What is a Rotated pelvis?
When standing – the pelvis should dieally be centered and orientated towards the front.
(The pubic bone facing directly forwards.)
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. Use of the content on this blog post is at your sole risk. 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.
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:
- away from the pronated foot and
- towards the supinated foot.
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 can be used to help identify which way your pelvis is rotated.
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.
- Stand with your feet shoulder width apart.
- Make sure the feet are level with each other.
READ THIS: These assessments are based on the assumption that your lower limbs are in a symmetrical position. For example – if your entire right lower limb is in an internally rotated orientation AND your pelvis is pointing towards the LEFT, it is still possible that your pelvis is in a RIGHT rotated pelvis position relative to the hips.
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
Note: This method can be confusing especially if you have:
- One knee bent
- One knee hyper-extended
- Bigger/Smaller thigh muscle on one side
- Significant amount of pronation/supination on one side
3. Buttock position
- 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
How to fix your Rotated pelvis
Note: These exercises are designed to be gentle and pain-free.
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:
Aim: This maneuver will assist in re-balancing the muscular tension throughout the pelvis.
- 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]
Aim: Reduce tension in the muscles of the left hip causing a right pelvic rotation.
- Hip external rotators
- Glute max, Piriformis, Deep hip muscles
- Rectus Femoris
a) External rotators
- 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
- 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
Aim: Reduce tightness in the muscles of the left hip causing a right rotated pelvis.
a) Piriformis stretch
- 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
- 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
- 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.
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
- 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
- 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)
- 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]
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
a) Hip Internal rotators
- 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!
- 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
Aim: To decrease the tightness in the muscles of the right hip that are holding the right rotated pelvis position.
a) Forward lunge
- 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
- 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
- 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.
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
- 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
- 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.
- 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
- 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
- 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
- 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
- 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.
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
- Perform walking lunges.
- Keep your pelvis facing forwards throughout the movement.
- Repeat 10 times.
b) Single leg Dead lift
- 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.
*** 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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1,292 thoughts on “How to fix a Rotated pelvis”
Why do I have less hip internal rotation when I go into posterior pelvic tilt?
If your femur (thigh bone) is staying in the same position as you go into a posterior pelvic tilt, the hip joint is already in a degree of relative internal rotation.
As your hip joint is already in a degree of IR from the starting position, it will appear that you have less movement when you move your hip.
Sorry im not too sure how to make an individual post. I have hip impingement in my right hip, feels like my internal rotation is stuck, and i have it band syndrome on my left leg. Does this mean i have a right rotated pelvis?
Is the hip impingement side usually the side that the pelvis is rotated towards?
Hard to say exactly which way your pelvis is rotating based on the information provided.
Generally speaking – the impingement side tends to be on the side the pelvis is rotating towards. (but this is not a steadfast rule)
For more information regarding impingement, see post: Hip Impingement Exercises.
Thank you for the reply, it doesnt let me reply to your post sorry about it again.
For my hip impingement issue, I have been dealing with it for many years and I have done most of the exercises in your other article without much success. I feel like it could be tight/weak muscles in my left hip that is causing my pelvis to be positioned in a way that impinges my right hip. Are there specific exercises you could recommend for my situation?
Thank you again for your help
If your hip impingement is specifically related to the rotation of the pelvis, the exercises mentioned on this blog post should help get the hip back into a more neutral position and might help with the hip issue.
You might also have to consider that your symptoms might not actually be related to a hip impingement issue. Could it be a hip flexor injury?
I dont believe its a hip flexor injury, I had a torn medial meniscus in my left knee, which led to IT band syndrome on my left leg so I used my right leg more dominantly and eventually I felt hip impingement on my right hip. Would this indicate a shifted pelvis to the right as well as a rotated pelvis to the right?
In this case should I strengthen my left glute medius and left TFL? I havent found too much info on a shifted pelvis but I cant really internally rotate my right hip without getting stuck/pain. Do you offer online physio sessions?
Thanks again so much for your help
Yep, a shift towards the right leg + right rotated pelvis does some congruent with a left knee injury.
To address a shifted pelvis towards the right, you will likely need to engage the left adductors and right glute med (and stretch the right adductors and left glute med/tfl).
If you are limited in hip internal rotation, check out this post: Increase Hip Internal Rotation.
I don’t offer online physio sessions as it is very difficult to assess someone accurately.
If you would like more help, feel free to message me on the posturedirect instagram account and I’ll see if I can point you towards the right direction.
If I have a rotated pelvis: either my pelvis is rotated forward and my torso is straight (usually when standing) or my pelvis is straight and my torso is rotated back (usually when sitting).
I’ve asked before on how to check if my hip internal rotation is improving. I am doing seated hip internal rotation test to see if the ROM has improved. I don’t see any improvements day to day.
I think it’s because If my torso is rotated back when seated that means I actually have negative hip internal rotation and not 0. If I had 0 hip internal rotation then my body shouldn’t twist when seated but just not have any ROM.
So my theory is I shouldn’t see any improvement in ROM in seated hip internal rotation but by strengthening hip internal rotation my torso should be going more and more forward each time and once my torso and pelvis aligns my hip internal rotation is at 0.
Does this make sense or should I see some increase in ROM in seated hip internal rotation no matter what if my hip internal rotation is improving?
You mentioned that when you are in a sitting position, the pelvis is straight (?neutral) and the torso is twisting backwards.
If this is the case, then the hip would not be in negative hip internal rotation as the pelvis is neutral. If your pelvis is slightly rotated towards one side, then yes , you can definitely be starting in more (or less) of hip rotation depending on which side you are focusing on.
If you have persisted with the exercises, I believe that there should be some changes in internal rotation otherwise there is something else that might be stopping the movement.
Yes the pelvis is “neutral” when sitting because the body compensates by twisting the upper body instead. It’s not “neutral” relative to the upper body.
I don’t think it’s possible for the pelvis to be twisted while sitting.
Ok i figured out how much hip internal rotation I have. I do it by having 1 knee on the ground and the other leg flexed at 90, like a hip flexor stretch. When my right back leg goes straight at 0 degrees my pelvis is twisted forward on the right and the only way to make my pelvis neutral is by going to external rotation at 45 degrees and when I internally rotate my leg back I am at the end range. So I have negative 45 degrees hip internal rotation.
Hello Mark, thanks again for all the help you offer. In all my pictures I have a pelvis that looks rotated to the left but I notice that my right leg is one step ahead of my left leg, which causes this rotation This is not intentional though, it just looks like balance in my body is off. When I bring my legs next to each other, I feel like my pelvis is rotated to the right, which explains why the right leg would be ahead as a compensation from the body, but my symptoms do not match with a right rotated hip. I have a severe lack of external rotation in my left hip and more internal rotation in my left hip compared to my right. As for muscle tightness, I really don’t know anymore as I feel groin, piriformis, adductors and glutes medius and lower hamstrings on both sides are tight. I hope you can help me identify the issue as I have tried for way too long to no avail.
Is there any chance that you might have some rotation occurring in your spine. I’m thinking that perhaps your lower back is rotating your whole pelvis (including the legs) towards the left? Keep in mind – you can have a pelvis pointing towards the left but be actually rotated to the right relative to your hips.
I see, I did not know that this is possible. Now that you mention it, it is definitely what is happening, as in my last X-ray 7 degrees of lumbar scoliosis was observed. The tight area under the concavity was the left side. Would this tightness on the left side be in line with my pelvic observing?
If yes, what would you recommend I do to fix this issue.
Thanks a lot for your help, I really cannot thank you enough.
Perhaps you might need to see if you can change anything in the lumbar spine. (See post: Twisted Spine)
It is possible that the pelvis/hip muscles are compensating for a twist in the spine. (Keep in mind – this is just a guess as I haven’t assessed you in person)
If your pelvis is being orientated towards the left because of your spine, you can try this simple stretch to get you started. Lie down on your back. Bring your left leg and cross it over your body. Keep your upper back flat on the floor. This stretch is just placing the spine in the opposite position. Compare sides. Is one side easier to do?
Indeed, it is easier to cross the right leg over my body compared to crossing the left.
My guess is that I have always had pelvis imbalances that used to appear in my gait (intoeing, extreme ease with the W sitting position), so can it be that the lumbar spine is compensating the pelvic imbalances and not the other way around?
Also, if my left side is tighter and it is where the concavity appears, does it make sense that my spine is rotating my pelvis towards the left?
Perhaps you will need to start addressing the lumbar spine before addressing the pelvis. It seems like if the lumbar spine is more neutral, the pelvis will also be in a more neutral position.
If you have a concavity on the left with a left orientated pelvis relative to the torso, it could be due to the muscles in the concavity are trying to counter tilt/rotate a pull that is coming from the right.
I have lower back fusion in two levels and i have rotated pelvic to left and my right shoulder is higher than the left i do these exercises and i feel well but can i do every da?
It is fine to do these exercises every day.
Hello mark, thanks for your answer
how long can this position of pelvic rotation be proven?
And does it have something to do with the fact that the shoulder is higher than the other and also the foot is flat?
If the right hip is round externally and the left hip is round internally, in which direction is the pelvis round؟thanks for everything
Thanks to this site I have the right hip externally rounded and the left hip internally rounded when I do an extension of the internally rounded hip the pelvis becomes balanced what does this mean and do I do these exercises too
You could be externally rotating (via glute activation) as you extend the internally rotated hip. This would help de-rotate the pelvis into a more neutral position.
This suggests that you may benefit from left glute external rotation based exercises.
Fawad; You should find an osteopath. I had similar condition and after months of dr visiits, PT and chiro, finally getting some relief with the treatment of an Osteopath dr
If I have a left rotated pelvis. Can I do side planks on my right side and abduction? It won’t make it worst right? Only external clamshells on that side will make it worst?
Completely fine to do side planks. It is even fine to do clam shells. If you are worried about the position of your pelvis, just make sure that pelvis is kept in a more neutral position as you perform the exercises.
How come it’s fine to do clam shells if it’s already externally rotated on that side?
From a strengthening point of view, you still want to do clam shells (or any other hip exercise).
From a purely postural point of view, you’d want to only perform clam shells on one side.
From a combination of postural and strengthening point of view, you can perform clam shells in a neutral pelvis position.
When I do seated hip internal rotation on chair I get like 0 degrees, I get more ROM if I lean to the opposite side. Is it okay to lean on the opposite side to do the exercise?
Is my pelvis suppose to rotate back to neutral before I get more than 0 degrees because there’s no improvement based on just looking at ROM seated.
Leaning to the side would not increase internal rotation in the hip. If you measured the relative movement between the leg bone and the hip when leaning towards one side, it would still likely be 0 degrees. It may give the illusion of getting more hip internal rotation, but this only because of the orientation of the hip/pelvis.
It sounds like you might need to keep working on loosening the joint and the muscles around the hip reclaim more internal rotation.
If one side is in hip internal rotation and one side is in hip external rotation, how come we don’t do hip external rotation stretches for the side already in hip internal rotation to improve ROM and instead do it on the side that already is in hip external rotation?
To address a hip that is stuck in hip internal rotation, you will want to:
1. Stretch/Release the internal rotators by placing the hip in an externally rotated position
2. Strengthen the external rotators.
You can still stretch the hip external rotators (namely the piriformis) in a position where the hip is external rotation if the hip is flexed by 90 degrees.
If my right shoulder turns forward when walking, does it mean that the pelvis rotates to the left and also the right shoulder is higher than the left thank you mark please answer please
If the right shoulder moves forwards as you walk, this does not necessarily mean that the pelvis is twisting to the left.
If your right shoulder is higher and more forwards, I would suspect that your spine is tilting/rotated towards the left. This can be related to the left rotated pelvis (but does not have to be).
Hi Mark! I’ve been using your guide for a rotated pelvis once I noticed my left thigh was more forward than my right. My other two symptoms are that my left piriformis will feel a small degree of pain/tightness and that my belly button is pointed to the right. It’s almost as if my left side of my belly is a bit fatter than my right. Also, I’ll generally feel tightness in my right groin come through time to time while I’m sitting generally.
Not knowing that this may be excessive, I followed your rotated pelvis guide for five straight days because it felt very good the first couple of days. Now, I feel like I should stop it there and see how I feel in a couple days. I was wondering what your thoughts on my approach is and if you have any suggestions if possible while taking the symptoms I mentioned into consideration.
Finally, I want to say thanks so much for all the great knowledge and experience you’re putting out there. I’ve read several of your articles/guides and they’ve taught me a lot and piqued my interest in the field that you’re such an expert at. Thanks for your time and hope you are having a wonderful weekend!
Hi there Jason,
First of all – thank you so much for your kind donation. I really do appreciate it!
Assessing how your body responds to new exercise is always a good thing to do. I usually encourage people start with the exercises 2-3 days per week and see how the body reacts. From here – you can adjust your frequency as appropriate. Keep in mind – some people may need to perform the exercises more frequently than others.
Also – After performing the exercises for a couple of weeks, you will also gain a feeling of which specific exercises give you the best results (focus on these!) and which don’t seem to be doing much (might be able to leaves these out if they are not appropriate for you).
I would like to thank you in advance for this post. It’s been informative, and a big help!
I have a question for you. I’ve been dealing with a pelvic “imbalance” for a while after pulling a muscle on my lower right back (near the SI joint) when I was about 21, seven years ago. As I’m transitioning back into an athletic lifestyle, I’ve noticed a myriad of issues. The muscles on the right side of my body, from my core down to my calf, do not “activate” properly; my right glute is significantly weaker than my left; the SI joint/lower right back is constantly cracking/popping (painlessly), especially when flexing right glute; poor internal rotation on my right leg (top of iliacus on right side constantly cramps with internal rotation); uneven gait (right stride shorter than the left); and, among many other things, all of my body weight seems to be shifted to the left side.
I know one cannot adequately diagnose over the internet for a multitude of reasons. That being said, if someone presented you these issues in themselves, what would you generally recommend as a plan of action? What would you recommend I read about/look into to get this solved — specifically, on this website? Your articles are extremely helpful, but I don’t know if I should try the stretches on the lateral pelvic tilt, the hip hikes, etc.
If you offer Skype sessions / telehealth consultations, and feel like that would be more appropriate to discuss this, I’d be more than happy to set up an appointment. My email is included on this comment. Feel free to reach out, or alternatively, respond here with an email and I’ll reach out to you.
Thanks for the questions.
To help me better understand your situation, please feel free to answer these:
1. Do you know which way your pelvis tends to be biased towards?
2. Have you tried focusing on single leg exercises such as mini squats, lunges, step up/down balance on the right side?
3. Have you had any other injuries that may have contributed to loading of the right leg?
4. What exactly did you injure when you were 21? Were there any scans ?
Thank you for your response.
1. It tends to be biased slightly towards the right (slight pointing of the bellybutton towards the right).
2. I have, and still do, as most of the muscles on the right leg are less strong / “activated” than the right.
3. Other than a pilonidal cystectomy, during which a small amount of tissue was taken from the upper left quadrant of my right glute to “patch” a hole where a cyst grew below my tailbone, there have been no other injuries.
4. It must’ve been a strain of the lower back muscles along/right above the SI joints. A scan showed a very mild herniation of L5/S1, but it didn’t, and hasn’t worsened to this day.
You mentioned loading of the right leg. Is the right leg loaded if I seem to place all the weight on my left leg and not my right?
I don’t know if this helps complete any pictures, but I have a waist crease identical to the first picture on your “Exercises for Lateral Pelvic Tilt”, also on the right side of my body — although, in this case, the hip seems to hike (if it is a hip hike) on the weaker side of my body and not the stronger.
It sounds like your body wants to put more weight through your left leg for some reason. (possibly due to the surgery on the right side? Could be other reasons though.)
This basically means you are still loading the right side, but perhaps less than the left side.
To get more weight on your right side, you will want to encourage more internal rotation of the left hip. Perhaps starting here might be a good place. (See post: Internal rotation of the hip)
If you have a waist crease on the right side but standing more so on the left side, this would make be believe that your torso is side bending to wards the right. This is usually coupled with a higher left shoulder. Is the case with you?
Yes, that is correct, at least from photos taken from behind. My left shoulder is noticeably higher than the right.
I have a rotated pelvis but have been getting no improvement in hip internal rotation doing reverse clamshells. What do you think about strengthening the iliopsoas to improve hip internal rotation? I read a weak iliopsoas could be the cause of it? I also have major anterior pelvic tilt so I am hesitant on strengthening the iliopsoas. I also find it impossible to do bilateral or unilateral glute bridges with a side to side pelvis rotation.
Should I try strengthening the iliopsoas or does this muscle have no affect on hip internal rotation?
If your goal is to improve the amount of internal rotation available in the hip, please have a look at this post.
See post: Hip Internal Rotation Exercises.
In regards to the iliopsoas: This muscle is actually a weak EXTERNAL rotator of the hip.
What about dysfunction where I lack hip internal rotation because the TFL is doing the work of the iliopsoas muscle due to weakness?
How should I measure if my hip internal rotation has improved? Currently I am just using my eyes on seated hip internal rotation and it has not improved in ROM in over a month. The only thing I noticed is doing hip internal rotation in side lie I would used to do with anterior pelvic tilt but now I can do it posterior pelvic tilt too but with reduced ROM. Could it take more than 2-3 months to improve even though I’ve been doing hip internal exercise everyday for 2-3 months?
Do you lack internal rotation passively or actively? If you have full passive but limited active internal rotation, you’ll need to work on strengthening the internal rotators. If you’ve been strengthening the internal rotators and it still hasn’t increased, chances are that you might be lacking the passive range as well.
A simple way to measure passive internal rotation of the hip is to lie down on your stomach with knees bent to 90 degrees, then letting the shin bone drop to the side.
In regards to an over active TFL – It’s possible that could compressing the joint and limited your rotation.
After 3 months of consistent effort, I’d expect some improvements. If there has been nil to minimal improvement, it might mean you are focusing on the wrong exercise/structure etc.
Ok my hip external rotators were really tight and I stretched them for the last 20 days. I could not even bend forward before when doing seated external rotator stretch but now I can a bit. Does this improve passive or active hip internal rotation?
A passive stretch to the external rotators will most likely improve your passive hip internal rotation.
You will need to do active hip internal rotation in the newly acquired range to improve active movements.
I hope you’re well. I think I have a right rotated pelvis, but I lack external rotation in my left hip. For example, I find it really hard to maintain the figure 4 position, especially lying, for my left leg. To my understanding, if my pelvis is rotated to the right, my left leg should be externally rotated, so such movement should be easy, right?
Thank you for your help.
It is possible to have a right rotated pelvis and still have less external rotation in the left hip (even though it is in external rotation already).
This can be explained that since the pelvis is stuck in the right rotated position (likely in the position that you are testing it in), the left hip is already in external rotation. This means that the left hip will reach the end range external rotation sooner as compared to the other side.
The possible reason is that there may have been previous injury to this left side which may be limiting external rotation.
Thank you for your reply. Does this justify the tightness in the left adductors and groin, which as I understand are usual signs of internal rotation of the hip? Also in this case, should I strengthen internal rotators on the left side despite having an excess of internal rotation?
Tension in the groin does not always equate to the hip being internally rotated. (You can get tension through the groin even with the hip in external rotation.)
In terms of getting your pelvis is a more neutral position, I would still engage the internal rotators on the left side.
I have a one-sided rib flare, should I complete these exercises and the exercises or should I start with these only?
Thanks in advance
Which side is your rib flare and which way is your pelvis rotated towards?
Generally speaking – you would likely need to address both.
Thank you so much for your post! I believe this will help me with my right rotated pelvis in time.
Just a quick question, I’ve had a right rotated pelvis (left side rotated to the right and right side a little back) for a very long time. I used to be quite overweight and lost the bulk of the weight with home workouts. I’ve managed to maintain a healthy weight for about 10 years now which is when I discovered the rotated pelvis, due to pain and strains in the left knee and even shoulder area when lifting weights.
I would like to ask if I can still workout as per normal(weight lifting and hiit workouts) while working on the pelvis rotation or would it be better to work on the rotation first then slowly go back to the routine of working out?
I feel like due to the working out over the years, I’ve depended too much on my right side (whole right side of the body) to complete workouts leaving me with muscle imbalances on the left (leg up to shoulder (I have a rounded left shoulder as well)).
Do let me know your thoughts, thanks!
It’s fine to combine these exercises for pelvis rotation with your normal exercises providing you are not causing more pain/injury/symptoms etc.
You may need to switch to more single leg bias exercises (such as lunges/step ups/staggered stance exercises) so that you don’t rely on that right side too much.
Focus on good technique for all of your exercises. If you find you are go back to the habit of relying on your right leg, you might need to consider reducing the intensity of the exercise.
I wanted to firstly thank you for providing so much content and support to so many people worldwide on these subjects.
I myself suffer from a pelvis that rotates to the left with also my left hip hiked too. I had a L5-S1 disc issue near my SI joint on my left side which has possibly been an issue from this, or caused this if you know what I mean. I can feel that my left side is much stronger along with tighter.
Regardless I hope you may be able to provide a few explanations.
Firstly, should I focus on the twisted exercises initially as opposed to your hip hike exercises?
Secondly, I have very limited Hip IR on my left side but average ER. And on my right side I have average IR but limited ER. I have been doing the 90/90 hip mobility with a view to improving my left IR / right ER however your recommendations are to do the opposite to what I am doing.
Would I need to still do what you recommend (basically the opposite to my current routine) even though I have very limited rotation with the opposite legs?
Thank you in advance
1. Generally speaking – I like to go after the rotation in the pelvis first. (But this really depends on what symptoms you are trying to address.) You might notice that the hip hike improves as you perform exercises for the rotation in this pelvis.
2. The combination of movement restriction makes sense if your pelvis is rotated towards the Left. If your pelvis is rotated to the left, the left hip is already in internal rotation, which means you’ll reach the end range of internal rotation quicker. (same for external rotation on the other side). Balancing the pelvis may help with this. However -that being said, it is also possible to have the said restrictions due to the actual hip joint.
I would try to balance the pelvis first and see if it has an effect on the hip range of motion. If it is still limited, then it would make sense to address the hip mobility directly.
I lost my comment so I will put it here.
I’ve got a left rotated pelvis with the right side anterior and the left posterior. Is it common that because of this twist my left hip is higher? I’ve read that its more common to have the right one higher.isn’t it?
Are this excersices okay for me?
I believe you can have any combination of pelvis rotation and hip hike. I tend to see higher hip hikes on the right side though.
If you definitely have a pelvis rotated to the left, the exercises mentioned on this blog post will be helpful. If you would like to address the higher hip, you may need to consider performing these exercises as well.
Thank you so much Mark. All makes sense in which I’ll take your advice on board.
Kindest of regards
I am having trouble determining which side of my pelvis is rotated based on the suggested tests as I did not get consistent results. I believe that I have a left pelvic rotation and a slight right lateral tilt, but I am not confident. Here are some of my symptoms: ride side of body more “forward” while walking/running, less movement in right hip while walking/running, tighter and larger muscles on left side, more weight applied to left side while standing, knee pain especially in right knee, and right knee is higher while lying down flat with knees bent. Please help me determine which side my pelvis may be rotated towards. Thank you
Sounds like it is rotating towards the left. (But you will want to be sure before starting the exercises!)
Can you get a health professional to check for you?
Hi Mark, Thank you so much for this content! I believe I have a pelvis that is rotated to the right but also a left hip hike. Should I follow the exercises for a rotated pelvis? or the lateral pelvic tilt exercises? I feel both are relevant but not sure which ones to prioritise. Also how many times a week should I complete the exercises?
I’d generally go after the rotation first. (Although it really depends on what symptoms you might be trying to address.)
In terms of frequency: Start with 2-3/week and re-assess pelvis position after 2 weeks. From here – you can adjust frequency as appropriate.
Hi Mark, great guide, I have a LS Rotated Pelvis. I was wondering what your thoughts on pallof press and is it helpful with this condition or counterproductive? Is one side better then the other because of the different stabilizing adductor/abductor activation being aligned with the hip shift recommendation vs the other side being against or does it even matter? I was trying pallof press seated following the hip shift recommendation to slightly position LS hip forward & out + RS hip back & inward.
Pallof press is helpful as long as you aim to keep your pelvis pointing in a forwards direction. You can do either direction as long as the pelvis remains neutral.
Hi Mark. First I want to say that I am grateful I found your website. It has helped me a lot. My problems are:
Chronic Lateral pelvic tilt (caused by left ankle injury 10 years ago) so my left hip is lower than the right and the left gl muscles are super tight and performing an external rotation with me left hip is very restricted. I even feel that there some kind of nerve lock maybe. I have been performed your exercises for the lateral tilt and they are helping.
