I have seen a lot of people have anterior pelvic tilt, others a slight others a lot more. How can i know where this can a problem that must be fixed or its no problem and i should not try to fix it? I mean is there a standard angle? If yes it is the same for males and females?
The a.p. position of the pelvis depends on two neighbouring structures - the hip joints and the lumbar spine. Furthermore, the pelvic tilt changes with the changes in ROM of both hips and lumbar spine. The normal lumbar lordosis varies from 30 - 50 degrees (average 40 degrees) in standing, provided that their are no hip joint contractures (i.e. flexion contracture). The normal ROM of the hip joint in the sagittal plane according to the so-called "Neural-Null-System" is 120 / 0 / 5 degrees. So in my opinion you should have to measure these parameteres, and if they are in the normal ranges then you can conclude if the pelvic tilt is "normal" for the given patient or not. So the a.p. pelvic tilt may vary a lot.
On the other hand, lumbar hyperlordosis and flexion hip contractues may lead to pathologically changed pelvic tilt.
you can found more informations in this article
http://www.ncbi.nlm.nih.gov/pubmed/23412086
Pelvic inclination, pelvic tilt, and sacral slope measurements should be done on an erect lateral scanogram of the spine. You can do it on "surgimap spine" software easily. It also has animation how to measure it.
After measurements, you may compare with the normal values to decide.
There is a comprehensive work on sagittal balance done by Roussouly. You should search his papers and there you will find answers to all your questions. Pelvic tilt is a variable parameter that shows the amount of retro-anterversion left in order to compensate changes in hip and spine ROM. But all this info is described in Roussuly's papers
You can measure pelvic tilt by the pelvic tilt angle on lateral standing X-rays, and measure also the pelvic incidence angle in the same X-rays.
Pelvic tilt (angle between the vertical line and a line traced between the center of the S1 endplate and the center of the hip joints axis -defined as the central point of the line between the center of the left and right femoral head-) in normal individuals is almost always lower than 21°. Higher values correlate to worse function and more back pain, and are usually due to posterior tilt of the pelvic to compensate for insufficient lordosis.
Additionally, a fair correlation between pelvic tilt (PT) and pelvic incidence (PI) has been found and described by Vialle. They published a formula to calculate the expected value of PT as a function of PI: PT=0,37PI-7°
Please see also:
Sagittal deformities of the spine: factors influencing the outcomes and complications.Diebo BG, Henry J, Lafage V, Berjano P. Eur Spine J. 2015 Jan;24 Suppl 1:S3-15. doi: 10.1007/s00586-014-3653-8. Epub 2014 Nov 12.
Pelvic parameters and global spine balance for spine degenerative disease: the importance of containing for the well being of content. Garbossa D, Pejrona M, Damilano M, Sansone V, Ducati A, Berjano P. Eur Spine J. 2014 Oct;23 Suppl 6:616-27. doi: 10.1007/s00586-014-3558-6. Epub 2014 Sep 12.
Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. Lamartina C, Berjano P, Petruzzi M, Sinigaglia A, Casero G, Cecchinato R, Damilano M, Bassani R. Eur Spine J. 2012 May;21 Suppl 1:S27-31. doi: 10.1007/s00586-012-2236-9. Epub 2012 Mar 13. Review.
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