How to fix a Rotated pelvis

What is a Rotated pelvis?

Ideally – the pelvis should be centered and orientated towards the front.

(The pubic bone facing directly forwards.)

rotated pelvis

With a Rotated Pelvis: The pelvis is twisted and facing more towards one side.

The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. For more information: Medical disclaimer.


Types of Pelvic rotation

“Which way is your pelvis pointing?”

Left pelvis rotation: The pelvis is orientated towards the LEFT.

Right pelvis rotation: The pelvis is orientated towards the RIGHT.

Implications

In regards to posture, the pelvis is located in a central (… and a very influential) position.

Poor positioning of the pelvis will result in compensatory postural adjustments throughout the whole body.

As a result – you get the domino effect of postural deviations! (see above)


Did you know…. A pelvis rotation usually occurs with some degree of a Lateral Pelvic Tilt?


What causes the pelvis to rotate?

There are multiple areas that can directly and indirectly cause the pelvis to be in a rotated position.

a) Foot: Pronation/Supination

In a situation where one foot is pronated (low arch) and the other supinated (high arch), the tendency is for the pelvis to rotate:

b) Hip: External/Internal rotation

In a situation where one hip is externally rotated and the other internally rotated, the tendency is for the pelvis to rotate:

  • away from the externally rotated hip (ER) and
  • towards the internally rotated hip (IR).

(Note: This will be extensively covered in this post.)

c) Lumbar spine: Rotation

If your lumbar spine is rotated, it can also pull your pelvis into a rotated position as well.

This is usually due to the function of the anterior/posterior oblique lines.

d) All of the above:

To be honest… a rotated pelvis is more likely to be due to a combination of everything!

This is because every part of the human body influences… and is influenced by every other part.

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How to tell if your pelvis is rotated

Here are 4 different methods which I personally use on a regular basis.


Starting point:

  • Stand with your feet shoulder width apart.
  • Make sure the feet are level with each other.

1. ASIS method:

  • Locate the Anterior Superior Iliac Spine (ASIS).
    • These are the pointy bones at the front of both of your hips.
    • (If unsure where they are, check it out on Google.)
  • Place a finger at the front of each of these bony land marks.
  • “Is one side more in front of the other?”

Left side is forward: Right pelvis rotation

Right side is forward: Left pelvis rotation

2. Thigh position:

  • Look down at the front of your thighs.
  • “Is one thigh more forward as compared to the other side?”

Left side is forward: Right pelvis rotation

Right side is forward: Left pelvis rotation

3. Buttock position

twisted pelvis

  • Take a downwards facing photo shot of your buttocks.
  • “Is one butt cheek more forward?”

Left side is forward: Right pelvis rotation

Right side is forward: Left pelvis rotation

4. Belly button

  • Look down at your belly button.
  • “Which direction is it facing in relation to your feet?”

Towards the right: Right pelvis rotation

Towards the left: Left pelvis rotation

Note: These are very general methods to determine if your pelvis is rotated to one side. For best results, aim to use these tests in conjunction with one other.

How to fix your Rotated pelvis

Note: These exercises are designed to be gentle and pain-free


READ THIS:

I will be explaining these exercises in terms of a RIGHT rotated pelvis.

(If you have a LEFT rotated pelvis, do the same exercises but on the opposite side mentioned.)

“Mark!… Do I have to do ALL of these exercises?”

No – In some sections, I have also listed multiple progressions to the same basic exercise. Perform the exercise that you feel is at your appropriate level of capability.


Do this first:

Pelvis reset

Aim: This maneuver will assist in re-balancing the muscular tension throughout the pelvis.

Instructions:

  • Lie down on your back with both of your hip/knees bent in the air at 90 degrees.
  • Place your hand on top of one knee, and the other below the other knee.
  • Whilst applying an opposing force on both knees, use your leg muscles to keep your knee in the same position.
    • (isometric muscle contraction)
  • Hold for 5 seconds.
  • Repeat on other side.
  • Squeeze a ball between your knees and hold for 5 seconds.
    • You may hear a “click” as you perform this step.
  • Complete 3-5 cycles.

[Left hip exercises]

1. Releases:

Aim: Reduce tension in the muscles of the left hip causing a right pelvic rotation.