But also this causes me a hip rotation (my left but is rather getting into internal rotation because of the lack of the external rotation and tight and weak gluteal muscles. So when I am standing my left but is bit more behind so that i cannot propely load weight on that left side of the pelvis. So could you help me understand in my case on which side I should perform your exercises. The way you have described or opposite? And sorry for my bad english. Hope you understand
Harri Haimakka from Finland
I’m having some difficulty understanding the position of your pelvis but it sounds like the pelvis is rotated towards the left. If this is the case – you’ll need to perform the same exercises on this blog post but on the opposite side specified. (But – just be very sure that your pelvis is indeed rotating towards the left otherwise you could be making it worse!)
Okay let me more clear. In my case the right hip is mooving freely so I am easily able to load the weight of my torso on the right hip. So there is no problem with the internal or external rotation of the right hip. Only thing I found out is that the right hip gluteal muscles are relativily weak (and maybe a bit elongated) because my body is also having a some level of lateral tilt (right hip hike) . The biggest problem with my lower body is that I am not able propely exetrnally rotate my left hip (because of shortened / weak hip flexors, which are pushing my left side of the pelvis into the anterior pelvic tilt and because of the super tight gl and all the other muscles that are responsible for hip external rotation, they are so thight that I am not even able to stretch them. That causes the problem that I my I cannot propely and freely load the left side of the pelvis with my torso so that I could stand on my left side freely. So in short terms I have a lateral pelvic tilt which is caused by the inward foot rool (old anckle injury) which is causing the inward rotation of the tibia and the femur and when the femur is rotated it is pushing the pelvic into anterior pelvic tilt. So in my case in order to get the left but more forward on the same level with my right but I need to release the tension of my left hip external rotators and left hip flexors to get the femur back in to the right position. That’s why I am bit confusing of doing the releasing stretches to the right side of the pelvis as you mentioned above.
Both #3’s for Strengthening say for rotated “left” pelvis, would the first one be for a rotated right pelvis? (my right side is shifted back)
Also for exercise 3-a Strengthening (it says Left rotated pelvis) Internal Rotation Sitting exercise, the range of motion on the left is not as good as the right, but the left has the tight rectus femoris/hip flexor (upper quad hip flexor area).
Would I do that exercise on the left or right for the right rotated pelvis?
That tight left area I believe is the cause for this mess, hip shifts left when squatting.
Thank you! I saw 8 PT’s and they recommended gluteus medius strengthening or custom insoles.
Bicycle racer and body building splits, professional fitter found I was using too small/narrow of a saddle which threw things out. 4 years…20k miles…awful lol.
To address a right rotated pelvis, you will need to strengthen muscles of the left AND right hip that rotate the pelvis towards the left.
In regards to exercise 3a), you will want to perform this exercise on the left hip to help address a pelvis that is bias towards the right. If you have tightness in the upper quad region, make sure that the weight of your leg is completely supported by the chair (i.e. you don’t want to be lifting the knee upwards as you bring the ankle towards the out side). You may need to consider sitting on a slightly taller chair to help with this.
Thank you sincerely for replying and that info included! I will start this today, I tried exercise 3a without hiking the leg up and could feel a difference.
Last question, would you say a right rotated pelvis (right hip shifted back) could cause hip impingement on the left side?
I shift to the left during squats and when I lay on my back and my legs in the figure 4, my left left folded, when I flex that glute, I feel the left hip joint crunching.
I’m hoping once I get my right pelvis more forward, it will fix the functional leg length discrepancy, hip shift, and that super tight area on the left quad/hip flexor with abduction.
You can get impingement on either side depending on what movement was being performed.
Pelvis rotation in it self will not likely cause a hip impingement. It usually needs to be paired with deep flexion of the hip + Load (eg. in the bottom of a squat).
Is your ankle dorsiflexion limited on the right side by any chance?
This is where I was confused, on the second 3a exercise – clamshells. It says,”To strengthen the muscles of the right hip that rotate the pelvis to the LEFT.”
I see you are doing clam shells on your right hip, since my pelvis is rotated to the right (right hip shifted back), would I do them on the left side?
Generally speaking, you will need to perform the clam shell exercise on the right hip to address a pelvis that is rotated towards the right.
Thanks again for getting back to me, whole heartedly appreciate it.
Ankle plantar and dorsiflexion is great, no issues there.
When I force-shift my right pelvis forward, the right supination is gone.
I ran through the workout this morning at the gym and noticed a little help so I will keep adding it to the routine.
Only issues I faced is the left hip flexor getting in the way with it’s tightness/weakness after the exercises above.
Stretch 2b hip rotation – hits the exact flexor area that is tight.
Also stretch 2a piriformis – I could feel tightness in the left peroneus (outside calf)
I saw Squat University on his “hip shift groin” stretch that is supposed to help with this.
I do the Faber test and on the left hip, the ROM is not the best from that flexor getting in the way but I’ve been stretching it 4-5 times a week the past 3 weeks with no difference so that is why I think getting the right pelvis forward will help that area. And I will do squats with bands to retrain the muscles. It stretches the left groin and on the right rotated pelvis I need to stretch the right groin.
Pretty crazy puzzle right!
I’ve been trying to fix my posture issues but now I started looking at my pelvic issues, because I’ve started noticing:
> my right foot is supinated (rotated to the right)
> right hip is rotated to the right (when I squeeze my right hip and try to bring it internally, it feels better)
> my right shoulder is more forward and hunched a bit, like when I try to do lower trap rehab exercises, I can feel them on my left side, but on the right it feels like it’s way too much out of place and they don’t fire up
> when I do abs, I feel them in the left side, but can’t feel in the right obliques
I just can’t determine if it’s a rotated pelvis or lateral pelvic tilt or what do I do at all
Thanks a lot of the detailed explanation and all the stretches, strengthening exercises. I have right pelvic rotation/twist. Please share any guidance on how to sit and sleep to balance my body.
In terms of sitting: Elongate (or push) your right knee more forwards as compared to the left.
In terms of sleeping position: Sleep with the left side down. Keep hip and knees slightly bent. Elongate the right knee more forwards compared to the left.
But honestly – focus on the exercises! They will help !
Is it possible for 1 hip to be in anterior pelvic tilt and the other to be posterior pelvic tilt?
I have a pelvis rotated to the left and I have been doing external rotation on the left side and internal on the right side. My hip internal rotation on the right leg always reverts back to 3-5 degrees the next day and seems like there is only temporary increase in ROM when stretching it. My left hip has 45 degree hip internal rotation.
I know for sure I have anterior pelvic tilt because my butt sticks out but I don’t know if it’s both hips? A while back a physiotherapist said 1 hip was anterior pelvic tilted and 1 was posterior tilted but I forgot which one. I read in your other post posterior pelvic tilt causes lack of hip internal rotation. Also when trying to fix my anterior pelvic tilt with glute bridges, single leg glute bridge or bird dog I can’t feel any contraction on my right side. Does posterior pelvic tilt make it unable to contract the glutes?
Does doing lateral abduction or adduction leg raises do anything for hip external or internal rotation? It targets the same muscle but will it only improve abduction and adduction?
Same for clamshells which strengthens the glute max. Will the glute max be better at hip extension when strengthening it doing clamshells (hip external rotation)?
You may get some internal rotation with adduction and external rotation with abduction.
If you are specifically addressing the rotation, I would tend to think that exercising the muscle with rotational movements would be more effective.
For a few years i have been suspecting i have some posture issues with my pelvis and spine.
my right shoulder is more rounded forward than my left,
right lower back is more arched than left,
right glute sticks out more than left,
left knee is more forward than right,
and right foot arch is more flat compared to left.
overall when i look myself in the mirror the left side seems ok, but the right side seems to have some problem…
Could you please advise me on whats wrong with me and what exercises i can do to get a better posture?
Thanks a lot!
Is it possible that you tend to place most of your body weight on your right foot? This may explain why your foot is flatter on the right side and why the right hip sticks out more to the side.
If the left knee appears to be more in a forwards positions as compared to the left, this may relate to a pelvis that is rotated to the right. (This is just a guess though, please check by performing the tests as indicated on this blog post).
Thanks for the feedback!
Is there anything i can do to correct my standing posture? Also how to address my shoulder issue?
Hey, Mark! Hope you are doing well. Would it be possible to get some advice? I’m not sure if I should focus on a rotated pelvis, twisted spine, or lateral pelvic tilt.
I have a left hip impingement whenever I bring my left knee towards my chest. My left inner hip would also feel pinched whenever I externally rotate my left leg outward. Addition symptoms include: left leg being weaker than right (glutes, hamstrings, quads, etc.) and left QL being tight.
Every time I rotate my left shoulder is would crack and pop. My left shoulder would also feel impinged whenever I do a shoulder workout. Everything I do a pull movement, my left side would feel more contraction. Both side feel very unequal in movement. I’m not sure if this is a twisted spine rotated to a right, or if a rotated pelvis is in action. When I squat my right leg would be more back then my left leg. Every time I push, it would feel like my right leg is compensating for everything in my left leg. When I stretch my neck, head tilted to the right, my left trap side would feel very tight compare to when I stretch the right side.
That’s all the symptoms I have. Hope you can help! Thank you for everything you do, it’s very useful to many people!
Hard to tell you exactly what’s going on with your posture without assessing you, but it does sound like it’s a rotation of the body to the right side. The symptoms you mentioned seem to align with this.
Generally speaking – I would address the rotated pelvis first to see if it helps the torso. If you notice that the pelvis rotation improves and the torso still is twisted, you then might need to address the twisted spine.
Also – you mention you have impingement in the left hip. Has this been followed up with a scan? If you have a pain when you externally rotate the hip, this might suggest that something is getting over stretched as opposed to being squashed/impinged.
Hi, I have a question for you, so i have a pelvis rotated to the right and basically all the symptoms of left aic pattern. I also love running, it something I used to do everyday.
I visited a pri specialist and he advised me not to run bc it only strengthens the right rotated pelvis/left aic pattern. What is your opinion, bc I don’t want to stop running
I think that you should still run as long as your symptoms aren’t significantly worsening from doing so. You might need to consider reducing the intensity of your run (eg. slower speed, less miles, flatter terrain etc).
You might also need to do some exercises before your run to help engage the muscles that you are probably aren’t engaging enough whilst running. Perhaps your specialist can give you some cues to think of whilst running to stop you rotating too much to the right.
Hey mark, I have a question right rotated pelvis and when I stand with my feet and pelvis alligned my right shoulder starts to hurt. The pain usually goes away when I stand misaligned or what my body naturally wants to do. Should I stand the way my body wants me too or should I try to stay alligned?
It sounds like forcing the pelvis to point forwards is changing the position/behavior of the right shoulder.
I suspect if you are correct a right rotated pelvis, your right shoulder may be moving forwards which can potentially place more pressure on it. If this is the case, you might also benefit from performing exercises on the spine.
See post: Twisted Spine.
Hi mark, I have a pelvis rotated to the right, I also have tmj, and only grind my teeth on the right side. Do you think there is a correlation?
It’s possible due to the domino effect changes stemming from the rotated pelvis.
You can test your theory by addressing the pelvic rotation and see it’s short and long term effect on the tmj. I would love to know how it goes.
Thank you for this helpful article. Recently, I realized that I have a left pelvic rotation and I’ve been doing these exercises for a few days.
Is it ok to do abs workout while having a pelvic rotation or will it cause more harm? I’m talking about simple ones like leg raises, planks, flutter kicks, dead bug, etc. I ask this because I feel a click around my left pelvis when I’m doing dead bugs. Are there any particular ones to avoid?
It is fine to train your abs. If your goal is to keep your pelvis fairly centered, you can place your hands on your pelvis as you perform the exercises to make sure you are not excessively twisting towards the left. (Keep in mind – some exercises may require some natural rotation to either side)
The clicking you feel may be explained as a Snapping Hip Syndrome. Check out this post to find out more information to see if that relates to you.
Quick question: when doing the seated internal rotation exercise, are we looking to feel the muscle contraction in the TFL? Or should there be another muscle this is intended to target?
Asking because I think I may have a right rotated pelvis + right lateral pelvic tilt. If I follow the lateral pelvic tilt guide, I will be releasing the left TFL. So if the seated internal rotation exercise is meant to strengthen the left TFL, the exercises essentially cancel each other out.
Hope that makes sense!
It’s fine to feel it in the TFL, however, this muscle tends to take over in a lot of leg movements. I would encourage that you also try to feel the glute medius (anterior portion) as you internally rotate the hip.
To do this, make sure you are not actively lifting or holding your leg up as the TFL is also a hip flexor. Have your upper leg weight completely supported by the chair. (Even better to perform it on a higher chair so that your legs are dangling off the floor.) Focus on the pure rotation.
Hi Mark, I have a pelvis rotated to the right. My left hip and thigh is in front and my left foot is pronated. My right foot is supinated. My body wants to stand in a way where the left half side of my body is in front while the right side is in the back. my left foot is pointed straight, while my right foot is pointed at a 45 degree angle to the right. When I walk or run, the left side of my body will always stay in front, like I’m leading w/ my left hip. I stand more on my right leg. When I try to align my feet and pelvis, I find it hard to breathe and my body gets all tight and feels like it’s rejecting the position. I don’t have insurance at the moment, but based of the research I’ve done, I think my body is stuck in the left aic pattern. However, I honestly don’t really understand the pri/left aic concept and find it confusing. I’m reaching out as a last ditch effort bc I’m expiercing bad health anxiety from worrying about the asymmetry in my body. Any advice would be helpful. Thank you
It does sound like you have a pelvis that is rotated to the right. This can cause the torso and head to counter rotate.
I think it might be an idea to give the exercises mentioned on the blog post a try and see how your body responds.
I’m in dire need of your help. It’s been 2+ years since I’ve been suffering from postural problems. I had an incident in around May 2020 where I got knee-d in my right back. That’s where it started, a harmless play ruined my body. I was in great pain, severe right lower back pain that made me lie in bed for days. I took pain meds and had my right side massaged my sometimes. My right pelvic bone was (and is still) poking out at my side.
Later in August 2020, I was able to convince my mom and we went to the hospital. Scared, ignorant and little 15 year old me did an hip xray thinking it was a bone problem since the bone was sticking out and the leg on that side was shorter. The results came out that my hip bones were fine. I was told by two doctors that there was nothing wrong with me. The other didn’t even bother, the latter noticed my uneven shoulders and told me fix my posture and I’ll be fine.
I came back devastated. I stumbled upon pelvic tilts and muscle imbalance however on the internet and realized maybe my case was similar. I self-diagnosed myself and started doing some exercises. I still didn’t miraculously get better. At a point in 2021, I gave up, stopped all exercises. I closed the chapter, I was helpless.
But later this year, February 2022, I was taken to the hospital yet again. This time I was directed to a physiotherapist, he sort of understood my problem. At least he didn’t treat me like I was spewing nonsense. He gave me a massage but due to money, time and distance I couldn’t go back for another session. When we were finally able to go back in June, the summary conclusion was that there was nothing really serious wrong with me, my muscle just needed to heal and I’ll be fine. I urged him to give me exercises to do, he gave me some stretching exercises and that was it. He advised not doing heavy lifting or bending to do chores (which one I’d been doing) and that I should be more active, I should walk. After a few months I would be fine.
But would that really be enough? Does just stretching fix everything? Over the years, from the sole of my feet to the tip of my head everything is disaligned is that really all? So I incorporated some night lateral pelvic tilt exercises. Truly I did see progress, but after a month, my muscles snapped (can’t remember where) and my body pressed reset. I started again, and it happened again. And again. I know my being inactive worsens my situation but anytime I’m active or moving too much even lying down, I strain different muscles by sudden unpredictable movements.
My most recent relapses are: I snapped my left neck muscle trying to look back, mistakenly chewed on my toothbrush while brushing and now my jaw hurts sometimes and the left side of my face looks slightly swollen. I snapped a muscle yesterday in the back of my left inner thigh while crossing a gutter. I’m tired. I’m scared.
I recently took a video of my full body and my recent observations are: my left side has also been affected, my left ASIS is forward and my right backward. The tip/top of my right pelvic bone is still sticking out. I think I have a right hip hike as it looks my V line draws backward to my right and goes up. I have weak abductors on my right and weak adductors on my left (I’ve been trying to strengthen them though). My shoulders are uneven, anytime I wear a shirt, the collar on the left side slopes down. My head is not in alignment, the left side of the back of my head ever since I snapped the muscle doesn’t touch the ground when I lie unless I adjust it. My right foot is pronated (high arch) while my left is supinated (low arch) it’s really uncomfortable when I wear shoes and I’d have to pad my right side sometimes. Also I think I have a hyper lordosis, because my lumbar spine kinda curves at the right side of my back. It hurts if I stand for too long or sit for too long. Hamstrings on my right side are also very tight, (I can raise my left leg higher than my right). My left leg is also longer than my right. As for my stomach, I think it faces forward even though I have a rotation/tilt in my hip.
Dr Mark, please come to my aid. I live in a developing country where such situation is uncommon and knowledge about body systems is pretty limited (the economy is even a greater concern) and I’m not from a financially bouyant family. Please help me, I’m just 17 and I’m female. It’s hard to live like this.
I’ve started right pelvic rotation exercises and stretches though based on your seemly helpful article. I feel better after a day, thanks. I’d be even more grateful if I can overcome this altogether. So please show me the right course of action to take. What are your opinions on my situation as a real and certified specialist?
When you say all your issues started after being kneed in the lower back one day, does this mean your lower back become hyper extended as this happened? I suspect this as you mentioned you may already have a pronounced lower back lordosis already.
If this is the case – this makes me to believe that you may have compressed a structure on the right side of your lower back. (Usually involves the joint in that area)
Have you tried decompressing your lower back? See post: Spinal Decompression Exercises. That might give some symptomatic relief.
It sounds like this initially injury has caused your body to compensate and adopt the posture you currently have. To address your posture, I would usually recommend trying to sort out your pain first.
As your injuries seem to be asymmetrical in nature, perhaps you could continue the exercises that address a right rotated pelvis to see if that helps with the rest of your posture.
Since your issues have been going on for a long time, a MRI/CT scan in the area would be helpful, but it sounds like this is not a viable option at the moment for you.
hey Mark, i’ve been doing your exercises for the past month.
I’m coming from a hip impingement surgery on my right hip and I have an anterior pelvic tilt, rotated pelvis, and lateral pelvic tilt.
I’ve been focusing more on anterior pelvic tilt, rotated pelvis with slow progress and lateral pelvic tilt with better progress, but i’m wondering if i should also do the hip impingement exercises.
I’m curious which one you propose i focus more on. I definitely feel the strength in my right hip is getting better from the lateral pelvis exercises.
Also the lower part of my leg, from knee to angles has deviated towards the right, from a couple of years of impingement. I’m curious if there are any exercises i can do for that?
If the front of your hip is still painful, is it usually better to focus on specific exercises on the hip impingement. Please note that it is better to run the exercise by your surgeon before attempting.
Once your symptom are under control, the next pelvis position to go after is usually the rotation.
When you say the lower part of the leg has deviated to the side, are you referring to the tibia (lower leg bone) is angled to the side?
I don’t feel a lot of pain in the front of my hip as it’s been 3 months and a half since my surgery, just some tightness.
However I do feel one of the abductors really tight since the last 3 months and am doing daily exercises and applying heat to release it, with slow progress. I’m definitely feeling it when i’m walking and I’m assuming this is keeping my pelvis rotated.
The lower part of the leg from the knee down, is angled to the right side, i assume it is because of the 2 years walking with hip impingement. You can see in this photo what i’m talking about
I also have ankle issues and also a flat foot on the right side because of this.
Was wondering which exercises I can do for that.
Appreciate it Mark!
Hi there Andrei,
Great to hear that you are not experiencing a lot of pain in the hip now.
I can’t see the image you linked to as all hyperlinks are removed in the comment section. From what I can understand, it sounds like your right knee collapses inwards and the lower bone underneath the knee (tibia) is sticking out to the right side? This leg position will also influence (or be influenced by the foot position). If this is correct, it sounds like you have knee valgus. Check out this post to see if it relates to you. Let me know if it doesn’t and I’ll try to brain storm other ideas.
Is your pelvis also rotated to the right side? If so – hip impingement would make a lot of sense in this right hip.
Hey Mark, yes i do believe i have knee vargus. Starting right now with the exercises for that.
The hip impigment was on my right side but i do believe i have a left rotated pelvis.
So you feel focusing on the knee vargus and left pelvis rotation is a good strategy for now?
My Pelvis is clearly rotated to the right, however it looks as though my belly button is off center to the left a centimeter or two. Should I address my right pelvis rotation before addressing any possible counter rotation in Lumbar? Also, how often should I do the pelvis exercises in the beginning, and how many days should I progress to for a full week? In addition, when I eventually progress to the simultaneous right and left hip strengthening exercises should I also continue to do left and right hip isolation exercises from the beginning?
I would address the pelvis rotation first. The belly button position suggests counter-rotation, however, it is also important to note that is not always a reliable indicator of what is happening at the spine.
In terms of how often to perform the exercises, I’d aim for 2-3/week. See how your body reacts, then adjust frequency as appropriate.
Your questions: “In addition, when I eventually progress to the simultaneous right and left hip strengthening exercises should I also continue to do left and right hip isolation exercises from the beginning?”
If you can perform the simultaneous left/right hip exercise effectively, you don’t need to address both hips separately. However – most people may need to focus on certain exercises (including the isolated exercises) as they may be weak at it.
My name is Zayn iam 16 years old male
I wanted to address a few problems
I have severe lower back pain on my right side almost extending to glutes.
My right glute is bigger is size than my left
My right leg is stronger than the other
I have left knee pain sometimes
Severe left ankle pain after a long time standing up and my right ankle clicks a lot
When I lay down straight my left hip rolls out and left knee roll inwards
I have a irritating hip joint
Moving towards upper body
I have prominent right side of ribs it rolls outwards
I have a prominent left shoulder from back
My inner left arm touches ribs and it very uncomfortable
I would to listen from you
Do you think you have a pelvis that is rotated to the right? Also – do you tend to favor standing more so on the right leg? Is your left shoulder higher?
I don’t understand which side my pelvis is rotated. When my hips/buttocks/pelvis is squared/neutral my belly button faces towards the left. When my belly button is neutral/facing straight my left buttocks is forward and my right buttocks is backwards. When I’m walking my belly button is straight. When I’m standing straight I can turn to make my pelvis neutral but then my belly turns towards the left.
In your example for a right rotated pelvis the belly button faces towards the right, but my belly button never does. It’s either left or straight in relation to my pelvis. So I have a left rotated pelvis??, but your other example also suggest if the right side of the pelvis is backwards that’s a right rotated pelvis??
Also I have right side lateral pelvic tilt.
Is this rotated pelvis or twisted spine?
If your pelvis is square to the front and your belly button is facing towards the left, this sounds like there is some rotation towards the left in your lower back on top of a neutral pelvis.
If your pelvis has the left hip forwards/right hip back orientation and your belly button in the middle, this mean your pelvis is rotated towards the right with your lower back counter rotating towards the left.
It sounds like you might benefit more from working on the twisted spine. See post: Twisted Spine Exercises.
Is my pelvis actually rotated to the right or just my body compensating so my belly is always point straight? Because my right hip actually has a hip internal rotation deficiency but a right rotated pelvis should have good hip internal rotation on the right hip?
It is possible to have both.
It is also possible to have a rotated right pelvis with a deficiency in right internal rotation.
Just a clarifying question to ensure that I’m doing the appropriate exercises. I have a right rotated pelvis and understand that the exercises listed are written for those; however, this section below confuses me a bit:
Aim: Strengthen the muscles of the left hip that rotate the pelvis to the LEFT.”
If I have a right rotated pelvis, should I do these exercises as listed or should I be doing the opposite? Apologies if this seems like a silly question but the “left” in caps caught my eye.
Hi De Marcus,
All of the exercises are listed for a right rotated pelvis. For you – you’ll just need to follow the exercises exactly as mentioned on this blog post.
All the best.
Thank you so much for the website and advice you provide.
Hopefully an easy question for you. I have what I believe both uneven and twisted pelvis/hips.
My right quad is more prominent with belly button also pointing left therefore a left pelvis twist.
I then have a left hip hike (right shoulder higher, right leg looking longer).
I’ve had a bad injury to my L5-S1 on my left side so it could be related to this or that i used to play golf a lot.
Do I need to work on the twisted pelvis or uneven hips firstly in your opinion, or both at the same time?
