Exercises for Lateral Pelvic Tilt (Uneven Hips)

What is Lateral pelvic tilt?

lateral pelvic tilt

It is the asymmetric positioning of the pelvis where there is:

  • One hip higher than the other side. (Hip hike)
  • One hip lower than the other side. (Hip drop)

It is also known as having Uneven Hips.

The content presented on this blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. It exists for informational purposes only. For more information: Medical disclaimer.


Lateral Pelvic Tilt Test

How do I know if I have uneven hips?

lateral pelvic tilt test

a) Whilst standing: (Static)

Instructions:

  • Stand in front of a mirror.
  • Place your hands on the highest point of your waist line.
    • Keep your hands flat to the floor.
  • Compare the level of your hands.
Results: If one side is higher as compared to the other side, then you have a Lateral pelvic tilt.

(Look out for a prominent waist crease! This is usually observed on the side of hip hike.)

b) Whilst moving: (Dynamic)

Trendelenburg sign

test for lateral pelvic tilt

Instructions:

  • Stand in front of a mirror.
  • Place your hands on the highest point of your waist line.
  • Stand on one leg for 10 seconds.
  • Perform a single leg squat.
  • Observe for any tilt in the pelvis throughout test.
    • (… Is there a change in waist height?)
  • Compare both sides.
Results: If there is unleveling of the pelvis, this may suggest that you have weakness +/- lack of control of the Glute Medius muscle on the side of hip hike.

Note: The side that hikes during the Trendelenburg test does not necessarily mean that the hip hike will be on the same side during a natural standing position.

(In fact – it is common to see the hike on the other side as most people prefer to stand on their stronger leg!)

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What Causes Lateral pelvic tilt?

a) Muscular imbalances: (Sagittal plane)

A Lateral Pelvic Tilt can result from an imbalance between the Quadratus Lumborum, Adductors and Glute Medius muscle.

Other muscles involved: Obliques, Tensor Fasciae Latae

(I would recommend that you have a look at the location of these muscles on Google.)

Summary:

  • The pelvis will HIP HIKE to the side of relative weak Glute Medius, tight Quadratus Lumborum and tight Adductors.
  • The pelvis will HIP DROP to the side of relative tight Glute Medius, weak Quadratus Lumborum and weak/elongated Adductors.

b) Weaker on one side

The body will naturally tend to stand on the stronger leg and away from the weaker leg.

This can cause the pelvis to hip hike on the stronger side.

For this situation, it is likely you will get more improvement by performing single leg exercises on the weaker side.

These exercises might include:

  • Step up/down
  • Lunges
  • Single leg squats
  • Single leg balance

c) Sub-optimal habits:

Answer these questions:

  • Do you lean on one leg?
  • Do you sit more on one butt cheek than other other?
  • Do you always sleep on the same side?

If you do… then you have postural habits that may encourage the tilting of the pelvis!

d) Leg length discrepancy

leg length discrepancy

Having one leg that is structurally longer than the other side will result in a Lateral Pelvic Tilt.

The side of the longer leg will generally have the higher hip (.. but not always!).

How to measure the length of your legs:

  • Lie on your back.
  • Measure the distance from the ASIS to the Medial Malleolus. (you might need to Google these land marks)
  • Do both sides.

Results: If these lengths are significantly different between the legs, then you may have a leg length discrepancy.

(Alternatively – you can get a CT scan to measure it.)


e) Neurological conditions

Any condition that impacts the nerves that supply the control of the pelvic musculature may result in a laterally tilted pelvis.

(The Superior Gluteal Nerve (L4-S1) supplies the Glute Medius.)

If this is your issue, you will need to address the nerve issue before addressing any muscular imbalances.


How to fix Lateral pelvic tilt

Note: The following exercises are designed to be safe and gentle. They should not be performed if they are causing you any pain or discomfort.



READ THIS

I will be explaining the following exercises in terms of fixing a RIGHT hip hike.

If you have a LEFT hip hike, do the exact same exercises but on the opposite side mentioned.


1. Releases

(You may need to Google the location of the mentioned muscles if you are not sure where they are.)

a) Quadratus Lumborum  (Right side)

Quadratus lumborum releases for lateral pelvic tilt

Instructions:

  • Place a massage ball directly on the right Quadratus lumborum.
  • Apply your body weight on top of the ball.
  • Roll your body over the entire length of the muscle.
  • Aim for 1 minute.

b) Glute Medius/TFL  (Left side)

gluteus medius release

Instructions:

  • Place a massage ball directly on the left Glute Medius/Tensor Fasciae Latae.
  • Apply your body weight on top of the ball.
  • Roll your body over the entire length of the muscle.
  • Aim for 1 minute.

c) Adductors  (Right side)

adductor release

Instructions:

  • Place a foam roller directly underneath the right Adductors.
  • Apply the weight of your right leg on top of the foam roller.
  • Make sure to cover the entire length of the muscle.
  • Aim for 1 minute.

2. Lateral Pelvic Tilt Stretches

a) Quadratus Lumborum/Obliques  (Right side)

Quadratus Lumborum stretch for lateral pelvic tilt

Instructions:

  • Start with your feet wide apart with your left foot turned out to the side.
  • With arms outstretched, start to bend all the way to your left side.
  • Reach your upper arm as far to the left as possible.
  • Keep your body in line with your left leg.
    • Do not rotate your body.
  • Keep your legs fairly straight.
  • Aim to feel a stretch on the right side of your body.
  • Hold for 30 seconds.

(Note: Check out this post. It shows 12 different ways to stretch your Quadratus Lumborum muscle!)

b) Gluteus Medius  (Left side)

gluteus medius stretch for lateral pelvic tilt

Instructions:

  • Assume the position as above with the left leg crossed over the right leg.
  • Sit up tall and arch your back.
  • Pull the left knee up towards your right shoulder.
  • Rotate your torso towards the left knee.
  • Aim to feel a stretch on the outer left hip.
  • Hold for 30 seconds.

(See also: 13 Gluteus Medius Stretches for Tight Hips.)

c) Tensor Fascia Latae  (Left side)

lateral pelvic tilt stretches

Instructions:

  • Assume the lunge position with your left leg at the back.
  • Maintain a narrow stance.
    • Keep both of your feet in line with each other.
  • Lunge forwards.
  • Rotate your pelvis backwards.
    • “Tuck your tailbone underneath you”
  • Lean towards your right side.
  • Aim to feel a stretch on the upper side of the left leg.
  • Hold for 30 seconds.
  • For more stretches, check out this post: Stretches for the Tensor Fasciae Latae.

d) Adductors  (Right side)

adductor stretch

Instructions:

  • Perform a side lunge towards the left side.
  • Aim to feel a deep stretch in the inner right thigh region.
  • Hold for 30 seconds.

 Is your groin really tight? Check out this blog post for 14 different ways to stretch the adductors.

3. Activation exercises

a) Hip hitch (Left side)

Muscle: Quadratus Lumborum

hip hike exercise

Instructions:

  • Sit tall on a chair.
  • Lean slightly towards the right side.
    • (Feel free to use your hands to balance if required.)
  • Lift your left buttock off the chair.
  • Aim to feel your left lower back muscles activate.
  • Hold contraction for 3-5 seconds.
  • Repeat 10 times.

b) Leg lift (Right side)

Muscle: Gluteus Medius/TFL

gluteus medius strengthening exercises for lateral pelvic tilt

Instructions:

  • Lie on your left side with your upper leg straight. (see above)
  • Elongate your right leg by pushing your foot away from you.
  • Lift your right leg.
  • Keep your pelvis completely still.
    • Only your leg should be moving.
  • Aim to feel your right hip muscle activating.
  • Hold the top position for 3-5 seconds.
  • Repeat 10 times.
  • Progression: Apply a resistance band between the ankles.

c) Leg lift (Left side)

Muscle: Adductors

adductor strengthening exercises for uneven hips

Instructions:

  • Lie on your left side with your upper leg bent forward and bottom leg straight. (see above)
  • Lift your left leg up towards the ceiling.
  • Keep your pelvis completely still.
    • Only your leg should be moving.
    • Make sure that you do not rotate the pelvis.
  • Aim to feel your left inner thigh activate.
  • Hold the top position for 3-5 seconds.
  • Repeat 10 times.
  • Progression: Apply a weight to the left ankle.

4. Strengthening exercises for Lateral Pelvic Tilt

The aim of the following exercises is to get all of the involved muscles on both legs to work together to achieve a more neutral pelvis.


a) 90/90 Hip shift
hip shift

Instructions:

  • Lie on the floor.
  • Place your feet on the wall with your hips and knees bent at 90 degrees.
  • Dig your feels into the wall and lift your tail bone off the floor.
    • Keep your back flat on the ground.
  • Without moving your feet:
    • push out your right knee forward
    • pull in your left knee towards you.
  • Feel the tension in your left inner thigh and right outer thigh.
  • Hold for 10-15 seconds.
  • Repeat 3 times.
  • Progression: Hold for a longer period.

b) Knee to Knee (Right side up)

strengthening exercises for lateral pelvic tilt

Instructions:

  • Lie on your left side with both knees bent.
  • Lift up your right knee.
  • Whilst keeping this position, lift up your left knee towards right knee.
  • Feel the tension in your left inner thigh and right outer thigh.
  • Hold for 5-10 seconds.
  • Repeat 10 times.
  • Progression: Hold for a longer period.

c) Side wall push  (Stand on Right side)

lateral pelvic tilt exercises

Instructions:

  • Lift your left hip to ~90 degrees and place the side of that leg against a wall. (see position above)
  • Bend your planted leg to ~10 degrees.
  • Push the lifted leg into the wall.
  • Aim to feel the the side of your right hip engage.
  • Hold this position for 5-10 seconds.
  • Repeat 10 times.
  • Progression: Hold for a longer period.

c) Hip hitch (Standing)  (Right side on step)

hip hitch

Instructions:

  • Stand sideways with your right leg on the edge of a step.
  • Keep your stance leg fairly straight throughout the exercise.
  • Movement:
    • Start: Drop your left leg as low as possible.
    • Finish: Lift your left hip as high as possible.
  • Aim to feel the side of the right hip engage.
  • Repeat 20 times.
  • Progression: Go slower!

d) Crab walk

exercises for uneven hips

Instructions:

  • Set up a resistance band as shown above.
  • Pull the band with both of your arms to increase tension.
  • Proceed to take small side steps with each leg over a short distance.
  • Keep your pelvis level through the exercise.
  • Aim to feel the side of your hips activating.
  • Continue for 1 minute.
  • Progression: Use more resistance in the band.

e) Single leg tap  (Stand on Right side)

level pelvis

Instructions:

  • Place your hands on your waist to make sure your pelvis is level.
  • Stand on your right leg
    • Keep it slightly bent.
    • Maintain your balance!
  • Whilst keeping your pelvis level, proceed to reach and gently tap your left leg on the floor as far as you can.
    • Cover every direction. (Front/back/side/diagonal)
    • Imagine you’re patting an ant’s head with your foot. Be gentle!
  • Continue for 1 minute.
  • Progression: Reach further and/or Tap your foot softer.

f) Step down/up  (Right side on step)

Instructions:

  • Stand on your right leg on the edge of a step.
  • Maintain a level pelvis throughout the exercise.
  • Slowly lower your left leg down towards the floor.
    • The right knee should bend as you do this.
  • Do not touch the ground.
    • Let it hover above the ground.
  • Return to the starting position.
  • Repeat 10 times.
  • Progression: Go slower!

g) Side plank with upper leg lift (Right side up)

side plank for lateral pelvic tilt

Instructions:

  • Assume the side plank position with the left side down.
  • Ensure that you keep your left lower torso muscles engaged.
    • Think about using the muscles that would crunch your body towards the left.
  • Elongate your right leg by pushing it away from you.
    • (This should pull the right side of the pelvis towards your feet)
  • Whilst keeping your pelvis still, lift up your right leg.
    • Make sure you feel your right glute muscle contract.
  • Hold this position for as long as you can maintain good technique.

 .. Want more hip exercises?

See post: Gluteus Medius Exercises

5. Improve your function

It is important to practice maintaining a level pelvis as you go throughout your normal movement throughout the day.

a) Sitting:

sitting with lateral pelvic tilt

Distribute your weight evenly between both buttocks.

… Do not lean to one side!

For more information: How to position your pelvis properly.

b) Standing:

standing on one leg

Distribute your weight evenly between both feet.

… Do not lean to one side!

If you are not sure if you stand evenly, you can check it by standing on 2 separate scales (1 for each leg).

If you are evenly distribute your weight, both readings should be the same.

A simple way you can monitor your pelvis position is by placing your hands on your hips.

Pay particular attention to your uneven hips in the following:

  • Walking
  • Running
  • Using stairs
  • Lunging
  • Squatting

c) Address Hip Bursitis

hip bursitis lateral pelvic tilt

If you have a significant amount of pain in the side of your hip, you may have this condition called Hip Bursitis.

The presence of pain in the hip will make it difficult to perform many of the suggested exercises.

For more information: Hip Bursitis Exercises.

6. Fixing bad habits

“So… I just have to do exercises for my lateral pelvic tilt, and I’ll be all fixed?”

No!

In addition to exercises, it is essential that you address the following bad habits that may be predisposing you to have a lateral pelvic tilt in the first place.

Common habits associated:

  • Favoring one leg when standing
  • Leaning to one side whilst sitting/driving
  • Always side sleeping on the same side
  • Holding/carrying on side of hip

7. Fix your Scoliosis

scoliosis and lateral pelvic tilt

It is very common to have a degree of Scoliosis with your Lateral Pelvic Tilt.

In this situation – the pelvis laterally tilts towards one side to help compensate for the side bending that is occurring in the spine.

If you would like to know how to address this issue, feel free to check out this post: Scoliosis Exercises.

How to sleep with Lateral Pelvic Tilt?

If you sleep on your side:

how to sleep with lateral pelvic tilt

The main aim is to maintain the straight alignment of the spine.

This will encourage a level pelvis as you are lying down on the side.

I recommend using 4 pillows to help support your body in this position.

1. Pillow for head

  • Make sure the entire side of your head AND neck is supported by the pillow.
  • If you have broad shoulders, you will need to use a thicker pillow.