  • Hip external rotators
    • Glute max, Pirifromis, Deep hip muscles
  • Rectus Femoris

a) External rotators

Instructions:

  • Place a massage ball underneath your left buttock region. (see above)
  • Whilst applying your body weight, perform gentle circular motions over the ball.
  • Duration: 1 minute

b) Rectus Femoris

Instructions:

  • Place a massage ball underneath the front of your thigh region. (see above)
  • Whilst applying your body weight, perform gentle circular motions over the ball.
  • Make sure to cover the full length of the muscle.
  • Duration: 1 minute

2. Stretches:

Aim: Reduce tightness in the muscles of the left hip causing a right rotated pelvis.


a) Piriformis stretch

Instructions:

  • Sit down on the edge of a chair.
  • Place your left ankle on top of your right knee.
  • Sit as tall as possible.
  • Pull your left knee towards your right shoulder.
  • Aim to feel a stretch in the back of your left hip.
  • Hold for 30 seconds.

b) Hip internal rotation

Instructions:

  • Lie on your back with your left knee bent.
  • Place left foot towards the left side away from the body.
  • Allow your left knee to drop towards the midline of the body.
  • Place your right foot onto the outside surface of your left knee to push it down further.
  • Aim to feel a stretch at the back of your left hip.
  • Hold for 30 seconds.

c) Rectus Femoris stretch

Instructions:

  • Stand up right.
  • Bend your left knee and grab your foot behind your buttock region.
  • Pull your knee backwards.
  • Make sure to keep your knees in line with each other.
  • To increase stretch: tuck your tailbone underneath you by squeezing your glutes.
  • Aim to feel a stretch along the front of your thigh.
  • Hold for 30 seconds.

3. Strengthen:

Aim: Strengthen the muscles of the left hip that rotate the pelvis to the LEFT.

  • Hip internal rotators
    • (pectineus, adductors, anterior glute medius)

(Note: For a comprehensive blog post on improving internal rotation of the hip, check out this post: Hip Internal Rotation Exercises.)


a) Internal rotation – sitting

Instructions:

  • Whilst sitting, lift your left foot to the side.
  • Make sure that your knee points forward throughout movement.
  • Do not move the pelvis.
  • Hold the end position for 5 seconds.
  • Repeat 20 times.
  • Progression: Perform whilst in the right side lie position.

b) Hip shift on wall

Instructions:

  • Lie on the floor.
  • Place your feet on the wall with your hips and knees bent at 90 degrees.
  • Dig your feels into the wall and lift your tail bone off the floor.
    • Keep your back flat on the ground.
  • Suck your left knee in towards the hip whilst pushing your right knee away from the hip.
    • (Make sure you keep your thighs straight and parallel with each other.)
  • Aim to feel your left inner hip muscles engaging.
  • Hold for 30 seconds.
  • Repeat 3 times.

c) Left foot lift (side position)

Instructions:

  • Lie on the floor with your left side up.
  • Keep your left knee pushing down onto the right knee.
  • Lift up your left foot as high as you can go.
  • Do not move your pelvis.
  • Hold for 3-5 seconds.
  • Aim to feel contraction of the muscles on the side of the left hip.
  • Repeat 10 times.

[Right hip exercises]

1. Releases:

Aim: To reduce tension in the muscles of the right hip that are pulling into the right rotated pelvis position.

  • Hip internal rotators:
    • Pectineus, Adductors, Anterior Glute Medius
  • Hamstring

a) Hip Internal rotators

Instructions:

  • Place a foam roller at the front/inside of your right hip region. (see above)
  • Whilst applying your body weight, perform a rolling motion over the foam roller.
  • Duration: 1 minute
  • Note: Be gentle! There are nerves that run through this area!

b) Hamstring

Instructions:

  • Place a massage ball under your right hamstring muscle. (see above)
  • Whilst applying your body weight, perform gentle circular motions over the ball.
  • Duration: 1 minute

2. Stretches:

Aim: To decrease the tightness in the muscles of the right hip that are holding the right rotated pelvis position.


a) Forward lunge

Instructions:

