting In and Out of Bed

Goals This Helps With

Rehab, performance, prevention, and mobility goals this exercise supports — essential means it's a cornerstone:

Low Back PainrehabLow Back Injury Preventionprevention

Research Notes

Evidence: PSTR exercises including pelvic tilts significantly improve pain and function even in severe hip OA [Hayashi 2022]. Enhance lumbopelvic awareness and reduce guarding in LBP.

Evidence Sources (6)