TheBroBrah's Guide To Correcting Excessive APT.

[KMadigan777]

Dam bros, back in this topic. I dont get it at all. Sometimes it will get better, but then it starts coming back. Seems to be related to if I am squatting, that seems to make things worse in general.

Really want to beatthis, but had it like 2 years.

[Coachjlr]

2 in 1. Seems like a good workout for APT.

yes it is

[MikeWines]

u have a research study supporting this ?

I've always heard 3-5� in men and 5-7� in women.

Here's some interesting food for thought: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565125/

[KMadigan777]

So what about tight thoracic/mid back? Most of the common solutions dont seem to make sense for me, I have good flexibility (3rd world squat is zero problem), pass the thomas test etc, but the one thing I notice, is a slight kyphosis posture, esp when doing 3rd world squats, if I lean back I feel my mid back seizing.

Perhaps this could be the source of the low back pain? ANyone else with this?

[bastianek]

So what about tight thoracic/mid back? Most of the common solutions dont seem to make sense for me, I have good flexibility (3rd world squat is zero problem), pass the thomas test etc, but the one thing I notice, is a slight kyphosis posture, esp when doing 3rd world squats, if I lean back I feel my mid back seizing.

Perhaps this could be the source of the low back pain? ANyone else with this?

Try this: https://www.youtube.com/watch?v=SxQkVD0UQNg

Also work on your (mid)traps and rhomboids -> Rows!!!

What also can help to fix upper back posture are front squats.

[MikeWines]

So what about tight thoracic/mid back? Most of the common solutions dont seem to make sense for me, I have good flexibility (3rd world squat is zero problem), pass the thomas test etc, but the one thing I notice, is a slight kyphosis posture, esp when doing 3rd world squats, if I lean back I feel my mid back seizing.

Perhaps this could be the source of the low back pain? ANyone else with this?

You will likely have some kyphosis in this position, that's natural. You're upper back may "seize" b/c you're not used to having to exhibit thoracic extension which is what happens when you try to get more upright in the bottom of that position.

Not to mention, a normal spine will have 25-30� of thoracic curvature, that is normal. Spines should never be stick straight and there is no one, specific source of lower back pain. I've posted this in countless other threads but you need to look into pain science if you want to start to understand lower back pain:

These is no such thing as perfect posture. Posture is HIGHLY context dependent - for example, the world's fastest men typically walk around in APT all day with no pain and movement competency for sprinting. See here: Current Position Statement on Anterior Pelvic Tilt

Correcting their posture towards more of the "perfect symmetrical" example listed by most functional gurus (Naudi Agular for example) would be the biggest mistake of any S&C coach's career as their biomechanical compensations are their body's way of adapting to produce the highest power output possible.

Also, APT isn't caused by excess sitting, he needs to check his facts on that one and stop assuming that anytime you maintain a specific position you will get structural adaptation (outside of perhaps extended time in a cast or splint in which case it IS possible for contractures to occur): Does Excessive Sitting Shorten the Hip Flexors?

Posture is a phenomenon which can be maintain with proper balanced training and an educated approach to movement within your warmup (i.e. target the asymmetries which are specific to YOU). Not everyone will need thoracic spine extension work. Not everyone has inactive glutes. Not everyone has shortened hip flexors.

Starett started the idea of "your posture is dysfunctional so that's why you're in pain" route which just simply isn't correct or supported by the current research on pain science.

If you're going to follow anyone in the PT world, stick to guys like Bill Hartman, Quinn Henoch, Seth Oberst, Aaron Swanson, etc.

Remember: PAIN IS NOT ALWAYS ASSOCIATED BIOMECHANICAL DYSFUNCTION.

Here's my word of caution regarding PTs...You must be very careful which ones you choose and why. Most PTs are looking for aberrant patterns and things that are wrong with a person. Most of the individuals coming to them already have something very wrong with them and as such, they're in pain. You're young, healthy, and in great shape. Sure, there are a few things that aren't quite "right" but that can be fixed over time as you get stronger. However, PTs like to find things that are wrong and tell you about them and as such, this can generate what is known as the "nocebo effect" within a person's psyche.

Basically, it's the opposite of placebo. When someone tells you that there is something wrong with you then you become HYPER-aware of it and as such, it may cause pain when there wasn't any to begin with.