  • Assume the lunge position with your left leg in front.
  • Point your right toe towards the outside.
  • Lunge forward as far as you can.
    • Do not rotate your pelvis. Keep your pelvis facing the front.
  • Aim to feel a stretch in the inside of your right groin.
  • Squeeze your right glute muscles to increase the stretch.
  • Hold for 30 seconds.

b) Half butterfly

Instructions:

  • Lie down your back with your right knee bent at ~90 degrees.
  • Let your right knee drop to the side.
  • Whilst keeping your left side of the pelvis down, push your right knee closer to the ground.
  • Aim to feel a stretch in the side of the right groin.
  • Squeeze your right glute muscle to increase the stretch.
  • Hold for 30 seconds.

c) Half frog

Instructions:

  • Lie on your stomach.
  • Bring your right knee up to your side. (see above)
  • Squeeze your right glute muscle to increase the stretch.
  • Aim to feel a stretch in the side of the right groin.
  • Hold for 30 seconds.

3. Strengthen:

Aim: To strengthen the muscles of the right hip that rotate the pelvis to the LEFT.

  • Hip external rotators
    • Glute max, Pirifromis, Deep hip muscles

a) Clam shell

Instructions:

  • Lie on your left side with your knees/hip bent at 90 degrees.
  • Whilst keeping your ankles together, lift up your right knee as high as possible.
  • Make sure that you do not move your pelvis.
    • Block the right hip with you right hand (see above).
    • Only the leg should be moving.
  • Aim to feel the muscles on the side of your right hip engage.
  • Hold for 3-5 seconds at end range.
  • Repeat 20 times.

b) Wall push whilst sitting

Instructions:

  • Sit on a chair with your right leg next to the wall.
  • Keep your feet shoulder width apart.
  • Push your right knee into the wall.
  • Maintain this hold for 1 minute.

c) Pelvic rotation in side lie (Obliques)

Do this exercise if your pelvis and belly button are rotated to the right side AND your sternum is facing forwards.

Instructions:

  • Lie on your right side. (see above).
  • Rotate only your pelvis towards the left side.
    • Keep your knees together throughout movement.
  • Do not move your upper torso.
    • You can use your arms to anchor yourself down.
  • Hold the end range for 3-5 seconds.
  • Repeat 20 times.

[Left & Right hip exercises]

It is important to progress to exercises that strengthen both the left and right hip at the same time.


a) Standing twist

Instructions:

  • Stand up right with your feet shoulder width apart.
  • Rotate your pelvis towards the left.
  • Keep your knees facing forwards.
  • Hold the end range for 5 seconds.
  • Aim to feel your inner left groin and right glute muscle engage.
  • Repeat 20 times.

b) Hip shift whilst sitting

Instructions:

  • Sit tall on the edge of a chair with your right side towards a wall.
  • Suck your left knee in towards the left hip whilst pushing your right knee forwards. (Yellow arrow)
    • Keep your thighs parallel to each other
  • Push out your right knee against the wall. (Orange arrow)
  • Bring your knee to mid line without moving your feet. (Orange arrow)
  • Aim to feel tension on the:
    • Outside of the right hip
    • Inside of the left hip
  • Hold for 30 seconds.
  • Repeat 3 times.

c) Hip shift on wall

Instructions:

  • Set your body as seen above.
  • Place a resistance band around your knees.
  • Place your feet on the wall with your hips and knees bent at 90 degrees.
  • Dig your heels into the wall and lift your tail bone off the floor.
    • Keep your back flat on the ground.
  • Suck your left knee in towards your left hip as you push your right knee upwards. (Yellow arrows)
    • Keep your thighs parallel to each other.
  • As you push your right knee upwards, push it out to the right side. (Orange line)
  • Bring your left knee towards mid line without moving your feet. (Orange line)
  • Aim to feel tension on the:
    • Outside of the right hip
    • Inside of the left hip
  • Hold for 30 seconds.
  • Repeat 3 times.

d) Hip shift in side lie

Instructions:

  • Lie on your left side. (see above)
  • Suck your left knee in towards the hip whilst pushing your right knee away from the hip.
  • Without your pelvis moving:
    • Lift your right knee and hold.
    • Lift your left knee and hold.
  • Aim to feel tension on the:
    • Outside of the right hip
    • Inside of the left hip
  • Hold for 5-10 seconds.
  • Repeat 5 times.

