Sway Back: Why Your Anterior Tilt is Causing Your Back Pain

Sway Back: Why Your Anterior Tilt is Causing Your Back Pain

pelvic floor exercises

Sway Back: How Your Anterior Tilt Can Cause Back Pain

A sway back is when your back arches too much and your pelvis is stuck in a rocked forward position. This places the hamstrings in an over-lengthened position and often makes them feel tight when they are not.

People with swayback posture (anterior tilt) tend to find themselves putting more weight in their toes than heels and letting their abdominal wall "hang" forward. It can look like you have a little pooch belly when you really don't.

What's wrong with having a sway back?

You place excess stress on the facets (little joints that connect the spine). Patients with a sway back will often complain of an ache with having to stand for periods of time. They constantly want to stretch forward and round their lumbar spine which can lead to damage of the disc. Over time this posture can lead to arthritis of the facets which can cause stenosis (narrowing) of the lumbar spine. Yep, that is as painful as it sounds.

How do you fix swayback posture?

#1 Awareness

When you stand make sure your weight is balanced between the balls of your feet and your heels. Do not hang forward into your pelvis fully relaxing your abdominals. Think about that plum line running from your ear down to your ankle staying in perfect alignment. (Not crazy military, just not forward.) Finding balance for the spine is important. If you catch yourself with all your weight hanging forward, shift it back and feel your core engage slightly. This will do the trick for supporting your spine.

#2 Turn on the right muscles

Getting your entire core and diaphragm to turn on is extremely important. Try blowing up a balloon while holding a perfect plank. Really focus on keeping your ribs in for the exhale and not letting your back drop down or over arch. It will be the most extreme core workout you have ever tried.

pelvic floor exercises
  • Soften your knees so your quads can relax slightly.
  • Do not let your head drop forward as you put air in the balloon.
  • Inhale through your nose and out through your mouth to blow up the entire balloon.
  • Good luck, it's hard when done correctly!

This is one of the many exercises I like to use for helping my patients get out of this swayback posture.

#3 Release your hip flexors
pelvic floor exercises


Foam roll your hip flexors. More instructions here.


I'm not a huge fan of stretching. But, sometimes a stretch or two can be useful. Try this dynamic hip flexor stretch to help get the muscle to let go and get out that swayback posture.

pelvic floor exercises

An increase in swayback posture can cause stress on the facet joints in your spine. Start today on the tips above to decrease this risk!