2. Pillow for arm

  • Hug a pillow!
  • This will help support the weight of the arm.
  • It will also help minimize rounding of the shoulders. (to an extent)

3. Pillow for knees

  • Place a pillow in between your knees and ankles.
  • This will support the weight of your leg and help prevent the pelvis from twisting.

4. Pillow for waist

  • Place a small pillow underneath your waist crease.
  • This will help minimize side bending of your torso and pelvis

 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!


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1,075 thoughts on “Exercises for Lateral Pelvic Tilt (Uneven Hips)”

  1. Hello! so I have been struggling for years with unevenness on my legs/glutes/and calves and I still have hope to know how to fix this! Ever since I was younger I always had a thinner calf than the other and the same with quad muscles , and glutes. When I run I can feel all the pain in my left leg/knee. And when I workout and do leg day (squats and deadlifts) I feel it in different areas in both legs. As of lately I can feel alot of my workouts only on one side of my quadratus lomborum on the right only and my left one seems to not even be activated while I walk. When I stand I can only feel the right QL engaged as well as sitting down. What exercises can I do to activate and engage that left one? I would really love to see your thoughts on this.

    Reply
    • Hi Andrea,

      Is it possible that your pelvis is shifted more towards one side? This may explain a lot of the symptoms that you have described.

      If I were to guess, it would be shifted to the right.

      If so – your right hip would be slightly higher than the left side.

      Mark

      Reply
  2. Hello Mark, I’ve just come across your site and am so appreciative for all the information you are sharing, thank you so much!

    I’m not sure if this is something you offer, but do you ever do telemedicine consults? I’d be happy to pay you to look at my scans and give some recommendations if you have the time.

    In any case, thank you again for everything!

    Reply
    • Hey Clifford,

      I don’t offer telemedicine consults at present.

      Although, if you send me your scan results today, I might be able to have a quick look for you.

      Mark

      Reply
      • Wow, thank you so much!
        I wasn’t sure where to send them so I sent them on FB Messenger.
        Let me know if you would prefer I send them another way..
        Thank you again!

  3. Hi Mark.

    I had contralateral pelvic and shoulder tilts for over 35 years – pelvis down to the left, shoulders down to the right, along with side-specific neck pains / soreness along the left side of the neck vertebrae, and some at the left shoulder / UFT. I have been working with a physio since Aug 2019, on these and other issues.

    As well as doing some of your excellent side-specific exercises from this web page, we found a couple of habits I had had, things one would not expect to affect pelvic tilts – yet once I changed those habits, improvements to the pelvic and shoulder tilts gathered pace.

    In the end we fixed nearly all the issues I had had before first seeing this physio – including the contralateral pelvic and shoulder tilts, which were both finally back to the horizontal by Oct 2020 and have remained so since then. But despite that and all her other good work, the left side neck and shoulder troubles have remained.

    I also had an old injury from playing squash nearly 40 years ago, a tear to the right rhomboid that I never dealt with over the years, until this physio found the old scar tissue from this in early July 2021. In a few weekly sessions, she was able to work this back into muscle again, leaving no residual scar tissue to speak of.

    In sessions since the scar tissue work, the physio has checked my posture and compared left vs right side muscle groups etc, of the middle and upper body. She has always found that each side is more or less “equal” to the other in terms of muscle tightness / looseness etc, and she has not been able to find any damage, deterioration, or indeed any sign of why I am still having these pains to the left side of the neck and left shoulder / UFT.

    I never had an injury specifically to the areas where these left side pains have persisted, either. The physio and I are both baffled as to why these troubles are still there. Her best explanation – given in our last session in mid Jan 2022 – is that there may be some residual neural muscle memory, such as to the rhomboids. She recommended further new exercises to re-activate / re-train the rhomboids. I did them for around 2-3 weeks and could feel those muscles beginning to behave more as they probably always should have, but this did not affect the left side issues – and then I had to stop doing those tasks, as they led to me straining the upper abdominals, and I had a devil of a time getting those to settle down again from that. Despite doing “light” core strengthening work tasks for them, I have weak abs in general and a tendency to get hernias in the male side of my family line, so I have to be especially careful not to overdo things where the abdominals are concerned.

    The left side neck pains feel like soreness, almost fatigue. I am left handed, and all the joints on the left side of my upper body are “noisier” than those on the right side. The left side of the neck vertebrae joints feel “looser” than on its right side, despite the physio’s assessment that the muscles on each side are roughly the same in strength / tightness / looseness.

    On some days, I feel these left side pains more or less all the time after getting up in the morning, both when active and at rest. On other days when they are not so prevalent as I get up to start the day, exercising often brings them on – I do various simple, light exercise tasks, some daily, others 2 x a week, and still others 4 x a week, and I usually take 2 walks and 2 runs each week, all a little under 4 miles.

    At times when these issues are prevalent, I feel pains to the left side of the neck and along the top of the left shoulder / UFT, when I turn my head either to the left, or to the right. But there are never any corresponding pains to the right side of the neck or right shoulder / UFT, from doing either of those head movements to the left or right. This is clear evidence of some sort of side-specific discrepancy.

    From work with the physio, we tried various types of pillow for sleeping on overnight, and now I sleep on a “medium” softness orthopaedic pillow, but turned over so the curved part is facing down, as the back side feels more comfortable for my head and neck body shape. We don’t think my sleep habits have been the cause of the left side issues.

    Taking all the above into account, I have a couple questions about these persistent left side neck and shoulder problems:

    • The pelvis and shoulders have both now been back at the horizontal for over 16 months. In your experience, can such side-specific pains to the neck and shoulder-UFT, linger for so long after having straightened out contralateral pelvic and shoulder tilts? If not, and some other cause is implied for those left side pains, what could that be?

    • Given that the muscles always assess as “even” left to right when the physio checks / re-checks them, could the left sides of the neck vertebrae joints be weaker than their right sides? If so, what exercises / stretches could I do to “even out” this discrepancy? The physio thinks I should only be doing bi-lateral work for the upper body muscles now, and given that she continues to find those are about the same left vs right, I tend to agree with her. Can you recommend tasks to target the tissue on just one side of the neck vertebrae joints, not the main muscles along the neck?

    Many thanks for your help Mark

    – Nelson

    Reply
  4. Hi Mark,

    Thank you so much for the detailed information.
    I was a bit confused about something. In your picture, it shows that the hiked hip is the side that’s more perpendicular to the ground. The leg with the dropped hip is more angled towards the midline. So more weight is on the hiked side.

    In my case though. I have a hiked hip, but my body actually moves away from that side. So my weight is more on the dropped hip side. Is this blog then still useful or is it more likely to be something else than a hiked hip?

    For a little more context: My right ASIS is higher in the frontal plane and a little bit behind the left ASIS in the transverse plane. It feels like my right hip is more posteriorly in relation to the the left. WhenI rotate my right side a little anteriorly while keeping the left side in place, I look more even, but it takes a lot of effort. I feel a lot of tightness in my right SI/QL/ oblique area, but also in my right deep lower abdominal area. When I sit in a chair, I also feel like I sit more away from the hiked hip, what’s actually making it hike more.

    I was wondering if you still think that sounds like a lateral pelvic tilt, or that it’s more a functional leg length discrepancy? Or is that actually the same thing? I was not sure because my right hip is hiked/more posteriorly rotated but is not the side I shift my weight towards. So I want to make sure to address it the right way.

    Thank you!

    Best,

    Wendy

    Reply
    • Hi Wendy,

      If you tend to place most of your weight on the dropped hip side, it could be due to a structurally shorter leg on the drop side. If this is the case – you can try a heel insert to see if that balances every thing else out.

      Another possible reason is that your torso might be leaning more towards your left causing you to place more body weight through the left foot. If this is the case, you likely have some sort of lateral bend in your spine. This might explain the way you that you sit.

      It also sounds like you have a rotated pelvis to the right which you might need to address if it is causing you issues.

      In terms of exercises, you can still perform the lateral pelvic tilt exercises, but it sounds like you will also need to address the torso.

      Mark

      Reply
  5. Hi Mark,

    Thanks for the detailed blog, it has helped me greatly with the lower back pain relief.
    Since 2 years after having severe back pain I have noticed I had right hip hike ,then I showed my PT, he said I have nothing to worry about and didnt show proper exercises then after researching on internet i came across your post and after doing those exercises I had a pain relief in my lower back pain..

    I have noticed :

    I have right hip hike
    I have smaller glutes on right side and bigger on left
    Right side of my body feels stronger

    I wanted to know how i can equalise my glutes size? will the right side drop or the left will hike up? and automatically both glutes will start looking equal after I have stabilised my pelvis..

    My situation is very embarasing, please help!!

    Reply
    • Hi Shivangi,

      You might need to focus on single leg glute exercises for now.

      This might include exercises such as single leg squats, step ups, lunges, bridges etc

      Are your calf muscles the same size?

      Mark

      Reply
      • Yes I have same size of calf muscle.. I can share images of my pelvic tilt.. where can i share?

        Single leg – bridge, squats, step up and lunges with right leg? My right side like legs and overall balance feels stronger than the left side..

  6. Question, i didnt understand how does the weak adductors on the lower side affect lateral pelvic tilt, if it is the pelvic that is on the side and asymmetrical its sounds obvious that the glute med affect the issue but how does the weak adductors on the other side affect this issue?

    Reply
    • Hi Daniel,

      The adductors on the low hip side is in a relatively elongated position as compared to the opposite side.

      If the adductor is not maintaining the neutral length in a static standing position, the pelvis will not be level.

      It works in conjunction with the opposite gluteus medius to keep the pelvis level.

      Mark

      Reply
  7. Hello, so i have a couple of questions:
    1. If um doing 1 exercise for the adductors and 1 for abductors (glute med) how much sets for each exercise should i do and how much rest between?
    2. How much workouts like these per week?
    3. How much time/workouts would it take to see serious difference and serious improvement in fixing this issue? Like a month/2 months/3, obviously everyone is different but still.??? Tnx

    Reply
  8. Hi Mark, I am your biggest fan and you have given me hope after dealing with pelvic tilt for almost three years now. I have a question concerning lateral pelvic tilt. When standing on in a neutral position my right side hikes hip but when doing the Trendelenburg test my left hip hiked up. After having an injury on my left knee I put all my weight on my right side and my left side feels week and knee feels unstable. Which lateral pelvic tilt should I address, left hike or the right hike?

    Thank you
    Rafay

    Reply
    • Hey Rafay,

      Sounds like you have a right hip hike secondary to injuring your left leg.

      This is because the body tends to move AWAY from the injured side.

      To address this – You will need to focus on strengthening the left side in general. (eg. single leg biased exercises such as step ups, balance, single squats, lunges etc_

      Mark

      Reply
  9. First of all, I’d love to share my gratitude towards this post. Nowhere else have I been able to get a more clear understanding of my conditions, and the steps that I need to take towards correcting them. Over the past few weeks, your website has been a blessing.

    However, there are still lingering issues that are preventing me from simply easing into good posture, and information for it has been quite scarce. Currently, as a result of 2-3 years of lateral pelvic tilt, my entire body is still very imbalanced. Although I am currently working on a lot of my imbalances (chest, arms, serratus anterior, shoulders, legs and glutes), I cannot find information on exercises I should be doing to fix my neck and core. The right sides of my neck and abdomen is significantly smaller and weaker, and whenever I try to do simple crunches, only my left abs can feel the burn. I believe my neck imbalance also enforces a slightly unnatural head position. For the past 3 or so weeks, I have completely relaxed my neck muscles into a state that feels equally stretched, but I not sure what I should be doing to strengthen the right side. Similarly with my abdomen.
    So, I would like to ask, what steps should I be taking in order to fix these issues? and or full scale muscle imbalances as a whole? Or will simply stretching them out on a consistent basis gradually strengthen them into normality?

    Anyways, thank you in advance! And I’m sorry if I’m asking for too much, I don’t mean to bother you so I would be understanding if you are unwilling to reply.

    Reply
    • Hey Timothy,

      As you feel the left side of your abdominal wall contract more so when performing crunches, it may be due to some sort of rotation in your spine. This would also cause your head to sit in an uneven position as well.

      Check out this post: Twisted Spine. See if that relates to you.

      As your shoulder and head sit on your torso, any twisting in the spine can result in asymmetries in the arm, chest, scapula and head.

      Mark

      Reply
  10. 1.Is it possible to have strong TFL and weak Glute med on the left leg but strong Glute med and weak TFL on the right leg ?
    2. If is, can it cause lateral pelvic tilt?

    Reply
    • Hey Aviv,

      Yes – You can have a relatively weaker TFL vs Glute medius on the same side. It can also occur in conjunction with a lateral pelvic tilt.

      Mark

      Reply
  11. Hi Mark, I’ve got the following issue. I have a tilting of my pelvis but it differs from your picture. My right hip is higher than the left but in contrary to your picture I lean away from that side to the left, my right shoulder is higher than the left and my head counter-tilts to the right. I feel my left abductors being tighter and my right abdominals being stretched. What can be reasons for leaning away from the hiked up hip? How should I modify your exercises?
    Kind regards,
    Stephanie

    Reply
    • Hey Stephanie,

      You can definitely have a higher right shoulder with a right hip hike. This just means that your lower torso did not counter tilt towards the right. (Your neck did instead.)

      In terms of why your torso is leaning to the left: Have you had history of one sided lower back pain? Your body may have learnt a bad habit from this.

      (Also check to see if you have any lateral curves in your spine. See post: Scoliosis Exercises.

      You can perform the exercises mentioned in this blog post and see if your torso automatically corrected to a better position. If not – it is more than likely that you need to address the torso (see link as mentioned above)

      Mark

      Reply
  12. Hi Mark,

    For the Leg Lift (3b), could I place an ankle weight on my right ankle as the Progression?
    For the Hip Hitch (Standing) (4c), could I place an ankle weight on my left ankle as the Progression?
    For the Step down/up (4f), could I place an ankle weight on my left ankle as the Progression?

    Frank

    Reply
  13. Hello Mark,
    first of all thank you very much for all those information – I’ve been having hip/ back pain for 5+ years now (I’m 28) and I’ve regularly checked this blog!
    Unfortunately I havent had too much success with overcoming my pain until recently, which is probably because I started overestimating myself in the gym way too soon…

    I am determined to finally fix my health for good and I’ve made some decent progress in the last 2 months but my head is full of questions.