I usually go after the pelvic rotation first. You might find that if you address the rotation, it might help correct the lateral tilt.
Hi mark, for twisted pelvis that has minimal foot sup/pro & and minimal IR/ER imbalance but has a Huge oblique imbalance component would you recommend to focus on? So everything indicates my pelvis is rotated to the left with right side hip bone forward compared to left hip bone sitting back. One thing that stands out as different though is that instead of belly button being pulled left facing left at angle, it is actually Centered facing straight forward. This is because the right oblique is massively shortened like half the length compared to left oblique. So the guide seems to work for me with regards left rotated pelvis, stretch Right quad/Left hamstring. However, where I am finding issue is with the lateral muscles, mainly Stretch right piriformis. This appears to destabilize things and makes pain and issues worse, giving me sciatica down the right leg. I think some how the oblique imbalance dominance in the rotated pelvis, with the right oblique being super short it is like pulling my Right piriformis Long, and stretching it further actually gives me Long piriformis syndrome. Doing no stretch but just focusing on standing fire hydrants for Right piriformis appears to be ok reducing my sciatica symptoms.
For the pelvis to be twisted towards one side, you will generally having involvement of the foot (pronation/supination), hip (internal and external rotation) and the torso (obliques, outer erector spinae, lats).
If you feel that the main issue are the obliques, you can focus on exercises that strengthen the obliques in the opposite direction that they are biased towards.
You can have a pelvis that is twisted towards the left with the belly button facing forwards. This usually mean that there is a lot of counter rotation towards the right occurring in the torso.
In regards to the right piriformis issue, does your right knee collapse towards the midline? This position can elongate the piriformis even if the pelvis is orientated to the right.
Thank you so much for putting together such an incredibly comprehensive website (and for thoughtfully responding to comments!). I have a couple questions regarding where to begin. I am a 29-year-old woman, and I’ve had some wonky posture stuff all my life, I think stemming from having very flat feet – I overpronate heavily. I adore running and have done a few half marathons, but I have a very odd running gait (significant knee valgus, I think?) and my feet swing out when I run, especially my right foot. I have a lateral pelvic tilt with the right hip higher, and running seems to make this tilt worse. My pelvis also feels like it might be rotated towards the right, but I couldn’t really tell from any of the tests on this page – bellybutton and thigh tests looked relatively even? Would it make sense for someone with a right hip hike to have a pelvis rotated towards the right as well? I just don’t want to be doing the wrong exercises.
Finally, my left shoulder is also higher than my right, which is weird because I always FEEL like my right is higher, especially when I wake up in the morning. I was told once by a physio that I had slight scoliosis.
Anyway, with all that in mind, where would you recommend starting? I’m very committed to working hard on my posture issues in the coming months as they are causing me discomfort (right hip pain, back and neck pain), but I’m not sure whether I should start with the pelvis exercises, feet exercises, scoliosis exercises, or all at once? And would you recommend continuing to run even if it seems to worsen my lateral pelvic tilt? It’s the only cardio I enjoy, ha.
Thank you SO much in advance!!!
If your postural issues have definitely all stemmed from the over pronation of your feet, I would say this area would be a good place to start. (See post: Exercises for Flat Feet)
In terms of your running pattern, it sounds like your hips are going into too much hip internal rotation and adduction. This causes the foot to flick out the side on the back leg. If this is the case, you will likely benefit from exercises such as standing fire hydrants with a resistance band, single leg hinge, single leg half squats, single leg balance etc. Keep in mind – just because you have this style of running does not 100 % mean it is causing your hip problems. (but it might be!). Coupling these said exercises with a strong foot base (as per the flat feet blog post linked above) should help out quite a bit!
In terms of the high hip on the right, it sounds like you tend to load your right side more… which is likely also stressing out the right hip as compared to the left. It is likely that you will need to teach your body to get comfortable with weight bearing on the left side so that it can accept more of your weight. The single leg exercises mentioned above (plus the foot exercises) can help with this. Make sure that your pelvis shifts towards the left side.
From what I’ve seen – It is more common to see a high right hip with a pelvis rotation to the right. If there is no significant rotation, perhaps best to address the other things I pointed out first.
Scoliosis can cause uneven shoulders. But keep in mind , everyone has a degree of scoliosis and does not always equate to injury.
Conclusion: Work on single leg stability in conjunction with foot exercises. (especially on the left side)
I’d encourage you to keep up with as much running as you can. You may need to reduce intensity or mileage as you work on your exercises. Try to find a nice balance between the two.
Hope this helps.
Thank you so much! That helps a TON. Much appreciated!
Hi Mark, i have a pelvis rotated to the right and also a lateral pelvic tilt with left hip hiking. Im trying to combine the two exercise programs but some exercises contradict themselves. Muscles that im supposed to strengthen to solve the one condition, im supposed to lengthen them in order to solve the other. Any tips? Also my mid and lower thoracic spine seems rotated to the right as well (lower ribs and belly button looking to the right) but Im trying to determine whether solving my pelvic issues fixes this problem. I have abnormal gait, muscles imbalances throughout my whole body, and i’ve been suffering from left scapula and left neck (trap, levator scap, scalene) pain for years, which I think is a result of my body compensating. Left shoulder is also a little higher, internally rotated and retracted.
It sounds like you might benefit from addressing the rotation in the pelvis first and see its effect on the torso and lateral pelvic tilt.
Sometimes addressing the rotation can help with the tilt in the pelvis.
Just wanted to thank you for your work! I’ve been doing exercises for a few weeks based on you advice and I feel better already.
I’m 22, I work as a programmer and I’ve been struggling with right biceps pain, right knee pain and left rotator cuff pain for some time, trying to go to the gym regularly, but facing difficulty.
I’ve been to 3 orthopaedists, 1 physiotherapist and 1 rheumatologist and none of them told me I have a twisted spine. Of course they told me I have a bit of scoliosis, but they couldn’t figure out why I have those pain problems. All they did was give me supplements and schedule kinesiotherapy sessions to correct my shoulder impingement, things that didn’t help me at all.
I always thought that something else is wrong. Wearing a shirt felt weird, I knew my body was somehow twisted.
I was very happy when I found your articles (rotated pelvis and twisted spine) that described exactly the things I feel, so thank you for helping people like me.
Great to hear that you are finding the blog posts helpful.
Rotation in the body is very common and sometimes problematic!
Hi Mark,if my left posterior superior iliac spine is more backwards and prominent than the right one is this left pelvis rotation?
If the left side of the pelvis is more posterior (as compared to the right side) relative to your feet, then this would be a left pelvis rotation.
Hi Mark,i understood that when the pelvis is rotated to one of the hip internally rotates and the leg gets more supinated and the other pronated respectively but i feel the opposite ,i feel like my pelvis is rotated to the right ,it feels shorter on the right and the leg is more pronated on the right and supinated on the left, what could this mean? What exercises should i do? Thanks in advance.
What you have described is perfectly possible.
In this scenario – you will still likely benefit from performing the exercises as mentioned on this blog post for the pelvis.
As for the feet, is it possible that you are standing more so on your left side more? As in – your pelvis may be shifted more towards the left?
When i am standing I feel like my left leg is longer and yes you were right and i misconfused ,my pelvis is rotated to the left because my asis on the right is lower and more forward (although i am a bit confused when i look at those asis bones) than the other one on the left but I also have uneven ribs ,the ribs on the left are forward and on the right are backwards,i think this is it,left pelvis rotation? Thank you again, I am struggling a lot with my problem for 2 years,I hope you can help me Mark, I appreciate your work!
Sounds like you have a higher left hip. Have you seen this post: Lateral Pelvic Tilt. That blog post has exercises that might help!
A higher ASIS on the left might be related to the higher hip on the left.
If your right side of the pelvis is more forwards, this suggests a left pelvis rotation. Although this can be skewed depending on what your lower limb is doing.
Hello Mark. I have uneven hips, scoliosis mainly in my lower spine. My whole pelvis seems to be too far to the right. I walk with duck feet and my interior rotators seem to be much worse on the right. I have been seeing a physical therapist to determine in just which position my hips are twisted. In her exam she saw that my right hip seems higher on the right when I am standing but in a supine position my left hip is higher. She measured my legs and there is no leg length difference. Do you have any idea what may be the cause?
When you are standing, you are using your muscles to hold your body in a particular position. When you are lying down, your body is passively assuming a position.
(keep in mind – the position of the body in standing and the lying down position may not always be consistent.)
Assuming that your body always has a high right hip in standing and a high left hip in supine, I would focus on the position that you experience your symptoms. For example – if you mainly have issues when you are up right and not so much whilst sleeping, I’d focus more on the standing posture.
Thank you very much. I will do that.
Hi Mark, Thanks SO much for what you do! After finding your site, I truly once again have HOPE!
My question concerns “where to start”. Ten years ago, I fell from a roof and broke both heels — the left was set incorrectly, & I limped on it, causing several issues. Two years later, I had corrective surgery, and I am still working on better range of motion (which is much better!).
After the fall, I graduallydeveloped a “very twisted pelvis” — rotated to the Right & with a lateral tilt, elevating the Right. I have scoliosis. My feet are still a bit “Duck-like”.
And my most life-changing issue that no-one can diagnose, is why I have difficulty reaching forward and walking erect without extreme effort. The only exception is when both my psoas & diaphragm have been “released/relaxed”. Then I have several minutes of “stress-free walking”.
I’ve been told my walking issue is due to weakness, & I’ve spent a year with a PT, getting stronger. It is true that I’m initially able to walk more easily directly after exercising, but it doesn’t last. My gut tells me my walking issues have to do with a very “tight diaphragm & psoas”. But after release, none of my muscles seem to “stay released”.
I know my feet are really important, but I have started with your “Rotated Pelvis” exercises because I didn’t know where to begin. Which exercises do you advise I begin with — & are there any areas that I can work on simultaneously?
Firstly- With injuries/surgeries to the ankle, it is very important to reclaim as much ankle mobility as possible as this can significantly influence your walking pattern (which in turn can lead to a twisted pelvis, duck feet posture etc).
If you are limited in ankle dorsiflexion: check this post.
It sounds like your body was trying to “move away” from the left ankle (likely due to pain avoidance initially) resulting to the right hip hike and right rotated pelvis.
If you notice some improvement in your walking after a psoas/diaphragm release, I wonder if you also have a hyper extended lower back? Do you have a noticeable arch in the lumbar spine +/- anterior pelvic tilt? If so – this could be related to your difficulty with leaning forwards and being up right as this posture tends to place more load on the lower back muscles.
You can start with the exercises mentioned on the blog post. I would do them all for a few weeks (I know that there are a lot, but since I can not assess you individually, it would be hard for me to tell you what exactly you need to focus on). Pay attention to what exact exercises seem to make you feel/walk better and focus on those.
I have an issue which I think is a right rotated pelvis.
My left foot and quad sit in front of my right foot and quad when looking down.
I have valgus in my left knee, and pronate on my left foot, and supernate on my right foot.
My left leg is slightly shorter than my right leg and appears to be rapidly getting worse.
Front of my right hip and inner thigh is very sore and binding up.
My clothes always sit twisted on my body and my zip on my pants and belt buckle are never centered with my belly button.
When I cycled, I cannot distribute power evenly, and my right knee/leg is pointed outward, and my left knee is always hitting the top tube of my bike. My shoulders are pointing forward, but my legs look like i am turning right.
Any suggestions woul be appreciative, as I have had this issue for over 4 years.
Based on what you have told me, it sounds like the pelvis is orientated towards the right side.
If you have a significant amount of pronation on the left and supination on the right, it might be an idea to address the foot area first and see what happens to the orientation of the pelvis. If you increase your arch on the left and flatten the right, does the bring the pelvis more centered? If so, have a look at these exercises:
– Flat foot (For the left side)
– High arch foot (For the right side)
Hi. I recently started seeing a PT hat diagnosed me with right pelvis tilt. My right knee is bent more than my left. He makes me do the wall 90 90 the same way you do but everything else is the opposite, strengthening my right Hip internal rotators and left external rotators. Do you have any information or articles you can link to back your opposite knowledge to my PT’s?
Is your PT addressing the pelvis TILT or ROTATION? They are addressed with different exercises.
Generally speaking – If you are strengthening your left hip external rotators and right hip internal rotators, it sounds like the PT is addressing a pelvis that is rotated to the left.
If you have pelvic tilt (ie. one hip is higher than the other), you might benefit more from these exercises: Lateral Pelvic Tilt.
Let me know if you have any questions.
Would these exercises help when my right pelvis is rotated forward and my left pelvis is rotated backwards?
Yes – But you would need to do the exercises to the opposite side mentioned on each exercise.
I’ve just now made a donation as a way of saying thanks for all that you do. Your knowledge base is awesome, nice work!
I’ve been living with a left rotated pelvis from a childhood accident involving a high-jump bar (landed firmly on my left ilium, ouch!) As an adult I’ve finally been diagnosed and have been using your Rotated Pelvis Exercises for a year or so, which have decreased the life-long associated headaches by 50%. Hurrah for Mark!
I’ve taken your advice about checking my standing/sitting/sleeping/holding/walking positions and corrected any positions that exacerbate the left pelvic rotation – very helpful.
I’m finding however that the rotation keeps returning quite quickly (mostly when sitting for more than 20 mins with a perfect posture). I have noticed that when I sit, my sit bones feel uneven beneath me and throughout the last year, (before chiropractic adjustments, after adjustments, always) when I sit on a hard, level, flat surface such as a sturdy coffee table, and I place a leveller across my thighs, when I look downwards my left thigh sits much lower and flatter than my right thigh (I can see this with my own observations) causing the leveller to show that my right thigh is higher than my left thigh. It’s as though my left thigh pulls left and I could imagine that my left sit bone or ilium has ‘fallen over’ to the left, resulting in a wider looking thigh when in a sit position.
I also find that my headaches reduce dramatically when I am not sitting in perfect posture. A perfect posture seems to promote headaches. Slouching reduces my headaches dramatically, or moving around such as gardening, walking etc.
In a standing position, my left glue is also very flat at the top like a ski-slope, however my right glute has a square top. I can’t help but wonder if my left ilium is experiencing some degree of torsion (on top of the obvious rotated pelvis) and all my hard work to keep my pelvis aligned might be further complimented by looking at the sit bones/uneven thighs in sitting position/wacky glutes, as a possible 2nd issue?
Perhaps if I can continue with the Rotated Pelvis Exercises and add something more to address the other symptoms, I may be able to train my pelvis to stay square to my body and my headaches might be permanently further reduced? What exercises can you recommend?
For your reference, I’ve been advised that along with the rotated pelvis, I appear to have a right posterior sacrum – sacrum issue (rather than a pelvic issue) because when I lay on my stomach and bring my legs up to 90 degrees, the chiropractor doesn’t see my leg length change so apparently this is a sacrum issue and sacrum adjustments have helped me to feel more squarely aligned…although after some weeks of chiropractic adjustments, I feel like I’m standing/sitting on a slope (uneven base) 24/7 which ends up causing a painful burning in my shoulder trapezius and this becomes much worse as the adjustments continue! We could not work out why!?
Also, do you know of any colleagues in Melbourne who are dedicated to investigating these issues like yourself, and in your opinion is worth a consultation? I’ve been previously disregarded by a Gonstead Chiropractor who has told me that any pain that I am still feeling is in my imagination so I’m now looking for someone helpful :)
Hopefully I’ve provided you with enough detail to enable you to assist whilst avoiding the risk of boring you to death, hahaha. Thanks again for your work in this space, I know by reading the many hundreds of comments, that you are making a real difference to the quality of people’s lives.
Thanks so much,
First of all – thank you so much for your donation!
HEADACHE: Great to hear the headaches have reduced by 50%! That’s awesome. I hope that they continue to diminish with time.
Headaches can get worse when attempting to maintain a more optimal posture especially when your body is not used to that position. Think about reducing the intensity of your correction and see if that helps. (Ie. Instead of correcting 100% of your posture, try 50% instead). Also – try to keep your body moving as much as you can. It is not advised to maintain the same posture for extended periods at a time.
Can you tell me exactly where the headaches are?
Also – Do you also have a Forward Head Posture?
If your left thigh sits lower in height as compared to your right side, 2 things come into mind.
1. Are you tilting your pelvis upwards on the right hand side? This would essentially lift the right thigh up. This would usually correspond with placing most of your weight on the left buttock cheek. This is generally due to an over active right Quadratus Lumborum.
2. Have you had your tibia (lower leg bone) bone checked to see if they are significantly uneven? True pelvis rotation in sitting wouldn’t really affect the the thigh high that significantly. Since you have been to a Chiropractor, I suspect this wouldn’t be the case as they would have mentioned it to you.
STANDING POSITION: Do you tend to stand more so on one foot? If so, please check to see if you have a Lateral Pelvic Tilt. This could get rise to the uneven glute presentation.
In regards to the exercises – the exercise mentioned on this blog post are addressing a whole pelvis rotation. If you believe you have a twisted sacrum that might be contributing to your issues, you might have to follow that up with a chiropractor as I don’t have a whole lot of experience with that.
It sounds like there has been a lot of focus on the pelvis, but what does the rest of your posture look like? (Eg. Uneven shoulders, scoliosis, twisted spine) . These can influence the position of the pelvis as well.
Looking forward to the reply.
Hi Mark, are you based in Sydney Australia?
Yes, I am.
Thank you so much for the information on this post and on this site, it’s been very instructive and helpful for me.
I wanted to ask you about some symptoms I’ve been dealing with and haven’t been able to get a clear explanation of from the PTs I’ve consulted, in case you might have encountered them before or have any thoughts on them.
I’ve been in PT to address an anteriorly rotated pelvis (right side) and a lateral pelvic tilt (left side). I’ve noticed that there is a visible “dent” in the skin/muscle/tissue of my right hip, around where the gluteus medius is. There is a similar but less severe dent on the left side, but it’s more posteriorly located. These dents appeared around the same time as my pain issues so I suspect that they’re related and need to be addressed, however they have not improved with treatment (and the pain has improved but is still nontrivial). Have you ever encountered anything like this before, and/or do you have any thoughts about what it could be a sign of, or what I could ask my PT to investigate?
Also, many of the muscles around my hip/glute region feel inhibited, and any attempt to contract them results in moderate to severe fasciculations (in only the muscles that feel inhibited, and I can stop them easily by disengaging the muscles, so I don’t believe it’s due to low iron/magnesium or other common causes for leg muscle twitching) and a sensation of the bones of the joint moving around. Again, have you encountered anything like this before and/or do you have any thoughts on what it could be?
Apologies for the long question and totally fine if you have no idea what to make of these symptoms, I’m just at wit’s end and trying to seek out some information wherever I might be able to find it. Thank you!
Thanks for the question.
I suspect that if your pelvis is rotating towards the left and shifting towards sideways towards the left.
This could be due to the glute medius, glute max and TFL being more active. This contraction can cause a little dent which is formed between the TFL/glute max/glute med.
The next question would be why are these muscles tensing up all of a sudden? You mentioned the dent appeared after some pain issues started. What exactly happened there?
Thank you so much for your response!
The pain worsened gradually, the only thing I can think to attribute it to is a yoga incident in which my hip cracked loudly during a stretch and subsequently started cracking/clunking with increasing frequency and feeling progressively unstable and “loose” for lack of a better way to describe it.
I’m also hypermobile (7/9 Beighton) and my PT has expressed a suspicion that doing yoga in general may have worsened my hypermobility and contributed to the overall sacroiliac instability I’m experiencing at present.
Anyways, the pain eventually got bad enough to really interfere with movement and functionality, and around then is when I started to notice the dent. The fasciculations started more recently, after I’d done a couple of rounds of prolotherapy (which did help me quite a bit), and when they happen they kind of feel like they’re trying to “pull” the joint into a better position (again, for lack of a better way to describe it).
Again, no worries if that all sounds nonsensical and you don’t have any suggestions, just trying to cast around for any possible ideas/explanations. Thanks so much for your time and consideration!
I just wanted to update this in case anyone with similar symptoms happens to stumble across this question: I was eventually diagnosed with adult tethered cord syndrome and that was evidently the cause of my fasciculations.
What kind of treatment did the doctor recommend for a tethered spinal cord?
Keen to know as I have not come across this before.
Oh my goodness…your article was an “A HA!” moment for me. I have struggled with what I thought was low back pain for years and with my 3rd pregnancy, it was almost unbearable. I have looked and looked for what was going on…thinking it must be something to do with my hips and somehow I got to your website and article. I did your little tests and…WHAT!?!? Sure enough, my right hip sits more forward…and I see it all the way down to the way my foot sticks out. I started doing your exercises and … WHAT?!?! The pain in my back was gone in a day or two. You are amazing! Thank you for this post and sharing your knowledge!
Wow! That is so awesome! Pain from several years disappearing within just 2 days. Amazing.
Thank you so much for letting me know. I love it when I hear success stories like this.
All the best!
sir you are a lifesaver! although still young I have chronic back pain and sciatica, lately the pain made me unable to walk, stuck in bed and no posture or exercise would help. Doctor told me I have right pelvis rotation but gave me the wrong exercises which were super painful… searched the net myself and just came across this post – after the first few hip shift exercises I already felt such a great relief, after the whole set there’s a huge difference, pain is finally gone!!!
Thank you so much :D
Hey Grateful Pete,
It’s so good to hear that you have got some good pain relief in your back pain by doing some of the recommended exercises on this blog post.
All the best!
Hi Mark – great content!! I wondered if you could help me…. I put the below comments together with the help of my Chiro.
Recent X-ray show that I have:
2. Right hip is up and rotated back
3. Left Mid back is convex
4. Low mid back is rotated right
5. Upper mid back is rotated left
Would I start with the above pelvis routine? Any other suggestions?
It really depends on what symptoms you are experiencing. But addressing the pelvis rotation might help address many of your other postural findings.
Hi Mark, i have a right rotated pelvis, but my hips and feet are opposite as to what you shown. My left hip is internally rotated and my right is externally rotated. My left foot is pronated and my right is supinated. I suspect my left leg/foot is internally rotated because the left side of my pelvis is APT, and my left hips clicks with externally movements. How should I go about fixing realigning my pelvis?
Is it possible that your pelvis is sitting more towards the right leg?
This can cause the left knee to collapse inwards relative to the left foot. This can give the illusion of being in internal rotation.
I’m not too sure what you mean by that. I do know that my left hip/pelvis tends to block my left side of my abdomen, when hinging at the hips or doing sit-ups. But I’m almost positive my pelvis is rotated to the right bc whenever I run or walk I always haves to readjust my pants to the left.
Any advice would be appreciated
Another way of thinking about it is: Does your pelvis located directly between your feet? Or is it closer towards one side?
I’m not 100% sure but I think it might be the case where my pelvis is sitting more to the right leg, what can I do to tell, and how should I go about aligning my pelvis?
If your pelvis sits more towards the right and also rotated to the right, you would still want to perform the exercises the rotate your pelvis towards the left in conjunction to shifting your weight equally between your feet.
You may also have a higher hip on the right side. If so, check out this post.
Hi mark, after doing some research I think I might have left aic pattern.
L AIC pattern is consistent with standing more on the right leg, pelvis rotated to the right and a higher right hip.
Hi Mark, like Jacob, my pelvis is rotated to the right, I have a pronated left foot and a supinated right foot. I found this consistent with the left aic pattern, but I don’t have the right bc pattern. My whole body is rotated maybe 20-30 degrees to the right. I noticed when I do push ups my hands follow the pattern of my feet, left hand higher and slightly IR and my right hand ER. You stressed to align your feet and pelvis when standing. When I do this, I get the right bc pattern. My right shoulder starts to round, but my pelvis starts to rotated to the left. What should I do?
If you find the correcting your foot alignment bring your pelvis into a more neutral position, you might need to initially focus your attention to your feet. (Just make sure that you do not over correct as this may cause your pelvis to rotated too far to the left.)
If your feet and pelvis are essentially centered but the rest of the torso rotates to the left (and right shoulder coming forwards), then I would say that at a certain level of your torso will need to be rotated towards the right. You can find some exercises here to help unravel the twisted spine.
Hello, how often do you recommend doing these exercises? Daily? Or a few times a week?
Start off with 2-3/week. Increase frequency as your body gets used to the exercises.
I have the right rotated pelvis as described in your post, but I also have a problem with my left leg.
When I walk or even stand left leg feels like it’s tensing up more than the right. Sometimes I have to stop walking to release tension. Also left leg feels less stable than right when doing single leg squats for example.
Are these 2 issues connected?
Yes – the 2 can definitely be related. Did you injure your left leg in the past?
