this post was submitted on 19 Sep 2026
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That's not quite right from a medical standpoint. While presentation can vary a bit, there are really consistent musculoskeletal features common to Autism and ADHD which are caused by reduced muscle tone. These are so common that some of them are actually diagnostically helpful.
Virtually all autistic people will have some degree of hyperlordisis of the lumbar spine related to an anterior pelvic tilt. You can also often see rib flaring as a result of this too. Both of these are also pretty common in ADHD and account for the balance board differences from NT people. The severity of ADHD/Autism symptoms are also proportional to the severity of hyperlordisis. That is to say the more severe one's ADHD or Autism is, the weaker the muscle tone will be and the more the pelvis will be tilted.
Also common but not diagnostically helpful for Autism are scapular protraction, a forward head posture, and a shortening of calf ligaments caused by tiptoe walking.
Because all bodies are different and the degree of pelvic tilt and severity of muscle tone weakness varies there are naturally going to be variations that most people wouldn't pick up on, but a physical therapist would be able to identify the commonalities.
TL;DR autistic people have a fat ass
I had to be sent to a physiotherapist to correct the issues caused by toe-walking as a child. My calf muscles had shortened and stiffened to the point where I was not able to participate in physical education without severe pain.
As an adult, I suffered from severe back pain until a physiotherapist explained the anterior pelvic tilt and helped me correct the years worth of compounded issues that stemmed from it.
It's a very real thing.
I also have such a tilt but haven't experienced any issues derived from it yet. Do you have advice on how I can correct it?
My physiotherapist helped me correct my posture by actively engaging my abdominal muscles to change the angle of my pelvis.
I too had no issues for a long time, but as you get older, your body's ability to repair itself slows down and the pain can creep up on you.
Squats, bridges, hip flexor stretches, and lots of walking can be effective.
Autistic people don't have a harder time building or maintaining muscle, they typically do less physical activity than their neurotypical peers. It seems to be somewhere between an executive function thing and a vicious cycle where poor coordination and low muscle mass lead to poor performance and frustration that leads to not exercising which worsens coordination and muscle mass.
Does this then not perpetuate a kind of stereotype? Myself and my brothers have ADHD and are also most likely autistic too but have been involved in team and solo sports all our lives and are relatively fit and have always had pretty good muscle mass. I have basically none of the issues you mentioned above and neither do my siblings. I think we do miss here that the "spike-iness" of one's autism profile doesn't necessarily preclude them from liking or engaging with exercise in whatever manner they enjoy.
I'm just talking broad statistics. Of course every person is different and there are autistic people who do enjoy lots of physical activity.
Or is the assumption that autistic people are likely to have poor muscle mass introducing a kind of selection bias that is in itself causing this statistical effect?
It is definitively not caused by selection bias. Given the fact that you're describing it as "most likely autistic" and the fact that you're here and present on social media and advocating for yourself, you would probably fall into LSN or Level 1 autism if that is the case. The degree and severity of muscle mass issues are least observed in Level 1 and most observed in Level 3.
Muscle mass is not directly used as a diagnostic criteria of autism or ADHD, so they aren't just selecting based on muscle mass. People of all neurotypes have all sorts of bodies, so while it can be diagnostically helpful as a clue it's not what doctors are looking for.
This effect is observed in all parts of the population, including those who are too young or noncommunicative to be aware of the effect, so it's also not some sort of self-fulfilling prophecy. We don't know 100% why it happens but it's probably sensory related at in early childhood and then becomes habituated as well.
Fuck, is that why my ass is so fat? I was called bubble butt when I was a kid :(
If it was present before puberty, it is almost certainly hyperlordisis.
It can result in herniated spinal disks, but depending on the degree it can be quite correctable with physical therapy and regular exercise.