Open Journal of Orthopedics, 2018, 8, 464-475 http://www.scirp.org/journal/ojo ISSN Online: 2164-3016 ISSN Print: 2164-3008 DOI: 10.4236/ojo.2018.812048 Dec. 19, 2018 464 Open Journal of Orthopedics What Is the Association between an Anteriorly Tilted Pelvis and Trendelenburg Gait? Yvonne Paul 1 , Mariette Swanepoel 2 , Terry J. Ellapen 2 , Marco Barnard 2 , Henriette V. Hammill 2 , Reino W. Müller 2 , Juandré Williams 2 1 Department of Sport and Dental Therapy, Faculty of Health Science, Tshwane University of Technology, Pretoria, South Africa 2 School of Human Movement Science (PhASRec), Faculty of Health Science, North-West University, Potchefstroom, South Africa Abstract Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biome- chanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubo- femoral ligaments to resolve the primary abnormal force-couple, with im- proved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthen- ing of the ipsi-lateral hip abductors and contralateral external obliques. Pa- tient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sar- torius synergistic dominance is in play. In conclusion, the association be- tween an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabi- litative programme to ensure successful rehabilitation of lumbo-pelvic hip How to cite this paper: Paul, Y., Swane- poel, M., Ellapen, T.J., Barnard, M., Ham- mill, H.V., Müller, R.W. and Williams, J. (2018) What Is the Association between an Anteriorly Tilted Pelvis and Trendelenburg Gait? Open Journal of Orthopedics, 8, 464-475. https://doi.org/10.4236/ojo.2018.812048 Received: October 5, 2018 Accepted: December 16, 2018 Published: December 19, 2018 Copyright © 2018 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access