    When looking at myself in the mirror I am pretty sure that my left hip is hiked. When lying down though, my left leg is DEFINITELY longer than my right (which would mean a drop of the left hip).

    To explain my situation a bit better here are other symptoms I definitely have:
    – I have flat feet.
    – My left shoulder is heavily impinged and my left trap is also very overactive.
    – The left of my rib cage (a bit under my left Pec) usually is very compressed and can sometimes release in a “Pop” when I extend my spine.
    – My left leg always is fully locked when standing with my hip pushing out towards the left (when standing, most of my bodyweight is on that left leg aswell)
    – My right knee likes to cave in towards the left side, while my left leg likes to “flare out” towards the left.
    – When performing lunges/ glute bridges etc. my right leg/ glute is for sure stronger than my left. Especially when doing lunges I am way more stable on my right leg.

    When combining those symptoms, does this paint a clear picture to you or are there any contraticting points? I personally believe, that my left hip is higher than the right whilst having a pelvis which is rotated towards the left (right knee caving in, left leg abducted more than the right).

    The pain I’ve been experiencing for years is located in my left SI Joint / left outer hip and lower back.
    (A heavy focus on glute med and general “anti-ATP” work has definitely helped so far)

    I hope I am not overwhelming you with this wall of text. It feels like I’m slowly discovering whats wrong with my body, but I have nobody to confirm these theories.

    I would highly appreciate any feedback from you – how would you assess my situation and what would you focus on improving first?

    Thank you so much in advance and thank you for helping so many people over the years.

    Jay

    Reply
    • Hi Jay,

      It sounds like you may be constantly using your muscles in the left lower back to support your torso on a tilted (left hip hike) pelvis. This may explain the pain in the said areas.

      If the torso follows the line of the left hip hike, the torso would be slanting to the right. The body will tend to compensate by bending towards the left. This may also explain the compression zone in the left rib region.

      If your left leg is longer and you are standing more so on this left side, the left hip will be pushed towards the left more. This can strain the left outer hip region leading to issues such as glute tendinopathies and hip bursitis.

      If your left leg is significantly structurally longer than your right, you may need to consider wearing a small heel insert. If you are not sure, you can either can a health professional to check for you and obtain a leg length measurement via a scan.

      Left pelvis rotation will usually be coupled with hyperextension of the left knee.

      In terms of where to start: I would go after the pelvis tilt first with the exercises mentioned on this blog post.

      Mark

      Reply
      • Thank you so much for that quick and very detailed answer!!
        Yes, that is a very good assessment! My left back and core muscles are definitely a lot stronger and active than my right.
        I will incorporate some of the exercises which focus on strengthening the right side while stretching the left (QL and such) – this is for sure a area I didnt pay much attention to.

        Thanks a lot for taking your time :) you’re doing an incredible job!

        All the best
        Jay

  14. Hi mark, what would you say the one best exercise for the glute med but only on one side, meaning only my left glute med specifically which i can also progress??? I know you give here a lot of options but if you choose one for only on one side and possible to progress with either resistance band or weights?

    Reply
    • Hey Aviv,

      It really depends on your ability to engage your gluteus medius effectively.

      For most people – I would start them in side lie without any resistance apart from the weight of their leg. The reason behind this is that many people will compensate by tilting the pelvis by using their Quadratus Luborum.

      Mark

      Reply
      • Im doing the side lie but im not sure if i activate the glute med it feels like the glute maximus is am i doing it right? I did it like you said without compensating with the QL and TFL, does the glute med and max supposed to work together in this exercise?

      • Glute max activation is okay but if you wanted to bias the glute medius, you would need to make sure that you don’t extend the hip too much.

        Mark

  15. Hi Mark,

    Very informative Article.

    My question is that, my right hip is hike and left hip is lower. But on the left side of hip, my knee feels kinda stiff and I can’t do heel to butt on my left side of hip. And it all started with left leg, it not feels in correct alignment and knee is clicking as well. I hope you will guide me.

    Thank you.

    Reply
  16. Hi Mark
    My case is i have left lateral pelvic tilt first then after couple months i start to have right rotated pelvic. Which issue should i fix first? Thanks a million

    Reply
  17. I pushed about 400-500lb, suddenly twisted to the left while my feet were stable and apart (about 2 feet), grabbed the load from the left, and pulled with my arms and upper body to the right to keep it from ramming into a wall (like trying to slide the base of the load which didn’t slide at all). Immediately I felt a sharp pain in my right lateral hip and right groin. The next day, sharp pain while weight-bearing, my lower back, and right posterolateral buttock pain developed. Over the next few weeks, working and not working, it would get better, then worse. Sometimes my teeth would chatter as though my core was under great physical stress and I was exhausted all the time. An event happened while working that felt like my entire body was twisting (a torsion) that brought me to my knees with cramping and pain. I then felt like I was unstable and/or crooked, that I needed a firm band or belt around my hips. Then a profound limp occurred and over 1 year my right hip cartilage completely deteriorated requiring a total hip replacement. That was recent. I am 12 weeks out with the same pain but now the right hip has something of a ball, like the femoral head or prosthesis palpable, like the pelvis is twisted outward on the right kind of pushing it outward…twisted. Again, I feel I need a belt or tight band around my hips to stabilize me. The IT band has become like a rock. The right buttock right behind the femoral head is sharp causing a limp, pain in the groin, the posterior sciatic nerve to the heel at times, and now the lateral right knee. Before this happened, I played kickball with the right dominant leg, worked 13 hours a day in a super busy emergency room, and had no hip pain at all. I was so strong!

    I came across your site seeking information about pelvic tilts; horizontal or vertical, torsion, or anything to diagnose this problem so it can be fixed. At first, I thought it was an impingement of some kind, my instinct was to put traction on my right ankle to pull my hip and I still have that instinct but don’t do it because of this new hip. I cannot do a straight leg lift and abduction causes sharp pain to the lateral hip, all since injury in early 2019. Your dedication to your craft is exceptional. Your teaching is simple enough to understand easily but complex enough to show your skills. I am too happy to have run across you. I know this space is not enough information (a lot of things are left out but the core is here). Do you have a clue regarding what has happened to me? Thank you so much for all you do for everyone here.

    Reply
    • Hi B,

      Just to clarify a few things.

      You mentioned that you recently had a hip replacement (12 weeks ago), but your pain still has not resolved?

      This leads me to believe that your original pain was not 100% due to the hip joint itself.

      It sounds like you may have some unresolved muscular imbalance issues which may be leading to your feeling of hip instability and being twisted.

      By the way you have described your mechanism of injury, it sounds like your pelvis was twisting to the left as the torso was twisting to the right? Does this ring true to you?

      If so – this could mean you over tensed the right lateral hip region and over stretched the inner hip (groin/adductors).

      The sciatic nerve passes through the posterior hip muscles which can compress the nerve and cause your said symptoms down your leg to your heel.

      Here are some things you might want to consider:

      1. Rehabilitate your hip joint first. Please be guided by a health professional! It is important to regain your full rotation especially. Get good at general movements such as squats, stairs, walking etc.
      2. Once your hip joint is fine – consider getting treatment to your groin and posterior hip muscles. I suspect you have unresolved issues in these muscles. If they are tight – you will benefit from stretching and releasing them.
      3. Determine if your pelvis is rotated. (See post: Rotated Pelvis). This will help balance your hip muscles.
      4. Once your pelvis is more neutral, consider strengthening the hip stabilizers. (see post: Gluteus medius strengthening exercises)

      All the best.

      Mark

      Reply
      • First I want to thank you more than you know! For almost 3 years, since I was injured this horrible problem has persisted and intensified. Imagine feeling hip cartilage grind away knowing it was not age-related or “normal” processes and the entire body deteriorate and atrophy from inactivity? I don’t even know how many “experts” or “specialists” I saw who had not a clue? Anyway, I did the Rotated Pelvis with the help of my daughter and immediately she saw the left thigh rotated forward from the front and the left thigh forward from the back, and the umbilicus pointing toward the right. I knew I was severely twisted! I felt it in my core, the fatigue as my body fought to stay aligned, and even my teeth chattering in the beginning when it was at its worse.

        I currently see Physical Therapy. This is a Worker’s Compensation case and the multibillion-dollar “healthcare” corporation will “only pay for the hip” as court-ordered, stating it was dormant osteoarthritis that appeared miraculously at the time I was injured. I will print out your Rotated Pelvis assessment and take it with me to PT and the surgeon. I read that a rotated or tilted pelvis will destroy a hip replacement and spontaneously dislocate even years out. I know I need to keep these hip muscles very strong to prevent that.

        I just have one more question. I’ve seen Neurologist, Neurosurgeons, Orthopedics, Occupational Med, general practitioners, a Surgeon and I need to know exactly who can measure the degree of this rotated pelvis and treat it? Is it a Physiotherapist I need to see?

        Thank you again, you are just perfect!

      • Hey there,

        The best would be to see a physical therapy or a chiropractor. They will be able to help with the rotation of the pelvis which strongly influences the hip.

        It sounds like your rest pelvis position is rotated to the right which places the right hip in a degree of internal rotation. Internal rotation is generally the position where the hip can get impinged.

        All the best!

        Mark

  18. 1) I have Hip hike on right side and have lateral pelvis tilt.. My right knee seems internally rotated.
    2) I checked pelvic rotation and after doing one set of the full exercises.. it looks fixed now when i checked my thighs.. my right thigh was forward earlier meaning i had right pelvic rotation..

    3) I wanted to know how to fix right knee internal rotation with lateral pelvic tilt?

    Reply
    • Hi Shiv,

      I would think that the hip internal rotators/adductors would be fairly tight on that right side. You will likely need to address this tightness first.

      Follow up with more hip abduction/external rotation based exercises for that right side.

      Mark

      Reply
  19. Does lateral pelvic tilt, functional length leg discrepancy,uneven hips affected by the glutes maximus? It seems odd that the glute max isnt mentioned when it makes sense that the strongest muscle that control the pelvic will have some to do with the problem, please explain.

    Reply
    • Hi Aviv,

      The gluteus maximus is definitely an important muscle when it comes to stabilizing the pelvis.

      However – I tend to see it more involved with rotation of the pelvis/hip than in controlling a frontal plane issue such as a lateral pelvic tilt.

      But you are right – you still want to train the glute max once the pelvis is more level.

      Mark

      Reply
      • Question, i do the hip hitch and i can do more than like 50 full reps very slow, isnt it better to just add weight? Maybe i need more strength than what i can achieve with my body weight…?

      • Hey Aviv,

        If that exercise is too easy now, you can add resistance to it now. However – if you are still having issues of uneven hips, then I would think you need to focus on another exercise that you are having difficulty with to get the best results.

        Mark

      • Question, i did a bone scan and they said im fine,so basically if have functional lateral pelvic tilt and i didnt broke any bones and i think i never injured then it most likely muscle imbalances, but the question is when it comes to the hip hike and hip drop it sound like the more the glute med and tfl is stronger and the more the ql is streched in the same side it would cause the hip to drop because it have more power to keep it being “dropped” and it also cause the leg to be longer becuase the hip is lower but i dont have structural longer leg so if i have one leg shorter and i dont have any structural problem then the only cause of my short leg is the weak glute medius and weak tfl. Because they arent strong enough to deal with the load so the pelvic just give up and the pelvic kind of goes to the side, and im saying this because every time i exercise the short leg until its exhausted right after the set i try to stand straight but im falling to the side that i just exercised and it feels like the leg became shorter but it didnt, its just the pelvic muscles that gave up because i exhausted them. So my question is, do you think my theories are true? And should i keep exercise the glute med and tfl on my shorter leg?

      • Also its sound very complicated to me, i thought about it and if someone have structural shorter leg then their hip on the short leg would be lower becuase the bone leg length have nothing to do with the pelvic so the long leg would drive the hip higher and the short leg would go down but if someone have functional shorter leg then their hip would be higher becuase if my theories are right then the hip would be higher becuase the muscle arent strong enough so they give up, so if this is true then all the knowledge i read in all the sites and every video i watched it only talks about structural becuase they arent explaining this, if what im saying is true then i hope you would add a similar and more broad information on this idea to your blog in order to help other people understand this extremely complicated chain reaction asymmetry topic of the human body in order to make more people understand it and hopefully fix my problems and everyone else.

      • Do you have a book on more knowledge about asymmetrical posture and how to fix it? Or is there a book you know that you recommend about asymmetry specifically? Im not sure im fixing my problem :(

      • I think my tfl and all the other muscles are improving but my glute med is staying weak, and now i think he doesnt even activate its like he is staying behind and the other muscles are taking over and not letting him do the work he should do… , what should i do if i feel the tfl all the time but the glute med doesnt activate, “fire” ?

      • Question, what do you think of the exercise clam/clamshell with band for the glute med? I tried it and i feel like it isolates the glute med… What do you think? Is it a good exercise for the glute med?

      • Hi Aviv,

        This exercise is fine to do for the Gluteus Medius.

        (Just make sure that you are feeling it in the correct muscle. Usually people tend to over use their TFL when they perform this exercise.)

        Mark

  20. Hi,

    When I am standing,I notice my left hip is the one thats higher. However, when I do the Trendelburg test and standing on my right leg, it is my left hip that drops more. When I stand, most of my weight is shifted to my left leg due to my lateral pelvic tilt even though my right leg is stronger. With that said, which side is the one with the hip hike (and hip drop)? I believe it is left but the Trendelburg test confuses me.

    Reply
    • Hey Jason,

      If your hip is higher on the left side, this would be counted as a lateral pelvic tilt with a left hip hike.

      However – if your left hip drops with the Trendelenburg as you test the right leg, this suggests that your hip stabilizers are weaker on the right.

      It is possible that you are standing more so on your more stable leg (even though the right leg may be your dominant/stronger leg).

      I would strengthen the right the side with single leg exercises such as step ups, single hinges, single leg squats etc.

      Mark

      Reply
    • Hi Caitlyn,

      If you structurally have one leg shorter than the other, you won’t be be to get your pelvis 100% level if your pelvis is sitting directly on top of your feet.

