Edit. Since I last wrote this post, which is almost three years ago, I have gained a ton of knowledge and experience in dealing with Lateral Pelvic Tilt.
I urge you to read my updated post as it reflects four years of education acquired through the Postural Restoration Institute and finally understanding where the tilt and the lower back pain was coming from.
Oh, what a twisted pelvis can do to a person.
Before I begin, I’ll note that my battle with lateral pelvic tilt has been well documented on this site.
A quick recap of events:
1. In August of 2011 I suffered horrible back spasms for two days.
2. I was left with a lateral pelvic tilt and painful back, mostly in the area of my SI Joints
3. I mostly leveled myself pelvis after stretching the quadratus lumborum muscle
4. The tilt returned (or never fully went away) due to a tight psoas muscle. I got relief by using an extra insole in the shoe of my low side pelvis. This leveled my pelvis and gave relief from pain, but did not address the real problem.
5. Eight months later, in April, a massage therapist got the psoas to relax and my tilt disappeared. The majority of my pain went away,
Although the pain of the “daily-hurt-that-makes-life-miserable” variety had waned, I never felt quite right. I was still living with residual pain and stiffness.
I Was Twisted
Quite literally, I was twisted.
The left side of my pelvis was tipped and rotated forward and to the inside, meaning that instead of facing straight forward, it was oriented to my right. As a result, my spine, from the mid-back on up (around T8), had to twist to the left to keep me straight.
So the situation is that the lower spine orients to the right as it moves with the left pelvis. The mid-spine then starts to compensate by twisting back to the left. What you’ll often see is someone with a left shoulder higher than the right shoulder.
The fascinating thing is that virtually all adults have a left pelvis that is forwardly rotated compared to the right. It’s completely natural due to our body’s internal asymmetries, the most obvious being that our right diaphragm is much bigger and stronger than the left diaphragm, thereby setting up a chain of events that allows the left pelvis to rotate to the right over time.
The other fascinating thing is that virtually no one in the medical field knows about this condition. Apparently this information is not taught in physical therapy school or anywhere else.
My Psoas That Wouldn’t Quit
For the past two years, I have experienced the following:
1. Psoas ache and tightness in my left lower back, just above the pelvis.
2. Constant right hamstring tightness, calf tightness, and reduced range of motion in my right ankle.
3. Stiffness and pain when getting up from a seated position, particularly after driving.
4. Occasional right SI joint pain and discomfort that I attributed to my tight right hamstring and calf.
The one constant was that though my pelvis looked level, I always “felt” my psoas muscle, like it was consistently agitated. The lateral pelvic tilt, when I had it, I could see clearly. It was caused by the tight psoas. Once the massage therapist got my psoas to unleash its death grip, my pelvis leveled out.
On the other hand, the rotated left pelvis was not visible, so I didn’t know I had it. Plus, through all my reading and research, I have never read anything about it until taking a course from the Postural Restoration Institute.
I decided to take the Myokinematic Restoration course through the Postural Restoration Institute for continuing education credits. The course is described as “an integrated approach to treatment of patterned lumbo-pelvic-femeroal pathomechanics”.
A cursory glance at the written material gave me a feeling that the course was something that would benefit me both intellectually and physically. As the instructor was explaining the situation, and specifically mentioned an overactive psoas, it felt like he was talking directly to me. I was experiencing what he was describing.
The instructor explained that, although when I looked down at my feet everything seemed normal, what I really looked like was this:
My left leg was slightly abducted (moved away from the mid-line of my body), slightly externally rotated (so my foot pointed out) and my hip was slightly flexed (can’t be seen).
My right side compensated by doing the exact opposite, adducted (moved towards the mid-line of my body) internally rotated (femur turned in) and my hip was slightly over-extended (can’t be seen).
If my pelvis was not tilted forward and in on the left side, this is what my foot positioning would look like when I looked down.
It would be completely wrong. However, since my left sided pelvis was, in fact, rotated into the faulty position, the foot position shown above actually looked perfectly straight.
Let me emphasize: the picture above is NOT the position you want to be in. But it IS the position I was in because my left pelvis had tilted forward and rotated in. The legs moved into the position above to compensate for my faulty pelvic positioning. The faulty pelvic position can’t be seen, but it was there. The abnormal foot position looked normal because of my faulty pelvic positioning.
The trick is to reposition the pelvis on top of the legs, which, it seems, I have successfully done.
I get more e-mails and comments about lateral pelvic tilt and anterior pelvic tilt that anything else. Unfortunately, there is no way for me to assess anyone or provide any definitive information on what may help. All the information I have provided in past posts is just general anatomy and what I have done to help myself.
Going through a drawn out biomechanical explanation of how I fixed myself will do almost no one any good unless they are already extremely well versed in physical therapy and/or more advanced anatomical concepts, and even then it’s hard to understand. I have talked to numerous physical therapists about this issue and I realize they have no idea what I am talking about.
The only thing I can do is refer you to the website of the Postural Restoration Institute. One of the tabs on the website is entitled “Find a Provider”. Click on that tab and you may find someone in your state who could help.
Postural Restoration Institute
My takeaways from this experience:
1. There are often musculo-skeletal reasons for back pain and usually these reasons can be addressed.
2. Don’t assume that all medical professionals are the same. They aren’t. I hadn’t seen anything like what I learned from the Postural Restoration Institute in anything I have ever read, and I assure you, I have read a lot.
3. Keep learning. If you aren’t intellectually curious about the human body, and you have an issue, you’d better get curious.
4. Never give up on anything that matters to you. Your health should matter–your body is truly your temple.