For example, if you look at the research on asymptomatic individuals and MRI imaging, there are hundreds of thousands of individuals that are walking about pain free with labral tears, disc bulges, and SLAP lesions in their shoulder (I would include myself in this group - I'm about 90% sure I have a torn right labrum in my shoulder from playing baseball when I was younger but having done substantial mobility/soft tissue/corrective work on myself, I've never had pain). However, none of these individuals report with pain or any incredibly obscure movement patterns. Yet, they might have gotten a recommendation from a physician or a friend to "get their back/neck/shoulder/hip checked out" just in case there might something wrong or they felt a slight "weird sensation". As such, when they see the damage on the MRI they begin to develop debilitating pain over the next few weeks/months.

Why?

Well, pain science is a very multi faceted issue and as such, it's not just as simple as the mechanical model would suggest - dysfunction creates mechanistic problems within the muscle/joint/tendon/etc. and then you get an inflammation response and pain. No, not the case. That is PART of the issue but not the whole thing.

See here for more information on the subject, all good reads:

- Pain Science: An Interview With Pain Expert Jason Silvernail]
- March Research Round-Up: Pain Science Edition
- A Revolution in the Understanding of Pain and Treatment of Chronic Pain

Point being: strength coaches, physical therapists, soft tissue specialists, etc. must all be VERY careful with their choice of words and recommendations to patients as this could cause further issues if they aren't aware of the person's psychological approach to the situation and how their words are being perceived.

I wouldn't recommend against a PT visit, but I would go with SPECIFIC questions - i.e. "I feel like I can't seem to get into my left hip" (S/O to Davis is you got the PRI reference), "My right shoulder sits lower than my left", "My left pec is bigger than my right", etc.

Also, I would find a PT who believes in STRENGTH work to correct the issue. Sure, mobility and activation correctives can be beneficial but at the end of the day, the goal is get you AS CLOSE TO NEUTRAL AS POSSIBLE (you will never be perfectly neutral which is why strength coaches, chiropractors, and PTs exist to help slowly bring you back to the spectrum of neutrality) and then allow to strength train to cement that new pattern.

Bottom line: Do your OWN research and go in with a potential hypothesis for what might be causing the issue or a basic understanding of the situation.

Doctors love (or really anyone for that matter) to feel like they have the upper hand when it comes to knowledge so if they feel like you don't know what's going on or you don't have a grasp on the situation then they're going to talk down to you and you'll have to deal with this inferiority complex that is generated between the two of you. Level the play field and go in there with some knowledge in your head or on paper.

At the end of the day, keep this in mind: STRENGTH IS CORRECTIVE IN NATURE.

Have an asymmetry on one side compared to the other? Cool, literally everyone does. There isn't a single perfectly symmetrical person in this world. People appear symmetrical until you load them beyond a submaximal capacity and then you will being to see the asymmetries.

However, doing more unilateral work (upper or lower) can be incredibly beneficial. Obviously these have to be PROGRESSED appropriately. Doing walking lunges on day 1 isn't going to fix a hip shift in a squat. haha

So, to recap on that novel:

1. Do your own research > leading to my next point...
2. Go in with some questions or a basic understanding/hypothesis of what might be going on.
3. Don't read into his wording/suggestions too much - if he starts about you being "broken" or telling you that you need to stop squatting or benching until you fix these issues, MOVE ALONG AND FIND ANOTHER PT or lets hop on a Skype session and we can talk through a variety of things.
4. Remember, that at the end of the day you're doing the best thing possible to correct unilateral deficits - STRENGTH TRAINING. A properly periodized program that is built around your personal needs and preferences will help to correct these if pregressions/progressions (i.e. lateralizations) are built into it.

To expound even further...

You need to modify a variety of factors (programming, warm up, recovery, mindset, etc.) and not think that one individual is going to be able to fix this problem for you. Insanity is doing the same thing over and over again and expecting different results.

Just because you got yourself out of pain doesn't mean that you have the movement competency to dive right back into what you were doing before. If you look at the current research on pain science, you'll see that situations (aka environment), word choice, noises, etc. can all lead to a pain response from the brain.