      Keep in mind- the body is strong and can adapt so having uneven legs does not equate to having more issues.

      I would suggest that you become efficient with single leg exercises such as single leg squats, lunges, single leg balance etc

      Mark

      Reply
  21. Hi
    I just noticed that I have uneven hips and one of my shoulders is higher than the other. The weird thing is that I have the hip hike and the higher shoulder in the same side which is my right side. When looking at the figure in the top I see that the hip hike and the higher shoulder is in opposite sides. What could be the reason I’m experiencing it in the same side? From different strength exercises and stretches I see that I might have the muscular imbalances descripted in the bullet point A.

    Reply
  22. Hi Mark I have mild functional scoliosis & my leg length is shorter & I have a pelvic tilt on the left side. In regards to the stool exercises you posted – the hip hitch & step up down , I’m doing them standing on my affected left side & It feels like it will make my pelvis hike up more than it already is … shouldn’t I be doing them on my right side so as to make the left leg drop & longer …. just wondering about this , if you could explain it to me pls … thanks a ton for all you do .. its so helpful ..
    Sarah

    Reply
  23. Question, in your picture standing where there is the hip hike, hip drop, i can see that your standing on the side so my question is it possible that if the body is standing on the side because of the lateral pelvic tilt it also cause one flat feet? on the side where the leg is longer because there is the leaning?

    Reply
  24. Hi Mark,

    I’ve stumbled across this article after 20 years of hip, glute , adductor and lower back pain. All in my left side. This pain started due to extreme flexibility from gymnastics and martial arts but I do remember my left side being more tight, but could achieve full spilts both ways and various flexibility feats. Seen various thearapist but nothing. I am currently doing weights including squats but all volume but nothing alleviates or fixes the pain and constant discomfort.

    So I more than likely have some un even hips and muscles imbalances … ie/ I have to carry anything in my left hand otherwise it I do it right handed it triggers lower left back pain and my lower left back muscle is much bigger (and tender) .

    Could you offer any advice as to where to start – I’ve been searching for relief for 20years. I would love to return to normal function and start some martial arts again .

    Many thanks

    Ps. I’m currently booking appointments with a osteopathic therapist – is there anything I can get him to check/ diagnoses?

    Reply
    • Hi Nick,

      Whenever there are symptoms predominantly on one leg only, I tend to think that the pelvis is not symmetrical.

      This usually involves the pelvis being laterally tilted (this blog post) and/or Rotated (See post: Rotated pelvis)

      I tend to see a bigger left lower back muscle in people with a right rotated pelvis.

      You might also have a degree of scoliosis.

      In terms of where to start: Get the osteo to check pelvis and spinal alignment. The therapist will likely then look at some movements to see what happens to the pelvis and spine.

      Mark

      Reply
  25. Hi Mark!

    A few questions:

    1) Regarding the hip hitch exercise (right leg standing straight – trying to correct a right-side hip hike) – I can definitely feel my right side hip muscles engaging, but aren’t the muscles on the LEFT side a bit weaker and shouldn’t these be worked by doing the opposite? Or is the idea of strengthening the right side for these muscles to pull down the pelvis to restore neutrality?

    2) About how long of performing these exercises multiple times daily should one start to see some improvement with, say, a moderate tilt? I know this all depends on the severity and how effectively the stretching/exercises are performed but about how long before one should consider a different cause – perhaps neurological or something else?

    Thanks in advance!

    Reply
    • Hi Kevin,

      Thanks for your questions.

      1. With the standing hip hitch, the goal is to feel the Left QL and the Right Glute medius muscles activate.

      Although having said that: If you find that the left side is weak in general, then you would want to focus on performing single leg exercises on the LEFT.

      2. Hard to say as everyone is different. If absolutely no difference within 6 -12 weeks of consistently performing the exercises, I would think you will need to address other areas that might be influencing the pelvis position. Eg. spine

      Mark

      Reply
  26. Mark, great content. I have a right side hip hike that is messing with my walking/running gait. Would you recommend standing on my weaker left leg while at work and/or using left insole heel cushions as a way to “passively” work the lacking muscles? Thanks.

    Reply
    • Hi Spencer,

      Single leg loading can be very beneficial when it comes to addressing a lateral pelvic tilt.

      Insoles are not always indicated but might help in the beginning especially if you have flat feet.

      Mark

      Reply
  27. Hey mark,
    Thank you! after years of pain and months of professional treatment i finally know what is wrong with my body.

    I have hip hike on right side and scoliosis(leaning toward left)

    I have 2 question,
    1: I always use to stand on my left leg and sleep on my left side,
    So should i now start giving my right side preference until i get more balanced pelvic.

    2: I also have pain on part of right femur which is visible under ileum(i don’t know what it is called).

    Reply
    • Hey Santosh,

      Thanks for your questions.

      1. If you habitually sleep or stand on one side, it is good practice to go on the other side from time to time. Otherwise- your body essentially gets habitually locked (or favors) in one position.

      2. Do you mean the pain is on the side and/or back of your hip? If so, it could be Hip bursitis.

      Mark

      Reply
  28. Hey Mark, thank you for this great content. I really appreciate your great work and really hope you can help me. I am suffering almost 3 years with pain in my thoratic spine after a rowing. I get multiple knots around my left erectors and they are always switch and refering pain into the front. It’s like from neck to the left hip and I got Triggerpoints in the q.lomotdum in the corner to the last rip. When this knot gets really bad I get a spasm in the left neck. When I look at my belly it’s rotate to the right side and I am crunched on the left. I feel the the problem is in the hip. I am muscular and the explanation from my therapist is, that the strong erectors an the lat try to compensate the misaligned hip. And when they get into spasm they put pressure on the nerves causing pressure on the facet joints.Is this possible and how can I fix it?What is irritating me, is that you teach to stretch the right side when the thorax is rotated to the right, but I feel tightness in the left side. I would really appreciate any help, been going from doc to doc and nobody can help me, please.

    Reply
    • Hi Dawid,

      If your belly is pointing towards the right, I would suspect that the pelvis is rotated to the right.

      This can cause the left side of your body to compensate for the position of your pelvis and lead to your said symptoms in the erector spinae muscle.

      If this is the case- you need to direct your attention to the pelvis first. (See post: Rotated pelvis)

      If your left erectors are fairly tight, you may also benefit from Erector Spinae Stretches.

      Since you also mentioned that you are a rower, you may be tilting towards one side as well which could force the left side to compensate. ( See post: Scoliosis)

      Mark

      Reply
  29. Hi Mark, my right hip is higher the other and it happened after a total hip replacement. I didn’t understand why with the left hip replacement everything was great and now with the right one things are so bad. 7 years later after seeing many doctors I figured it out my pelvis was tilted after the right hip replacement. I started googling and thankfully found this page. I will start your exercises today. Thank you so much for all this information. Is it too late to fix it? I really hope not since I’m in a lot of pain due to this. Thanks a lot

    Reply
  30. Hi Mark

    My right glute seems much tighter than my left. I also experience pain around my right si joint/upper glute maximus zone. Occasionally my left quadratus lumborum starts spasming and leaves me in pain for Days and wont be able to bend or get up without pain.

    I took some pictures of myself in the mirror of my back and can see that my left glute is slightly higher than my right. Also slight scoliose, so basically a letter S on my back.
    I also have tight left upper back muscles.
    Do you think this is due to a structural leg length difference, my right leg being shorter? Since i also prefer my right leg, stronger leg and also used to always lean on this leg?
    But then keep in mind that i think i have a left hip hike due to structural leg length diff.
    Thanks

    Reply
    • Hi Vullnet,

      It could be due to a leg length issue. If you are not sure and want to find out, you can get a scan for this.

      If it isn’t, there exercises mentioned on this blog post should help (and perhaps some scoliosis exercises)

      Mark

      Reply
  31. Hii mark
    My right hip is higher and smaller or loser and my left hip is lower bigger and my right leg or arm is bigger than left
    I m confused what to do
    Please help me

    Reply
  32. Hi Mark

    I’m pretty sure that my right hip is higher than my left and my right leg is internally rotated with my right foot pointing outwards. I’ve read that its typically the lower hip that internally rotates with a pronated foot. Is this correct? Now I’m thinking my right hip can’t be higher if that’s the case…?

    Reply
    • Hi Rosie,

      You can definitely have a right hip hike with internal rotation of the hip.

      In addition to the exercises mentioned in this blog post, I would also recommend having a look at this post: Knee valgus.

      Mark

      Reply
  33. Hi Mark

    I’ve got a higher right hip but my right leg is in internal rotation. Should I do the exercises as outlined in above or should I do them differently? I don’t want to be making my right leg more internally rotated…

    Reply
      • Hi Mark,

        I had met with an accident and have got 1.4cm of shortening in my right leg due to
        which my left hip has become higher. Can you please suggest so e good exercise so that my posture becomes like earlier.i don’t want to use any soles.
        Would be waiting for your reply 🙂

      • Hi Ayesha,

        I would suggest giving the exercises mentioned on this blog post a try first.

        Your structural leg length shouldn’t change unless there was a major trauma to your leg bones in the accident?

        Mark

  34. Hey mark ,
    Lateral/anterior/posterior hip tilts normally should take how many months of strengthening and stretching to resolve(and based on what training volume in a week ?)

    Reply
  35. Can pelvic tilt cause difficulty in walking. Sometimes, not from pain but just because I can’t seem to move I have difficulty walking. Please help.

    Nadine

    Reply
  36. Hi Mark, thanks for the info.

    Quick question. I am a plasterer (construction worker) and spend a lot of time bent over and predominantly lean on my right side whilst doing this. My right hip is hiked and my right QL is sore, my right glute medius feels like it’s tired and possibly overworked as I stand on my right side, however in your article it states that the glute medius on the side of the hike is weaker? Could you please explain this, as if I’m standing on my right side a lot wouldn’t that make the right glute medius stronger than the left and therefore I need to strengthen the left side?

    Reply
    • Hey Cobi,

      You can have a stronger glute medius on the right side with a right hip hike as well. Since you use this right side more, it is likely all of the muscles (not just glute medius) will be stronger on this side.

      In this case, you will need to teach the left leg to take your weight to help balance out. Single exercises on the left side should help address this issue.

      Mark

      Reply
  37. Mark, hello brother.

    I’m confused. I need your help, Mark.
    1. My pelvis is turned to the right, does this mean that the left side of the pelvis will be lower than the right?
    Or could it be that the pelvis is turned and the left side of the pelvis is higher than the right at the same time? It seems to me that way.

    2. My left shoulder is also higher than the right and turned to the right, the upper trapezium muscle is shortened. The left leg also rotates to the right. The entire left side of the body is turned to the right and weak. What could be the reason? Should I strengthen the entire left side of my body?

    3. When I sit in a chair, my left thigh is higher than my right. I do not understand what’s the matter.

    Help. Tell me what to do and what is the reason. I don’t have scoliosis. This is a muscle imbalance of 100%.
    Health to you and your family. I’m waiting for your answer, Mark. You are the best!!!

    Reply
    • Hi Fred,

      1. The pelvis can be higher on either side with pelvis rotation.

      2. The torso may be following your rotated pelvis. Addressing the pelvis position might help correct the torso alignment. If the pelvis is corrected and you still have torso rotation, I would recommend having a read of this blog post: Twisted Spine.

      3. This suggests that you tibia bone may be structurally longer on the left side. You can get this checked out with a CT scan.

      Mark

      Reply
  38. Hey Mark

    So when I do squats or stand straight or even do hip bridges the stance of my feets are uneven like I always put my left feet a bit forward. Like it is the comfortable position for my body to squat and when i try to make both stance at same level the squat feels un-even .

    And when I stand and put my hands on side of my pelvis the left side feels a bit outward and curvier like a bone pointing out and the right side feels concaved and when I join my feet together the difference is more visible.

    Also when ever I feel both of my glutes in my hand the left one is more round and small and the right one is more long and elongated.

    And when I do long walks there is pain on the outer side of my left knee

    Your workout here are is gonna make my left gluteus medius more strong and the right one weak .

    And since my right glutes already have more hip-dip than left side I fear it might make them more un even.

    And also when I do Bulgarian split squat the right glute has better mind muscle connection than left glute .

    Although I feel my left pelvis is a bit higher but i fear that these excercise will make my right gluteus medius more weak.

    And also when I put my right feet a bit elevated like 1-2 cm the difference on the side of my pelvis is mostly gone like completely. That’s how I came to a conclusion that I have left hip hike.

    Please solve my almost 4 year old problem.

    Reply
  39. Mark,
    I had bilateral sports hernia and bilateral inguinal hernias surgery 2 years prior.
    After surgery things got better, but never fully returned.
    I ended up relying on kratom for pain and slowly became sedentary to avoid pain
    I am a 26 yr old male who trained martial arts and wrestling and I have become severely depressed due to no physical activity bc of this pain and stiffness.

    Your blog helped me realize I have left sided hip dominance and right weakness as well as iliopsoas bursitis. I actually thought I had a right sided hernia recurrence from the palpable lump that is my bursa.

    Your blog changed everything for me.
    You gave me hope and a plan. Something the dozens of doctors I saw couldn’t do
    Thank you so much. Please keep doing what you do. You are changing lives.
    Sincerely
    Ryan Jellema

    Reply
  40. Hii
    My spine is slightly tilted to left side of my lower back and My right hip is higher and more curvier than my left ,
    My left hip has no curve at all . My right waist line is also slightly curvier than my left one.
    I am very much confused what to do to cure this. Plss answer!

    Reply
  41. Hi Mark!

    This is so so helpful, thank you for putting it together.

    I have a left hip hike/right hip drop, with significant SI joint pain on the right side and inflammation of the right rhomboid. I’m right handed and generally feel like my right side is stronger but it sounds like I should be strengthening the right side and stretching the left side. Is that right? Are there any movements (not necessarily listed in your guide) I should avoid?

    Reply
    • Hi Jasmine,

      If you are stronger in your right but you have a left hip hike, this could mean your left leg is structurally longer.

      If your leg length are equal, it could then suggest that you tend to stand more on your left side. Is this true for you?

