Pelvic Tilt Test: How to Identify Anterior and Posterior Pelvic Tilt

If you have a client complaining of low back pain who spends long hours sitting (or, on the flip side, trains a lot of quads and not much glute), the pelvis is one of the first places to look. Pelvic tilt describes the forward (anterior) or backward (posterior) inclination of the pelvis, and it has a direct impact on lumbar curvature.

What does this test measure?

It assesses the angle of pelvic tilt in the sagittal plane (viewed from the side), comparing the position of the anterior superior iliac spines (ASIS) and posterior superior iliac spines (PSIS).

• Anterior pelvic tilt: the pelvis "tips" forward → usually accompanied by lumbar hyperlordosis
• Posterior pelvic tilt: the pelvis "rotates" backward → usually accompanied by a flattened lumbar curve (flat back)

Neither is "bad" by definition, but pronounced and sustained tilts are associated with specific pain patterns and muscular imbalances.

What you'll need

• A goniometer (or a smartphone angle-measuring app)
• Optional: a tape measure to locate the ASIS and PSIS

Step-by-step protocol

1. The person stands in profile, in their natural posture
2. Palpate and locate the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) on the same side
3. Place the goniometer along the line connecting both points
4. Measure the angle relative to horizontal

Common mistakes

• Palpating the bony landmarks incorrectly (practicing with feedback from a colleague helps a lot here)
• Measuring while the subject is consciously "correcting" their posture
• Not comparing both sides (there can be pelvic asymmetries in addition to overall tilt)

How to interpret the result

ASIS-PSIS angle	General interpretation
~7-10° (ASIS slightly lower than PSIS)	Range considered "neutral" in many references
> 10-12°	Pronounced anterior tilt — assess for tight hip flexors/lumbar erectors and weak glutes/abs
< 0-5° or ASIS higher than PSIS	Posterior tilt — assess for tight hamstrings/glutes and thoracic stiffness

These ranges are a general guide: what matters most is consistency with the rest of the assessment (is there visible hyperlordosis? does the Thomas Test confirm tight hip flexors?) and, again, how it evolves over time.

How it relates to other tests

Pelvic tilt is almost never interpreted in isolation. Pair it with:

• Comprehensive postural analysis — to see the associated lumbar and thoracic curvature
• Thomas Test (hip flexors) — to confirm whether tight psoas/rectus femoris is contributing to the anterior tilt
• Adam's test — if there's pelvic asymmetry, it's worth ruling out spinal asymmetries too

Why it's worth tracking

A pronounced anterior pelvic tilt that doesn't improve despite months of mobility and core work can be a sign that the program needs adjusting. But you'll only know that if you compare real data from 2-3 months ago, not impressions.

In Movalytics you can save the pelvic tilt angle alongside the rest of each client's postural tests, and see in a single chart how it evolves together with their reported low back pain.

FAQ

Does anterior pelvic tilt always cause low back pain? Not directly, but a pronounced and sustained anterior tilt increases the load on the posterior structures of the lumbar spine, so it's a factor worth keeping in mind, especially if symptoms are present. Can pelvic tilt be "corrected" with exercise? It can be modified by working on hip mobility (flexors/hamstrings depending on the case) and core/glute strength, along with sitting posture habits. Do men and women have different reference values? Yes, there are anatomical differences in the pelvis between sexes that can slightly influence "normal" ranges, so it's better to focus on individual progress rather than general comparisons.