So, in the case of your example, you may find that those exercises/positions which generated the pain before (hinge and squat) might produce excessive muscular tension and you'll have a hard time getting into position as your body is hypersensitive to them. In this case, it might be use to build your way back into the pattern using regressions.

I discussed them in this article but linked below for those who don't feel like digging: Train Like An Athlete, Look Like A Bodybuilder

Squat Progression
Dumbell Goblet Squat
Double Kettlebell Front Squat
Belt Squat
Safety Bar Squat
Front Squat
Back Squat

Lunge Progression
Step Up
Split Squat > Front foot elevated
Reverse Lunge > Front foot elevated
Single Leg Squat to Bench
Bulgarian/Rear Foot Elevated Split Squat (RFESS)
Single Leg Squat off Bench
Walking Lunge
Foward Lunge
Lateral Lunge
Pistol Squat

Hinge Progression
Hinge with PVC pipe: 3 points of contact (back of head, between shoulder blades, and tailbone)
Cable Pullthrough
Kettlebell Sumo Deadlift
Romanian Deadlift (RDL)
Trap Bar Deadlift
Sumo Deadlift
Conventional Deadlift

Build yourself back into the pattern using something like goblet squats, split squats, cable pull throughs, glute bridges, and RDLs. Don't just jump right back into what you're doing unless you want to be stuck in this pain cycle...

[KMadigan777]

Well I have been focusing huge on mid back stuff, scap wall slides and so on and seems to be helping. Hitting glute med every day I workout, seems to help a lot as well.

[EatMoBettah]

Contrary to the post at the top of this page, I didn't really research APT and am only getting to it now. I've been through the whole thread, post-by-post. A few questions if I may:

-How do you keep from tilting your pelvis too far forward when correcting your posture?

-What kind of shoes/sneakers are you guys wearing? I saw Svartberg mention some earlier in the thread, but would they be advisable for a complete beginner who isn't even doing exercises yet.

-When you guys lie down to go to sleep or to lay down on an exercise mat, are you able to lie down flat automatically, or do you have to tilt yourself into that position? I got that little bridge/arch and of course I want to fix it without surgery.

-Did any of you use a back-brace or foot insoles to ease pain during this whole process? I was told once to not get the foot help for flat feet because it's kind of like a crutch, and it's better overall to strengthen the muscles instead. What would you guys say on the back-brace/foot insoles front?

-If I have pain while running during my APT phase, then I shouldn't run. But what if I don't get any pain while running (although I def. 100% still have some nasty APT shape), can I still run?

*Also, right now I'm at the point where I try to squeeze my glutes and can't really differentiate between the glutes and my kegels muscles. I'm feeling more of a kegels squeeze now then a glute squeeze.

[EatMoBettah]

Also, I saw on this link where someone was asking about Usain Bolt and how he has Anterior Pelvic Tilt, yet most likely has strong glutes.

They pretty much told the threadstarter that it's perfectly natural to have a slight arch, and that working at it too hard will cause Posterior Pelvic Tilt and lead to a whole bunch of other spinal issues. What do you guys here think of this?

[svartberg]

Contrary to the post at the top of this page, I didn't really research APT and am only getting to it now. I've been through the whole thread, post-by-post. A few questions if I may:

-How do you keep from tilting your pelvis too far forward when correcting your posture?

Tbh I wouldn't bother trying to correct your posture too much, it never worked for me.
The best part of APT is fixing back problems, improving other lifting performance etc ...

-What kind of shoes/sneakers are you guys wearing? I saw Svartberg mention some earlier in the thread, but would they be advisable for a complete beginner who isn't even doing exercises yet.

Basically most sport shoes have heel drop = encourage more APT.
I use flat ones for running (nike frees)
Note they won't improve your posture, beginners should stay far away from them, tbh I only wear them cause they feel way better & natural after fixing APT.

-When you guys lie down to go to sleep or to lay down on an exercise mat, are you able to lie down flat automatically, or do you have to tilt yourself into that position? I got that little bridge/arch and of course I want to fix it without surgery.

A bit of arch is healthy, it's what help protects the spine

-Did any of you use a back-brace or foot insoles to ease pain during this whole process? I was told once to not get the foot help for flat feet because it's kind of like a crutch, and it's better overall to strengthen the muscles instead. What would you guys say on the back-brace/foot insoles front?

