Anterior Pelvic Tilt Isn’t the Problem… Here’s What Actually Is

In this episode, Dr. Becky Allen argues that posture should be assessed as a signal of a patient’s movement, balance, and breathing strategies rather than treated as the problem. She critiques common assumptions about anterior and posterior pelvic tilt (including “Lower Crossed Syndrome”) and explains that the nervous system drives posture, with the rib cage influencing pelvic orientation and pelvic floor function. Two common patterns are described: “Big Booty Judy” (anterior tilt with flared, inhaled rib cage and short, descended pelvic floor) and “Pancake Butt Paul” (often an underlying anterior tilt with compensatory glute clenching, forward pelvic translation, pump-handle down rib position, and even more pelvic floor pressure). Treatment follows an order: establish nervous system safety, restore rib cage compression/expansion, address pelvis (including shifting center of mass back and internal rotation), then integrate rotation and load, with example drills like wall sit reach-and-breathe, quadruped push-and-breathe, side-lying rib compression, TRX squats with a block, and front-foot-elevated split squats. Dr. Becky reiterates “best posture is your next posture” and promotes an upcoming fall course via an email list.(00:00) - Posture Is a Signal(03:11) - Two Posture Types(05:42) - Big Booty Judy Breakdown(07:18) - Pancake Butt Paul Explained(11:23) - What To Do With This(14:05) - Order of Operations(14:51) - Respect the Nervous System(16:05) - Address the Rib Cage Compression/Expansion(23:22) - Pelvis and Center of Mass(27:12) - Integrate Rotation and Load(28:45) - Key Takeaways and Wrap UpJoin my email list so you don't miss what I am building next! https://www.thepelvicpowerhouse.com/sign-me-upGrab your free guides:* From the Ground Up: The Foot + Pelvic Floor Connection: https://www.thepelvicpowerhouse.com/fromthegroundup* From the Top Down: From the Ribcage to the Pelvic Floor: https://www.thepelvicpowerhouse.com/fromthetopdown Clinicians, be sure to learn about Dr. Becky and Dr. Corrie’s Pelvic Powerhouse Clinical Mastermind: https://www.thepelvicpowerhouse.com/group-clinical-mastermind-2026-live Follow Becky on Instagram: https://www.instagram.com/drbeckypelvicpt/ Follow Genesis PT and Wellness on Instagram: https://www.instagram.com/genesisptwellness Subscribe to "From the Ground Up with Dr. Becky Allen”: * Apple Podcasts: https://apple.co/47eQP84 * Spotify: https://open.spotify.com/show/4QMmH0LDL0CrCEvVpJaOzd * YouTube: https://www.youtube.com/@FromTheGroundUp-u4n/ Pelvic health professionals, if you want to grow your practice, provide great patient care, and create the life and business you love, then visit The Pelvic Powerhouse: https://www.thepelvicpowerhouse.com/ "From the Ground Up with Dr. Becky Allen” is the podcast for pelvic health pros who are done playing small in the clinic or in business. Your host is Dr. Becky Allen, a physical therapist and the founder and visionary of Genesis PT & Wellness. As your coach, Becky will share with you what it really takes to lead a mission-driven, team-powered, game-changing pelvic health practice.