Mulberry Whale by Joyymer

I have always believed that hard work matters, though perhaps not in the way many imagine. Some say, “The harder you work, the more luck you get.” My experience is slightly different: “The harder you work, the harder work gets.” This case illustrates why effort alone is not enough. Careful observation and questioning matter just as much.

First Impressions: A Tilted Pelvis

At first glance, many experts would have identified her posture as hyperlordosis. The anterior pelvic tilt, slouched shoulders, forward head posture and even mild knee valgus all seemed to confirm it. I also made the same assumption and initially focused on correcting her pelvis.

Background

Client: Female, 25+ years old
Occupation: Flight attendant who spends many hours in high heels and prolonged unsupported sitting
History: Baker’s cysts, chronic knee pain, lower back discomfort, and persistent neck and shoulder tension.

Initial Plan and Progress

The first strategy was straightforward. I worked to improve pelvic alignment, strengthen the core and increase flexibility. She presented with tight hamstrings, weak core, tight quadriceps, weak hip flexors and overactive erector spinae.

We addressed those imbalances, and she quickly improved. Her low back pain decreased, knee pain resolved, yet she still experienced recurring neck tension and soreness in her lower back after long periods of sitting.

Asking Better Questions

That ongoing discomfort was frustrating. I do not want clients to remain in pain, so I shifted perspective. Instead of asking “How do I fix the tilt?” I asked “Why is her pelvis tilted in the first place?”

After much research and re-examination, the answer became clear. She did not have hyperlordosis at all. Instead, her lumbar spine was flat, showing a reduction of natural curvature. The anterior pelvic tilt was a compensation, not a primary fault. Her body was tilting the pelvis forward in an attempt to create lordosis that was missing. At the same time, the cervicothoracic junction stiffened, producing postural kyphosis.

This aligns with research evidence. A study by Pourahmadi and colleagues in 2020 found that individuals with chronic low back pain often demonstrate a flatter lumbar curve during functional transitions such as sit to stand and stand to sit, rather than excessive lordosis. Understanding this distinction completely changed the direction of her training.

Results

By shifting the focus from correcting the tilt to restoring lumbar mobility, thoracic extension and pelvic control, her symptoms improved significantly. She now reports no more back pain, except occasional discomfort during her menstrual cycle.

She has been consistent with her program, even investing half of her salary into a fifteen class course. She views it as preventative care, which is a wise investment. Interestingly, several of her colleagues who avoided training have already needed surgical interventions. She never asked for a quick fix, only to learn how to move correctly, and that mindset has made all the difference.

Takeaway

Not every anterior pelvic tilt is hyperlordosis. Sometimes what looks like excess curvature is in fact the body’s attempt to compensate for a loss of natural lordosis. Careful assessment, open questions and attention to compensations are what prevent misinterpretation and allow for better, longer lasting outcomes.

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