Hey mark, i asked you questions on other posts like lateral pelvic tilt,flat feet,knee valgus and i found myself here and it looks like the root cause or the base for my issue, the thing is i didnt understand exactly how to determine which side im rotated to so i can train the right muscles, i know i have right flat foot foot and knee valgus on my right leg which i dont have on my left leg, i tried the tests to determine which side and i think it is to the left but i dont know, is the flat foot and knee valgus on my right leg only and my “healthy” left leg are giving enough to determine which side im rotated to??? Im want to apologize for asking a lot of questions on your posts and taking room for other people, i just cant seem to fix my issue because it is complicated for me to understand.
Great to hear that you figured out that your rotated pelvis might be the root cause of all your postural deviations.
It’s not really possible to determine which way your pelvis is rotated to by just going by the side of your knee valgus and flat feet as the pelvis can rotate towards or away to this side.
If you place your hands on your ASIS bone on the pelvis, can you tell if one is more forwards?
I originally commented on the Anterior Pelvic Tilt blog and you brought me here. I certainly do have a degree of spinal and pelvic rotation.
However, I still have concerns for the overall muscle balance of my body. I do not feel as if I am adequately addressing the muscle imbalance of my core, despite doing all the exercises listed above and on other posts. My glutes are becoming more equal, but the same cant be said for my abdomen. My right abdomen is much weaker, and I am looking for unilateral exercises which may aid my condition. I have anxiety with equal activation whilst doing ordinary leg raises etc.
I believe this imbalance may affect my walking posture.
what would be your suggestions?
Single sided planks are unclear to me; Is the side that is being activated most the one facing towards the ground?
Assuming that you are already addressing the rotation in the pelvis or torso, I would then recommend checking to see if there is any lateral pelvic tilt or side bending on of the spine.
If there are nil significant findings there, I would then go after the unilateral exercises.
When you say you right abdominal region is weaker, which specific movement are you referring to? Is it just the leg raises? If so, you’ll just need to so single raises with the right side for now. Keep in mind – it could also be a weak hip flexor on that side.
With the side planks, the side that is closer to the ground is that side that is being worked out.
I’m dealing with the same thing as in all your photos. I previously had an anterior rotated left ilium which made me left leg longer. I managed this for years at home with a simple stretch… Just so I understand, is this kind of pelvic rotation stemming from anterior or posterior rotations of the ilia? I’m trying to figure out of this is my old issue or a new one. Sadly I still am quite twisted after a few days of these great stretches! No scoliosis.
Thanks for the article though, I hadn’t previously found anything online about my kind of rotation, only ones where one hip is higher than the other (upslip or down slip).
This blog post is addressing the whole pelvis twisting towards one side.
As part of the pelvis rotation, there will likely be intra pelvic torsion (anterior rotated left ilium) occurring at the same time.
If your pelvis is neutral, but you tend to only have the left ilium anteriorly rotated, you can try activating the left glutes (hip extension) from a fully flexed position for 5 seconds x 5 reps to see if that helps.
My left pelvis is higher than the right side and rotated forward toward to the right, my left foot points outward. I have left SI joint pain on and off, right shoulder is lower than the left side and pointed forward. I’m in pain mostly everyday. Please help. Thanks a lot
Sounds like addressing the rotated pelvis is a good place to start off with.
You might find it also helps to level out your shoulders as well. If not, you might consider checking to see if you have Scoliosis as this can lead to uneven shoulders as well.
really sorry to come and write this here but it was the only way for me to have your help.Hello my name is Patrick I am 21 years old I am in Africa more precisely in Ivory Coast. I did weight training without equipment and I was not symmetrical so I had an imbalance in my posture because I lean to the right when I walk and the most serious I have had is the right leg being shorter than the left leg which I have not done before. I did some research and I know that I have an imbalance in my pelvis, I cannot see a physiotherapist or an osteopath because I really do not have the means and they are rare in my country, in my research I came across your blog which shows how to rebalance the crooked pelvis. I really need your help. here are more details about me: I have the right leg shorter than the left and even when I try to put a second tongue in my right shoes I feel like I shorten my right leg, when I walk and put my right leg in front of my upper body leaning forward, when I lift a heavy object with my left arm it tires me especially my right side where all the weight of my body rests.
If you feel you have issues with a shorter leg, please feel free to have a look at this blog post: Lateral Pelvic Tilt. See if that applies to your situation.
If your pelvis is “off”, it can have a flow on effect to the rest of your body leading to the issues you have mentioned. I would also encourage you to have a look if you have Scoliosis.
My right hip is more forward but my left hip is higher and it´s in internal rotation and my right leg is shorter than left can this fix my problem?
Sounds like a pelvis that is rotated towards the left.
The exercises should be able to help you with that!
So based off what I read from your post, I believe I have right rotated pelvis. However, in the photo you have where you talk the foot position, my feet seem to be the opposite. My left foot rotates inwards and right rotates outwards.
When I run, I seem to feel more activation on my left calve and right hamstring, resulting in a bigger left calve and right hamstring. When I do abdominal work, I can only feel my right side working. Sorry for the long post, but you mentioned that we should be consciously trying to be aware of our hip, knee, feet alignment. I have been doing so for the past few months and it’s leaving me with chronic tightness in my calves and quads. I subconsciously align my body when I sit or stand but it still feels so unnatural and my legs immediately get tight. Any advice would helpful, thank you!
It is possible to have deviations in foot position with a rotated pelvis to the right. It really depends on how the body is compensating.
If keeping your lower limb alignment creates more issues, it is likely something else in the body needs to be addressed as well.
A good place to start is the foot or the pelvis/hip region. Since you mentioned the rotated pelvis, perhaps starting here might be a good idea. As the position of the pelvis will affect the hips, it will also impact the alignment of the lower limb.
If this creates more issues, then switch to addressing the feet and assess its impact on your ability to keep your legs aligned.
I have a somewhat on topic question.
I noticed that you are certified in dry needling. I’m not sure what courses they offer in Australia but I’m pretty sure the science is the same.
If a patient has left anterior gluteus minimus trigger points they will have a pain referral both locally at the muscle and down the side of the leg.
If the patient is trying to do a right side lying left adductor pull back with left internal rotation via the anterior fibres of glute min, wouldn’t the patient only make their pain worse from the constant nociception from the trigger points ?
Also you are a certified dry needler. Do you treat myofascial pain syndrome in your clinic ?
These exercise techniques are great but if the patient is in pain it will not make their condition worse, you agree?
If you are trying to engage the anterior glutes which already have points of increased tone, it can definitely create more tension within the muscle.
If this is the case, the anterior glutes would benefit from a release and/or needling technique beforehand.
Once the tone has settled, you can then follow up with the exercise at perhaps at 10% intensity and gradually progress it to a level where the muscle can comfortable tolerate.
I’m qualified in needling but I do not use it very often.
In terms of myofascial pain syndrome – I find that it is often related to an imbalance in posture and movement. So ultimately – by addressing that, should help with the fascial slings.
If there is acute inflammation – this will need to be sorted out first prior to performing the exercises otherwise any additional input to the body can irritate the system.
Hope this answers your questions.
Is a rotated pelvis the same as a pelvic torsion? I have a pelvic torsion (right side forward, left side backward). Will your exercises also help? If yes, should I do them for a right or left rotated pelvis? (I don’t want to go to chiro, I hate adjustments and strongly believe that my torsion is from muscular imbalances and I can get rid of that with exercise not manipulation).
Pelvic torsion is generally referred to the iliums moving relative to the sacral bone. This means that there is movement occurring at the SIJ and pubic symphysis.
Pelvis rotation is referring to the entire pelvis twisting towards one side as one unit.
Pelvis torsion should occur with pelvis rotation.
Generally speaking – if your right side is forwards and left back is backwards, this is consistent with a left rotated pelvis. The exercises mentioned are not specifically for pelvic torsion, but they can help.
I have a twisted pelvis to the left but it doesn’t really seem like my left leg is the problem. my right hip is definitely externally rotated tho. should i only focus on internal rotation exercises on the right hip? i think my left hip is straight.
You might need to just focus on the right side if there is no issue with the relative position of the left leg.
I have a right rotated pelvis with a longer functional right leg. I also have bowed legs and supinate — my left side is more severe. Based on what you’ve conveyed here, I feel like I should be doing the activities for the “left” leg on both sides, but fewer repetitions for my right leg. AKA, increasing internal rotation for both sides. Does that sound right?
I have been working extensively on strengthening my TVA and stretching my hip flexors, which has seemed to ease a bit of tension.
In severe pelvic pain, please help!
How many times a week should I do these exercises? And also the exercises for scoliosis?
Аnd can you please write to each post how often to perform different sets of exercises?
It will be very convenient! Thank you!
2-3/week is good place to start. Adjust frequency depending on how your body responds.
If one has a right rotated pelvis. ( Right hemi pelvis going backwards and left hemi going forward.
When doing a forward lunge, is there any way to increase it’s intensity. Such as putting a block under the left foot. Reaching with a left arm ? Tilting the body backwards? Rotating the thoracic to the right ? Obliques ?
I assume you are referring to the lunge stretch for the hip?
To increase intensity: you can posterior tilt the pelvis, push hips to the side and reach over to right with left hand, drive hips forwards etc
I have a combination of right side un even hips and a slight right side rotation.
Should I do all the exercises for un even hips and rotated hips?
I would focus on addressing one at a time. In some people – fixing one thing can lead to the other improving as well!
In terms of which one to start with, that really depends on what issues you are having. But generally speaking – I would address rotation first.
As a chiropractor, I find most of this confusing and counterintuitive. Is your work referring to a rotated hemipelvis? I so, I think internally/externally rotated pelvis makes more sense the right vs. left
I use it in a sense of the whole pelvis as one unit being rotated relative to the hip joints.
It is not specifically referring to the intrapelvic torsion.
Hi, Mark…I have a rt pelvis hike…and I have what appears to be a left rotated pelvis…I have been trying to address this lt pelvic rotation for quite some time by way of the hips and have tried at the core which has not been successful…in fact I often want to undo any exercise I have done trying to fix it…I have better luck using the lateral tilt exercises, but this is not enough to get out of the transverse rotated position…I notice you state the pelvis can still be rotated rt in relation to hips even if it appears to the left (assuming lower limbs are symmetrical)…can you please explain what you mean by symmetrical limbs and how the pelvis can appear lt in relationship to a rt hip internally rotated..wouldnt they just both be equal with neither being out in front of the other?…I’m confused about that…I feel my rt lower limb is entirely internally rotated and the left is externally rotated… and I have lt laterally tilted pelvis and maybe even a APT… and transverse rotation… I can feel myself turning obliquely with something as simple as walking… when I am swinging my rt leg forward with walking it is swinging up/forward/to my left side…does me no good to fix a left pelvic rotation for a pelvis that may as you mentioned be rotated rt…can you please elaborate on how one understands what you are saying and how to tell for sure what they have? Thank You. Crystal
The tests to determine if you have a pelvis rotation as mentioned in this blog post are very general and can sometimes be misleading.
It may appear that you have a left rotated pelvis, but the pelvis may actually be rotated to the right RELATIVE to your hip joints.
For example – if your left foot has a high arch and your right foot is more flattened, this can ORIENTATE your pelvis towards the left, however, the pelvis could actually be rotating towards the right in this left pelvis rotation orientation. If you use the tests that I mentioned in the blog post, this would give you the false reading of a left rotated pelvis. If your body starts to feel worse after performing the exercises, it might be because you have addressed the incorrect pelvis rotation direction. If you have what I have explained, you will likely need to address the feet and see its effects on the pelvis. Sometimes addressing the feet first may actually unwind the pelvis rotation! If your pelvis rotation remains after correcting your foot position, you’ll likely need to do the pelvis rotation exercises next.
I hope this makes sense! It’s a bit confusing!
I think I have a left rotated pelvis (my right leg is in front of left one, my belly button looks to the left). However I went to a physio that is trained in Postural Restoration/Myokinematic Restoration. She said that a true left rotated pelvis doesn`t exist and it is always rotated to the right. She also says, the reason for this is the right diaphragm being stronger and bigger than the left one and so the rib cage and the pelvis are rotated to that side. When I do targeted exercises at the gym, I feel my right hamstrings being weaker than my left ones and my left glutes being weaker than my right ones. Also I have problems to internally rotate my left leg and my right rectus femoris and glute max are extremely tight. In my opinion that matches your description of a left rotated pelvis, so I am a little confused. Does a left rotated pelvis really not exist? Are there other tests I could do (physio didn`t do any tests). Kind regards, Isa
If you follow PRI principles, pelvis rotation to the left does not really exist unless your organs have switched sides. Sometimes your pelvis could be in a right rotated pelvis relative to the hips, but present as the right side being more forwards. This is usually due to some sort of knee collapse/foot pronation on the right side.
I believe left pelvis rotation can and does exist. You can try the PRI exercises for awhile and see how you respond. If you don’t seem be improving, you can try doing the exercises for a left rotated pelvis and see if you feel any better.
Is it normal to have posteriorly tilted on one side and anteriorly tilted on the other side in a rotated pelvis?
The external rotation on my right leg doesn’t seems to neutralize unless I do piriform is stretch all the time.
From my experience (I tried various things) I get the most optimum results (not perfect yet but there is progress) from this rotation exercises but I would like to know if I should include ppt exercises to my right side and apt exercises to left side while doing these rotation or could this exercises help uneven ppt-apt between 2 glutes?
One last thing I really would like to contact with you. Is this possible?
Many thanks for your support and contribution.
If you have a left rotated pelvis: It is common to see a left posterior tilt and a right anterior tilt.
Is this what you have?
I couldn’t decide whether I have apt or ppt on a side but I do feel these exercises seems helping me a lot. When switching to another exercise all the problems come back. The most improvement I feel after doing these exercises I on my upper and lower back on the right side. Normally I can not sit or stand for a long time without my upper + lower back hurting (muscle spasms) but after doing couple of sessions with these exercises I drove my car for 7 hours without any pain on the right side upper back lower back. This feels good.
I don’t understand why I lost mobility on my right side whereas why I do have more than normal mobility on left side. This is applicable from ankle to head (ankle, knee, hip, back etc.). Is there any logical answer for this?
Sounds like you are on the right track with the exercises.
Your body moving relative to how you habitually position your body throughout the day.
This is usually related to how you sit. It can also be related to habitual muscle pattern use in sports.
Hi mark i have a lot of questions to throw at you are your ready lol ?
1-Will It be beneficial to see an osteopath for a rotated pelvis and can i depend on the results i get from an osteopath
2-I have mostly the same pattern that you discussed on this post i also have hamstrings and quad imbalance right weak ham left weak quad
3-will training the quad and hamstring in a traditional way like doing leg extensions and ham curls help because honestly most of the exercises PT’s show are complicated to me and will doing them only the weaker side and avoiding the strong side be helping
4-will ignoring this condition cause permanent damage to the spine and hips if left untreated
I know im throwing alot at once im trying to not keep asking the same questions i will deeply appreciate any response from you ive dealing with this issue for 2 years now thanks
1. Yes – osteopaths will be able to help you.
2. Yes – the hamstrings and quadriceps will be involved with the rotated pelvis.
3. They will help activate the muscles, but it is best to activate them in a way that encourages the pelvis in a more neutral position. For example: Sitting leg extensions for the quadriceps will not likely significantly help correct the pelvis position.
4. This is definitely possible! (.. but also at the same time, it’s not guaranteed)
Thank you for all your useful posts it really explain everything clearly and sufficiently.
I have a question
I have a rotated pelvis to the right, also a twisted torso and i also slouch forward leaning on my right side so have very bad abdominal pain on the right side as well as back pain in the same area.
Will addressing pelvic and thoracic rotation be enough to also fix the one side bending and get the weight of these tight right abdominal muscles.
Addressing the rotation should help, but you may also need to address the actual side bending of your spine.
See post: Scoliosis Exercises.
I’ve got tight and short quadriceps, adductors and Hamstrings only on my right side. I performed Thomas Test, figure 4 Test and leg raise Test to confirm that those muscles are really short not only feel like that. I’ve had no injury, symptoms started slightly one day and got worse over time. Stretching doesnt help at all, I do strength exercises every day and can easily do Weighted Single leg tasks like SL squat, bulgarian SQ and so on. So I am not sure whether it is a strength Problem or not. I know that my LEFT glutes are slightly weaker and that I tend to sway back at upper lumbar spine but according to your test I have normal/very mild anterior pelvic tilt. May that be a rotational problem?
Thank you in advance!
If symptoms only started 1 day ago, I would think something must have happened. Did you start any new exercises or activities?
If you have 1 sided issues, pelvis rotation could definitely be a factor. But it’s hard to say without the full history leading up to the issue.
I have a right rotated pelvis. It means my belly button is pointing towards right.
So should I do all of these excercises as shown. Or do I need to change them.
Like rn I’m doing strengthening excercises for left hip and releasing excercises for right hip. Is is the right way . Or do I have to do all of them for a right rotated pelvis .
For a pelvis rotated to the right, you will need to do the exercise as shown in the blog post.
Would these exercises help if we have one foot with a fallen arch? What if this rotation led to fallen arch? Any suggestions regarding to fix fallen arch exercises to add these rotation movements?
Pelvis rotation can certainly lead to one arch collapsing.
If your arch has collapsed for some time, you might also benefit from foot exercises. (See post: Flat foot exercises).
I write a lot sorry for this :-). I would like to give some feedbacks.
First of all the exercises (left rotated pelvis for me) seems working for me (although i still feel i am missing stg.). Especially working left glute medius seems to balance things out. I always think i could have weakness in my right gluteus medius but now i am realizing that left hip could be lacking. I had an ACL surgery on right side but when i stand on one leg left leg stabilization seems worse than right leg also left leg knee feels too much mobile compared to right (acl side). When i begin the exercises esp. left external rotation exercises, i begin feeling my left knee less mobile (or more controlled). This feels good.
I know i may have swayback on my right side but the thing is having swayback one side is difficult to proceed with swayback exercises since it effects only unilaterally. Also from my experience this rotation makes it impossible to work muscles evenly. For example on the right side (externally rotated side) i have very well defined lateral muscles from ankle to head whereas on the left side inner muscles are much prominent. When there is a rotation i do not think working on such dysfunctions like swayback or anterior pelvis tilt (since those may effect only one leg). So can we say fixing the rotated pelvis is priority in these kind of instances?
I generally go after asymmetrical postures first such as Pelvis rotation. But it also really depends on what symptoms/issues you are experiencing.
If you tend to have asymmetrical symptoms, address the rotation in the pelvis first.
That makes sense!
I also suspects quads + hamstrings strength asymmetries also play a role in rotation maybe?
I definitely have weaker hamstring on the right side and weaker quad on the left side (compared to their antagonists). Especially the hip lift feels great and feel left quad activating while right hamstring activating (although it feels a little subtle compared to left quad activation).
Could this be a contributing factor?
Yes – hamstrings and quads will play a role in rotation as well.
I passed all the test and i have “left rotated pelvis” :-). This is like 3-4 years and i have difficulties in walking even standing.
I have 2 questions if you could share your thought about these.
1) I had ACL surgery (hamstring graft) on right knee (where leg is externally rotated) and there is a clear imbalance between quads and hamstring quad is dominant. Hamstring is very weak. Could this be a cause of this rotation or rotation leads this (of course besides surgery) and on the left side? The story is totally opposite (hamstring stronger)in the left leg (internall rotated).
2) ı also have Psoas imbalance between sides where right side is significantly weaker than left. I read some post regarding psoas imbalance leading to uneven or rotated pelvis. Could this be a cause of pelvis rotation or again pelvis rotation is the cause of weakened right psoas (externally rotated one)?
Bonus question:) How can i understand whether there is a true tightness or tension related with weakness(e.g adductors)?
Thank you so much
Thanks for your questions.
1. Surgery to your right knee can definitely cause your pelvis to rotate. It’s common to see more strength (and reliance) on the unaffected side which in turn could bias the pelvis towards that side.
2. Asymmetries in strength of the psoas can also be related to the rotated pelvis. It is also possible that asymmetrical weakness can lead to a rotation in pelvis. Either way, I would encourage you to strengthen the psoas in a more neutral pelvis position.
Could these exercises help me?
I believe so!
Yes me too thank you!
Especially 90/90 hip lift feels great right after doing. My weak left hamstring and weak right quad working.
After doing these exercises my pelvis returns to neutral. So it works but the thing is my right leg (ACL side) is straighter than left side (can not maintain a little bend) while standing or walking left side stays in bend / flexed position. What could be leading this how can I maintain a flexed knee position?
Hey Mark is it normal to have posterior pelvic tilt on the right side (in left rotated pelvis)?
No – the right side would tilt forwards in a left rotated pelvis.
I don’t know my neutral pelvis :-). I get used to this wrong pattern :-(
I have more than one issue happening and it seems like a lot of the issues you address on your site can be interrelated. It is very overwhelming and I’m just not sure how to proceed.
I have some lateral pelvic tilt on the right along with a rotated pelvis to the right. And because of that I have some twisting in the spine or scoliosis. I have rounded shoulders and even some hunchback. I have hyperlordosis or possibly anterior pelvic tilt but then if I have rounded shoulders does that mean I have swayback posture too? I also get a snapping sound in my hip when laying on my back and bringing my right knee to my stomach and then setting it down. It doesn’t hurt. It’s all so confusing Mark. How would I start?
I just left you a donation and would appreciate if we could have a one on one chat to see how I can address my situation.
It can certainly be overwhelming. Let’s see if I can help!
“I have hyperlordosis or possibly anterior pelvic tilt but then if I have rounded shoulders does that mean I have swayback posture too?”
I tend to use the term sway back posture as where the pelvis is shifted forwards relative to the feet causing the torso to sway backwards. Keep in mind, some people also use the term “sway back” as referring to the hyperlordosis. (confusing, I know)
Snapping in the hip is generally due to a tendon flicking over a bony prominence in the pelvis. (See post: Snapping hip syndrome)
As you have multiple areas that could be addressed (which is very common), I usually suggest just focusing on ONE area to begin with. This is to avoid getting overwhelmed.
In terms of where to start – this really depends what kind of issues you are trying to address.
Thanks for the donation! I rarely get donations so it really means a lot when someone kindly gives. Feel free to message me on my facebook page and I’ll see what I can help you out with.
I went to your Facebook page as you’ve indicated in your reply to me and I’m not sure what is the best way to message you on there. I sent you a direct message through Facebook messenger but I got an automatic reply. So please let me know how I can get in contact with you.
Hi mark. I am a real mess. All started 8? Months ago after I lifted something clearly the wrong way. I feel so twisted. Right side of my body hardly works now. My pelvis is all over the place. But I can’t figure it out. Some have said I am posterior on on side but I don’t think that’s a constant. This picture of the excercise you have have on this page lying with left leg rotated out then rotating the right leg in is how I am constantly. Any ideas where to start? I don’t match all the pictures lol I am so uneven . But really tight adductor on my right side . Look foramward to hearing from you.
True tightness in the inner hip might suggest a pelvis rotated to the right. Or if you sense “tension” in the right inner hip might actually be a pelvis rotation to the left. (It really needs to be specifically assessed)
Is your spine twisted as well? (see post: Twisted spine) Asymmetrical postures can cause an imbalance between the left and right side of the body.
How can I use some at home orthopedics to increase the supination on the forward rotated side and increase the pronation on the side the posterior rotated side.
I’m trying to use kinesio tape and a paper towel. I’m placing the paper towel with the kinesio tape for pronation ok the inside of the foot.
For supination im putting the paper towel and kinesio tape on the outside of the foot and outside heel ? Does this make sense ?
You can do that in the short term, but would strongly recommend that you have a look at these 2 posts:
– How to fix High Arches
– How to fix Flat feet.
These blog posts will go through exercises to address the feet.
I have been keeping up with these exercises for a year now, yet when I look in the mirror it’s all the same. I see all these comments from people, there are so many it’s insane. But I have to ask the most blunt question, have you actually had success in fixing a rotated pelvis on a patient permanently? Or does this issue really never resolve?
Yep, there is are over 1000 comments on this one blog post!
To answer your question: Yes – people can fix their rotated pelvis permanently. If you have tried for 1 year and still have not seen any changes, I would say that you might need to address another area that is causing your pelvis to rotate. (Eg. Foot and spine would be the go-to regions.)
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?
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.
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.
You can try addressing the rotation of the pelvis first. This should take the left hip out of internal rotation.
I have similar conditions and i also live in Turkey. Did you find a solution to your problems?
Yes, i do some these streches every morning it´s getting better i think.
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
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
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.
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?
It sounds like your hip is shifting to the left as you place your weight on that left leg.
