Assessment of the degree of pelvic tilt within a normal asymptomatic population
PainSci commentary on Herrington 2011: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Herrington examined pelvic tilt in 120 healthy, pain-free people (65 males, 55 females) with an average age of about 24 years. Using a PALM palpation meter (a glorified protractor), the angle between the anterior superior and posterior superior iliac spines was measured. Results showed that 85% of males and 75% of females had an anterior pelvic tilt, while 6% of males and 7% of females exhibited a posterior tilt. And 9% of males and 18% of females presented with a neutral tilt.
A statistically significant side-to-side difference in pelvic angle was found in males (p = 0.002), but the size of the difference was smaller than the smallest detectable difference, suggesting it may be due to measurement error.
The takeaway? Anterior pelvic tilt is normal. If anyone tells you your slight tilt is causing all your woes, you might want to get a second opinion. This data suggests we should not villify your pelvis.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
In clinical practice the degree of pelvic tilt is commonly assessed because of its reported relationship to pelvic, spinal and lower limb pathologies.
There is little normative data presented within the literature establishing typical findings within an asymptomatic population from which to make comparisons in pathological populations. The aim of this study was to report typical pelvic angle in an asymptomatic populations and also the degree of side-to-side asymmetry which might exist within the pelvis.
Pelvic angle was measured by finding the angle from horizontal of a line between the anterior superior and posterior superior iliac spines of the ilium using a PALM palpation meter in 120 healthy subjects (65 males, 55 females) with a mean age of 23.8(2.1) years.
85% of males and 75% of females presented with an anterior pelvic tilt, 6% of males and 7% of females with a posterior tilt and 9% of males and 18% of females presented as neutral. There was significant difference in pelvic angle between sides for males (p = 0.002) but a non-significant difference between sides for females (p = 0.314). But the difference in angle for males between sides was less than the smallest detectable difference statistic found in the reliability study, so most likely to be due to measurement error.
related content
- “Interrater reliability: the kappa statistic,” McHugh, Biochem Med (Zagreb), 2012.
- “The measurement of observer agreement for categorical data,” Landis et al, Biometrics, 1977.
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- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.