Progressions:

Once you are comfortable with the previously mentioned exercises, try out these other exercises to help solidify your newly acquired neutral pelvis position.


a)  Walking lunges

Instructions:

  • Perform walking lunges.
  • Keep your pelvis facing forwards throughout the movement.
  • Repeat 10 times.

b) Single leg Dead lift

Instructions:

  • Have your feet in the staggered stance with one leg forward.
  • Keep your pelvis facing forwards throughout the movement.
  • Perform a dead lift.
  • Repeat 10 times.
  • Alternate legs.

Daily activities:

*** READ THIS ***

(This is the MOST important section of this post!)

There is absolutely no point doing all of the above exercises if you do not actively change the positions that encourage your rotated pelvis to in the first place.


To keep your pelvis in a more neutral position, consider the following:

a) When Sitting

  • Sit on your Sit bones.
  • Distribute your weight evenly on each buttock.
  • Do not lean to one side.
  • Keep your knees and feet symmetrical.
  • Make sure that your torso and pelvis are facing forwards.
    • “Point your pubic bone forwards”

b) When Standing

  • Stand evenly between your feet.
  • Do not lean to one side.
  • Make sure your pelvis is pointing forwards.
  • Look down. Keep the front of your thighs level.
  • Make sure you do not have pronated/supinated feet.

Do you have Scoliosis?

If you have a rotated pelvis, it is likely that you will have a degree of rotation in your spine.

For more information, check out this post: How to fix a Twisted Spine.


What to do next…

1. Any questions?… Leave me a comment down below.

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the exercises for your Rotated pelvis!


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1,047 thoughts on “How to fix a Rotated pelvis”

  1. Hi mark
    I need your help.

    So my right side is more forward than my left and it feels like it´s anteriorly tilted and also when i bow and take picture from back it looks like my left it´s more upwards and my right is lower and my spine looks like it´s a bit twisted. And last question. Is i a rotated pelvis and aic pattern the same thing?

    Many thanks

    Emre

    Reply
    • Hi Emre,

      Sounds like your pelvis is rotated towards the left. The Left AIC pattern would be a pelvis rotation to the right through PRI principles.

      If your left side is higher in the bent over position (and if it’s directly related to the pelvis position), it could be due to the left hip already being in internal rotation. As you bend forwards, your left hip joint might be running out of space which forces the right side to move more.

      Mark

      Reply
      • Thanks for the reply mark

        I also think so because normally my spine is not curved or twisted it only happens when i´m on a bent over position.
        And what should i do for the internal rotation of the left hip.

        Emre

        Reply
  2. Hi Mark

    I am told by chiro that my pelvis is rotated backwards from right side and spine is also twisted to right, i had so much tightness on right side..
    Now he has released below muscles on both sides

    Rectus femoris
    Glutes max
    Abductors
    Could u suggest me what other muscles should i ask him to release before aligning pelvis..

    When i exhale i feelso much tightness in front of right thigh to pubic bone, dont know whuch muscles are these.
    Thanks for reading

    Reply
    • Hello Varsha,

      Sounds like you have a pelvis that is rotated to the right.

      You can target the muscles under the stretch and release section in this blog post to help align with pelvis.

      Mark

      Reply
  3. Hi Marc.
    I really need your help.

    My pelvis is rotated to the right and i am doing your exercises for 2 month now.

    One problem persists, when i walk, my left hip flaps backwards and outwards once i put weight on my left leg.

    This leads to an instable movement while walking.

    I can feel the extra hip movement
    at the point used in the asis Method while walking.

    Which exercises can stabilize my left hip, so that i am no longer walking like a drunken irishman?