Have you tried strengthening the gluteus medius to stabilize the hip?
See post: Gluteus Medius Exercises.
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
Perhaps you can see if there is anything happening at the ankle/foot.
Do you have high or low arches?
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
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.
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.
If your hips are level, I am assuming that you have know lateral pelvic tilt.
If your pain is more towards the front of the hip during a staggered (left leg forwards) dead lift, it could be FemoroAcetabular Impingement.
For a detailed guide, Check out this post: Hip Impingement Exercises.
If the pain is more towards the SIDE of the hip, it could be Hip Bursitis.
See post: Hip Bursitis Exercises.
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.
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 ?
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.
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.
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, 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?
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.
i think i am having a slight tilt in my pelvis which is tilted towards the right side and i am doing some exercises. when i do some of the exercise i feel like my muscles are loosen up but withing just few seconds it goes back again and the muscles that is the side of hips become tight again and giving the appearence of the right pelvic tilt… i am 15 yrs old……and i feel like my coccyx bone is at the right side and not straight. And also my i feel some sort of tightness in my upper and lower back and my neck also get tight. When i am moving my neck when i get the feeling of tightness or strain, i am hearing sounds like as if some thing is rubbing between the bones…and i am also my knee turned a bit inwards like as if i have knock knees….i also have a a feeling of high hip or is it because of the tilt …i do not know………. pleaseeeeeee help me…… i am waiting for ur fast reply……..thankyou…….
sir u have replied to others but not here,…….pls reply…….
Sorry – I must have missed your comment.
If you have a right high hip, I would suggest that you have a look at this post: How to fix a Lateral Pelvic tilt.
This might be the reason for the said symptoms.
If your knee falls inwards, this is referred to as Knee Valgus . (see post: Knee Valgus)
I don’t think my pelvis is rotated it’s more just shifted to the right of my torso and my right leg stance is out wider then my left leg any idea on what I need to do to fix this ?
Sounds like you need to teach your body to accept load on to the left leg and/or address any lateral pelvic tilt.
A reason for a rotated pelvis might also be ‘butt gripping’ meaning you always unconsciously contract your glutes during the day and every movement, sometimes even when sitting. If you do it more on one side or only on one side, this can also lead to a forward rotation of the pelvis on that side. It might be because of core weakness (including pelvic floor) or only a faulty movement strategy you acquired. I only wanted to mention that because I really love your content Mark, but unfortunately all your exercises for rotated pelvis didn’t help to bring my pain down. I visited several physios nobody had a clue. I had a training session at my gym for improving my squatting form. The trainer there told me I have a wrong technique because I squeeze my glutes too strong. That was when everything changed. I got conscious about my butt gripping and I had to relearn how to move properly. Since then my pelvis is straight and I have no more pain. I thought it might be helpful for some other person. I was told butt gripping is quite common. Kind regards, Annabelle
Great to hear that your pain has improved.
Butt gripping (relatively more on one side) can certainly result in a rotated pelvis. It can even push the pelvis forwards relative to the feet as see in Sway Back Posture.
Hi Mark, I was just wondering if you might be able to give me some advice. My right foot is externally rotated (not flat) and when I straighten my foot, my leg internally rotates. I’ve also got some right knee pain.
I’ve tried the pelvis rotation tests and I don’t seem to have a rotated pelvis but when I exercise, my hips shift to the right, which makes me think I might have a left pelvis rotation? But I’m not sure. What could be causing my leg to internally rotate? My left leg is fine but my foot is flatter on that side.
It sounds like you may have a degree of tibial external rotation. This can explain why the knee rotates inwards if you keep your foot straight. (See post: Duck foot posture)
If you shift your pelvis towards the right, it can occur in conjunction with a left or right pelvis rotation.
If my pelvis is turned to the right, does it mean that my left leg will be in the outer rotation (varus), and the right in the inner rotation (valgus)? is this always the case when turning the pelvis to the right?
and tell me when varus is the pronation of the leg?
thanks for the great work, Mark!
Usually – with a right rotated pelvis, the left knee would collapse inwards (valgus) and the right knee would push out wards (varus). But keep in mind, there are always exceptions to the rule.
Same thing with the foot pronation. Usually the left foot will be in pronation as it follows the knee valgus on the left side. However – it is not always the case and will need to be assessed individually.
But in this post, the picture shows that if the pelvis rotates to the right, then the left hip will be in external rotation?
And now you are saying the opposite. Help me understand …..
Keep in mind – with right pelvis rotation: You can have the left hip in external rotation whilst the knee is still caving in (relative to the foot) as it follows the pelvis.
Yes I can confirm that I have exact same issues Mark mentioned (knee valgus on the opposite direction of the rotation and varus on the same direction of rotation)
Hi Mark. A question to which I have not seen the answer anywhere. Help me.
If the pelvis is turned to the right, then the left leg will be in external rotation, right? And do you need to do the exercises that you wrote in this article?
If the left gluteus maximus and gluteus medius are weak, then the left hip is slightly upward and turns to the right, and the left thigh will be in internal rotation and brought, but the pelvis will also be turned to the right? And the opposite exercises should be done, as for internal rotation of the leg?
How can you tell the difference between the two? As you can understand, the left pelvis, due to weak gluteal muscles, turns to the right, or the pelvis is turned to the right, and the exercises for these options will be different.
HELP US WITH IT. GOOD TO YOU AND YOUR FAMILY.
Generally speaking – a pelvis that is rotated to the right will have a left hip that is in external rotation and a right hip that is in internal rotation. Keep in mind – this is assuming that the hips are still pointing forwards.
If the left hip is higher, then this would be consider a lateral pelvic tilt. (See post: Lateral Pelvic Tilt)
It sounds like you might need to do a combination of the exercises mentioned on this blog post for a pelvis rotation to the right in conjunction with the exercises for a left hip hike.
I have a twisted torso as left side of my ribs is flared more than the right. But I don’t seem to have a rotated pelvis. Is this common?
P.S. I had a lateral pelvic tilt which I fixed thanks to you and this blog.
You can have a twisted torso with no rotation in the pelvis.
If this is the case, the exercises mentioned on this page should help!
Hi Mark Wong! I’m 37yo. For over 2 years I’ve been in so much pain almost not being able to walk. Recently i’ve found out I have a rotated pelvis and realized I have all of the signs mentioned (left knee valgus, left flat foot and right pelvis rotation) . I was born with scoliosis but never had any big limitations. I wanna start doing your exercises but where should i start from? Feet, knee or hip? Thanks in advance!
There is no wrong area to start. But if you wanted a more methodical way, I would start from the feet and work your way up as required.
Thank you for your response, Mark. Not knowing what’s the origin made me wonder what should i fix first.
Hi Mark, I have a pelvis that is rotated to the right. Does that mean that the muscles on the left leg are weak while the muscles on the right side of my leg are tight?
For a pelvis rotated to the right, there will be some muscles tight or weak on either side.
Mark, hello. You are a genius, your site is super!
“Did you know…. A pelvis rotation usually occurs with some degree of a lateral pelvic tilt?” (с)
If the pelvis is turned to the right, what will be its lateral tilt? Which side of the pelvis is higher?
Thanks for your comment!
The pelvis can tilt either way if a rotated pelvis to the right.
I hope you can help…my right foot is externally rotated outwards and it overpronates. My right knee is turned slightly inwards and when I do a squat or deadlift, my hips are asymmetrical because of my foot.
I thought that it might be a pelvic rotation issue and my pelvis rotating to the left, but I’m not sure. I think my knee is rotated inwards because of my ankle and to solve my ankle problem, I need to do external rotation exercises. But if I have a left pelvic rotation, my right hip would be externally rotated and I need to do internal rotation exercises.
I can’t really see any signs of pelvic rotation other than my asymmetrical exercises but it makes sense.
I’m just wondering what you think and how I can go about this problem? I don’t want to keep doing external rotation exercises and be making the problem worse! Or vice versa and turning my knee & ankle inwards even more :(
just a clarification, you mention:
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.)
but some of the headers are confusing, isn’t the 3rd and last ones opposite side?
Aim: Reduce tension in the muscles of the left hip causing a right pelvic rotation.
Aim: Reduce tightness in the muscles of the left hip causing a right rotated pelvis.
Aim: Strengthen the muscles of the left hip that rotate the pelvis to the LEFT.
Aim: To reduce tension in the muscles of the right hip that are pulling into the right rotated pelvis position.
Aim: To decrease the tightness in the muscles of the right hip that are holding the right rotated pelvis position.
Aim: To strengthen the muscles of the right hip that rotate the pelvis to the LEFT.
You will likely need to strengthen both the left AND right hip to correct a rotated pelvis.
I have a Big rotated pelvi right
I have my left arc feet arcmmm very very High and my right Is normal. How i Can fix my left feet ?
Sounds like you have a high arch in your left foot?
If so, check this post out: How to fix High Arches in Feet.
My left foot points outwards and my left knee is turned slightly inwards, especially when I try to straighten my foot. Do you think I have a left or right pelvic rotation? And if my foot points outwards, does that mean it is pronated?
Do you have Knock knees? I’d check that out first.
In regards to pelvis rotation, the pelvis can point towards any direction irrespective to the position of the foot.
A foot that point outwards can be pronated or supinated. You can determine this by assessing the arch.
I definitely have a degree of knee valgus in my left knee and my left foot is externally rotated.
I’m a bit confused because to improve knee valgus, I need to work on external rotation exercises but as my foot is externally rotated, doesn’t that mean my hip is already externally rotated? Sorry to keep asking questions, it’s confusing!
Your tibia might be externally rotated relative to your femur.
If you check out this post and scroll down to the knee section, you’ll find some exercises there.
If my right foot is pointing outwards, could that mean that I have a left or right pelvic rotation?
Thank you :)
Your pelvis can be rotated either way (and even be neutral) with your right foot pointing outwards.
I can’t decide which way my pelvis is rotated. My left foot is flat and my right foot points outwards. My right foot is quite flat but not as flat as my left and it has more of an arch. When I do exercises, it feels almost impossible to keep my hips symmetrical.
It is hard to determine which way the pelvis is rotating by just looking at the feet.
It is best to do the tests as mentioned in the blog post. If this is difficult, I would suggest seeing a health professional to assess you in person.
All the best.
Thank you for this post! My left foot is almost completely flat and my right foot points outwards slightly. When I do a squat or deadlift, my hips angle towards my right foot and my right knee started to hurt. Is this a right pelvic rotation?
Also, in the post, what does it mean to ‘suck’ your knee? I was just getting a bit confused.
If your pelvis faces towards the right side, this would be a right pelvis rotation.
“Sucking in” the knee involves internal rotation of the knee in the hip socket. Another way of describing it would be to bring your knee in towards the hip socket.
Hi Mark I’m not sure if I have rotated pelvis or lateral pelvic tilt? My QL on the right is tight also right shoulder and pecs tight. My right hip seems to be pulled forward and down hamstring on that side is tight. I do have limited mobility in my left ankle and a slight collapsed arch. What’s you thoughts?
If your right hip is pulled forwards, it sounds more like a left rotated pelvis. This would also place the hamstrings on the right on a stretch.
I also find that the pelvis tends to rotate towards the tighter ankle in my patients.
Mark hello my friend! My name is Alexander, I am from Russia. I want to say thank you very much for your work. You are a great person. Your site is awesome!
Help me please, I’m ready to pay or make a donation, I really hope for you.
There was a knee injury, the leg was weak and then I twisted my leg and the problems began. Something happened to the muscles on the left side of the body.
1. My left shoulder is turned inward, my upper trapezium and pectoralis are shortened.
2. The left shoulder blade is higher than the right one.
3. The left ribs stick out more than the right ones. The chest also looks to the right, the left sternum protrudes more. Also, the left ribs are lower to the side of the pelvis than the right ones.
4. The left thigh rotates inward, the pelvis looks to the right (the left pelvic bone is turned slightly forward). But on the left side, the pelvis is higher than on the right, if you stand straight and keep your legs straight. And if you get up and relax, then the left bone seems to be lower and in front. Or is it a compensation of the legs or it seems to me? The posterior pelvic bone is always higher on the left than on the right. I can’t figure out whether the pelvis is turned to the right (rotation of the left pelvic bone forward in the sagittal plane) or is it just all higher on the left side (frontal plane)? I’m confused.
5. The gluteus maximus muscle on the left is tense and smaller than the right one. Also, the gluteus maximus on the left is slightly higher than the right when viewed from behind.
6. The thigh bone of the left leg is higher than on the right, especially if you lean forward with the body.
7. On the left foot at the bottom, the bone protrudes inward. Pronation of the foot. The size of the left leg has become larger, the foot has lengthened a little and it is weak. When you stretch your foot forward, the toes go up, something pulls them.
8. Lying down the left leg is longer than the right, but if you rise to a sitting position, the left becomes shorter.
Could it be because the shoulder was injured and weak now? Therefore, the pelvis turned. I want to understand who is to blame for this all, the shoulder or the pelvis? Or maybe the foot of the foot?
Please help me, Mark. I am very tired and confused. I always had good posture and I myself was a sporty guy. I don’t know which muscles to start with so as not to harm. This has been going on for almost 2 years. I have studied and read a lot, do a lot of exercises. But I’m not sure if I’m right.
Please help me understand. I will definitely thank you friend. There are no doctors in my city, they do not understand and do not know anything about this. I’m stumped, friend. I hope for your help, thank you again.
It sounds like your whole posture has reacted to your knee injury.
If this is the case- you will first need to make sure that your knee has completely recovered. I am not sure what is wrong with your knee but there are some general strengthening exercises on this blog post.
If your knee has recovered 100%, then the next thing to target would be the foot. If your left foot in stuck in pronation, it can bias the pelvis to rotate towards the right. I have some flat feet exercises listed here.
If your pelvis is still twisting towards the right, then try out all the exercises mentioned on this blog post for a right rotated pelvis.
If your pelvis is neutral and your shoulder is still uneven, you may have a degree of rotation and/or lateral bends in your torso.
These 2 blog posts would be there ones to target:
– Twisted spine
If your torso is neutral and you still present with uneven shoulders, then I would suggest that you have a look at these exercises for uneven shoulders.
Don’t get overwhelmed! Do one thing at a time and assess to see how your body responds.
Mark, I have questions.
1. My pelvis is turned to the right. Does this mean that the left pelvic bone rotates forward and the right one back? Right? Or is it another case, I don’t understand.
2. In the exercise to stretch the right side “Lunge forward” – are we stretching the psoas muscle? But after all, in theory, you need to stretch the left, or am I wrong?
3. In the exercise to strengthen the oblique muscles “Rotation of the pelvis while lying on its side”, which muscles do we strengthen? Outside oblique to the right and inner oblique to the left, or vice versa?
And also tell me, can the turned shoulder and flared ribs on the left side turn the pelvis and the whole body to the right? I think my problem might be over the shoulder?
This is very important and interesting to me. Please help me understand. Thank you, Mark!
2. It is aimed to stretch out the internal rotation fibers of your adductors. It gets a bit tricky with the psoas as you have to take into consideration what the lumbar spine is doing in reaction to the pelvis. It’s definitely involved with the pelvis rotation, but I would say it is not the main one (it’s a weak hip external rotator).
3. If you have right side down and twisting pelvis to left, it would be left External and right internal obliques.
Left rib flare is usually as a response to a right rotated pelvis. However – it works both ways as well. You can have the upper body affect what the pelvis does too.
Mark, thank you, your friend for the answer, you are a real person!
I will clarify:
1. Look, if my left pelvis is lower than the right one, there is a pronation of the left foot and also the inclination of the left pelvis forward, does this mean rotation to the right?
2. I read in your article that the rotation of the pelvis happens with the tilt of the pelvis? If the rotation of the pelvis is to the right, then the left pelvic bone is lower than the right one?
So the left shoulder will be higher than the right one? My shoulder and shoulder blade turns inward and I do not understand whether it is higher or lower than the right one.
2. So I need to strengthen the oblique muscles, as shown in the photo here above? Right outer and left inner? Can this be done in a simulator in a gym, rotation (left shoulder) of the body to the right? Oblique muscle trainer in the gym.
3. Should the psoas & iliacus muscle on the left need to be stretched?
4. If my left pelvis is lower than my right and rotates to the right, what muscles need to be strengthened on the left side? To lift the left pelvis up? Adductors, quadratus, gluteus medius …
5. The most important thing for me. My left foot has become longer, almost a one size larger, there is a slight pronation, which was not there before. I do not understand what’s the matter. And my toes, when you stretch your leg, your toes go up. Why is this?
Maybe you, as a professional, will understand why it is and who is the culprit: foot, shoulder or pelvis ??? I’m tired and don’t know what to do anymore, we don’t have good doctors. If you can help me understand.
I think many people have such a problem and they will find many additional answers in our smart dialogue, we will help them improve their health.
It’s a shame you didn’t answer my questions below, Mark. I wait and hope for your answer. Thank you friend.
I was wondering why the hips tends to rotate “away from the pronated foot and
towards the supinated foot” when it rotates “away from the externally rotated hip (ER) and
towards the internally rotated hip (IR).” That would seem to correlate foot pronation with hip external rotation. I read your post about foot pronation and it seemed like internal rotation was what lead to pronated feet? “An Anterior Pelvic Tilt can orientate the whole leg in a position of internal rotation. This collapse of the entire leg can lead to Flat Feet.”
So is it hip internal or external rotation that causes pronation at the foot? I just want to make sure I understand things before doing the exercises.
The SHIFT of the pelvis towards one side will tend to cause pronation of the foot on other side. (That is – a pelvis shift to the right will tend to cause pronation in the left foot). It is more so the relative position of the pelvis to the feet that causes the foot pronation/supination, rather than the rotation of the hip.
However -If the pelvis sits perfectly on top of the feet (ie. no shift), hip internal rotation would likely result in foot pronation.
I have been battling something wiring in my pelvis now for two almost three months, prior I was extremely active. Gym weights,HIIT, and I added Pilates. And I do yoga off and on. I started having some back issues that would radiate into my butt (around piriformis) and thighs…sometimes one side sometimes both sides. I was told I have some torsion form a craniosacral therapist and a chiro but not sure which way and why it would all of a sudden bother me. My posture is decent as I used to be a dancer…however my right foot has always been extremely rotated outwards compared to my left. I started doing your exercises last night but not sure if I should do all of it for both sides since I don’t know which way I’m rotated and perhaps need to strengthen areas I haven’t been. Is that ok? And based on my supination can you tell my issues? The back pain also originates normally in my side left SI/piriformis and my right knee can also sometimes have some pain off and on. I wish you lived closer! I need someone like you ? thank you for any advice you can give me! No one seems to know how to help me so I’m glad I found your site!
Sorry for misspellings…was texting too fast! Also, wanted to mention I can feel pain or discomfort In The sacral area sometimes as low as tail bone…I have had nerve sensations also after therapy so I stopped the chiro which my body didn’t seem to like and am trying to help my body heal itself functionally. Thank you again for your direction!
Radiating pain to the butt and thighs could be referred pain from a structure further up such as the lumbar spine, SIJ and certain muscles.
If your symptoms seem to jump sides, I would think it would be more related to the lumbar spine.
(A scan to the lower back should help determine if there are any structural issues in the lumbar spine)
Sounds like you have duck foot posture in you right foot. See post: Duck foot posture. This can occur in conjunction to a rotated pelvis.
To get the most of the exercises listed on this blog post, you will need to determine which way your pelvis is rotated towards. If the self tests are a bit difficult, you might need to get assessed by a health professional.
Thank you so much for these resources.
I do have left pelvis rotation, so I was wondering when I get to the section that is entitled “left and right hip exercises” do I do each exercise listed but on the opposite side that is mentioned? Hope this makes sense. Thanks!
For a left rotated pelvis, you will need to do all the mentioned exercises but on the opposite mentioned in the instructions.
I have a left pelvic rotation, can this also cause my upper body like my shoulder to rotate as well?
A rotated pelvis can orientate the whole body towards on side. This includes the shoulder.
In your picture with your left foot rotated outward, does that mean you are rotated to the right? I’m confused with myself because my right foot is outward and my whole right side is very weak. My glute medius tightens up so bad when I go walking. I feel like my left side(which doesn’t ever hurt) is taking the blunt of everything and the leg and glute appear bigger than the right. I’m not sure which side I should be focused on. I’m assuming the weaker side(right) with the foot outward would be the one to strengthen. I also was confused if I’m rotated to the left or right.
The picture shows the left foot is turned outwards and the pelvis is rotated towards the right.
Keep in mind – you can also have a left foot that is turned outwards and have a pelvis rotate to the left.
If you are definitely weaker on the right side, I would encourage you to strengthen it with single leg exercises such as step ups, lunges, single leg hinges etc
Thank you so much for responding, it means a lot when professionals answer back. I appreciate all your information and the time you put in to do all these exercises. I started the rotated pelvis exercises last week, they do help. Since you’ve answered my question, today I’m going to start the single leg exercises.
I have a lateral pelvic tilt to the right. Due to the overload my quads and glutes on the same side are very tight but my hip abductors are weak. I think because of my tight quads, my pelvis is rotated to the left and because of my tight glutes my right leg is externally rotated. My glutes and hamstrings are much weaker on the left and also my adductors. So I got a little bit confused whether I should strengthen my right adductors or not. Should I adress the lateral tilt first and then the rotation?
Kind regards, Jerome
I generally go after the rotation first.
It sounds like you need to do more generally strengthening on that left side. Single leg exercises such as step ups, lunges, single leg squats and single leg hinges are great for this.
It might just be a matter of getting the left side to tolerate your weight better.
Your site has been an awesome tool for me.
Despite having a PT I go to and watching YT videos and reading some
journals, I find the information your site has to be most organized
and applicable to me. Once again, I really want to say thank you so much.
I have a pelvis that is rotated to right and rotation of the ribs.
My right side of pelvis seems jacked forward (anterior tilt?) whereas my left side of pelvis
seems to slump back (posterior tilt?), and the right bottom portion of my left ribs flare up whereas my right shoulder is severely rounded and slumps down.
This is a long term alignment issue and my body feels like its stuck with all the force on the left side. It’s like my body does not want to accept the weight/pressure on it’s right side.
Would doing the pelvis rotation program + spinal rotation program help with my issue? I have been doing them and see some improvements, but some days, my right side gets tighter and restricted than ever.
Right side hip deals constantly with over active TFL, priformis problems and glute med that just does not want to activate..
Thank you so much hooking us all up with this gem of a site man.
Thanks for your kinds words.
Can you please confirm if I have the following correct:
– Pelvis rotated to right
– Left flared ribs
– Right lower shoulder
Which leg do you tend to place most of your weight on?
Thank you for posting all of this helpful information!
I have a left pelvis rotation, and I went through all of the exercises doing the opposite side for the right pelvis rotation ones. I just have one question
for left hip exercises #3 strengthen it says
Aim: Strengthen the muscles of the left hip that rotate the pelvis to the LEFT.
for right hip exercises, #3 strengthen it says
Aim: To strengthen the muscles of the right hip that rotate the pelvis to the LEFT.
Do I need to strengthen the muscles on the side my pelvis is rotating or should it be the opposite side?
Also, for b) Rectus femoris exercise it says to use an exercise ball to move in a circular motion but it looks like a foam roller is being used in the picture. Do I do an up and down motion instead of a circular motion if using a foam roller, or is better to use an exercise ball?
You will need to do exercises for both the left and right hip for a rotated pelvis. Both hips (and not just one) are used to rotate the pelvis back into the neutral position.
For the rectus femoris release, you can use either a ball or foam roller. I tend to use the up/down method for the foam roller and the cicculat motion of the massage ball.
Both are completely fine to use.
Hey Mark I’ve been working with someone in the PRI space trying to fix some issues and basically it seems like i have “Left AIC Pattern” which to me translates to a right rotated pelvis along with left anterior pelvic tilt.
It seems like the overactive muscles won’t let go and it’s hard to get the weak muscles strengthened up and to turn on and do their job throughout the day. Thoughts?
Hey Taylor, if you are keen to go down the PRI route, try to stick to the easier exercises to avoid the overactive muscles compensating.
The hip shift against the wall is an exercise that you will need to get efficient at performing.
Alternatively – you can perform releases of these over active muscles before performing your exercises.
When I do all the checks to myself, it definitely looks like my pelvis is rotated to the right. I constantly have a tight left glute medius and TFL, but at the same time, it feels like my glute max is shut off. The other thing is though, I tend to get more of SI joint and/or sacrum low back pain on my right side. Does this all make sense with a right rotated pelvis?