      Mark

      Reply
  42. Mark, hello. Please tell me what this means?
    “This can cause the pelvis to hip hike on the stronger side” (c)

    On the strong side, will the pelvis be higher or lower?

    And he also asked. If the pelvis on the left side is turned slightly forward? Will it be higher or lower than the right side of the pelvis? Which muscles on the left side to strengthen and which ones to stretch to bring the pelvis back? The quadratus muscle, oblique, adductor, gluteus medius, gluteus maximus, hamstrings, psoas? In what tone will they be on the left side? This is very important to understand.

    I did not find information about this on you.

    Thanks for the answer. You are the best!

    Reply
    • Hello Fred,

      If your hip is generally weaker on one side, the pelvis can shift towards the stronger side causing the hip to my HIGHER on the stronger side.

      Keep in mind – you can also have a hip hike on the side with a weaker GLUTE MEDIUS.

      If you would like some exercises which addresses the issue of one side of the pelvis going more forwards, check out this post: Rotated Pelvis. It also goes through which muscles are involved.

      Mark

      Reply
  43. Hello, i didnt understand please help me, if my right shoulder is higher than my left shoulder is the right leg is stronger than the left leg or the left leg us stronger? It really confusing to me please help me with this…

    Reply
    • Hey Aviv,

      I won’t be able to tell you which leg is stronger purely based on having a right shoulder that is higher.

      If you uneven hips, it is possible that this may be related to your uneven shoulders.

      If that is the case – I would recommend trying these exercises mentioned on the blog post.

      Mark

      Reply
      • Hey mark, i took a couple of pictures of myself and my left shoulder is lower than my right and my left hip pop out more than my right idk if the left hip is higher but it is more prominent. But i didn’t understand which side is the weaker side? I read everything but it is so confusing to me. How can i determine which hip/glute/leg is the stronger one and which is the weaker?
        You said: “ This can cause the pelvis to hip hike on the stronger side.”
        But when i squeeze my glutes my pelvic rotates like in the anterior pelvic tilt, so isnt it supposed to be when the glutes are stronger the hips are lower because the pelvic rotates ? I ask because i just want to understand which side is the weaker side so i can improve…

      • mark, is there a way i can send you a picture maybe? it would really help me if I can improve this thing that cause me a lot of frustration, is it possible to send you a picture? i know that it is never the same as meeting the doctor office but I would like to hear an opinion on picture of myself to see what the problem is…

  44. Hi Mark,
    I have right scoliosis and I started doing these exercises because you mentioned it in your scoliosis fix post. How long do I have to do these before I move on to exercises in that post or can I do both of them consecutively?
    Also is there a particular sleeping side for right scoliosis or should I be changing sides like you mentioned above?
    Thanks. Looking forward to your reply.

    Reply
    • Hi Sefal,

      You can do them both, but it’s best to stretch/release the concavity to allow for movement to be available to strengthen in the first place.

      If your concavity is on the right side, you can sleep with the right side down with emphasis on flattening the right side onto the bed.

      Mark

      Reply
  45. Hi Mark. I’ve been dealing with right side pelvic hike on and off for 10 years. It typically comes on after doing some type of strenuous activity while squatting. This, in turn, has created some lower back issues as well. I can immediately tell when things have gone “out of alignment” and it is evident by a right shoulder drop and waist crease on the right side. I’ve been working on strengthening the right glute med and left adductor but still having these “events”. Any tips on an exercise to realign the pelvis during one of these episodes?

    Reply
    • Hey Mike,

      It sounds like you need a squat assessment (especially when you are hitting fatigue). You are likely relying on the muscles on the right side more. A simple answer to this is to do more single leg exercises on the left side. This will teach the left side to absorb stress as much as the right.

      In terms of what exercises to realign the pelvis, the exercises mentioned on this blog post should help with that.

      Mark

      Reply
      • Thanks Mark. Any suggestions on what qualifications to look for when finding someone to do a squat assessment? I’ve been through PT several times but feel like the issue has never been as pin-pointed as it is here on your site. (they’ve always had me strengthen/stretch both sides which I’m assuming has helped with symptoms but not correcting the underlying problem) Thanks!
        Mike

      • Hey Mike,

        PT, Chiro, Personal Trainers, Strength and conditioning should be able to help you out with that.

        Make sure that you have equal ankle dorsiflexion and hip flexion mobility also.

        Mark

  46. Hi Mark,

    Thank you for this post. I have right hip hiked up, in this post you have mentioned that the left side TFL/glute medius need to be stretches. However, there is no tightness in my left glute medius and tfl, instead my right TFL is over active and my right external obliques are tight.
    Can I leave strecthing the left glute medius/tfl and follow the rest of the exercises.

    Thanks

    Reply
    • Hey Rohan,

      Yes – this is fine.

      There will always be exceptions to what is stated on this blog post as everyone has an unique presentation.

      Mark

      Reply
  47. Hi,
    Thanks for putting such a detailed post to help people.
    This may sound silly but I have looked at I see I have a left Hip Hike. I do feel some discomfort in my left too. Especially in the gluteus medius, which feels tense.
    How do I now that this is not actually a right hip drop?

    Reply
    • Hey Amit,

      A dropped right hip will occur in conjunction with a left hip hike.

      From my understanding – I think you are asking which side would be the cause? It can be either the left, right or BOTH!

      If your left hip hike is due to the right side, it is likely due to over activity of the right hip abductors. In this case – I would focus on releasing these muscles.

      I would also check to see if you had a shorter leg on the right side.

      Mark

      Reply
  48. Hi Mark,

    I’ve had SI joint pain for around 6 years now and have struggled to shake it. My physio believes the cause is likely due to a lateral pelvic tilt due to a functional leg length discrepancy. I have a couple of questions:

    Given that I’ve had chronic SI joint pain (and likely a lateral pelvic tilt) for many years, is it likely to take longer to achieve a level pelvis? Could I be looking at months/years to achieve this?

    Is it also possible that an SI joint injury may have caused a lateral pelvic tilt as opposed to the tilt causing SI pain?

    Thanks,

    Kristian

    Reply
    • Hi Kristian,

      The general rule is that the longer that you have had your posture, the longer it will take to improve. (Keep in mind, there are always exceptions to the rules)

      6 months is usually the time frame that I generally tell people.

      Is it also possible that an SI joint injury may have caused a lateral pelvic tilt as opposed to the tilt causing SI pain?

      Yes – 100%. The body will tend to compensate to avoid pain. The tilt may have occurred as a result of your pain.

      Mark

      Reply
  49. Hi Mark,

    I have a right hip hike but I’m always leaning on my left leg and my left leg is stronger. Would these exercises still be applicable to me.

    Reply
    • Hey Umaf,

      Have you been assessed for a true Leg length Discrepancy? This may explain your presentation.

      If so – you may benefit from a heel lift for the shorter side.

      Mark

      Reply
  50. Hi Mark,
    I had severe lateral pelvic tilt to the right side and was able to correct it with your exercises. But now my right leg always feels too long. When standing I always put it slightly in front of the left one and I tend to bend that knee a little bit more than the other one. I have a true leg length discrepancy of 6mm r>l measured via standing x-rays. I went to an orthopedic specialist but he says, that a discrepancy of less than 1cm shouldn`t be corrected with heel lifts. Is he right? Should I just wait and maybe my body will get adopted to that?

    Reply
    • Hey Stephanie,

      If you have a true leg length discrepancy, then you will not be able to completely correct the lateral pelvic tilt.

      However- that being said, this does not necessarily mean you will be symptomatic as a result.

      If you have tried strengthening each side and worked on getting the pelvis as neutral as possible and still present with issues, then a small heel lift could help!

      Mark

      Reply
  51. Hello Mark,

    I have left-sided scoliosis and a left hip hike (I’m not sure, but it seems to me that it is on the left). Some exercises seem to make my scoliosis worse (e.g. «hip hitch» exercise – I bend in the same direction as my scoliosis). Is it true?
    I also have a right pelvis rotation (which I’m not sure about either) and some similar pelvic tilt exercises are done on the other side (e.g. «hip shift on wall» for right pelvis rotation and «90/90 hip shift» for left hip hike). Is it ok?
    Can these exercises be harmful if I am mistaken with a side and do it on the wrong side? Or I don’t have it at all and it will appear because I did the exercises?

    (P.S. my message got lost so i duplicate it)

    Reply
    • Hi Liza,

      If the exercises make the posture worse, they might be the wrong ones for you. (or perhaps some of them might need to be tweaked for your individual presentation)

      If you have a left hip hike and a lumbar concavity to the right, the right hip hitch exercise can certainly encourage the torso to further bend to the right. If this is the case – you can still do the hip hitch, but you will need to make sure that the torso moves at the same rate as the pelvis. (ie. the relative position of the torso and pelvis remain the same).

      You will then likely need to stretch out the upper lumbar spine region on the right side to get the torso more up right on a more balanced pelvis.

      Mark

      Reply
  52. Hi,

    I powerlift and have uneven pelvis, I have my one leg longer than the other and is compensated by a heel lift (thought it was genetic at first). Would doing these exercises along with powerlifting help my cause? Or would I have to stop in order for everything to correct over time?

    Reply
    • Hi Logan,

      If your goal is to correct your lateral pelvic tilt, you will need to make sure that your powerlifting does not undo the improvements made with the corrective exercises.

      As you gain more control of the pelvis, you can start to progress your lifts.

      Mark

      Reply
  53. Hi mark, could you explain what treatment the neurological condition first would be? What sort of neurological conditions effect the glutes?

    Reply
    • Hi Melissa,

      Any issue with the nerves that supply the glute muscles may result in weakness. This can lead to a lateral pelvic tilt.

      A common condition would be an impingement of a nerve in the lumbar spine. If this is the case – you are better off addressing the lumbar spine to help restore the glutes.

      Mark

      Reply
  54. Mark – when sitting, one knee (right) is in front / further out than the other – is this due a pelvic tilt, twisted spine, etc?

    Reply
  55. Hello Mark,

    I have left-sided scoliosis and a left hip hike (I’m not sure, but it seems to me that it is on the left). Some exercises seem to make my scoliosis worse (e.g. «hip hitch» exercise – I bend in the same direction as my scoliosis). Is it true?
    I also have a right pelvis rotation (which I’m not sure about either) and some similar pelvic tilt exercises are done on the other side (e.g. «hip shift on wall» for right pelvis rotation and «90/90 hip shift» for left hip hike). Is it ok?
    Can these exercises be harmful if I am mistaken with a side and do it on the wrong side? Or I don’t have it at all and it will appear because I did the exercises?

    Reply
    • I am sorry for repeating the message, there is some kind of delay in messages and I send them 2 times as they first disappear somewhere, and then appear

      Reply
  56. Hi Mark!

    I have left-sided scoliosis and a left hip hike (I’m not sure, but it seems to me that it is on the left). Some exercises seem to make my scoliosis worse (e.g. «hip hitch» exercise – I bend in the same direction as my scoliosis). Could it get worse because of this?

    I also have a right pelvis rotation (which I’m not sure about either) and some similar pelvic tilt exercises are done on the other side (e.g. «hip shift on wall» for right pelvis rotation and «90/90 hip shift» for left hip hike). Is it ok?

    Can these exercises be harmful if I am mistaken with a side and do it on the wrong side? Or I don’t have it at all and it will appear because I did the exercises?

    Reply
  57. Hello there Mark, have been doing these exercises for a few weeks now, how many times do you recommend to do the entire routine weekly?

    Reply
  58. hi mark. in doing the tests i cannot decipher which hip is hiked and or dropped but my pelvis defintley feels rotated and causing me back pain when bending over or to the right. i am noticebly tighter on my right side for example while doing a thomas test as well as a figure 4 hip stretch and my left leg is longer. the ql’s feel evenly tight and my glutes seem to both pass the tests above as well. when laying on my back my left hip seems to open more and the foot will point more outward while the right stays more toward the ceiling. any idea which side i need to be strengthing and which i need to stretch/ release ? thanks

    Reply
    • Hi Riley,

      If you definitely have a rotated pelvis, try out these exercises here.

      It sounds like you might have a rotation to the right, but I would suggest that you check out the link and do the tests to see which way.

      This may explain your said symptoms.

      Mark

      Reply
  59. Hi Mark,

    This is amazing with thorough information, body is the most important thing for sure, but i am lazy in terms of trying do this many or even a couple of excersizes daily although I try regularly. Is there a quick/easy fix or what would you say the best 4 excersizes would be.

    Also by doing these excersizes how long do you think the issue will be fixed roughly and also will they need to be done for ever or once cured its okay to not do them again

    And i have not usually sat on 1 hip or anything you have mentioned much, i have however deadlifted and using a overarm and underarm grip which could have led to one shoulder being forward and uneven body.

    Would doing something like Tit Tar i think they crack the body parts and say they realign not sure how true it is help me do you think?

    Thanks

    Reply
    • Hi Ily,

      In the beginning, I would strongly recommend that you perform all of the exercises.

      This is to show exactly which exercises are helping you the most.

      Once you know which exercises are the most effective in your individual presentation, then you can cut down the time to perform the exercises by just focusing on the 3 or 4 best exercises.

      Once your pelvis is more aligned, you don’t need to perform the exercises as often. You will need to continue with the exercises as the body will have a tendency to go back to its old habits.

      I am not too familiar with Tit Tar method.

      Mark

      Reply
      • Hi Mark!

        I just want to say thank you for this post, I am so excited to start doing these exercises. Im going to make sure I do them 2-3 times a week. My left hip is higher which I think is caused from me using it Predominantly since I am blind in my right eye. Just my own theory ha! I will be keeping in touch to let you know my progress! My hips are uneven by inches it’s Miserable!

  60. Hey Mark,
    I have rock hard adductor on the right side, and rly tight psoas on that side as well, and physically my right side hip feels more bloated than the other.
    Do you think its related to lateral pelvic tilt?

    Thanks!

    Reply
  61. Hi Mark,

    I’m a ballet dancer and my right hip hike and dropped right shoulder, although subtle, are making it difficult to stand in correct alignment while dancing. I’m having a hard time not sitting into my hips and when I try to lift out of it I’m not strong enough to hold myself there. Any advice? I’ve been doing these exercises and seeing a chiropractor but so far I just feel sore and my tilt is the same. I also do not have scoliosis.

