Iliopsoas tightness in Down syndrome is often due to which posture?

• A. Posterior pelvic tilt
• B. Anterior pelvic tilt with increased hip flexion in sitting and standing
• C. Neutral pelvis
• D. Pelvic tilt to the side

Answer: (B)

An anterior pelvic tilt with increased hip flexion in both sitting and standing keeps the iliopsoas in a shortened position, leading to adaptive tightness. When the pelvis tilts forward, the hip flexors are repeatedly shortened, so they tighten over time. In Down syndrome, hypotonia and trunk weakness often promote forward pelvic tilt and greater reliance on hip flexors for stability, reinforcing this pattern. Posterior pelvic tilt would lengthen the iliopsoas and reduce tightness, while a neutral pelvis or a side tilt doesn’t place the hip flexors in the same shortened state. Addressing this involves stretching the iliopsoas and improving pelvic and trunk control to reduce forward tilt and balance hip flexor and extensor strength.