Dunno about flat foot, but backbraces are counterproductive, the whole point is for the muscles to improve and do the work.

-If I have pain while running during my APT phase, then I shouldn't run. But what if I don't get any pain while running (although I def. 100% still have some nasty APT shape), can I still run?

Run forest run!

*Also, right now I'm at the point where I try to squeeze my glutes and can't really differentiate between the glutes and my kegels muscles. I'm feeling more of a kegels squeeze now then a glute squeeze.

Totally different, and should optimally 100% never trigger each other.

Also, I saw on this link where someone was asking about Usain Bolt and how he has Anterior Pelvic Tilt, yet most likely has strong glutes.

They pretty much told the threadstarter that it's perfectly natural to have a slight arch, and that working at it too hard will cause Posterior Pelvic Tilt and lead to a whole bunch of other spinal issues. What do you guys here think of this?

Ya perfectly normal to have an arch, I actually developed posterior tilt long time ago.
But mind you I was only doing glute bridge like a maniac, while my quads & lower back were piss weak.
Nowadays my quads/back are way stronger, and my glutes are lagging again haha.

So don't worry about it & work dat ass ey, all the best bro

[Jax05]

I really need to jump into this...my lower back has been super tight, posture sucks, squats have stalled (i even managed to develop butt-wink).

I've been reading a lot of articles on this and the only thing that is consistent so far is that T-Nation articles are very contradicting and confusing. One will say do RDLs, squats, etc, the other one will say don't do them at all, third one will say do variations, etc. I don't think any of them are necessarily wrong, they just fail to explain when you should do them and when you shouldn't.

Anyway, back to the topic...
How do you guys program these? Do them as warm up before lifting? How often?
Do you guys avoid squats/deadlifts for a few weeks?

[cumeke]

Hi,

I had previous knowledge that i had a slightly hyperlordosis (APT) but didn't focus too much on the problem because i didn't experience pain.

I have an desk job and probably the main reason why i have APT.

After being on a bro/split program for about 2 years, i started the Fierce 5 novice program 2 months ago.

As i progressed on the Fierce 5 I experience an more and more back pain. First i thought that was normal but then it kept aggravating.



Now i want to fully focus on fixing this problem. And i want your advice on this plan.

i'm thinking about to continue following the fierce 5 novice but focusing on form. Deloding 50% of the weight and stay there until this problem is fixed. Doing the exercise with the complete Row of motion, pain free.

For the fixing, i was thinking of doing this exercises/stretchs everyday

link: ttp://posturedirect.com/fix-hyperlordosis-arched-back/

What do you think of this !?

[Ginaathletic]

Wow, what an awesome and helpful thread! Thanks!

[SkinnyBeast24]

I'm actually looking at the effects of a resistance training program on anterior pelvic tilt and can give you guys all the information in a few months once my data is finished.

It's 8 weeks. Here are some of the exercises I'm using

Core Work
Planks
Leg Lower Drill
Deadbug
Bent Knee Tucks

Resistance Exercises
Glute Bridges
Hip Thrusters

Cool-down "Static Stretches"
Kneeling Hip flexor stretch
Lying down single leg quad stretch

First 2 weeks on the resistance work, use eccentric temp. 5-6 seconds and 3 sets of 10-12.

Next 2 weeks, you bump up the weight.and use isometric with 3 seconds hold at top. 8 to 10 reps

Final 4 weeks is regular tempo with heavier weight. 4 to 6 reps.

I can post more when I'm done with my Thesis.

I strongly recommended limiting squats and other movements that become quad dominant and put you into anterior pelvic tilt (rdl's) if you are serious about correcting anterior pelvic tilt.

RDL's can work but most people do NOT engage their glutes at all and do not put themselves into posterior pelvic tilt at the top of the rep so it's not effective

[svartberg]

Hey hey brother, long time no see!

Atm using an old lower bench, it's not perfect but better than before
Digging the wood idea, defo gonna try it some time, cheers mate

Followup, ended up getting an elevated aerobic step bench (no homo), only slightly lower than the bench but getting much better glute activation.

