Most people actually have some degree of pelvic tilt, and it’s often completely normal. A study of 120 healthy, pain-free adults found that 85% of males and 75% of females naturally had an anterior pelvic tilt. So the real question isn’t whether your pelvis tilts at all, but whether it tilts enough to cause problems like lower back pain, tight hips, or visible postural changes.
Types of Pelvic Tilt
Your pelvis can tilt in a few different directions, but the two most common types involve forward and backward rotation.
Anterior pelvic tilt means your pelvis tips forward, toward your toes. This pushes your butt outward and creates an exaggerated arch in your lower back. It’s the more common of the two and is strongly linked to prolonged sitting and tight hip flexors.
Posterior pelvic tilt is the opposite. Your pelvis tips backward, tucking your tailbone under and flattening your lower back. People with posterior tilt often look like they’re slightly slouching through the hips, even when standing upright.
Lateral pelvic tilt means one side of the pelvis sits higher than the other, which can make one leg appear shorter. This type is less commonly discussed but can contribute to hip, knee, or back discomfort on one side of the body.
The Mirror Check
The simplest way to get a rough idea of your pelvic position is to stand sideways in front of a full-length mirror, wearing fitted clothing or just underwear. Stand the way you naturally would, without trying to correct your posture.
Look at the curve of your lower back and the position of your hips. If your lower back has a deep inward curve and your belly pushes forward while your butt sticks out noticeably behind you, that’s the signature look of anterior pelvic tilt. If your lower back looks unusually flat and your tailbone appears tucked underneath you, that points to posterior tilt.
For lateral tilt, face the mirror straight on and look at your waistline. If one hip crease sits higher than the other, or your belt line slopes to one side, you may have a lateral tilt. Placing your hands on the tops of your hip bones (the bony points at the front of your pelvis) can make the difference easier to spot.
The Wall Test
Stand with your back against a flat wall, with your heels about two inches from the baseboard. Let your head, upper back, and butt touch the wall comfortably. Now slide one hand behind the curve of your lower back, palm flat against the wall.
In a roughly neutral pelvis, you should be able to fit your flat hand in the gap between your lower back and the wall, with a little room but not much. If you can fit a clenched fist or more, you likely have an excessive anterior tilt. If there’s barely any space and your lower back presses almost flat against the wall, that suggests posterior tilt.
The Lying-Down Hip Flexor Check
This is a simplified version of what physical therapists call the Thomas test, and it checks whether tight hip flexors are pulling your pelvis forward.
Sit on the very edge of a firm table or high bed so that your tailbone is right at the edge. Lie back slowly, pulling both knees to your chest. Hold one knee firmly against your chest and slowly lower the other leg, letting it hang toward the floor. Keep your lower back flat against the surface.
Watch what happens to the lowered leg. If your thigh can’t rest level with the table surface and stays lifted above it, the muscles at the front of your hip are tight. If your lower back arches up off the table as you lower the leg, that’s your pelvis tipping into an anterior tilt to compensate for that tightness. Both are signs that hip flexor stiffness is contributing to a pelvic tilt. Repeat on the other side to check for asymmetry.
The Bony Landmark Check
Physical therapists assess pelvic tilt by feeling for two specific bony points on each side of the pelvis. The first is the bony bump at the very front of your hip bone, technically called the ASIS, which you can feel if you press your fingers into the front of your pelvis just below your waistline. The second is a bony bump at the back of your pelvis, roughly where the two dimples sit above your butt.
In a neutral pelvis, the front point and the back point sit at roughly the same height, or the front sits just slightly lower. With anterior pelvic tilt, the front point drops noticeably lower than the back. With posterior tilt, the front point rides higher than the back. You can try feeling for these landmarks yourself, but they’re much easier for someone else to locate while you stand naturally. This is one of the primary methods clinicians use to measure tilt angle, sometimes with a small tool called a palpation meter or inclinometer.
What Pelvic Tilt Feels Like Day to Day
Not everyone with a pelvic tilt feels anything unusual. As the prevalence numbers show, most people walk around with some degree of anterior tilt and never notice it. Tilt becomes a problem when the imbalance is large enough to create muscle strain or joint stress.
With anterior tilt, the most common complaint is a dull ache in the lower back, especially after standing for long periods. Because the pelvis pulls the spine into a deeper curve, the small muscles along the spine work overtime to keep you upright. Your hip flexors (the muscles at the front of the hip that let you lift your knee) tend to feel tight or shortened, while your glutes and abdominal muscles may feel weak or hard to engage during exercises like squats or planks. Some people notice their belly appears to protrude even at a healthy body weight, simply because the forward tilt pushes the abdomen out.
Posterior tilt tends to cause a different pattern. The lower back feels stiff and flat rather than achy and arched. Hamstrings are often tight, and sitting for long stretches can feel uncomfortable because the tailbone presses into the chair. Some people with posterior tilt find it difficult to sit up straight without feeling like they’re forcing it.
Lateral tilt can produce pain that’s harder to pin down. You might notice one-sided hip soreness, a knee that always seems to bother you on the same side, or the feeling that your weight shifts unevenly when you walk or run.
When Tilt Actually Needs Attention
A mild pelvic tilt with no symptoms is a normal anatomical variation, not a diagnosis. The tilt becomes worth addressing when it’s paired with persistent pain, limited range of motion, or difficulty performing activities you care about. If the wall test or the hip flexor check reveals a large discrepancy and you’re also dealing with nagging back or hip pain, those two pieces of information together are meaningful.
A physical therapist can measure your tilt angle precisely and identify which muscles are tight and which are weak. Treatment is almost always exercise-based: stretching the muscles that are pulling the pelvis out of position and strengthening the ones that aren’t doing their job. For anterior tilt, that typically means stretching the hip flexors and lower back while strengthening the glutes and deep abdominal muscles. For posterior tilt, the focus shifts to stretching the hamstrings and strengthening the hip flexors and lower back extensors. Most people see meaningful improvement within a few weeks of consistent, targeted exercise.