Also, I wanted to mention that my left leg seems to rotate outwards. When I stand I notice my left foot is out to the side more. When I lay flat on my back my left foot falls outward more than my right.
And moving up the chain, my right shoulder tends to be higher than my left and I get this overwhelming tightness in my right scapula area.
Is this all due to a rotated pelvis to the right? I assume the torso is trying to counter-rotate to the left.
Yes – the mentioned presentation seems to all go with the right rotated pelvis.
As a follow up, it seems like I have a counter-rotation happening in the thoracic spine/ribcage going to the left. I get this stiffness in my right side and kind a general stiffness between the shoulder blades as well as a tight right scalenes.
I notice I tend to put more of my weight in left foot.
And I know that in this situation, usually the right shoulder is lower than the left but in my case the right shoulder is higher. What would cause this?
Looks like the muscles on the left side of the torso have counter rotated (and tilted) to a point where the right shoulder is now higher.
It is likely you will need to do some exercises for the tilt in the spine as well once the pelvis has been addressed.
See post: Scoliosis Exercises.
Hello Mark. Thanks for this helpful information. If you have a right rotated pelvis, would it cause left side pain on the ilium bone area. I have chronic pain in this area. I just had one spine decompression machine session. Didn’t help that much. Do you think these sessions will help along with your exercises. Thank you.
Yes – a pelvis rotated to the right is commonly associated with a left lower back pain.
Sounds like you are referring to traction to the lumbar spine. This can help if you are quite compressed.
I have other was to help you decompress your back.
See post: Spinal Decompression at Home.
I can’t thank you enough for this post. I’ve been going through these exercises daily and they have helped so much. My gait has improved, which has reduced the pain I would get in my calves when walking. It also feels like I have so much more space to squat deeper, and when I squat, my knee no longer clicks. Thank you! Currently on furlough but I will definitely donate once I get back to work.
All the best,
I love these kind of comments! Thank you so much for taking the time to write to me.
Awesome to hear you responded really well to the exercises!
I got left rotated pelvis (did all the tests you have). There is one thing i would like to understand. When i do pelvis reset exercise in the beginning, i do not feel any strong contraction on my right side when my hand is above the knee position. Also, same happens when doing some tests for hip flexion especially above 90 degrees. This show me that my right Psoas is weak. Could it be also related with my left rotated pelvis? Rotated Pelvis cause this or weakness in the psoas cause the rotation?
Hi Mark, First of all I want to thank you for the information you give out on this blog. Pretty sure you’ve helped a lot of people.
I’ve had a left pelvis rotation so I do everything in reverse. Your exercises are the only ones that have worked for me. I’ve been doing them for over 2 weeks now and every time I finish the whole set my pelvis goes back where it should be, in neutral position. For a day or two it feels great , but unfortunately I can’t seem to maintain that position once I start doing house or yard work. Even doing the elliptical seems to take me out of neutral. I do the forward lunges, and practice sitting and standing as you mentioned but still can’t seem to keep the neutral position for long.
My question is, if I keep doing all of these exercises for a couple months or more do you think my body will eventually learn how to maintain that neutral position. I don’t mind doing them but I would just like to think that in time the neutral position will become permanent.
Thank you for any information you can give me!
Great to hear that you are responding to the exercises!
It sounds like your body is reverting back to the left pelvis rotation once you start to load/challenge the pelvis. This is because your muscles are not used to using your pelvis in neutral YET.
This is quite common and will get better as you strengthen the muscles that are maintaining the pelvis in the correction position.
If you know certain activities causes your pelvis to go back to default, try to make a conscious effort to keep the pelvis neutral whilst performing the activity.
Thanks so much for your reply! Yes, my body reverts back to left pelvis rotation when challenged
In your response you said it will get better as I “strengthen the muscles that are maintaining the pelvis in the correct position”. So just to be clear you were talking about your exercises to CORRECT the rotation, not just the walking lunges and single leg dead lift, correct?
Again, I can’t thank you enough for all the help you’re giving to so many of us, I can actually walk a normal gait again for the first time in over a year. God bless you!
Yes – the exercises in this blog post will help maintain the correct pelvis position.
But you will also want to practice keeping the pelvis neutral whilst doing other general exercises such as lunges, dead lift etc.
You are awesome, thank you!!
I have the exact same conditions just rotation to opposite direction (left rotated pelvis).
I got this condition since i injured my right ACL.
When i stand my right leg my body immediately turns inward (to the left) also my right leg is in external rotation constantly (feet directed towards outside). For the other side (left) i have hyperextension at the knee. Why these happen?
Also, i have tight quads on the right side (i can not flex/bend my knee above 90 degree).
After completing your session (doing for the opposite side) I felt better.
It is common to have a hyper extended knee on the left side if you:
1. tend to stand most of your weight on your left side.
2. pelvis rotated to the left.
(I have a blog post on Knee Hyperextension coming out in a few days. Be sure to follow me on Facebook to get notified when I post it.)
Hope the exercises helps!
But my asis on the right side is more forward than left one. Isn’t this left rotated pelvis?
HI, Sorry, I meant to write pelvis rotation to the LEFT in my reply. I will edit it.
Thanks for the great explanation!
One last thing why the right side of my body is stiff and limited (mobility) and the left side is hypermobile? Any reasoning behind this?
Thank you for your post.
I have a question about postural control concerning rotated pelvis.
How do i maintain posture with this asymmetry when it comes to pelvis position. I have an arch on my right and my right glute is weak. I noticed that i have to arch my back from the left to activate my right glute. Otherwise its stuck
If the neutral position won’t hold by itself, do i just keep activating the muscles, you suggest in these exervices.
I have a right pelvis rotation.
Is the left aic pattern the same as having a pelvis rotated to the right?
Yes it is. However – if you follow PRI principles, it is not usual to have a left pelvis rotation unless your organs are reversed in position.
Hi Mark thanks for your help
According to what I have read Mark “The left AIC pattern” is when you have a rotation to the right.
Or maybe I’m not getting it right?
I leave you the link to the “Left AIC pattern”
This is correct.
Hi, the last chiropractor I saw told me that : “Your sacrum is posterior on the left (forward nutated on the right), and the Right PSIS is posterior and inferior”
I was wondering if I should then do the same exercises you showed on this page but my opposite leg?
I just recently found this site and I match all the criteria for a left rotated pelvis (but really the entire left side of my body is rotated). My right pelvis is forward of the left, belly button is rotated left, I have an IR left leg/ER right leg, my right shoulder is forward of my left, etc. In addition to being rotated, my left pelvis is also tilted forward more (my left iliac crest is higher than my right – I assume this is a slight hip hike on my left?) causing my left rib cage to flare out more relative to my right, and my left shoulder is sunken in and lower than my right shoulder. With that said, I have two questions:
1. Just to make sure I’ve reading the exercises correctly, because you state these are all for a RIGHT rotated pelvis. The very first exercise is 1a – releasing the external rotators under LEFT hip exercises, does this mean I should be doing this for the RIGHT hip since I am fixing a LEFT rotated pelvis?
2. Do you recommend working on these exercises, or the ones you have for Lateral Pelvic Tilt as well? I say this since I mentioned my left hip is also tilted forward causing my left iliac crest to be higher than my right.
Thank you, and I just want to say I am very happy I found this website and hope it can help me correct my body.
1. Yes – you do all the same exercises, but on the opposite side mentioned on this blog post.
2. Start with the rotation. Get the most out of these exercises. Then if required, switch to the lateral tilt.
My belly button moves towards right and my left abs feels weak and when bracing its hard for left side to pull in and brace
When I do the groin stretches: forward lunge and half butterfly on my left leg (doing everything backwards for a left rotated pelvis)–I am only feeling these in the outside of my hip, not in the groin as you say i am supposed to. I also find that I am unable to keep my pelvis facing forward during either of these. Wondering if there are alternative stretches that may work better in my case? Been doing them for a week or so and this wont seem to go away
Also on the pelvic rotation in side lie i cannot for the life of me get my pelvis to move independent of my knees and back.. wondering what that could mean
If you can’t feel the groin stretch, you might have limited hip external rotation.
If this is the case – you probably can not get deep into the range to feel the groin stretch. Instead – focus on the releases for now.
I am a teenager and I think I don’t have the symptoms for rotated pelvis but more like internal rotated leg. To describe it more precisely its like when I am standing my knee is internal rotated while my tibia and foot external. And it looks very ugly and makes me self conscious. And my tibia is also not straight. Also I believe I have weak muscles becuz I have hip dips too. And once I noticed the that I have flat foot. What I need from you is I hope u can suggest me some exercises for them.
Thank you ??????
Do you think you have Knock Knee?
Check out this post: Knee valgus exercises
As I’ve been searching on web since years ago, right rotated pelvis can be a part of classic right handed posture ( left rib flare, left anterior iliac rotation, low right shoulder). Your post is far the best post about this pattern, but I have a little confusion. My left foot is supinated and right foot is pronated but my pelvis facing away from the supinated foot (right rotated). However I’m more stable on my left leg (vestibular dominant), and even if I am standing on both feet, I tend to lean towards the left leg bearing more weight on it, however this is my functionally longer leg. (Actually my left knee is further forward if I’m sitting with bent knees.) One more thing: my left si joint is stuck, and my right is hypermobile (clicking is some movements) however pelvis still remains facing right. Do You have any further advice or modifications for me, or I need to do everything as You described.
Thank You :-)
Gabor (from Hungary)
Do you tend to lean on that left side more? This might explain the supination in the left foot. Oh wait, I just read more of your comment and you just mentioned you do.
If this is the case, you might be presenting with a lateral pelvic tilt. To address this – I feel that you would need to do more single leg exercises on that right side to teach is to accept load.
A longer left knee in sitting is usually due to the pelvis rotated to the right.
With a right rotated pelvis, the Left SIJ is compressed and the Right SIJ is less compressed. (which seems resonate with what you have mentioned). Addressing the pelvis rotation back to neutral should help with this! If that Left SIJ won’t move, you might need to do some Muscle Energy Techniques for an anterior inominate. Best to look on youtube for this!
What if both my hips were internally rotated and my left leg was more forward. Would the exercises change, I see your saying here that the forward leg is externally rotated and the other is internally but both mine appear to be rotated inward just the left is more cause both my feet are pronated, the left is worse though.
If your left hip is in front, this would suggest at right rotated pelvis.
You can have internally rotated hips with a right rotated pelvis. (perhaps you have knee valgus?)
This would mean your right hip would be in a significant amount of internal rotation. If this is the case, I would focus on regaining more external rotation of the RIGHT side to help bring the pelvis back into neutral.
This might help place the left side in a better position as well.
This is extremely helpful thank you! Seeing improvements just on day 1 of trying this. I’ve been going weekly to a chiropractor for almost 2 months and can’t seem to make it past that time frame without going backwards/being in pain. I am pregnant and rotating to the left. Is there a certain way I should sleep at night to try to help things out? I normally am on my left side with a pillow between my knees and slightly under my belly.
Thank you for your time!
If you have a pelvic rotation to the left and want to address it whilst sleeping (and you prefer to sleep on the left side), place a pillow behind your back/pelvis (length ways to your torso) so that you can slightly roll the right side of your pelvis backwards.
In this position, the left knee should appear to be further away from you as compared to the right side.
Hey Mark, I have left pelvis rotation (pelvis faces to the left). My left leg is internally rotated and right leg is externally rotated as well as my feet have arch’s that match your description. So your article explains what I have perfectly. To take it a step more, my pelvis also shifts to the side, over my right leg. Like I’m pushing my hips to the right while they face to the left. My right shoulder is also lower so it appears my right hip is higher. My left leg is also always hyperextended, I suppose in order to bring my left hip level to the right. Is this how it usually presents itself, with the hip higher on the side that it rotates away from. I know you have another article great article on lateral pelvic tilt. But if you combined the two is this how it should present itself?
You can have a rotated pelvis to either side in combination with a left or right hip hike. It really depends on how the body has compensated.
Your left knee hyper extension is probably linked with the left pelvis rotation. If you have a higher right hip, you are probably shifting your weight more so on to the right hip. If you have a lower right shoulder, I would think that perhaps the right latissimus dorsi muscle might be tight (along side the Right QL).
Generally speaking – I would go with addressing the pelvis rotation first and see how the body responds to that. Sometimes it might even correct the lateral tilt.
Might also be an idea to assess for any twist in your spine. See post : Twisted spine.
Thank you so much for the reply Mark! I need a little more clarification:
1. Can I start addressing forward head posture even when neck is in this twisted state?
2. When you say to release and stretch the tight muscles before doing the strengthening exercises. Do you mean to do that for each exercise session or do you suggest that I first only do the release and stretches for some time before moving on to the strengthening exercises? Also, I have been told I am hyper mobile. Should I still do the stretches?
3. For APT, do you advise to purposely put the pelvis into neutral position when you walk, stand or even lay down? I have been trying to do that for a while now thinking it will help but I am starting to think I caused more issues because it feels like there is more pressure on my knee and feet when I do that. I also have flat feet that I am working on addressing which I know is a huge culprit for APT. Lately I have been doing the short foot stance with my feet when I walk and stand instead of forcing the neutral pelvic position as that feels like it stabilizes things more instead of feeling like I am forcing my pelvis into a position it is not ready to be in. What do you suggest? Because you have mentioned for pretty much all these postural issues, what we do in our day-to-day outside of these corrective exercises are important to see change
1. Yes- but the exercises will be even more effective if you weren’t in a twisted starting position.
2. If you are very tight, you will be better off focusing on stretching/releases for a couple of weeks as to make the strengthening exercises more effective.
If you are hypermobile, it is not likely you have true tightness. You may be experiencing tension in a muscle as opposed to tightness in a sense of losing muscular length. In this case – go with strengthening straight away.
3. Yes – but be subtle. It shouldn’t feel like you are forcing it as you will lead to other areas compensating. Think of it as correcting it by 10% as you are walking.
If you find that addressing the feet automatically corrects the pelvis, you might be more effective at directing your attention to your feet rather than your pelvis.
Hello Mark. I’m hsving difficulties understanding one thing. If someone’s pelvis is internally rotated, and so is his tibia and the foot is pronated, what should (which muscles) that person be stretching and what should be strengthened? What muscles are shortened and what are lengthened?
Thank you very much.
Hey Karlo, When you say “pelvis is internally rotated”, I assume you mean the HIP is internally rotated?
If this is the case – then you would want to stretch the groin muscles responsible for internal rotation, and then strengthening the glutes (external rotation).
Yes, thats what I meant. Thank you very much for the answer. I have a follow up question, are external rotation of the hip and external rotation of the femur two separate movements or?
External rotation of femur is same as external rotation in the hip.
I can’t thank you enough for what you are doing for people like me. The information on your site has been SUPER helpful!
I need some guidance on a couple of things and would really appreciate your help. I have a lot going on at the same time: anterior pelvic tilt, right pelvis rotation, right lateral pelvic tilt, hunchback posture, rounded shoulders, forward head posture, Dowager’s hump, patellar femoral syndrome, right supinated feet and flat feet (both).
1. I understand this is a process and not an overnight thing, but I want to start working on all these issues at the same time. Is it possible to do that without aggravating symptoms? For instance, say I am trying to do Glute bridges and planks to help with anterior pelvic tilt, would that worsen the pelvic rotation and lateral tilt issues since there are a lot of muscular imbalances
2. When there is a rotation of the pelvis, does the neck follow as well? I read your post on a twisted spine, but I can’t find a post on a twisted neck. It feels like that is what has happened to me. In my case, my pelvis is rotated to the right, and It looks like my neck followed as well; since I need to look straight ahead, my head moved to the left thus the twisted neck (this is my assumption so please correct me if I am wrong) Since I also have a right lateral pelvic tilt, my shoulder is depressed on the right, making those neck muscles on the right pretty flaccid. Any suggestions on how to deal with this issue? Also, It’s very hard to do chin tucks to address forward head posture when my neck is in this state because my neck is completely uneven and I am afraid doing chin tucks will only make the imbalance worse. What do you suggest?
3. Do you recommend incorporating a light yoga flow while doing these correction exercises or do you think I should wait until things improve? Would that create more imbalances?
1. You can tackle all issues at once, but this can be quite overwhelming (… and time consuming!)
My suggestion: Focus on 1 or 2 of the main postural distortions. Get them as good as possible. Then move onto the next.
If you are wondering which one to start with, that would depend on what symptoms you persist with. If you have issues equally on both sides, you probably should start with anterior pelvic tilt, hunch back or forward head posture/dowagers.
If you present with asymmetrical symptoms, go with the pelvis rotation or lateral tilt ( i tend to go for the rotation first).
2. With pelvis rotation, there will usually be some sort of counter rotation that occurs in the spine and/or neck. In regards to your neck position, Your assumption that the neck needs to compensate for the pelvis is 100% correct.
By the way you are describing things, it sounds like you need to address the rotation first. Start with pelvis. And then work your way through the twisted spine exercises.
The neck should start to sort it self out if everything below it is balanced. If not – you will need to do specific exercises for that as well.
3. This is 100% fine to do.
Hope the answers help you!
As per your blog I have left pelvic rotation but when I visited to my doctor he told me right..
He was talking about something right stance PRI..
When I went home and search then I found pelvic restoration institute..after digging more found that it is rare to have left pelvic rotation..
So it is possible to have left rotation? Because you also describing on blog as right pelvic rotation not left …
I believe you can be rotated to either way.
However – I do find that many people are rotated to the right.
According to PRI, you would have a left rotated pelvis if your organs were all on the opposite sides than where they are normally.
As I told you previously that I have left pelvic rotation and have corrected 80%..
Problem now is my left leg has corrected as it is rotating outward now but still it is backward and right leg is forward..
When stand on right leg..knee turn inward and feeling tention/bit pain in right foot arch..
Should we only do the left hip exercises on the left and the right hip exercises on the right?? I thought you should always repeat the exercise / stretch on the other side too?
As a rotated pelvis is an asymmetrical position of the pelvis, you do not want to address the left and right hip equally.
This is why there are different exercises for the left and right hip.
Is there a typo in your post? For the first part when you talk about
[Left Hip Exercises] – you say that these exercises are to help the cause of a right pelvic rotation? do you not mean left pelvic rotation?
[Left Hip Exercises]
Aim: Reduce tension in the muscles of the left hip causing a right pelvic rotation.
Then when you talk about [Right Hip Exercises] – you also say these exercises are to reduce right rotated pelvis again?
[Right Hip Exercises]
Aim: To reduce tension in the muscles of the right hip that are pulling into the right rotated pelvis position.
Or is it not a typo and I am supposed to do both of the left and right hip exercises above as noted as I have right rotated ilium?
You will need to address both left and right hip if you want to correct a rotated pelvis.
after coming to know i have left pelvic rotation i am doing your exercise from last 1 month but now my left leg is almost externally rotated to 10 o clock… and i did not see any improvments ..then by one post i come to know that i have weak gluteus medius and after doing side leg raises from last 7 days i can see bit improvement … i am confused what it can be…because my all symptoms match with you mentioned in post…
About how many times a week would you recommend doing these stretches and exercises? Also, in approximately how many months should I expect to see an improvement?
I would start with 2-3/week and then adjust accordingly. More the merrier!
You should see some small improvements within a few weeks.
I recently had an injury where I stepped too hard on a rugged ground when I was about to kick a ball. Doctor labeled it a knee dislocation but I believe I have more complicated problems as what I felt was more of a structural mess up rather than a knee one. I checked your tests and it appears I have a left pelvis rotation. Not only that I have been having ITB issues where something feels like it pops out and back in, I have been having issues of pain in my hamstring and right below my buttock when I try to rotate my left foot to its most rotated left position laying on my back. My hamstrings on the injured foot are extremely weak so are my quads. What do you recommend I do? When I do hamstring exercises the ITB issues seem to calm down for a while, specifically hamstring exercises that target my lateral hamstring (by putting foot pressure in a supine position). It’s a whole lot of here and there and in depth issues (let me also mention I have had historically weak glutes I never worked on), so please give me some sort of guidance. Again, I have a left pelvis rotation based on the tests. Thank you.
ITB making a popping noise is called ITB friction syndrome. It’s where the ITB flicks over a bony prominence in the knee.
ITB issues are generally linked to a poor hip control. Poor hip control could be related to your rotated pelvis.
If your hamstring hurts as you rotate your foot outwards, this may suggest a strain to biceps femoris.
If this is the case – you will firstly need to rehabilitate the injury. Strengthening hamstrings is the way to go. (dead lift, hinges, curls etc). From here, make sure you have good hip control. Some exercises here might help: Gluteus Medius Exercises.
Thank you in advance for taking the me to read this. I have been having pelvis/hip issues for the last 2 years and I do not know what to do. I have done PT, AIRROSTI, Chiro, Orthopaedic Specialist, acupuncture, etc with no luck. I am currently working with a Chiro hat has been helping some, but can’t seem to get it all the way there.
All of that said, the current diagnosis is “left anterior superior and right posterior inferior pelvis”. I had a few weeks over the holidays that I was not able to see him and came across this article and thought I would give it a try. From that diagnosis, I did the “right pelvis rotation” series but things got worse over a few days. I then figured I would try the “left pelvis rotation” and it has helped quite a bit. After doing it most every day for 3 weeks, I went to the chiro for the first time in a while and he said that while it did seem backwards to keep doing it.
I am worried that since he agreed it seems backwards that this could be helping in some ways, but hurting in others and I should be utilizing one of your other progressions.
Thank you so much and I look forward to hearing back from you.
By the sounds of it, the left side of your pelvis is going upwards and the right side of your pelvis is going downwards. This is consistent with a left rotated pelvis and would make sense you are starting to see some benefit after performing the exercise for a left rotated pelvis.
Appreciate the in depth articleo have been struggling with a right medial knee injury for over a year.
I had been running for 18 months previous to this without many issues.
Towards the end of the 18 months, started with left sided ITB pain and a tight right hamstring.
Which I ignored…….
Have had steroid injections in my right knee. After being diagnosed with an MCL strain and then some degraded cartlidge.
Been slowly trying to improve my strength on the right side, due to muscle wastage after an arthroscopy.
The question I have is with all the above knowledge.
I have a right leg which points at 1 o’clock. Ext. Rotated??
Which is struggle to rotate internally.
My left leg is really tight in the hip and pelvis are with external rotation.
When I do the above tests, I see my right thigh as further forward.
Does this tally with everything I have wrote.
I also seem to have a Trendelenburg gait when running/walking. With a drop on the right side when striding on the left.
Again does this tally.
What would be the best way forward.
A trendelenburg sign on the left side suggest weakness in the left glute medius.
A weak glute medius can be linked with a lateral pelvic tilt with a left hip hike. Check out this post for more information: Lateral Pelvic Tilt exercises.
Weakness in the left glute medius could cause the left ITB (and presumably the Left TFL +/- glutes max) to compensate leading to ITB issues.
If the right thigh is further forward, this suggests a left pelvis rotation, however, it will be more accurate if you do the rest of the recommended tests as well.
Another thing I usually check in most people is the amount of ankle dorsiflexion in the ankle as this can cause a whole lot of lower limb issues (including the foot pointing outwards). For more info: Ankle Dorsiflexion.
On top of addressing any tilt or rotating in the pelvis, I would encourage you to get good single leg exercises. (Single leg squat, balance, lunges etc)
I really want to fix my rotated pelvis but I have a question before I begin. If I have a right rotated pelvis should I only do the exercises/stretches above that mention “…causing a right pelvis rotation”, “…causing a right rotated pelvis” , “…pulling into the right rotated pelvis position”, etc. Or should I also do the ones that mention a left rotated pelvis? I read the explanation above but I am still a little confused.
For a right rotated pelvis, you will just need to follow the exact exercises as mentioned.
Note that you will need to do exercises for both the left and right hips.
I am having a hard time identifying which side my pelvis is rotated. I took the test to determine which way my pelvis was rotated. However, for the ASIS method I got left pelvis rotation. For the thigh position I got right pelvis rotation. For the buttock position I am having a hard time identifying which side is forward, sometimes it seems like the left and other times it seems like the right. For the belly button I got left pelvis rotation. How do I know which way my pelvis is rotated. I want to start doing the exercises but I want to make sure to do them correctly.
P.S. I also have a right hip hike.
I would go with the ASIS method as the thigh method is not as accurate.
Hello Mark, Thanks a lot for all this! I have found out I have a “Left Pelvis Rotation”. My question: Does it apply to ALL of the exercises you give, that they are described for a Right rotated pelvis. So I should do ALL of them opposite? I guess what confuses me, is that you talk about “left hip exercises”, “right hip exercises” and “left and right side exercises”. Again, thank you so much sharing all the informaton in this post, I really appreciate it! Yours Charlotte
Generally speaking – for a left rotated pelvis, you will need to do all of the exercises mentioned, but on the opposite side.