On another note, while hip thrusts are super quick & awesome exercise, I've noticed it takes ages to setup.
Just clocked like 25min for what is essentially a 10min exercise, any of your brahs noticed it?

[KMadigan777]

Giving an update here, had this chit for like 2-3 years, so bad a few times I would cry and be paralyzed for part of day (dead srs). I can say I am 98% cured, only a little pain one a week or so, hardly even notice it.

Huge things that help: (these are your absolute core you need to do)
1. Stiff legged deadlifts really sticking your butt out. These will make of break you, do them wrong and you CAUSE the problem (see below), you want to feel like your hamstrings are ripping and at top your butt it flexing. I'd drop about 50% of your normal weight and do it, trust me you will feel it. I was dling about 270 for sets and dropped to 160ish and that was the right weight to get the right muscles, otherwise your low back starts working.
2. Side leg lifts/clams. Seem weird AF but these get your butt muscles that never work working. Do like 20 and you will feel the burn and realize they are weak.

Small things that help: (not a huge make or break)
Standing a lot more
stretching/rolling. Bros swear by this, but it never really was my magic pill

small bad things to avoidwont cause it, but make it worse)
sitting a lot (I still sit a lot but my pain has gone away which made me realize this wasnt the major cause for me)
squats - not sure why but always seemed to make my pain come back next day
sex/masturbation. I feel the contractions/tenseness in my low back afterwards slightly

major thing to avoid at all costs:
heavy deadlifts, especially convetional. I am utterly convinced in retrospect. Never had apt until heavy lifting, thought it was the 'cure' once I had pain etc. The problem is the normal way almost always turns into a type of back extension at high weight - exactly the thing we do NOT need. To put some numbers on it, I would do sets of dls, 5x3 at max weight and my highest was around 275. I could tell it turned into more and more back right around the 220ish mark. I had to drop to around 160 to start to do it purely on hamstring/butt (and different setup obvivously). Cut heavy dls out for a while, slowly go back into stiffleg/hamstring dls.

rep or pm if you got questions. gl bros

[AdventureRocks]

This is bad APT right? i have no idea if to keep bulking or cut it is very difficult to tell with APT? i have been lifting for a year and have gone from 70kg > 82kg .

I am reading every page of this thread , this is my number 1 priority this year.

[AdventureRocks]

Giving an update here, had this chit for like 2-3 years, so bad a few times I would cry and be paralyzed for part of day (dead srs). I can say I am 98% cured, only a little pain one a week or so, hardly even notice it.

Huge things that help: (these are your absolute core you need to do)
1. Stiff legged deadlifts really sticking your butt out. These will make of break you, do them wrong and you CAUSE the problem (see below), you want to feel like your hamstrings are ripping and at top your butt it flexing. I'd drop about 50% of your normal weight and do it, trust me you will feel it. I was dling about 270 for sets and dropped to 160ish and that was the right weight to get the right muscles, otherwise your low back starts working.
2. Side leg lifts/clams. Seem weird AF but these get your butt muscles that never work working. Do like 20 and you will feel the burn and realize they are weak.

Small things that help: (not a huge make or break)
Standing a lot more
stretching/rolling. Bros swear by this, but it never really was my magic pill

small bad things to avoidwont cause it, but make it worse)
sitting a lot (I still sit a lot but my pain has gone away which made me realize this wasnt the major cause for me)
squats - not sure why but always seemed to make my pain come back next day
sex/masturbation. I feel the contractions/tenseness in my low back afterwards slightly

major thing to avoid at all costs:
heavy deadlifts, especially convetional. I am utterly convinced in retrospect. Never had apt until heavy lifting, thought it was the 'cure' once I had pain etc. The problem is the normal way almost always turns into a type of back extension at high weight - exactly the thing we do NOT need. To put some numbers on it, I would do sets of dls, 5x3 at max weight and my highest was around 275. I could tell it turned into more and more back right around the 220ish mark. I had to drop to around 160 to start to do it purely on hamstring/butt (and different setup obvivously). Cut heavy dls out for a while, slowly go back into stiffleg/hamstring dls.

rep or pm if you got questions. gl bros

hey man,

How long did it take you to fix the issue?

It is really getting me down now

[KMadigan777]

hey man,

How long did it take you to fix the issue?