    Reply
    • Hi Liza,

      How’s our balance on your left side as compared to the right?

      If it is worse on the left, and you tend to stand on the right: It may be due to general weakness of the left side.

      If this is the case: I would recommend concentrating on single leg exercises such as lunges, step ups, single leg squats etc on the left side.

      This might help the body shifting more towards the left and balancing out the hips.

      Mark

      Reply
  62. Hey Mark
    So my mom is 85 and “knock kneed pigeon toed as long as she can remember” by her own admission. Two hips replaced. And one hip higher than the other as shown above – in past senior years.
    Recently (last 9 months) her right knee has tilted in significantly and she has pain walking.

    For all the above advice/exercises – Which of these would be “senior safe” and help her regain that proper knee alignment? Or at least prevent it from getting worse?

    Thank You in Advance

    Reply
  63. Hi there. Thanks so much for all of these exercises. I have been waiting years to find something like them in hopes of addressing a number of musculoskeletal imbalances that have plagued me for as long as I can remember. My question for you is this: I have so many imbalances that I don’t know where to start (rotated pelvis, lateral pelvic tilt, flat feet, a crooked back, rounded shoulders, badly winged scapulae).. just wondering in what order to address these ailments to ensure the best of result. Thanks again

    Reply
    • Hey Tim,

      I would usually address the pelvis rotation first.

      That being said, just pick one area to work on, get the most out of it with the exercises. Once you have done as much as you can, move onto the next area.

      Mark

      Reply
  64. Hi Mark,

    I have the left-sided scoliosis of the lumbar spine (C curve), the right prominent waist crease and the right pelvis rotation; my right shoulder is higher than the left and my left leg is shorter than the right. I couldn’t figure out where the hip hike is, maybe my pelvis is level? or which side can it be tilted to?

    And do I need to even the pelvic first (pelvis tilt and pelvis rotation exercises) and only THEN I can do scoliosis exercises? Or I can do all of these exercises TOGETHER?

    Thank you!

    Reply
  65. Hi Mark,
    Thank you for these lateral pelvic tilt exercises. They really help realign my pelvis. I’ve been battling this since 2003. In 2002 I did a bent over row exercise and heard a snap in my spine. I went to the chiropractor after two weeks and I was back in the gym within a month. But in 2003 I did a bent over row lying down on a machine. The bar with weight is on the left and you have to lift then bring it to the center. After doing this I felt a terrible pain in my QL. Ever since, I’ve been having frequent urination. It took 2.5 years of doing knee to chest with resistance from a luggage strap to align the rotated pelvis. Then my orthopedic researched the frequent urination and discovered I had CPPS. Chronic Pelvic Pain Syndrome. Long story short, I was referred to a pelvic floor specialist and she massaged the entire pelvic area. This affects the iliopsoas muscle and transversus abdominus, adductors etc… The left side still goes out if I lift anything heavy, shovel snow, gardening etc… Your exercises align my pelvis without doing muscle energy (knee to chest with resistance from luggage strap or using a broomstick). My questions are:
    1. My left side is the problem. I felt tightness on the right hip/ IT Band area and did a hip flexor stretch with my hand straight up in the air. I tightened my hip flexor, glute and abs and bent my arm to its’ side. I had frequent urination after that. Do you think it’s better not to do any other stretches other than yours?

    Reply
    • Hey Nicholas,

      With frequent urination, I would suggest that you get a scan to see if there is any Central Canal Stenosis. This basically relates to the spinal cord (which controls bowel and bladder) being squashed.

      Probably best to see your doctor before continuing any exercises just to make sure that it’s nothing serious.

      If you get an MRI and there is a bulged disc, have a read of this post: Bulged Disc Exercises.

      But please be very careful! Best to be guided under a health professional when nerves may be invovled.

      Mark

      Reply
      • Mark ,

        Thank you so much for replying to me. I had an MRI for the lumbar spine in 2005. It found a herniated L4 and bulging L5. It didn’t say anything about Central Canal Stenosis. It mentioned nothing for S3 which controls urination.
        When my pelvis is aligned (not rotated) and not laterally tilted, urination is okay (every 2-3 hours).
        If I am not tight internally (rectum), psoas, then urination occurs every 3-4 hours.
        So, the problem is staying aligned and the frequent urination that occurs as a result of not being aligned. This is because the psoas, GM, TFL, QL hamstrings and other muscles are pulling/compensating because of the hip rotation. So when these muscles pull to compensate, they “hit” or interfere with the urinary bladder.
        Please let me know if I am wrong.

      • HI Nicholas,

        Was the L4 and L5 disc herniation/bulge anterior or posterior? Anterior disc bulges can touch the spinal cord and lead to bladder issues.

        If there is no compression of the nerve in the spine, it could be an issue with the actual pelvic floor muscles (which is strongly influenced by the muscles that control the pelvis and the actual position of the pelvis)

        By any chance, is your pelvis rotated to the RIGHT?

        Mark

  66. Hi, mark!
    If you read my message then, while sitting i feel a bone bulge on right side (think its the sit bone) and it hurts alot. I feel that i stand more/ burden my right leg than left. I went to chiro and they half fixed the pain. It still is the same as before. Im a medical student and i need to be able to sit longer to study, which is impossible with this pain.

    Thank you before hand

    Reply
      • Hello

        I think its the reason, im doing excercises such as cardio and weight lifting. This hurts like damn flicker. Why wont it just go away? This thing is not going away. Did alot of exercies for lateral tilit. Dosent get better :/

  67. Hi Mark,
    I have a left hip hike. Ive been doing these exercises and I do all of them the opposite from what you do. However, it just feels like I’m overusing my left leg (which is the stronger one) more than my right which is the weaker one. I feel as if the left leg got even stronger while the right leg stayed the same. Am I doing it wrong?

    Reply
    • Hey Nikki,

      It is also possible that you may have a generally weaker right leg. This would cause your body to stand and lean on the left leg (and hence causing a left hip hike).

      In this situation, I would just focus on single leg exercises such as step ups, lunges, single leg squats on the right side on only. This is to teach the right side to take load.

      Mark

      Reply
  68. Hi Mark, Thank you so much for the wonderful content. I’m living in a foreign country on a small island so don’t have access to a physio so your page is beyond helpful.

    I have a right hip hike, right hip crease and right shoulder is dropped BUT my left QL is noticeably larger and sometimes tight. In the past I’ve had issues with left scapula thoracic pain when sleeping. Now, I have no pain but my sacrum feels a little “off”. I’m weight training and aware that I should make an effort to sort out these imbalances.

    Should I adapt something from this post since the left QL actually seems to be the far more dominant one? Outside of MRI is there any way to self diagnose scoliosis?

    Thank you so much for your time!

    Reply
    • Hey Farra,

      With a right hip hike + Right low shoulder, I would think that the right ql is relatively tighter than the left.

      However, it could be that the Left QL (and perhaps the erector spinae muscles on the left) are working harder to compensate for a rotation in the spine/pelvis.

      Do you have a rotated pelvis or twisted spine?

      Mark

      Reply
  69. Hi Mark,

    I have been suffering with this for years,countless physiotherapy session, chiro etc… and they would help but never gave a plan for fixing the root of the problem. I will start as soon as possible and let you know about my progress.
    I wish I could upload a photo here for you guys to see my shift …terrible.
    I train, teach and compete in BJJ for 28 years always using my right leg forward and now I can’t really train without getting super stiff and locked.
    Thank you for sharing I think that info will be super beneficial.
    Arigato Guga

    Reply
  70. Hello – thank you SO MUCH for the amazing content and advice you have on your pages. I wish i could do a consultation with you!

    I have been doing many of the exercises on your page for a while (a bit on and off, must admit!) but I am often hindered by worrying whether I am tackling them in the right order, given my diagnosis: right flat foot and poor dorsiflexion (from a teenage injury), rotated pelvis and lateral pelvic tilt (right pelvis is backwards and higher) and some scoliosis.

    What do you recommend that I focus on first? And what should be the progression?

    Thank you so much!

    Reply
    • Hey Louise,

      I always say there is really no wrong way to start.

      However – lacking ankle dorsiflexion is quite a big thing in terms of its effect on your walking pattern. Once your walking pattern is out, it can lead to a domino effect of changes throughout your whole posture (rotated pelvis, lateral hip hike, scoliosis etc).

      See post: Exercises for Ankle Dorsiflexion.

      Perhaps start there for next few months and see how it influences the rest of your posture.

      Mark

      Reply
  71. Hi Mark,

    Neither of my hips is higher than the other but on the right side my waist the crease comes in more compared to the left side of my waist that is more straight and not as creased. Any thoughts?

    Thanks,

    Harry

    Reply
  72. Hi Mark,

    Definitely the best page I have come across.

    I have a hip hike on my left side. Pain starts in the lower left of my back, travels down and across the left side of my flank/hip, and sometimes will radiate down the left groin and left glute. Standing up fast or unbalanced usually causes a searing pain, and causes the tilt. And of course it is no fun to walk. Have had an mri and no disc issues. And have no visible rotation.

    After reading some of the comments I am a bit confused on what I should concentrate on. Should I focus on the left side where all the pain is, or on the right side that might be causing me to over compensate with my left side.

    And should I be focusing on strengthening or stretching to start?

    Thanks for any help

    Eric

    Reply
    • Hi Eric,

      Glad you like the website!

      I haven’t assessed you, however, it sounds like the tilt occurs as a result of the pain. (as opposed to the tilt leading to your said pain).

      With the pain distribution you mentioned, it sounds like you need a good assessment of your left hip joint (and the surrounding muscles).

      With pain on the side of the hip, a common issue is hip bursitis. See post: Hip Bursitis Exercises.

      Mark

      Reply
  73. Hello Mark. I’ve got a running injury at the moment which is sending my posture all over the place. Do you have a blog post that I could work through that takes me through all the steps to work out what’s going on and then I can read the appropriate page for your detailed advice such as this one? There’s definitely a real need for advice like you’ve given here so thank you very much for all your time and effort producing this help.

    Reply
    • Hey Ali,

      I don’t have a blog post that takes you through a full assessment. This is where seeing a healthcare professional comes in handy!

      This should give you a good starting point. From here – you can use this blog to help address 1 issue at a time.

      Mark

      Reply
  74. Hi Mark, thanks for the fantastic content which you create and the resources you share.

    I have not noticed any strong indicators of a lateral pelvic tilt from the tests which you mention in this post, however I do notice that in the butterfly pose, one of knees (my right) rests significantly higher than than the other (though both are far from being flat on the floor).

    Can you tell me what this is indicative of? (e.g. lateral vs rotated pelvic tilt etc.)

    Thanks in advance.

    Reply
  75. HI Mark,
    Thanks for all of this. What about the shoulder area? Because my body slumps on it, it’s not on the right position anymore (it’s also rounded forward) and i’m in pain 24/7 because of it. If I try to fix my posture, my body wriggles out of it and I can hold it maybe for a few minutes but after that, my spine rotates, and slumps again. Any advice? I’ve been to physios for the last 3 years and still can’t fix my posture! (And I’m religious about doing my exercises)

    Thanks!

    Reply
    • Also my left glute is harder to active than my right, I don’t know if it’s because it stronger, cause my right fire fast and my left takes a while

      Reply
    • Hi Angelina,

      Not necessarily. You would have to assess the glute max strength as otherwise you would just be guessing if it was weak.

      Another thing to keep in mind is that glute max can perform multiple hip movements. (Extension, external rotation, Abduction). Which movement are you referring to?

      Mark

      Reply
  76. Hi mark, i have been having trouble for a year now with my low back hurting, left knee hurting and right hip bothering me, my right hip appears higher and my right glute doesnt feel like its working. I am trying to figure out which side i should be doing your routine on first. I also find it easier to balance on left leg and not on right.

    Reply
  77. Hey mark. I have a APT and LPT. Hike on left hip, Right QL is tight. Right pelvis rotates forward. Left shoulder is higher. My right should wants to orient to the left. My left glute don’t fire like my right. Both of my arches on my feet want to cave in. I couldn’t hardly walk 3 months ago. The tingling is still on my right side. 21 years old I don’t want to feel like this for another 20 years. If you could point me to the right direction I’d really appreciate it.

    Reply
    • Hey Chris,

      It sounds like there a few things going on with your posture.

      I usually start in the area with most prominent symptoms.

      For example, if tingling down the leg is the main thing concerning you, you would probably want to address the pelvis first and see how the body responds.

      If there has been nil improvements at all, you can try addressing another area.

      But by what you have described, the pelvis and spine would be good areas to start with.

      Mark

      Reply
  78. Hi mark,

    I am suffering a lot with my right leg pain. My right leg is completely different from my left . It’s bigger than my left . I also had an fracture at tendinitis at age of 4. Now I am in my 30s.
    While walking my right leg is not coming fast as my left also my right hip and butt also big when compared with left.
    During my menstruated cycle the size will be even bigger and feels heaviness.
    Having flat foot but more on right side. Also have pain in my upper right back.

    Please tell me what Exercise I should follow .

    Thanks
    Chachithra

    Reply
  79. Hi again Mark.

    I first sent you a comment in late May 2020, and after you replied I sent a further one. As well as lateral pelvic tilt down to the left, I had an old squash injury that had affected my shoulders, and it had pushed their tilt down to the right, well beyond just being compensation for the pelvic tilt in the other direction. Your comments at that time in May were quite helpful.

    Since then I have been doing various of your side-specific tasks from this web page for lateral pelvic tilt. I was seeing my physio now and then for her to re-check the alignment of the pelvic bones left vs right. Despite me being quite disciplined about your side-specific tasks as from this web page, for many weeks there did not seem to be any improvements to the pelvic tilting. Eventually we discovered two things I had been doing, both of which were counteracting all the good work I had carried out. I wanted to share those things with you, as you might not have come across them before.

    The first thing that we now know had been contributing to the lack of progress, was that around March 2020, I had made a switch to which slopes of road cambers I would deliberately run on, when taking my twice-weekly runs of around 4 miles each. For about 3 1/2 years up to March 2020, due to left knee issues, I had run mainly in the cambers that slope down to the left side of the road – but I then changed to the ones sloping down to the right side, for the next 5 1/2 months from April 2020 to early August 2020. Then in early Aug 2020, a review of the mechanics involved in running – in particular in relation to how the glute medius on a given side works to hold the waist level when you take a step with the leg on the opposite side – helped me to realise that it had been a mistake to make that switch to right-down-slopes, as it was defeating my work to strengthen the weak right glute med and loosen up the tight left glute med.

