Sajida Bibi Noonari

Lecturer at
National institute of physiotherapy
rehabilitation and medicine
- The right and left
sacroiliac joints
(posterolateral)

- The symphysis
pubis (anteriorly)

- The Lumbosacral
joint (superiorly).
 Pelvic motion along with hip and vertebral
column makes the normal sinusoidal curve
in gait cycle, these pelvic motion called
pelvic tilt.
 It also occur in some pathological
problems.
 During walking, the pelvic moves in all
three planes.
1. Anterior pelvic tilt
2. Posterior pelvic tilt
3. Lateral pelvic tilt
4. Pelvic drop
5. Pelvic rotation
 Itoccur in Sagittal plane and coronal axis
or frontal axis.
 Lumbosacral angle, pelvic inclinometer
and vertical line are used to measured
the a/p pelvic tilt.
 Normal angle 30 degree
 Lumbosacral angle is determined by
drawing one line parallel to the ground and
another line along the base of the sacrum.
 This angle will increase as the pelvis
tilts anteriorly and decrease as the pelvis
tilts posteriorly.
 The lumbar lordosis decreases
lumbosacral angle decreases.
 As the lumbar lordosis
increases  the angle
increases.
 One arm of the
inclinometer placed
over pubic symphysis
and another over the
PSIS.
 3O degree is normal
 Verticalline drawn
from the ASIS to the
pubic symphysis
align in the same
line.
 Anterior tilt occurs when the
pelvis tilts forward

 movingthe ASIS anterior and

downward to the pubic symphysis.

 Increasesthe lumbar lordosis,

Thoracic kyphosis and sacral
Angle.
 Abdominal and hip extensors muscles
are responsible for preventing anterior
pelvic tilt.
 Contraction of hip flexors and spinal
extensors results in the anterior tilt.
 Posterior tilt occurs
when the pelvis tilts
backward, moving the
ASIS posterior to the
pubic symphysis.

 Decreasessacral angle,
& Lumbar lordosis.
 Hip flexors and spinal extensors are
responsible for preventing posterior
pelvic tilt.
 Contraction of spinal flexors and hip
extensors muscles results in the posterior
tilt.
 Forthe body to remain upright when the
pelvis tilts forward, movement in the
opposite direction must occur in the
joints above and below the pelvis.

 When the pelvis tilts anteriorly  the

lumbar portion of the vertebral column
goes into hyperextension while the hip
joints flex.
 Placing your thumbs on the ASISs and
determining if your
thumbs are at the
same level.
 It occurs in frontal
Plane and AP axis.
 Both ASIS aligned
in the horizontal line
in the normal pelvic.
 Lateral tilt occurs when the two iliac
crests are not level.
 Because the pelvis moves as a unit, one
side moves up as the other side moves
down.
Left pelvic tilt  is when the right side of
the pelvis is elevated higher than the left
side (left side is dropped)
Right pelvic tilt is when the left side of
the pelvis is elevated higher than the
right side (Right side is dropped)
 During walking, the pelvis is level when
both legs are in contact with the ground
(double stance). However, when one leg
leaves the ground (swing phase), while
the another leg in contact with ground
(single stance/ unilateral stance), it
becomes unsupported and the pelvis on
that side drops slightly.
 Itis impossible to drop the pelvis on the
weight-bearing side.
  the point of reference for lateral tilt
will be the unsupported, or less
supported, side, or the side farthest from
the weight-bearing joint axis. The person
bears weight on the right leg while lifting
the left leg from the ground The left
side of the pelvis becomes unsupported
and drops, or laterally tilts to the left.
As the pelvis tilts (drops) to the right  the
vertebral column laterally bends to the
left.
  While the weight-bearing hip joint
(left) adducts, the unsupported hip
(right) becomes more abducted.
 Itis possible to raise the pelvis on the
unsupported side “hip hiking.”
 When walking with a long leg cast or
brace, this motion assists the foot in
clearing the floor during the swing
phase.

 Shifting
from one ischial tuberosity to the
other also involves raising the pelvis on
one side. This is useful in allowing some
pressure relief during sitting.
HIKING DROPPING
 During hiking ASIS moves  During dropping ASIS
upwards and medially. moves inferiorly and
medially.
 Flexion of spine in same
side.  Flexion of spine in opposite
side.
 Abduction of hip in hiking
side.  Adduction of hip in drop
side.
 Hiking occur contraction of
quadratus lumborum &  Positive trendelenburg’s
spinal side flexor. sign.
 Pelvic
drop occurs due to the opposite
hip abductors weakness.
 Inthe anatomical (neutral) position, both
ASISs should be in the same plane
 Rotation occurs in transverse plane and
vertical axis.
 Forward rotation of the pelvis the non-
weight bearing side is swinging forward 
moving the ASIS of the non-weight bearing
side forward the ASIS of the weight bearing
side.
 Backward rotation of the pelvis the non-
weight bearing side is swinging backward
 moving the ASIS of the non-weight
bearing side backward the ASIS of the
weight bearing side.
 the left leg is weight bearing and the
right leg is swinging forward.
This causes the right side of the pelvis to
rotate forward moving the right ASIS
forward of the left ASIS.

This pelvic rotation is occurring because

the pelvis is moving on the weight-
bearing hip joint.
 The unsupported side is the point of
reference!!!

 Right Forward rotation of the pelvis

the left leg is weight bearing and the
right leg is swinging forward. This causes
the right side of the pelvis to rotate
forward moving the right ASIS forward of
the left ASIS.
Right Backward rotation of the pelvis
 The left leg weight bearing
 The right leg  is swinging backward.
 The right side of the pelvis to rotate
backward moving the right ASIS
backward of the left ASIS.
 To tilt the pelvis anteriorly, the lumbar
trunk extensors, primarily the erector
spinae, pull up posteriorly while the hip
flexors pull down anteriorly.
 Conversely, to tilt the pelvis posteriorly, the
abdominals pull up anteriorly while the
gluteus maximus and hamstrings pull down
posteriorly.
 Inboth cases, the opposite muscle groups
are acting as a force couple, causing the
pelvis to tilt
 The force of gravity, without any muscle
action, can tilt the pelvis laterally when
that leg becomes unsupported. However,
to control or limit the amount of lateral
tilting, opposite muscle groups work as a
force couple as well.
 ina reversal of muscle function action,
the left trunk lateral benders, primarily
the erector spinae and quadrates
lumborum, pull up on the left side of the
pelvis, while the right hip abductors
(gluteus medius and minimus) pull down
on the right side to keep the pelvis fairly
level.
 Allof these same muscle groups can
work together to provide stability by
preventing the pelvis from moving.

 Pelvic
and trunk control are necessary to
provide the stable foundation upon which
the head and extremities can move.