I think part of my rotated pelvis problem is from glute atrophy. My left glute is smaller than my right glute, and I can’t seem to squeeze my left glute without my TFL and hamstrings tightening up. What would you recommend?
If you are trying to engage your glutes but other muscles are trying to compensate, try to make the glute exercise easier.
For example – you can try pushing your knee out against a wall whilst sitting. Push as hard as you can without engaging the TFL and hamstring.
I really love the amount of information you give, it’s really helpful and simple to comprehend, so keep up the good work…
In trying to figure out my lower back, coccyx and left hip problem one thing that is constant is that when I stand on my right root my body rotates (internally?) to the left a lot…It doesn’t really do this when no weight is applied and I only have a slight rotation when two feet on the ground.
Any ideas what muscle tightness is causing this? Should I just follow your fix it post?…I feel like I have a cascade of problems that run from here to left hip , then lower back (slowly going) and pain near coccyx (horrible), but I don’t understand which muscles are pulling/pushing all of it.
If I were to guess, it might be that you are using your glutes on the Right side to external rotate the pelvis towards the left. (as a way to stabilize your pelvis)
This suggests that you might be lacking control of the glutes in a more internally rotate position on the right side.
A simple exercise would be to hold onto something for support, and stand on the right leg without letting the pelvis rotate towards the left.
You can also check if you have limited hip internal rotation by checking out this post: Hip Internal Rotation.
Back in April 2020 I noticed I had a lateral pelvic tilt with a hip hike on the right side and a weak glute on the left side. I have been following the stretches and exercises on your post “how to fix a lateral pelvic tilt” since April 2020 up until now (January 2021). I’ve noticed little improvement. However about a month ago I noticed the right side of my hip is also leaned forward, I started doing research and I came across your post “how to fix a rotated pelvis” and I noticed my pelvis is also rotated. I completed the test andI believe I have a right pelvis rotation. My question is what should I do, should I continue addressing the lateral pelvic tilt even though I’ve had little results in 9 months or should I begin addressing the rotated pelvis?
If you have persisted with addressing lateral pelvic tilt for 9 months and there hasn’t been any significant changes, I would tackle the rotation and see if that also helps with both the rotation and tilt.
Keep in mind, if you have a weaker left side, the body may naturally want to stand on the right side giving a right hip hike. In this case – you would want to work on strengthening the left glute with single leg exercises.
Hello Mark!First of all thanks for all you are doing!
I have a left side hip impingement diagnosed through x-ray and MRI.
At this moment I find myself with multiple “areas” to fix.
*Right side rotated pelvis.
*Anterior pelvic tilt
*Duck feet with left side more accentuated
.Where should I start working?
I would usually start with the area of pain (ie. the hip), and go from there.
Try not to address everything at once as this is far too overwhelming.
would you suggest to start with hip impingement rehab?
Yes – if that is your area of pain.
Hi Mark, I have left pelvis rotation and have been doing these exercises for around 10 days now. Over the past couple of days I have been getting sciatica in my left periformis muscle. Any ideas on why this might be? Thanks Glen
You might need to address whatever is causing the sciatica.
If you have a history of bulged discs, these exercises might be ones to consider doing before addressing the rotation in the pelvis:
Bulged Disc Exercises.
All the best.
Thank you. I am definitely looking into the links you have me. I also have an issue of time. The exercises and things take time .. I work from 6 am to 430pm and with 5 children it seems hard to get it all in… Also what is better to try to do it in the morning before work or before bed.? Is there a way to simplify a routine for each day and compile a more complex one for Saturday and Sunday? How often should these be done, every day or… I work at a machine shop.
I have had 8 hip surgeries. They started around the age of 12 with bilateral scfe with severe external rotation. my first surgery was to pin, second was to remove hardware, third was an osteotomy on my right, fifth was hardware removal, sixth was osteotomy on left they had complications so that side was rougher once they had the top of bar inserted they had to bend it because it did not line up right, the seventh was hardware removal. This is where I stopped briefly … the pain never stopped.. I was 17 and told it was arthritis … then by age 19 I was told I had a bad hip impingement with bone spurs… I had been being told I needed a hip replacement and that i was too young. So I went on living and started my family… I had 5 children then last year in the summer of 2019 I had two more surgeries… I had developed a condition from having the osteotomies at such a young age which was causing over growth of the bone making the impingement worse and now I also had labral tears… They preformed an arthroscopy surgery on both sides to repair it. I finally had relief and for the first time in years went back to work in Jan 2020. I have started to have pain again. my pain is esp. in the left groin. I believe it’s due to p.t. being cut short. I have about a 6mm length difference in my left leg being longer. I have what I believe is a right rotated pelvis. And I’m currently pregnant with my sixth child. I’m due July 4th 2021. Any advice would be so welcome. I’ve seen what your posts can do and how much you have put into them and I thank you and hope you will continue these great works. happy new year.
Wow! That’s quite a few surgeries!
I have a blog post that specifically covers hip impingement.
Check out this post: Hip Impingement.
If you have had multiple surgeries to this hip, I would also assume that you may be lacking hip internal rotation.
Check out this post: Hip internal rotation exercises.
It is common for the pelvis to rotate AWAY from the side of pain. Perhaps in your case, your rotation is due to your pain, as opposed to it causing your hip issues?
With 8 hip surgeries, I would also assume that your hip stabilizers are probably weak.
Check out this post: Glute medius exercises.
Please have a read of those blog posts as I think they may be appropriate in your situation.
Hi Mark I am suffering from back and shoulder pain, a physio I am seeing tells me that I have a pelvis that is rotated to the left and a thorax that is counter-rotating to the right.
When I google this issue it seems to be referred to as ‘left AIC/Right Bc’. A lot of the info seems to suggest that its very rare or unheard of for the pelvis to rotate left and thorax to the right.
Do you think it is possible that I am actually rotating to the left from my pelvis and right from my throax or has my physio misdiagnosed me ?
The LEFT aic/Right BC pattern is based on Postural Restoration Institute principles. This generally means you are stuck in Right stance which involves pelvis rotation to the RIGHT, higher right hip, torso side bending to right, torso counter rotating towards the left.
You could definitely have a rotated pelvis to the left.
after doing your exercise i have almost corrected my left rotated pelvis nearly 80% but now i think i am not able to correct remain part . i am still performing your exercise but dont know why its not working or growth has slow down…? and sir i feel very little activation in clam shell exercise ..is there any variation like doing on 45 degree ..? and how would i know if i have corrected it i mean any specific indication ?
Great to hear that you have corrected 80% of your rotation with the exercises.
The remaining 20% (if it doesn’t come over time with the same exercises) will likely mean you will need to address other areas.
This could be addressing the foot (flat vs high arch) or perhaps even the spine.
Thank you for reply sir…do you have flat and high foot arch blog?.. can’t find..
From what I can tell I have a left rotated pelvis as my right thigh I more forward than my left.
Could you please help me with the following exercise?
For this exercise:
Pelvic rotation in side lie (Obliques)
Which side should I lie on please?
For a pelvis that is rotated to the left, the left side should be down whilst you rotate your pelvis towards the right.
I have piriformis syndrome and when I do my squats, I notice that I have hip shifts to avoid the pain. Overtime, this resulted in my pelvis rotating towards the left.
My question is:
Do I fix my piriformis syndrome first and then my rotated pelvis or vice versa?
Can I manage both at once?
Do I still continue with my barbell back squats?
Look forward to your reply soon.
I would address the painful area first (ie. perhaps release, stretches, activation exercises) to reduce your symptoms.
Once your symptoms are more tolerable, you can start addressing to rotation if that is your goal.
I would caution performing exercises that are reproducing your pain or causing you to compensate significantly. Perhaps you could try squatting with less depth/weight or stick to other leg exercises such as lunges, hack squat etc.
Thank you so much for this interesting article.
I have a short question: I have a light scoliosis and when sitting on the floor or laying on the ground, my left leg falls outwards while the right one is rather straight. Is this due to a pelvic rotation?
My doctor said it might be that the Femur bones are just at a different angle in the hip socket. But at the same time I often feel pain at my left outer hip (sometimes down to my left knee). When I am sitting on the floor, putting my feet together and dropping my right knee/leg outward, it always cracks and feels like I’m constricting it. Two others doctors could not really help me …
Are these exercise suitable for my problem? When standing I think my pelvis might be a little rotated to the right but I am rather worried why my legs seem to be rotating in different directions. Could it just be that my left gluteus is to tight?
I would appreciate it if you could give me some feedback,
I have been doing your exercise for 2 weeks and can I see physical results too?..I mean now I can see my right groin area is looking stronger and wider.. is it good indication? I have left pelvic rotation.
You will want the right groin area to become stronger to help address a left rotated pelvis.
thankyou for helping so many people for free.
i have left pelvic rotation and i think this problem came from when i started weight training.
now i dont feel my form is proper in gym while exercising. and i feel pain in my knees. what can i do about this?
and [IMPORTANT] when you say hip and knee bent at 90 degree in clam shell does it mean i lift my bend knee front of my body till it is straight to my hip in one side lying position. because i feel my form is not proper and it rotates my pelvis further to left.
english is not my first language.
I think you have made a mistake in the article? You state (and I agree) that when the belly button faces right you have a right pelvic rotation. However, if you then rotate the pelvis so that the belly button faces straight forward, the RIGHT thigh now sticks forward. You state however that left side being forward is a right pelvis rotation?
Thanks for the comment.
I’m not too sure what the exact question is but maybe this might help:
– If the right thigh is more forwards (and assuming that the right side of the pelvis of following the right thigh), then the belly button would be facing the left.
– If your pelvis is neutral (where the pelvis and thighs are even), then the belly button should be facing forwards.
Let me know if that makes any sense.
I’ve a chronic pain in lower left butt and left groin, and suffer from tight hamstrings.
1. Pain originates from left glute cheek/ sit bone (earlier looked like PFS but not)
2. Pain radiates from left glute to hamstrings over the knees, and back of the calves
3. Pain in psoas muscle on left
I still dont have any diagnosis from any physio yet, and really desperate to work towards the right rehab therapy. Can you please help advise, is there a video consultation possible?
It is very hard to give a diagnosis without a proper assessment.
Some ideas that you can run by with your physios:
– Referred pain from the SIJ
– Lumbar spine nerve impingement
– Nerve tension
– Trigger points in the glutes
Phenomenal article Mark!
I’m a 29-year-old golfer (in the little spare time I get) who used to play constantly in high school. Now that I’m really hitting weightlifting, I’ve noticed hip imbalances. I believe I do have right pelvis rotation (think of how a right-handed golfer shifts their hips) due to tightness and impingement in the left and/or weakness in the right. Squats have illuminated this imbalance.
So thank you for all these tips! Just did some and they definitely are helping out or at least addressing my weak points!
Thanks for the comment! Hope the exercises continue to help you out!
first of all, I would like to thank you for your detailed articles! I have a slightly rotated pelvis and lateral pelvic tilt on my left side (left hip hike), approx. 1 cm. I have this problem for a couple of months now since I had 2 herniated discs (L4/L5, L5/S1) and very acute back pain for 2 months. I want to do your exercises as a daily routine that could hopefully help me, but unfortunately, I still suffer from mild or worse lower back pain, and I do not know if I should wait until the pain is away. The problem is that I am not sure if my back pain (now its 6 months) did not go away because of the instability. My doctors cannot say, and one of them even told me that I will be crooked like that forever (he did not offer treatment, though…). I cannot walk properly, I am limping, and I feel pain in my hips after longer distances. I just do not believe that I will be pain-free until without a leveled pelvis, but at the same time, I am worried that I can make it worse if I do these exercises. What do you think? Thank you very much for your answer!
I would encourage you to get the pain under control first as some of the exercises that address the pelvis may actually make your lower back pain worse!
If your pain is specifically caused by the disc bulge in the lumbar spine, check out this post: Bulged Disc Exercises.
Once the pain is under control, start to address the pelvis.
I have bad hip and left glute pain…. been told I have a right lateral pelvic tilt, right anterior Ilial rotation and a separate left posterial ilial rotation. I was treated with PRP injections which was of no help. I don’t know where to start and everything I do hurts and seems to make things worse. I have seen so many people.
Is the hip pain like Hip Bursitis?
Hi Mark, the hip pain I guess is more the left side of my hip rather than the hip itself. Palpating of the muscle on the left side and all over the buttocks are sore and to the left of the sacrum. I do sometimes experience some dull pain down the back of the leg.
Every stretch and massage I try and do exacerbates the pain. Sometimes lying on that side at night is sore. It’s been this way for four months now. MRI showed nothing.
I appreciate your help. I’m struggling for answers.
Pain on the side of the hip, to the buttock, left of sacrum and down the back of the leg may suggest referred pain from the lower back.
You mentioned the MRI showed nothing. Was this a scan of the lumbar spine as well? Or just the hip?
Also, have a quick google search of “Piriformis syndrome” and see if that fits your symptoms.
Hi Mark, the pain could potentially fit perifomis however the peridot is stretches aggregate the pain. It was a pelvic MRI, however I have had two abdominal pelvic CTS last year and there was no mention of anything in the lumbar spine.
Can you have referred pain from the lumbar spine even if the lumbar spine isn’t sore?
You might need to get a specific MRI of the lumbar spine. Pain can refer down from the lumbar spine even though there is no pain present.
Have you tried sciatic nerve glides? Have a quick google search on the many ways of performing this exercise. The goal is to only feel a gentle stretch.
hello sir ..
as per your blog we should strengthen left side glute medius .
but clam shell is exercise for strength glute medius which you have mentioned for right side hip.
and you also have told to release it in right side but we are strengthing it by clam shell ..
please guide sir..i am confused..
On internet clam shell is for glute medius.
There is something anterior and posterior.
Would be helpful if MARK can EXPLAIN by COMMENT:)
I see clam shells as a good exercise for the posterior fibres of the glute medius.
Is it possible to have a rotated pelvis AND a lateral pelvic tilt?
In terms of your analysis of what muscles I should have tight/weak, it matches a rotated pelvis to the RIGHT. (Left hip feels slightly forward and pulled down whilst pelvis shifts towards right).
BUT from behind it looks like I have a slight lateral pelvic tilt e.g. On the left there is a waist crease and the left leg has all the problems, it feels mechanically wrong, it feels longer and its generally weaker.
I dont know if I should do the lateral or rotated pelvis exercises. I feel like the rotated exercises match more how my body feels, but there is definitely a leg length discrepancy that is caused by the tilt.
It is possible (and common) to have a rotated pelvis and a lateral pelvic tilt.
You can address the rotation first and see how your body responds. It might even help with some of the lateral tilt.
Hi, first thank you for helping other people for free.My left trap is higher than my right and also my right shoulder is depressed and little bit forward.I feel like all my right side is weaker than my left.Also my right hip is always tight and painful.Is enough to do just this exercieses for rotated pelvis to fix all this imbalances?
If the rotation in the pelvis was the main reason why the other postural deviations have occurred, then you should see a good improvement in all areas when addressing the pelvis.
(Not sure if my last comment posted) Please could you help me( I sustained an exercise injury back in May which caused a constant burning pain down my right groin and inner thigh. I admittedly sat and rested with bad posture for a long time as walking was painful. After a couple of months the pain eased but I noticed that both of my hips/sides were now painful to lean on in bed and I can feel them pulsing – is this hip bursitis? I also noticed that my hips will click during certain movements but causes no pain. Is this hip snapping syndrome?
More recently, I started having pain in my lower back (not dead centre) and after a lot of research I think the pain is coming from my SI joints. Sometimes it is right sided and sometimes it is left. I feel the right joint clicking a lot. I also feel pain/tension/tightness in my glutes, hips, thighs, hamstrings on a daily basis and struggle with sitting or walking for too long, my legs often feel weak and unstable. My hips are still painful to lean on in bed but now it is also painful to lie on my back. Does this sound like SI joint problem to you? Can this occur with hip bursitis?
Finally last week I noticed that my pelvis was rotated quite dramatically to the right. Could this be causing all of the above problems? Or have those problems caused a rotated pelvis? They all seem to be interrelated so I am confused and overwhelmed with information, it seems my initial injury has had a knock on effect on everything.
I wanted to ask whether I should address my pelvic rotation first? Or SI joint / hip bursitis first? Can these rotation corrections be done safely with other problems or are there ones I should omit? And lastly, how often do you recommend performing these exercises? Is once daily enough?
By the location of the pain, it is possible that it might be hip bursitis.
See post: Hip Bursitis Exercises.
A clicking hip is usually either the joint and/or tendons flicking over a bony prominence.
If you feel that it is a snapping hip issue, see post: Internal snapping hip syndrome.
If lying down on your back in bed with pain in the SIJ region, this could be a Long Dorsal SIJ ligament issue.
The body will tend to adopt a posture that minimizes pain. This could be the reason why your pelvis is rotated to the right.
I would tend address the painful areas first. (eg. the hip). Performing exercises 1/day is fine if your body can comfortably tolerate it.
Having said that – I would strongly recommend that you get a good assessment from your healthcare provider so that they can give you a diagnosis and specific advice on what exercise is best for you.
Hi Mark! Thanks for sharing this blog! Great information. I have a right rotated pelvis, lateral tilt, flat left foot, mild scoliosis, and lean left. I started last week to correct the lean and worked with the lateral tilt exercises. Not sure how to put this together. Thanks!!!
If I were to pick one area to start with, it would be to address the pelvis rotation.
In the long term, however, it is likely you will need to address all said areas.
Thank you for your content, it is extremely helpful however I’m having an issue with fixing my pelvis rotation. My pelvis rotates to the right just like in your post but my right foot pronates too. Is there anything I could do? I did the stretches and exercises and my pelvis still rotates with my belly button facing forward.
only one question-
in [Left & Right Hip Exercises] [ c ] hip shift on wall
do we need to keep one foot ahead compare to other. same in[ b ] ??
i have left pelvis rotation.
is it ok to use tennis ball for massage?
You can keep one foot ahead. It doesn’t really matter.
And yes – You can use a tennis ball to massage your muscles.
I just want to say thank you so much for the wonderful content!! Super eye opening!
I was reading your “rotated pelvis” article and figured out that I have rotated pelvis that is orientated to the left. In my case along with my hips to the left, my left neck (scalene and scm) are extremely tight. My left shoulder seems to be more rounded and left psoas is extremely tight.
I was wondering if you had any releases, stretches or strengthening exercises for the neck, shoulders and abs to help with hips rotated to the left. Thanks so much!! You are really changing lives and I can’t thank you enough!
Sounds like there might be a rotation in the torso leading to your neck and shoulder positions.
Have a quick look at this post: Twisted Spine.
I have anterior pelvic twist also my right side buttocks is sticking out. Also from my hip to knee my right leg is bigger in size, is this result of pelvic rotation ?
Also while sitting always I am leaning on my right side . I noticed my neck also slightly slanting down to left, what is the reason and suggest me what exercise and all I should follow??
Hello Mark, I started having right hip flexor and gluteus medius tightness about 6 years ago due to bad posture. It’s not really painful but more like discomfort, and I usually get temporal relief from occasional stretching. However, this annoying discomfort never really got away and then recently I came across your page and finally realize that my problem might be due to a left rotated pelvis.
So I have followed your above exercise faithfully for the past 20 days. I think I felt better for the first 10 days (less tightness, or even feeling perfectly tightness free and my hip balanced especially right after finishing the exercise for the day). But then for the past 10 days, I don’t feel that there’s much improvement (FYI I have also been constantly mindful to sit and stand evenly to keep a good posture). Sometimes after sitting for a short while (30 min), some tightness in my right hip flexor and gluteus medius comes back again.
1. As such, do you think that a left rotated pelvis is really my main issue? Because when I look at the mirror now, I don’t see much if any left-right imbalance or rotation in my pelvis, although I still have anterior pelvic tilt (on both sides) to tackle.
2. Should I keep doing the above exercises? I am not sure if I have done it correctly but I am having some knee pain doing the hip shift on wall exercise.
3. If I continue to do the above exercises for rotated pelvis, roughly how long do you think it will take for my pelvis to stay neutral?
Thank you so much for your advice!!
1. Addressing the pelvis might give you a % of the results. You might need to start to look at different areas of the body that might be contributing to your symptoms. (eg. knee valgus, flat foot, twisted spine etc).
It might also be that these muscles may be weak and need strengthening. Weak muscles can become stiff.
2. If you believe the pelvis rotation has completely resolved in standing posture, sitting posture and with movement, you can wean down the intensity of the exercises.
3. If you are able to correct it within 20 days, chances are it shouldn’t take much longer (maybe up to 6 weeks?). It might just be a matter of the body getting used to using the muscles in a certain way so that it does not revert back to the default settings)
Hi Mark. Great page.
Quick question because I am frankly abit confused.
My right hip is facing forward
I am getting the stretch on the right side.
Basically do I need to strengthen my left side more? This is what your page is showing
If the right side of your pelvis is more in front as compared to the left side, this would be classified as a left rotated pelvis.
In this case – You will need to strengthen CERTAIN muscles on EACH of the sides of your pelvis.
Thank you for helping people by sharing your knowledge. I’d like to ask few question if you don’t mind.
I did all those test you mentioned above and according to them I have left pelvic rotation. So I should do all those movements you showed but to opposite sides? My right glute isn’t firing as much as my left glute and it feels weaker. Also my right hamstring is tighter compared to left. My right hip feels like it has less mobility than my left hip. My right glute and hamstring ache when sitting prolonged on a car . So wouldn’t it make more sense to release my right hamstring and strenghten my right glute? I mean because if I mirror your movements shown above I’d be releasing my left hamstring and strenghtening my left glute even more, right?
Yes – for a pelvis that is rotated to the left, you will want to do all the same exercises but just switch sides to the side mentioned.
It is difficult to say exactly what you should be doing in your individual case.
Just make sure you are not confusing true tightness with FEELING of tightness as they are completely different things. In general – Muscles which are relatively stretched already may actually feel tighter.
Also – the glute is what is referred to as Tri-planar muscle. This just mean it moves in 3 different planes. You can be weak in one plane, but strong in the other. For example, you could be quite strong in external rotation, but weak in hip extension.
Hi Mark. You sent me to this page after I described my issue, even though I originally thought I had lateral pelvic tilt. I will say that I am very impressed because this is exactly the issue that I have. My chiropractor was wanting me to have adjustments done which included digging into the iliopsoas muscles, but I am worried that that would not be necessary given the expensive costs. So my question to you is that I am wondering if stretching, foam rolling, and strengthening will be enough to fix this issue of a right rotated pelvis? I am very thankful for your site and the fact that you offer all of this for free is a real testament to your character.
I think the most important thing is to understand why you are having your issues. What is the root cause?
Once you know this, you can implement the exercises yourself (as mentioned on this blog post).
If you were to see a health care practitioner, I would encourage you to ask them what exercises you can do for yourself, as opposed to completely relying on a treatment.
I have my right illium downwards and sticking out more at my right, does this mean I have a left pelvis rotation?
And I think my torso also rotates to the right.
The exercises for a left pelvis rotation, you said do the exercises on the opposite side, so where u mentioned exercises for the left hip, does that mean I will do the left hip exercises for the right hip, and the right hip for the left? Is that doing the opposite?
Yes, this would suggest a left pelvis rotation. (provided that you don’t have any major SIJ laxity issues).
The exercises mentioned on the blog post are for a right rotated pelvis. If you have a left rotated pelvis, you can do just do the same exercise on the opposite side.
So I just recently realized I have a left rotated pelvis before I assumed I had a right rotated pelvis and I had been doing exercises for it for like a week. If I start the correct exercises instead would I encounter problems??
And lately I’ve been feeling tightness in my left side neck, is this because of the wrong exercises I carried out??
Performing the exercises for a right rotated pelvis when you have a left pelvis rotated may have encouraged your pelvis to further rotate to the left.
Due to this reason, it could be the reason for your said left sided neck symptoms.
You should be fine to start the correct exercises.
Mark….what if my pelvis has become “locked” in a posterior tilt due to a fender bender.
I am unable to push my pelvis to the floor. Please help!
Hey Barbara, do you mean you can extend your lower back?
I appreciate your post and would like your advice.
I have along history of rotated hips, incorrectly diagnosed leg length discrepancy, piriformis issues, and ITB issues. Also, recently identified scoliosis, which I believe is functional as I never had this identified as a child.