    When I saw the physio on 10 Aug 2020 after seeing little to no progress with the lateral pelvic tilt, we decided to measure just how far out of the horizontal my pelvic bones were from left to right, on that day. We did this by her first checking where the left and right iliac crest bones were as I stood with both feet flat on the floor (as a startout reference), and then she added pieces of 3mm hardboard one at a time under my left foot and kept checking the pelvic bones each time, until they were horizontal again.

    We were amazed to find that it took some 27mm of hardboard added under the left foot, to level out the pelvis! That was quite a lot, we thought.

    As a result of this measurement, and following discussions with the physio about road cambers – from which she confirmed my ideas on the mechanics involved – on that 10 Aug 2020 date, I then switched back to left-down-sloping road cambers for my runs, as well as for all walks taken 1-2 times a week, of most of the same running route. I have walked and run on those left-down-sloping cambers, ever since then.

    After 1 week of left-down-sloping road cambers, on 17 Aug 2020 I had a further idea about something else that might have been counteracting all the side-specific work I had been doing as from your items on this web page. For a long time – over 35 years – whenever I would sit cross-legged, I would always tuck the right leg and foot “innnermost”, then have the left leg and foot more forwards and in front of the right leg. This is not in the traditional “lotus position”, but instead I would just have the legs and feet flat on the surface I was sitting on.

    Over the years, I had gotten into the habit of eating meals with a tray on my lap as I sat watching TV, and this would be the position I sat in – right leg tucked in more and thus stretching the right glute medius more, and with the left leg tucked “outermost” so the left heel rests just up against the front of the lower right leg – which thus meant that the left glute medius was comparatively more relaxed and thus looser.

    As well as when eating, I would also adopt that cross-legged position at other times, such as for part of a hour of daily practice of tuning in to inner peace – something I have done for over 35 years.

    Once I realised on 17 Aug 2020 – a week after having switched to left-down-sloping road cambers again – that this long-standing cross-legged position was probably also working against the attempts to straighten out the lateral pelvic tilt, after again confirming that the physio agreed with my assessment about how to best cross my legs, I then changed this around as well, so that I would tuck the left leg “innermost” and thus stretch the tight left glute medius more, and have the right leg “forwardsmost” and thus be looser on its right glute medius, which has been the weak side.

    The first time I tried this new cross-legged position on 17 Aug, I immediately felt that it was beneficial – and I have been crossing my legs in that new position ever since then.

    I then saw the physio again on 22 Aug 2020, just 12 days after we had measured up and found I had needed 27mm to level out the pelvic bones. On 22 Aug, we repeated the 3mm hardboard checks, and at that time it only took 9mm under my left foot to level out the pelvic bones from left to right! In other words, changing nothing except which road cambers I was walking and running on, and which leg I had “in front” when sitting cross-legged, had taken the pelvis some 2/3 of the way from where it had been, to the horizontal. It was scarcely believable, but the measurements were accurate – and I was naturally greatly encouraged by this.

    A further 3 weeks later, on 11 Sep 2020, I saw the physio again, and by then it only took 3mm of hardboard under the left foot, to get the pelvic bones level from left to right.

    Another 3 weeks on, today 02 Oct 2020, I saw the physio for one more session, and the pelvic bones are now completely horizontal from left to right. Horray!

    During today’s session with the physio, with the pelvis now level, we agreed that it’s time to start running and walking on the left vs right slopes of road cambers as more or less 50/50. That’s easy, if I just run and walk on the same parts of the road / pavement, for both the “out” half of a given walk or run, as on the “return” half.

    We also agreed that I would now revise some of the side-specific tasks I have been doing for the last several months as from your web page here, either omitting a given task previously having been done only for 1 side, or for some, now doing them for both sides. We agreed that I will also retain a few key tasks as side-specific – partly due to the old squash injury to my right rhomboid (as in my original comment posts to this web page in late May 2020), and partly because I play table tennis and am left-handed, and even though I am unable to play right now due to Covid, thinking ahead to post-Covid times, my ferocious left handed forehand will once again be overworking the left side of my body, as it had been doing up until Feb 2020, when I had abandoned all table tennis playing, due to all the left side upper body issues that playing had been aggravating – issues that are also showing great progress by the way, with the pelvis now level from left to right.

    I am over the moon about the success achieved to level out my lateral pelvic tilt, and I wanted to thank you for your excellent and clear instructions on this web page. The various stretches and exercises do work, and I would advise anyone thinking of trying to address a similar pelvic issue, to work with those tasks, and to be a disciplined about that, as best they can.

    In the other two planes of pelvic alignment, I also have some anterior pelvic tilt, and a small bit of pelvic rotation. I will be using the tasks from your anterior pelvic tilt web page next, to see if can make improvements to that. I do suffer from Upper Crossed Syndrome (UCS) as well, and with the lateral pelvic tilt now addressed, I will be working on that at the same time as the anterior pelvic issues – my understanding is that the various exercises and stretches for anterior pelvic tilt and typical tasks to target UCS, do not tend to conflict with each other.

    I will of course be keeping a close eye on what the pelvis is doing from left to right, and if there is any sign of slipping back to tilting again, I will revise tasks etc, as needed.

    Once again, many thanks for your efforts to bring this highly useful information to so many people. Your work on this is much appreciated.

    – Nelson

    Reply
    • This was fascinating to read, thank you for sharing your story. I suffer with the same weakness/pain on my right side and have been doing exactly the same things – (1) consciously been avoiding pavements which create an uncomfortable incline and (2) frequently sitting cross-legged with right leg underneath. I’ll give your method a trial

      Reply
    • Hey Ryan,

      I would usually go with rotation first but it really depends on what symptoms you might be experiencing.

      Sometimes if you address rotation, the lateral tilt might automatically improve.

      MArk

      Reply
  80. Hi Mark! Thank you for all this work you do. Here’s my question: is it possible for a dysfunction/weakness with a shoulder to be the cause of a pelvic tilt? I’ve recently had surgery to remove tons a small tumors in my right shoulder. Over many years the pain of those tumors caused a lot of weakness in my shoulder. I am still recovering, but prior to my surgery I did a round of shoulder strengthening PT which didn’t help my shoulder pain, but helped my right lumbar/left hip pain. I’m hoping the pelvic issues will resolve easier when I regain function of my shoulder. Is there a connection here or is this just wishful thinking? :) Thanks!

    Reply
    • Hey Abby,

      It is very possible that a shoulder surgery can cause a chain reaction into your pelvis and spine.

      If you have definite weakness in the shoulder, try to strengthen it as much as you can as to regain full function. This could help with the tilt!

      Mark

      Reply
  81. Hi Mark,

    I have both Anterior Pelvic tilt and some degree of lateral pelvic tilt, and have been working just on anterior pelvic tilt until now. I am now wondering if I should be completing all of the exercises from both pages, or if some are “pre-requisite” across the pages? ( For example, my external rotators are so weak on my left side that I can lift it up only about 5 inches when doing a clamshell; so I feel like i should wait to do the knee to knee exercise until that’s stronger. Are there any exercises that take priority in terms of strengthening in this way across the ATP and LPT exercise sets (my atp is more severe than my LPT)

    Many thanks,

    Andrew

    Reply
    • Hi Andrew,

      I would advise to focus on the APT first. You don’t want to spread yourself too thinly with the exercises.

      If you would like to address both at the same time, you would need to perform all of the exercises to see what the body tends to respond to the best. From here – you can just focus on the exercises that give you the best results.

      Mark

      Reply
  82. Hi,
    I have scoliosis (19° and 20°) and I also have a lateral pelvic tilt. My right hip is higher than my left. If I do scoliosis and pelvic exercises everyday, how long would the estimated time to fix my spine and hips be?

    Reply
  83. Hello Mark,

    I have been following this page throughout this whole pandemic and doing the exercises, and I really appreciate how informative and thorough it is. All along I have known that one of my hips is hiked and just thought it was lateral pelvic tilt. However, would it be possible to have anterior pelvic tilt on just one side causing a slight hip hike? It seems more plausible that it’d be lateral pelvic tilt from sleeping on my side from time to time because I suppose the only way to get anterior pelvic tilt on one side of your body would be to heavily lean on side while sitting a lot.

    Reply
  84. Hello Mark,
    I am 22 years old and I have a lateral pelvic tilt with my left side being lower than my right (my left glute is also weaker than my right). I have also noticed that the heel of my foot is slightly tilted inward and my left shoulder is higher than my right shoulder. I have been following your suggestions above for almost two months about how long will it take for me to have both sides of my hip and shoulders aligned? Also do you have any other suggestions?
    Thank you.

    Reply
    • Hello Sophia,

      It’s very difficult to say how long it is going to take for the hips and shoulders to be completely aligned.

      Although within the first few weeks, there should at least be some improvement.

      If not – you might need to address any Scoliosis that you may possibly have.

      See post: Scoliosis Exercises.

      Another thing to do – if you feel your left leg is weaker than your right, doing single leg exercises on the left side ( or exercises that emphasize the left side) should help as well.

      Mark

      Reply
  85. I got meniscus surgery on my left knee and now I have a tight right QL/illiac crest/glute med area. My balance is also weaker than my right on my left side. My i am deadlifting 400+ and squatting 300+ again so my left side is not weak by any means but it may still be somewhat weaker than my right side (my left calf is still ¾ inch smaller than my right). Along with my right low back tightness, my left glute doesn’t seem to activate when I’m standing while my right one is always on.

    Do you think these exercises/routine is something I should follow or should I still focus more on getting my left leg stronger through activation and strength movements?

    Other notes:
    • I recently switched to back sleeping or sleeping on my right side since I realized sleeping on my left side with no support could have been adding to my right low back tightness
    • I am 17 years old
    • my left shoulder seems to appear higher than my right
    • I have added a shoe support to my left shoe to artificially lengthen my left leg in hopes of evening out my pelvis while I work on other parts of the issue

    Reply
    • Hey Joe,

      It sounds like you tend to place more weight through your right side.

      If this is the case, I would recommend doing exercises that force that left side to take weight. (Single leg exercises)

      Mark

      Reply
  86. Hello Mark,
    I am 22 years old and I have a lateral pelvic tilt with my left side being lower than my right (my left glute is also weaker than my right). I have also noticed that the heel of my foot is slightly tilted inward and my left shoulder is higher than my right shoulder. I have been following your suggestions above for almost two months about how long will it take for me to have both sides of my hip and shoulders aligned? Also do you have any other suggestions?
    Thank you.

    Reply
  87. Hey marc i know i ask lot of questions but i dont want to be doing things the wrong way and hurting my body more, so if i have hip hike and swayback should i be doing tfl strecthes as they are a hip flexor??

    Reply
    • Hey Chad,

      You can still stretch the TFL, however, if addressing your posture is your goal, then best to stretch the OUTER fibres of the TFL (ie. Keep the hip in adduction and not extension)

      Mark

      Reply
  88. Hey Mark,
    I have slight hip drop on my left side and pretty prominent anterior pelvic tilt and I just wanted to ask is there a way to measure my real height with both anterior pelvic tilt and lateral pelvic tilt? Also I know anterior pelvic tilt can take away 2-5cm’s but how much will slight lateral pelvic tilt take away?

    Reply
  89. Hi mark, I’ve been getting upper back/shoulder pain for few years now prior to training in the gym I had to stop few years back due to this,
    I have tried physio here but didn’t help at all,
    Basically I find that the only thing that gives me any relief is if I shift my pelvis to the left side so I’m getting a slight stretch on my tfl/itb and side hip and then rotate my pelvis/body around to the right slightly all at the same time… any idea of what could be going on here and how I could improve my dysfunction further?

    Reply
  90. Hi Mark,

    Thank you so much for this amazing post! I had a scoliosis from my childhood and also got a car accident on my left leg about 10 years ago (I am in my late twenties). So I did need this information and exercise guidelines.

    With regard to your post, I have two questions.

    First, can you please confirm whether my self-diagnose is correct?
    When I do the whilst standing (static diagnose), I can see a right hip hike. When I test for the Trendelenburg sign, my right hip goes down when I stand on my left feet. (The opposite does not occur when I stand on my right feet.) I am wondering whether the Trendelenburg sign also signals that I have a right hip hike.

    Second, are the exercises for the right hip hike?
    I actually got to know about this blog in English from your Korean blog (tistory). As I see, directions and guiding photos for several postures are the opposite in the two blogs even though both say these excercise aims to fix the right hip hike. (e.g. Quadratus Lumborum, Glute medius/TFL). Can you please clarify which one is correct?

    I do want to do these exercises regularly so that I can fix my hip hike and scoliosis. Thank you in advance for your time. I will be waiting for your reply :)

    Best,
    Cana

    Reply
    • Hi Cana,

      1. If your left hip hikes (and right hip drops) when you stand on the left leg, this suggests your left hip abductors aren’t controlling your pelvis optimally.

      If you have a Right hip hike in standing posture, it is likely that you are favoring that right side and place more weight on that right side.

      So it sounds like you would have a weak left hip but favoring the right side causing the right hip hike.

      2. I don’t have a Korean blog? Can you please link me to the website that you came to know this site.

      All of the exercises mentioned on this is for a right hip hike.

      Mark

      Reply
  91. Hello Mark
    Thank you so much for this post it is really informative!
    I’ve been in gym for 5 months and with the pandemic i continued my workout at home.
    After a while i found that my whole left side is well-developed and muscular than my right side.

    When i noticed that, i visited a physical therapist and did a MRI on my Cervical vertebrae.
    The MRI showed Straightening of the cervical with no disc bulge. In fact that i have burning pain at my right shoulder specifically at the traps.
    Now i suffer from muscle imbalance, the most annoying that my left leg carries more of my weight than the right which causes heel pain.
    Also, when i do deadlift (even the single leg deadlift) i feel the tension just on my left leg and nothing for the right.