    Many thanks,
    Chris

    Reply
  4. Hi Mark,

    I have a rotated pelvis to the right and also my torso is rotated. Ive been trying to correct this with daily exercises for ages ( longer than a year) and honestly dont feel like im getting anywhere. My main problem latley is my inside of my right knee constantly feels tight and painful and also the outside my foot near my ankle is very tight too. Have you any suggestions of a stretch i can do to help this please. Thanks Claire

    Reply
      • Hi Mark,

        Thanks for getting back to me. Id say my left foot feels like its falling inwards when walking and the right foot feel like it falling to the outside. Is this caused by the rotated pelvis or is this causing the rotated pelvis? I do walk with fitted insoles that support my arch (been wearing these for over a year, twisted pelvis was before this) . Would you suggest i just keep going with the twisted pelvic exercises in hope that itwould fix it eventually. Or do i need to tackle my feet? And how of so? Thanks so much for your help Claire

        Reply
        • Hi Claire,

          If you feel that you have addressed the pelvis rotation as much as you can, the next area I would address is the feet.

          If one foot is pronated/supinated, this can lead to a rotation in the pelvis.

          Mark

          Reply
  5. Hi Mark,

    Thanks for the page. I have been dealing with left hip pain for over a year. Been going to physio but nothing helps.

    I am pretty sure I have a right rotated hips. My waist line is even but my left greater trochanter protrudes significantly lower than my right one.

    When I do a staggered deadlift (Left leg forward), I can feel the tightness of the back my left thigh, while pain in the left hip. Do you have any idea what is going on?

    Any response would be very appreciated.

    Daniel

    Reply
  6. I am confused. For many years I thought I had right external hip rotation and left internal rotation. This is because of what I felt in my asis “bones”. However, after going to a PT who does PRI and this article, I am now thinking that my hips are not only twisted to the right but shifted to the right and that is somehow causing the appearance of right external rotation and left internal rotation. I suppose it’s my body trying to walk straight forward – instead of in circles. My right leg definitely bows more inward, but the toe wants to point outward and the left leg does the opposite (more outwardly inclined with the toes going more inward). however with all of that said, the structures that are “tight” mentioned above are def. “tight” on me. I just want to get better – it’s been years – and I now have some nerve issues as a result.

    Reply
  7. In a right roated pelvis (right side is posterior and the left is anterior) what happens to the ankles and gastrocnemius on each side. Which can plantar flex and which can’t ? Which side of each calf muscle is tight ?

    Reply
    • Hi Johnathan,

      With the pelvis rotating towards the right, the right ankle will be in more of a RELATIVE plantarflexed position as compared to the left ankle which will be in more relative ankle dorsiflexed position.

      In this case (and not looking at any other influencing factors), the right calf muscle would likely be relatively tighter than the left.

      Mark

      Reply
  8. Hi Mark, I recently noticed that my right ASIS was a bit off position and was protruding out more than my left one last week . Your instructions were really clear and according to that I had a left pelvis rotation.
    1) But when I tried to do the Pelvis Reset Exercise involving the knees to squeeze the ball, I get sharp pain around the ASIS. Is this Normal?
    2) I read from your other page that the torso twisted towards the right side MAY be the cause of a rotated pelvis, So Considering I’ve checked that my spine is straight , would my flared ribs on the right side and uneven hips get fixed if I fix the rotated pelvis?
    I’ve had these doubts for about a week , It’d be really helpful if you’d clarify it to me.
    Thanks a lot.

    Reply
    • Hi John,

      1) Pain is not normal, but it may suggest that you may have an issue in that said area. Muscles that attach to the ASIS are your long hip flexors.

      2) It is possible that addressing the rotation of the pelvis will help improve the other areas. I usually find left pelvis rotation goes together with a right rib flare.

      Mark

      Reply
  9. Mark, in the comments here you write that when you turn the pelvis to the right, the left leg will have valgus and internal rotation.
    Why then do we strengthen the adductors in the left leg? Hmm ?!

    And tell me, if when walking my pants twist to the left (the button and the fly of the pants are to the left of the navel), but I feel that the pelvis is turned to the right. Is this a correct observation, or what do you think is the matter?

    Thank you.

    Reply
    • Hi Victor,

      A pelvis that is rotated to the right will generally have the left hip in External rotation. However – if there is a prominent right pelvis rotation, this pulls the left knee to the right as it follows the pelvis. This would give a inward knee appearance relative to the feet.

      It’s possible that the pants get pulled to the left if your pelvis is rotating right. This would normally occur as your right leg is forward and left leg back.

      Mark

      Reply

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