It is really getting me down now

Depends how hard you hit it, takes about 1-2 weeks for the major pain to go away, but no joke takes months and months to fully go away. I forgot to mention reverse lunges are a GREAT thing for your butt too. Basicly, your butt is likely inhibited and needs massive stimulation to pull your back down correctly.

[AdventureRocks]

Depends how hard you hit it, takes about 1-2 weeks for the major pain to go away, but no joke takes months and months to fully go away. I forgot to mention reverse lunges are a GREAT thing for your butt too. Basicly, your butt is likely inhibited and needs massive stimulation to pull your back down correctly.

Thanks for getting back to me.

Do you have any before and after photos for dat motivation?

Also any core exercises you would recommend , i have read you do not want to be doing one which are firing the hip flexor muscles as that is just going to make them tighter which is the problem in the first place.

I was thinking:

Cable crunch
pallof press

Would love any further recommendations.

For hamstrings and glutes what did you do?

I see you metnioned Stiff legged deadlifts and Side leg lifts/clams.

Just wondering what your program looked like exercises , sets , how often etc would be really appreciated!

[svartberg]

This is bad APT right? i have no idea if to keep bulking or cut it is very difficult to tell with APT? i have been lifting for a year and have gone from 70kg > 82kg .

I am reading every page of this thread , this is my number 1 priority this year.

Ya dude wow this is textbook APT, you can drastically improve this, all the best bro

[KMadigan777]

Basically, for me the key was realizing it was not stiffness that was the issue (of course it doesnt help) basically you need to be honest about if you are at ALL flexible its probably a muscle imbalance (for me it was) like if you can do a lot of these stretches and not feel anything, its the muscle imbalance.

For abs I really like leg raises on the bar (lifting knees to face), planks did chit for me.

The big three exercises are: reverse lunges (huge), strict/light hamstring deadlifts, and side clams/leg lifts. The 3rd seems really homo until you only do 20 and its burning super bad. Try to do it about 3x a week with weights, and do leg lifts at least once a day.

[acarsey]

Strengthens bands.

when the bands are used correctly I can only see the perks. What about using the bands in a “brace like” man or? Example, since I’ve undergone 13 surgeries ranging from shoulder and ankle reconstruction, spinal fusions and abdominal mesh, I’ve found myself trying to push the limits of my current abilities. Using bands to help restrict specific movements while I conduct my workouts. Common sense says that the bands are serving more as a crutch than a strengthening aid?

Comments?

[offbeatmatt]

Thanks for this thread and all this advice. I'm really curious as to whether I have this issue. My butt has always stuck out and my gut has always protruded a little forward. I've had back pain since I was in elementary school and I started seeing a chiropractor when I was 9, but it never helped the pain. I saw a physical therapist 5 years ago and she was having me do hamstring stretches, but it didn't feel like it was helping either. I know this can cause lower back pain and neck pain (which I have), but can it cause upper back pain? The sides of my upper back from my shoulders to below my shoulders hurt all the time.

I just took three side pictures. Is this a healthy degree of lumbar curvature and pelvic tilting? Often throughout the day I'll squeeze my shoulders backwards because I'm in pain, and the curve moves further up the middle of my back (I think that was happening in the second picture).

[916biking]

I believe that the link for the foam roller exercises no longer works anymore. If anyone could link me to an alternative it would be greatly appreciated.

[DrMarcPT]

So important to focus on prehab/rehab. As a physical therapist, I agree with your post.

Another major factor to consider is motor control of the pelvis. The abdominals and glutes may be strong but many people don't know how to activate them during certain activities.

For example, I personally forget to engage my glutes and abs when standing which results in an excessive APT.

Strengthening is definitely important and its equally important to improve motor control for APT. And does anybody have back pain?

Pain changes activation patterns of muscles and can inhibit the glutes and abdominals from maintaining a proper ATP. Just more info to consider.

Thanks for posting bro!

[svartberg]

I believe that the link for the foam roller exercises no longer works anymore. If anyone could link me to an alternative it would be greatly appreciated.