Recently, right hip feels more forward, but PTs tell me they are in alignment. Since beginning prescribed stretching and strengthening right piriformis in spasms and entire glute & hip has knots and painful spots. When lying flat on back, entire right leg from butt to ankle does not lay flat against the surface and is higher than the left leg. PT says due to tight hamstrings and old medial meniscus scars. I think it is the hip. How to help identify and how to correct.
If your pelvis is level but do these exercises for a rotated pelvis, this could lead to imbalance!
If you indeed have a left rotated pelvis (right pelvis more forwards, lower limbs aligned), performing these exercises should help address this.
If you feel your whole right leg is lifted off the floor, you may also have a right rotated torso. (See post: Twisted Torso)
I am generally confused on what to do as I’ve been struggling with this for years. Any help you can give would be much appreciated.
Here are my symptoms: Left hip hike, pelvis is rotated to right(left side is forward in both thigh and buttock position exactly as your pictures show). I used to have a pronated right foot, but I’ve fixed it almost completely, yet my hip hike and pelvis rotation remain. I’ve noticed when I do bridges lying flat on the floor that my left hip gets stuck(where my pelvis and leg connect) and I can’t get fully flat(knee to upper torso being flat while doing a bridge). Instead of it being a nice flat line, something is stuck there on my left side right at that point. My right side is fine and can form a full extension bridge.
I’ve read your lateral pelvic tilt post and this rotated pelvis post and I’ve noticed a lot of the excercises overlap, but say different things as seen below:
Lateral pelvic tilt post(left hip hike) – stretch left side
Right rotated Pelvis – stretch right side
Lateral pelvic tilt post – strengthen left side
Right rotated pelvis post – strengthen right side
Lateral pelvic tilt post (left hip hike) – Push out left knee, suck in right
Right rotated pelvis – Suck in left kene, push out right
I’m not sure what exercises to do at this point. Could you help?
Hi, Mark, I have one question, will the rotation of pelvis affect the stability of the head and shoulders ? In my case, I have left pelvis rotation and I feel that I have rotation of torso and the head as well. Should I do other exercises apart from the exercises u recommended in my case ???
Pelvis rotation can lead to changes in the position of the head and shoulders.
In many cases, addressing the rotation may improve the resting head and shoulder position as well.
First of all, thank you for putting such a great informative content.
I have confusion what should I follow regarding content on lateral pelvic or rotated pelvis?
I always found my right hip to be higher. So recently did a whole spine x-ray. The x-ray report points out that I I have bifid spinous process seen in L5 vertebra. Although right hip from x ray seems up as well compare to left.
Any guidelines to fix this.
To address a Right hip hike, check out this post: Lateral Pelvic Tilt.
If the hip is only slightly higher, it could be from the pelvis rotation.
Hi marc if i have hip hike on right side which way would pelvis probably be rotated? To the left?
It can be rotated either way.
Hi Mark, any tips/ strethches or strengthening exercizes for an anteriorly tilted left side of pelvis?I’ve been told that this can also cause rotation of the pelvis towards the right as well as a counter rotation of the torso towards the left. Im having trouble with many of the recommendations in the post which I believe is due to the anteriorly tilted left side.
I would try the exercises for a pelvis that is rotated to the right.
If your twisted torso remains after correcting your pelvis, check out this post: Twisted spine.
Hi! Thank you SO much for the direction! I just need one thing cleared up before I begin to move forward with exercise…when talking about right and left rotation, is this from looking anteriorly at the body as someone else is looking at my body, being their left/right? Or do I think of left/right as my left/right (as in I write with my left hand)?
The direction of rotation is relative to YOU.
That is , if your pelvis points more towards your right, then this would be classified as a right rotated pelvis.
Hope this makes sense.
This info is so helpful!
Question…I have a rotation to the right with lots of pain and tightness in my left ql, glute medius, tfl, and it band. When I do these exercises, ot is hard for me to “turn off” my left tfl? Any suggestions?
Might need to spend more time stretching the left TFL.
Check out this post: TFL stretches
Hey Mark! Do you do assessments and programming for people? I have compound issues and it’s frustrating figuring out what to fix first. I at least have APT, Left rotated pelvis, my right hip externally rotates (duck foot/ my foot arch seems fine though), after training for a marathon I developed a click on the outside of my right knee which became painful. My right glute is weaker than my left, but my right hamstring is tighter etc. My right hip also clicks very loudly when I bring my knee up and swing my foot to the left. I also have very tight shoulders (tight chest, ant deltoid etc) and probably rounded shoulders. I also recently developed minor tendonitis in my right heel. Sorry for the long message any help you could offer would be greatly appreciated.
I don’t offer assessments at present. (But that could change if the demand is there!)
In regards to your issues, it is possible that addressing the rotated pelvis could positively influence all of your symptoms (feeling of a tight right hamstring, weak right glute, right clicking hip etc).
I would lean towards targeting the pelvis rotation before the anterior tilt and rounded shoulders.
However – if you have active pain in your knee, you will likely need to sort that out first. The 2 main structures that will cause clicking in the knee: 1) Patellofemoral joint and 2) Lateral meniscus.
Hi Mark, Thank you so much for all that you do to help us in need.
I would like to know if you have the exercises for pelvis rotation, scoliosis, etc. in a book format? I would like to get a printed copy in case internet goes down. Also, do you do consultations (remotely/virtually/over phone, etc.?) I would like to pay you for these things and will definitely be donating if nothing else.
I don’t have any ebook for my blog posts unfortunately. Perhaps the next best option is to copy/paste into a word document?
I don’t offer consultations at the moment. Hopefully the blog posts will be helpful to you though!
This page is fantastic, and boy have you answered a lot of questions! It’s amazing that you have taken the time to do so!
I have a slight pelvic rotation to the right, but I am also dragging my right leg. When I walk I find I am pivoting on my left leg rather than picking my right leg up properly, which means I kind of swing my right leg around to move it forward. I get pain in my right buttock and the side of my right hip, and I have had bursitis and tendonosis around my right hip too. Bursitis is made worse with clam exercises. My right side feels like it’s being pulled back and is stuck. When I try to walk properly the pain in my right hip is worsened. I am hyper mobile in some of my joints, including my hips, and I am developing plantar faciitis and ankle problems on my left side. Is this likely down to the pelvic rotation or is something else going on in your opinion?
Many many thanks for reading!
It sounds like you are circumducting your right hip. This is commonly seen when pain is affecting your walking pattern.
If you have hip bursitis, check this post: Hip Bursitis Exercises.
Development of the plantarfasciitis is likely due to increased demand on the left side. (as it compensates for the right right).
I would encourage you to really get this right hip under control first. This will likely improve your walking pattern .
Hi Mark, first of all you have a great bit of information on here. Secondly , I have a left rotated pelvis for the last 3.5 years and didn’t knew what to do. Now with your help I have been doing your exercises for the last 22 days and I can see some positive results. My question is how long it will take to get 100 percent neutral pelvis? Thanks for your great work.
Great to hear of your results so far.
In terms of how long it will take to get 100% back to neutral, that is very difficult question to answer.
As long as it is heading in the right direction, you are on the right track!~
I have had problems with my right leg,foot,hip for 6 months.I have been doing lifting job for a year before with poor posture.Basically I was doing a movement that I believe took me out of alignment(is like when you stand and you have a ball on your left side in front of you and you bend more from the left leg to pick it up, using the right hand twisting the torso to the left,which i have done it repeatedly…).I had symptoms down the leg in the buttock.I went through several MRIs and all that was found was a disc bulge at L5-S1 on the right which because is very small apparently pressure on the nerve couldn’t be seen.,so no radiculopathy….Another thing that can be seen on the MRI is that the right piriformis muscle is more developed than the left one,while the right gluteus medius is underdeveloped compared to the left one.I took your tests and it seems that I have the tendency to lean over to the left side and is hard for me to find a neutral pelvis as I tend to put the right foot in front when standing straight(the right tigh is forward).I also have a tightness and dull pain in the right QL and right rotation is limited,either from the spine or the pelvis.I also have issues with the right scapula and shoulder and right side of the neck….As I figure it I would say I have a left rotated pelvis with a twisted spine on the left.
Would you say my assessment is correct?And with what should I start?
I look forward to hearing your opinion on all of this as I find your feedback valuable from what I have seen on your great work.
L5/S1 is commonly involved with injuries where the person bends forwards. This movement can also lead to strains to the muscles around this area.
If you feel your pelvis is rotated to the left (which sounds consistent with your own assessment), this can orientate the torso towards the left as well. This can also lead to the right side of your body working harder than it should.
I would address the pelvis to see if that helps with your issues.
If not, You will need to most likely address the torso.
See post: How to fix a Twisted Spine.
Hey Mark. Great website! Helped me through anterior and posterior pelvic tilt in the past!
So I’ve had a problem for the past two years I’d say. Where the right side of my body feels weak.
I can’t extend the thoracic back on the right side (the cracking that you can generate from your back if you extend), but I can on the left side. When I do glute bridges my glute on the left seems to extend and I can feel the full power, whereas the glute on the right sort of grips and clenches and it never ends up growing. Also, I can’t seem to rotate my thoracic spine to the right and resultantly I’ve had a lot of right shoulder problems.
I’m also not sure of this but can a rotated pelvis cause the deep core muscles on one side to deactivate? In my mind, that seems to be the cause of all these problems (deactivation of deep core muscles on right)
I read this article below stating that those with glute clenching/grabbing on one side usually have a twisted pelvis. So that’s how I ended on this specific page of yours.
Also do you do consults?
A rotated pelvis (and possibly a rotated torso) can lead to your said symptoms.
Which way you are rotating towards?
Hello, so I believe I have left pelvis rotation. I noticed that there are strengthening exercises for the left hip in that case, but my issue is that my right hip is lacking the strength. My right glute is very under developed compared to my left. I was wondering what you suggest here. Should I just do those exercises for my right hip?
If you are specifically address a pelvis rotation, then I would do the exercises for both sides.
If you have weakness in the right, you may have another issues that you need to address.
Do you stand on the left or right leg more?
Really helped me out tons with all the basic programs.
If you have both a case of rotated pelvis and lateral pelvis tilt, is it okay to do
both programs at once or should I look to work on one first and then the other?
Right side ankle is overpronated(?), right side QL is super tight and right side shoulder is rounded severely compared to the left. I have constant tension all over the right side in the body.
Thanks for all your resources and effort!
P.S – Will you ever take video clients?
I would recommend start with one thing at a time.
Once you feel that you have achieved as much as you can with the one, start to introduce the second and monitor how your body responds.
YOu can also address the areas in isolation to see if that helps:
Ankle pronation: How to fix Flat feet.
Tight QL: Quadratus Lumborum stretches
Rounded shoulder: How to fix Rounded shoulders.
I have an issue that looks something like this. If I assess it with the techniques you have shown, I would end up with “Right pelvis rotation”.
Following the stretches and exercises, I am supposed to stretch outer leg muscles and strengthen inner leg muscles on my left side and do the opposite on my right side.
However, I have noticed tension in my inner left thigh, not the outer (my leg feels like it always wants to go right), and my right leg hamstrings are not tense, but weak and loose.
My left leg is stronger than my right one—left buttocks is a lot more defined, left quadriceps and biceps (around hamstrings) muscles are more defined and even my left calf muscles are more defined.
I feel weakness in my right leg—I can squeeze right buttocks, but it feels odd and the words to describe it would be “unable to squeeze to maximum”. The same goes for biceps muscles on the right leg and my calf muscles.
Additional things bothering me:
– I cannot do a proper squat, I have issues with balancing and my left hamstring “skips” and gives me some tenderness. I end up doing squats on my toes and unable to activate my quadriceps.
– My knee caps “fall” to the outer part of the leg, increasing pressure when bending the leg—this is more prominent on the right leg
– I have tightness on my right side of the trunk.
– My head tilts to the right (I have binocular vision dysfunction, which eye doctors cannot explain nor help me with) and that tightens everything on my right side.
– My coccyx is not vertically aligned—it is torqued to the right, a lot (like one slash, /, of X).
Things I have tried:
– Various stretches and releases for quadratus lumborum, pelvis, hamstrings, and whole spine chain (neck, upper, middle and lower torso).
– Your exercises for rotated pelvis.
– Strengthening of pelvis area.
I am assuming, but all this might have come from my posture when sitting on a toilet and wiping my rear—I would always shift my body weight onto the left buttock, stabilize with left leg and lift my right side off to reach down with my right arm. This would always stretch my left and tighten right latissimus, serratus, quadratus lumborum, and probably a lot of other muscles in that area. I know this might embarrass some, but I need help.
What do you think I should do? I am fighting this for a very long time now and it is debilitating.
I’ve got an extra lumbar vertebra (L6) that is fused to the sacrum on one side and not fused on the other. This presents a number of rotational problems for me. I love to run and I’ve noticed that recently as my runs have lengthened, my hamstring and quad stretches don’t seem to relieve a nagging pain in my back – almost right in the middle of my back. When I lie down at night, as my muscles are relaxing into sleep, there’ll be a painful pop and then my back relaxes, but turning over in my sleep is painful and wakeful for me. Any thoughts here? I came to these exercises because I can confirm that my left hip is rotated forward, but didn’t know if you thought that such a thing might be related to my mid-back “tweak/pain/aggravation.” In the mornings when I get out of bed, usually takes about 3 steps and my back spasms, but then evens out. Appreciate any thoughts you have.
Sounds like you are describing a “Sacralization”.
When you say middle of the back, I am assuming you are referring to the middle of the torso? (thoracic spine)
If cracking of the back gives you some relief, this sounds like it is more so a joint issue causing your issues.
What kind of thoracic spine do you have?
– Flat thoracic spine
– Hunchback posture
Have you had any scans to this area to check for any structural issues?
You have a great website! It’s helped me greatly in the past few months with hip and shoulder issues.
One question with the rotated pelvis exercises: When doing the half frog, do you bring your knee up to your side while keeping it touching the floor? I’m just having a problem picturing it.
Yes – the aim to keep the inside of your leg touching the ground.
If you can’t do this, you might need to lie on a block to elevate the pelvis. In this case – you just are aiming for the inside knee to be in contact with the ground.
Hey Mark, Just wanted to clear something up from the article:
You start off saying “I will be explaining these exercises in terms of a RIGHT rotated pelvis.” But later under section 3. Strenghtening, you say “Strengthen the muscles of the left hip that rotate the pelvis to the LEFT.”
I realize that you need to address both sides of the hip but first you say you’re writing about a right rotation in the pelvis and then you mention a left rotation in the pelvis.
Do you mean that the aim is to strengthen the muscles of the left hip that rotate the pelvis to the right?
For a pelvis that is rotated to the RIGHT, you will want to:
1. Strengthen the muscles on the RIGHT hip to rotate the pelvis towards the left.
2. Strengthen the muscles on the LEFT hip to rotate the pelvis towards the left.
… so that the pelvis can return back to the neutral position.
You will need to strengthen the muscles that produce left rotation of the pelvis to correct a pelvis that is rotate to the right.
Hope this makes sense. If not – let me know.
My hip rotation causes my shoulder also rotates in opposite direction of hip rotation.
Will it be automatically adjusted if I fix hip rotation or any particular exercise for shoulder also I have to do simultaneously with hip rotation exercises?
It’s more likely you will need to address both.
But you can try focusing on one and see if it affects the other location.
Thank you for the great content on your website!
I have been dealing with pain on the right side of my body for two years now and so far nobody has been able to help me (three different physical therapists, orthopaedic doctor and a podiatrist). So I really hope you can give me some advice. I’d like to apologise in advance for my long post, but I wanted to be thorough and I really want to find something that could help me eliminate my pain.
I have pain in my right groin area and the left side/inner thigh of my right leg often feels really tight and tense. Especially after loaded Bulgarian split squats (with left leg in front so right stretches), hip hinges and squats. I also have pain in my right hamstring and on the right side of my sacrum/SI joint area. My right side spinal erectors can also become really tight sometimes.
When I stand up straight I cannot really tell which hip is more forward than the other. But when I break at the hips/ hip hinge/squat, my right hip tends to rotate out and my right foot tends to follow and supinate and left to pronate (I try to counteract this by gripping the floor, creating an arch in the foot by “turning on glute meds” during exercise). It’s as if my right side opens up and I have to be very mindful to keep both hips pointing forwards. It feels as if my left knee naturally wants to go more forward than my right knee and my hips rotate open to the right. (I try to counteract this during loaded exercises)
Also when I sit on the floor with my legs straight, my right leg/foot falls a bit outward and my left leg inward. (Both only 5-10 degrees or so). When I lie down, they fall equally outward (15 degrees or so), but when I come up my right foot stays there whereas the left rotates more inward.
When I sit on the floor with my knees bent and feet flat on the floor, it feels as if my right hip pulls in, pushing my left hip more forward.
I also have a shift to the left when I squat.
I thought my pelvis was rotated to the right (only when I move, not when I stand up straight), but when I wanted to do your suggested exercises, it feels counterintuitive. For example, to reduce tension in the muscles of the left hip that cause a right pelvic rotation you say to stretch the left gluteal muscles and rectus femoris. One should also strengthen the muscles on the left that internally rotate the left leg and the muscles on the right that externally rotate the leg.
But to me it sounds counterintuitive. When the hip is rotated to the right, I thought the external rotator muscles on the RIGHT are tight, pulling the hips towards the right/open up. How can the left external rotators “pull” the right hip to the right like you mention? And I would assume that the LEFT external rotators should be strengthened to externally rotate the left hip so that the right hip comes back into alignment. Rather than strengthening the right external rotators, to pull the right hip even more into external rotation like you suggest? Could you explain to me what I could have misinterpreted? Am I not rotating to the right perhaps ? Or maybe it not even a rotating issue at all?
I’d really appreciate it if you could help me. Thank you so much!
All the best,
If you do not have an obvious pelvis rotation in standing, the exact exercises mentioned in this blog post may not be the ones you need.
Pelvis rotation may not actually be your problem, but it is the compensation itself.
If this the case, you will need to find out why the pelvis is twisting as you squat/hinge etc.
If you shift to the left (which usually will couple with a pelvis rotation to the right) during a squat, make sure to check that you have:
– Full ankle dorsiflexion in right ankle to allow the right knee to as forward as the left knee.
– Full hip internal rotation in 90/90 position in right hip to allow the right hip to receive full flexion in a squat.
– No hip impingement in the right hip.
– Good single leg strength in right hip. (eg. single leg bridge, single leg squat, balance) to avoid relying on the left side .
– Good left glute med strength
– The torso should sit in line with the pelvis. Go here and check if you have equal “Thoracic translation” Movements” (exercise #13).
Also check to see if you tend to place more weight through your left side. If your pelvis rotates right and your right knee goes out, the right hip will actually be in external rotation.(which could explain how you injured the right groin). The left hip would also be in external rotation (relative to pelvis) but appear to collapse inwards due to the left pelvis coming forwards/inwards.
Hope this helps.
I live in the Netherlands and I read your articles with great interest. I don’t write in English every day, so I apologize for that. I have a sharp pain in my right hip (front side) and also in my left shoulder area for several years. I have already been to several physiotherapists, but nobody seems to be able to help me. My right hip (upper leg) is about 5 cm pointed forward than the left hip. And it seems like my right hip is turning externally out. I have a supinated foot on the right and a pronated foot on the left. In sitting position, I have pain in my left lower back and my torso rotates to the right. My left shoulder turns to the right. It seems like there is a constantly tightness in the muscles around my left scapula wing.
Is this recognizable to you? What could I do about it? I especially have complaints when sitting on a chair for a long time.
Thank you very much and I look forward to your response.
With best regards,
Based on what you have said:
– The pelvis is rotated to the LEFT.
– The right hip in in EXTERNAL ROTATION
– Supinated right foot and pronated left foot may suggest you are standing more so on your right side. Is your right hip higher?
– Twisted torso to the right (most like counter -rotating the pelvis rotation to the left)
If prolonged sitting is the issue, I would suggest that you take breaks every 30 minutes, or at least try to adopt different positions.
You can also address your rotated torso by doing these exercises mentioned on this blog post:
How to fix a Twisted Spine.
It is common for a torso that is rotated to the right to have left lower back pain.
My right side of pelvis is straight while the left side is on anterior making my left leg longer,if i stay neutral my left hip points out and the right side is going forward and causing me sciatica nerve pain in the left leg
All this started 2 years ago with a pain in the left leg nerve,when i went to the doctor they make x ray in my spine and found out that i had scoliosis that i never notice before(i was 28years old)the doctor never went in futher examination even when i complain that i feel my left hip in extreme pressure while walking and the right leg shorter,he just give me pills and ignore complete that my work at that time have to do smth with my pelvis
(I was working as a courier for years 12hours per day lifting my right leg 300-400 times to sit and get up of my motorcycle daily)the whole right side of my body is much more muscular due to this work
Which side exercises i should follow cause i get confused and also u said scoliosis is connected with the rotation of pelvis so some muscles that create a rotation on pelvis can make a fake scoliosis based on the fake length leg or im over dreaming that im fine and i will get back to normal?
I think I understand what you are trying to say.
Do you mean when you are standing, the left side of your pelvis is more forwards compared the the right side? But then when you bring that left side back into a more pelvis neutral position, the left leg is pointing outwards?
This may suggest that you have a pelvis that is rotating to the right. Your left hip might just be very tight into the externally rotated positions which could mean really right glute muscles.
In regards to your sciatica symptoms, it may be related to the pelvis position. I would recommend that you get a scan to rule out any involved of your lumbar spine.
If you feel that you have a pelvis rotation to the right side and it directly connected with your symptoms, you can try the mentioned exercises and see how the body responds.
Thanks for the reply mark and sorry my English ain’t that good to explain it correct and make u understand it easy
Isn’t my left side that goes forward but is the right side of the pelvis and is going forward and drops like it aiming my left foot,and the left hip is pointing outwards,that happens if i relax my body and just try to stand without forcing my pelvis to stay in a correct position
If i try to correct the right side and try to bring it backwards to have a correct position the left hip get in a better straight position without pointing outwards i feel burning pain in the right side where the gluteus minimus is,based on u answer so i have a left side rotation
A foam roller doesn’t seems to reach the gluteus minimus in deep can i use a tennis ball or i will make more problems with the use of it?thanks again for u effort to my issue
Can you help me please.
My right side is little bit forward and that Bony is like 1 inch lower than the other. Which side is weak and What should i do?
Sounds like a pelvis that is rotated to the LEFT.
You can do the exercises mentioned on this blog post, but do it on the OPPOSITE side mentioned.
Great content hear.
I’m confused with “b) Hip internal rotation”.
I found myself already doing this to try an correct myself but I’ve been doing it to push the hip back. In image it has an arrow pushing hip forward. The leg my heel is on feels like that hip is getting pushed backward.
The arrow in this picture is mainly to show the internal rotation of the left hip. (not so much the orientation of the pelvis)
Sorry if that is unclear. (…I use windows paint for all my graphics! haha)
If you are addressing a pelvis that is rotated to the right, you do want that left side of the PELVIS backwards.
Hi Mark! Thanks for putting this awesome resource together.
I’m a 25 y/o male that has played a lot of tennis growing up, and the right side of my body is more well developed than the left side. Lately I’ve been having troubles walking and feel very unbalanced while also experiencing medial knee pain of the left knee, outside the greater trochanter of the left femur, and tightness just above the left side of my sacrum. I have minor scoliosis starting at the lower lumber that breaks towards the left.
My leg length while lying down is even; however, when standing the left leg feels 1in. longer. While performing your diagnostics I’ve found that I have a right rotated pelvis, and a left hip hike. While searching elsewhere online I’ve found that most right handed tennis players will have a right rotated pelvis with right hip hike, and also longer right leg. Could you please provide some clarification on whether my findings make sense and explain some of my symptoms?
If you are a right handed tennis player and do a whole lot of forehands, this would make sense to me that the pelvis is rotated to the right. (although if you mainly did back hands, this would fall more in line with a left rotated pelvis.
In regards to hip hike, I feel it could go either side really!
Perhaps try working on rotation first and see how the body responds.
Thank you for posting all this valuable information. I have a question about proper sitting. You discussed the importance of sitting correctly to maintain pelvic alignment. You demonstrated how to sit on a chair, on the sit bones, knees position, etc. But what about floor sitting? Is it possible to sit on the floor and still be in an optimal pelvic position?
I hear so much about how sitting on the floor is healthier and more natural for humans than sitting in a chair. But my pelvis is currently oriented more towards the right and I want to correct that. If sitting on the floor is going to deter me from regaining that balance, I’d like to know. What’s your opinion on floor sitting and how it relates to proper pelvic alignment? Is there a good floor-sitting position that you recommend? Thank you.