Hey dude, just youtube search foam rolling for (1) lower back (2) quads / hip flexors

Thanks for this thread and all this advice. I'm really curious as to whether I have this issue. My butt has always stuck out and my gut has always protruded a little forward. I've had back pain since I was in elementary school and I started seeing a chiropractor when I was 9, but it never helped the pain. I saw a physical therapist 5 years ago and she was having me do hamstring stretches, but it didn't feel like it was helping either. I know this can cause lower back pain and neck pain (which I have), but can it cause upper back pain? The sides of my upper back from my shoulders to below my shoulders hurt all the time.

I just took three side pictures. Is this a healthy degree of lumbar curvature and pelvic tilting? Often throughout the day I'll squeeze my shoulders backwards because I'm in pain, and the curve moves further up the middle of my back (I think that was happening in the second picture).

You got bit APT, hard to tell exactly due to that legendary hair haha

Unfortunately no, APT doesn't cause mid-back / rear-delts pain, look towards your upper body instead.

There's a trick to find out where any muscle imbalance lie, do myofacial release for muscles and see where you got knots.
I'd bet my money you got overactive tight pec major/minor (chest), try get a tennis ball and look for knots in your chest muscles. (vid below)
Post update here with your findings, good luck!

So important to focus on prehab/rehab. As a physical therapist, I agree with your post.

Another major factor to consider is motor control of the pelvis. The abdominals and glutes may be strong but many people don't know how to activate them during certain activities.

For example, I personally forget to engage my glutes and abs when standing which results in an excessive APT.

Strengthening is definitely important and its equally important to improve motor control for APT. And does anybody have back pain?

Pain changes activation patterns of muscles and can inhibit the glutes and abdominals from maintaining a proper ATP. Just more info to consider.

Thanks for posting bro!

Hey doc, you asked for personal experience.
I used to have severe lower back pain, but doing these exercises many years ago completely cured me and I had no single issue since.
I don't do any motor exercises, I just got my glutes & core to ridiculous levels with weights.
I still sit all day long (for work purposes), a flexible chair helped to prevent static posture (which is never good), but ultimately what helped me were these exercises.

Agreed about motor control, there was a bit discussion here a few years back, about how glute/core exercises are not only important for strengthening, but also to constantly "remind" our brain how to use these inhibited muscles.

A question for you about mobility, to what extent have you seen habits reprogrammed among your patients?
I.e. even with strong balanced muscles, ultimately sitting all day means I'll always have some APT & forward neck when I get up, I learned to live with it as it's harmless.
When going on trips/backpacking, my posture does slowly become better after a few days.
So I do wonder if it's possible to override these strong neural habits that form over constant sitting?

Thanks for reading mate

[AdventureRocks]

Slowly making progress but this is so dam frustrating that I can't squat do any quad exercises or deadlift until I sort it out!

Doing core 3 times a week
Hip bridges 3 times a week with barbell
Hamstring exercises 3 times a week
Foam rolling twice a day
Stretching quads and hip flexors twice a day

Will post progress pictures soon

[svartberg]

Slowly making progress but this is so dam frustrating that I can't squat do any quad exercises or deadlift until I sort it out!

Doing core 3 times a week
Hip bridges 3 times a week with barbell
Hamstring exercises 3 times a week
Foam rolling twice a day
Stretching quads and hip flexors twice a day

Will post progress pictures soon

Nice man, post more lift stats for above

[AdventureRocks]

Nice man, post more lift stats for above

Glutes - Barbell Hip bridges from the floor 120kg (i assume the small 75% size Olympic bar is 20kg) 4 sets 12-15 reps, pausing for 3-5 seconds at the top of the movement and then coming down controlled not touching the floor with ass. Last night i majorly messed up and felt i really sharp pain near my ass hole after 3 reps on first set so stopped immediately hoping i do not get that when i go back on Friday.

Core - i found this great video on youtube which does not seem to use any hip flexor movements "At Home Core Workout | Clutch Life: Ashley Conrad's 24/7 Fitness Trainer" video id = dJlFmxiL11s (can not post links)

Hamstrings- Doing the leg curl machine at 60kg for 4 sets between 8-12 reps

Progress pictures 8 weeks today. Am i going in the right direction or is this progress slower than expected, i feel as though i am going to be another 12 weeks at least? I should still be avoiding squatting and deadlifts until this is sorted still?