    What is your advice ? I really need help
    Thank you so much

    Reply
    • Hi Mark,

      I have been working out in gym from last 2 years. And when I used to do any shoulder exercise I use to feel abnormalities like not being able to life equally on the both side and also when I use to do any leg exercise like squats or deadlift,I would always feel very uncomfortable and it would only go when i would put the right leg 4-5 inches back.
      Moreover bcs of my shoulders my it hammered my right chest too.

      Now i have my left side of the body stronger and more muscular than right.

      My right hip,chest and shoulder is lower than left ones. My right glute is much smaller and lower than left side.

      I went to a chiropractor,he did some alignment fix and did some cupping,it helped the next day but after 2 days my body would go back to being crooked again,I had 4 sessions already,its really expensive and now my whole right side is back to being bad.

      Would these exercises help me?
      And how long would it take,please reply I would ve waiting!

      Reply
      • Hi Lokesh,

        If you have uneven shoulder, hip and chest heights, I would feel that you could benefit from these exercises.

        You might need to consider also addressing any side bends in the spine.

        See post: Scoliosis exercises.

        Mark

  92. Hi Mark,

    Thanks for this super informative page! I have a question regarding the 90/90 hip shift. The image shows some arrows to the right but the text description doesn’t include any such directions. Can you elaborate? Also many hip shifts on YouTube entail removing the right foot off the wall. Is that recommended? Basically if you could send a link to a video of correct 90/90 hip shift, that would be super helpful!
    Thanks a lot :)

    Reply
    • Hey Salim,

      Sorry – I used the same photo for another blog post (How to fix a Rotated Pelvis) which requires the orange arrows.

      I’d actually perform this exercise with the hips in NEUTRAL (supine). I will need to update the photo soon!

      Thanks for bringing this to my attention.

      Mark

      Reply
    • Thanks for the clarification. Still not clear regarding taking the right foot off the wall. Can you confirm whether this should be done or not? Again a link to a YouTube video would be much helpful. Thanks

      Reply
  93. Hey Mark!

    I have been dealing with an issue on the left side of my lower back. It started with tightness for about a year. Something I could work through. Within the last few months, it’s gotten much worse where now I’m getting a lot of pain when I move in certain positions.

    If I’m standing and shift my hip to the left, I’ll feel the pain, which feels deep behind my spinal erector on the left of my spine. Or when I shift my hip down to the left.

    I’ve been doing a lot of research and trying to find ways to correct what I believe is an imbalance of some sort. I seem to get some relief when I lay down and smash a lacrosse ball with a weight above on it to smash the psoas. I feel like my imbalance is tightening my psoas that is also affecting my inner hip probably where the psoas attaches which I feel when I lift my leg.

    What are your thoughts? I’m not sure if I have any pelvic tilts or rotation bc I can’t really tell but not sure.

    Thanks
    Aaron

    Reply
  94. Mark-
    Do you provide any one on one video sessions just for a consult?
    I have been in chronic pain for 1 year and seen 4 PTs and no one can correctly diagnose me or give me the correct exercises. I know I have lateral and anterior tilt and need just a few mintes of personal guidance.
    Thanks!

    Reply
  95. Hi Mark,

    First off, thank you for your service. This is an extremely informative post you have here. Your time and effort is greatly appreciated.

    I don’t want to take up much of your time so I’ll try to make it quick and get to the point.

    Like the others, I have spent way too much time/money researching and getting treatments with no luck. I’ve tried everything from seeing several different chiropractors, getting acupuncture, massages, and foam rolling but this only temporarily relieves the pain. The more I try to address the problem at home with the correct workout/stretches (recommended by professionals), working on posture, the more pain I’m in. Also, I’m not able to workout like I used to anymore due to the pain and this has caused me to put on some weight in my hip/upper thigh area. The pain is becoming more frequent and unbearable. I also feel like it’s causing my depression to come back..

    Growing up, I have been told by several chiropractors that I have leg length discrepancy due to a “crooked hip”. Due to this, I experience extremely painful PMS cramps, my pants are noticeably uneven while wearing them, skirt shifts, etc. and I’ve learned to live with this until..
    About a year ago, I developed sciatica pain on my right leg (hip hike – leg is longer and thicker). I also have a constant dull numb ache deep in my buttocks, top of thigh (near pelvic bone) to the side of my buttocks (piriformis syndrome – self diagnosed based on thorough research). I can definitely tell my right hip/butt area has become noticeably weaker when I workout and my right bum has also become noticeably smaller and droopier. All my recent workouts have been targeted to strengthen my glutes and muscle imbalance and there has been no improvement whatsoever. Sometimes I can’t even feel my workouts in my right butt (even when I do glute stretches to activate them before a workout) it’s the strangest thing ever.. But since a couple days ago, I’m now having difficulty sitting for even a short period of time (even just from driving!) and it’s driving me NUTS.

    I just made an appt. to see a different chiropractor tomorrow and I’m thinking of getting an MRI to find out what the exact cause is even though I’ve already been “diagnosed” by my PD and other chiropractors. But as usual, they will only suggest several treatments. I no longer have health insurance and I simply can’t keep affording this.

    Can you help me out here? I look forward to your response!

    Kindly,

    Reply
    • Hello Gina,

      I’ll try to give you a response based on what you have told me but sounds like you need a good in-person assessment to get more specific feedback.

      If you have a right hip hike and do not have a structural leg length discrepancy (therefore a FUNCTIONAL leg length discrepancy), it might mean your pelvis is positioned more towards your right side.

      This could also mean that you place more weight/load on this leg which could predispose you to placing more weight through the right side of your lower back leading to your sciatica on that said side. (It seems that the pain pathway you describe is consistent with the sciatica).

      With nerve issues, it is possible for the muscles to become weaker and atrophy. (This could also be related to avoiding placing weight on the leg as well)

      If you have pain on the side of your glutes, it could also lead to hip bursitis. (Check out this post: Hip Bursitis Exercises)

      I would say you need to address your sciatica first before addressing the lateral tilt. I have a blog post on this coming out soon.

      I think getting a MRI will help with the correct diagnosis as well.

      Mark

      Reply
    • Thank you so much for your response!

      I went to the chiropractor and he wants to align my hips first to see if that will help before recommending an MRI for a possible disc bulge. He also said it could be piriformis or lumbar facet syndrome.

      Reply
    • Hello Gina,
      I have the exact same symptoms you described. I have been experiencing pain for a couple years now. (I have let this issue go on for far too long) I used to be a long distance runner until my muscular imbalances resulted in the pain you are describing. I have my master’s in exercise physiology and thought I could solve my issues myself but haven’t had any positive results yet. I would love to talk to you more and hear what chiropractors and PD’s have told you. I saw a chiropractor and PT myself. I didn’t find their feedback beneficial. I’m happy to find Mark’s web page. It has been educational and helpful. I am going to try and implement the exercises he provides. Anyways, I hope we can talk more and share our stories!
      Thank you,
      Sadie

      Reply
    • Hi Gina,

      I have just come across Mark’s page and read through your comment to see that I suffer the exact same symptoms as yourself and have yet to find a solution. Just wondering if your chiropractor has managed to diagnose your pain and help you address it.

      Many thanks. Ella

      Reply
  96. Hi Mark,
    My wife suffered from a post partum rt sided paralysis caused by a brain stroke and stayed at the ICU for 25 days. After stating the PT we got a rapid result neurologicaly but the new problem popped up. That the right leg is longer than the left one. After physical examination they found that it is a symptoms of quadratus lamborum and the weakness in the right hip due to the stroke. So please we need help for the best exercises for this case and I can provide you with photos and videos showing the results we got until now.
    Thank you in advance

    Reply
    • Hey Ali,

      Sorry to hear that your wife had a stroke.

      What may have happened is that the stroke caused weakness in the muscles of the right leg.

      If the right hip is now hiking (Trendelenberg sign), it is suggestive that the right glute medius (hip abductor) is weak.

      You can try doing the side lying exercises where the right leg is being lifted up wards to help strengthen it. (non-weightbearing exercises)

      Given the medical history- Please do the exercises under supervision of a trained professional.

      Mark

      Reply
  97. Hi Mark,
    I have a lateral pelvic tilt with the hike on the left side. It is very noticeable visually. As a result, I have substantial sciatic pain running down my left leg and a limp. I am a pharmacist and work standing at a computer for 10 hours a day. I tend to stand with more weight on my left side for comfort. The more I try to stand evenly on both feet the more pain I feel in my left hip and leg. I find myself not wanting to do much but lay down on days off from work because of the pain. It is beginning to take a toll on my quality of life. I have gone to a chiropractor for about 10 visits, but it doesnt seem to be effective. I am overweight as well; would substantial weight loss help? Any advice on effective therapies and exercises would be much appreciated.

    Reply
    • Hello Pharmacist Devin,

      Have you been cleared (via CT or MRI scan) for a nerve impingement in the left lumbar spine ? This could explain a lot of your symptoms. I would recommend specifically checking for a posterior/lateral disc bulge that might be pressing on the nerve. (+/- foraminal stenosis)

      If this is the case, I actually have a blog post coming out very soon which will go through was to decompress the nerve in the lower back.

      Make sure to follow me on facebook for when I post it.

      Mark

      Reply
  98. Hi Mark,
    When i do pushups I put one arm(right) higher then the other(left) one, when i want too even them the left side of the chest is not feeling like the right one and i feel like i am not aligned. Also the same is when i do squats one leg is in front of the other, when i hold them even i am not feeling the same muscles. What can it be?

    Reply
    • Hey Stefan,

      In regards to the hand placement: if your torso is side bent to the right (left shoulder higher), this may make it more comfortable for you to have the left hand higher when doing a push up.

      Here are some exercises for that: Scoliosis exercises.

      It may also be that actual shoulder girdle is uneven. Check out this post: Uneven shoulders.

      In regards to the squats: A rotated pelvis may explain this. Check out this post: Rotated Pelvis exercises.

      Mark

      Reply
  99. Hi Mark

    I think I have a slight lateral pelvic tilt but struggle to see it during my tests. I was seeing a chiro last year and he said I had lateral pelvic tilt however at that time my left sided pain was so bad I couldn’t walk without a bad gait and severe pain so I could walk fo 6 minutes without developing a limp.
    This pain came on gradually in my lower back(left side) then my hips and my upper leg (tfl and adductors)
    So I went from playing football 3 times a week and jogging every other day plus a been manual laboured job to not being able to do any sports and ive been on light duties in work for over a year now.
    I am now able to walk and I am functioning but every day I am still in pain and unable to get back to playing football.

    So sometimes I notice my left shoulder is lower than my right.
    So my daily problems are.
    All left side.
    Spinae pain
    QL pain
    Oblique pain
    TFL pain
    Adductor pain when used.
    Glute med pain
    Plus upper back and neck pain on both sides.

    I had left leg weakness were I would sit and lift my left knee up and someone could easily push it down with 1 hand with no resistance however in the last week I have stretched my rectus femoris and this strength has came back, it was so tight when doing a psoas stretch or any stretch that included my quad the pain was so bad when I squeezed my glute I actually thought I was getting nerve pain through my quad but I think it was because it was so tight the pain was so intense.

    Basically I’m struggling were to go from here, every day I’m stretching my Qls, psoas, adductors, glutes, quads and streghtening (both sides) but I am getting nowhere , my pain is not improving one bit.

    Whats confusing me is that all my pain in my lower back, pelvis and hip is on my left side, and my right side feels are strong as its ever been.
    Also my left leg feels longer like when I am walking I am dragging it slightly.

    Hope you see this message.
    Thanks

    Reply
    • Hey Bryan,

      If you can’t really tell if you have a lateral pelvic tilt using the suggested tests, then it’s not likely that you have a prominent tilt in standing position.

      If your pain is only on the left side, make sure that you screen if you have a rotated pelvis. A rotated pelvis can place more stress on one side.

      For more info: Rotated Pelvis. ( I have a feeling it is towards the right)

      Once you start limping due to pain, it’s fairly common for the QL, glute med, TFL and adductors to kick in to compensate. This may indicate you are walking side-to-side when walking forwards. (Frontal plane movement)

      Check the rotated post. That might be a better place to start!

      Mark

      Reply
    • Hi mark, i also dont think I have a rotated pelvis, I sometimes feel my left side of pelvis is higher when im lying down however I now think this might be because my left glute is bigger than my right.

      Also doing your pelvic drop test, my pelvis seems level however when I stand on my right leg and bend my knew pelvis on left side drops significantly plus my body tries to rotate .

      This all started in my lower left back pain and I continued to work and play football for 2 months, the leg and pelvis pain did cone a few weeks after the original back pain.

      Starting to wonder if I had a weak right glute, causing an overworked left QL and because I kept working my manual job and playing sports other muscles became tight due to compensation, does this seem possible ?

      Another question I have that could help prove me theory is as I said my left glute feels bigger than my right. Is the smaller glute more likely to be weaker ?

      Reply
      • Hi Bryan,

        A hip drop on the right side may indicate a weaker right glute medius.

        You are spot on when you say that Left QL could be compensating for this when it tries to “pull up” the pelvis on the left side.

        If this is the case – you would want to regain the right glute med control and test it with the right single leg squat.

        A bigger left glute may not necessarily mean that it is strong (or smaller glute weak). It also depends which glute you are referring to. I feel that you are referring to the glute max as this would push your left side upwards if you are lying down on your back.

        Mark

  100. Wed 20 May 2020

    Hi Mark. I have suffered from a sore neck on the left side of the body for many years, as well as other things. Recent work with a new physiotherapist, has brought to light that I have contralateral tiltings of the pelvis and shoulders. My tilts are exactly as in the photo of you at the top of this web page, which I came across a few weeks ago. I even have the classic waist crease on the right side as in your photo.

    As part of my treatment, I have been following various of your side-specific tasks as you have so clearly and concisely outlined above. It helps that my condition is the same “way around” as all your photos above.

    Although the hip drop / hip hike has still not shifted to any degree, a few days ago an old squash injury area just to the left of the right scapula flared up again, something that has troubled me on and off for nearly 40 years, since I first injured it at age 26. At age 30 I was told by a physiotherapist that I had torn a muscle there, but that it had healed up again. Being young and foolish, I had not asked that physio which muscle I had torn, and I did not have any clear idea about that, until this past weekend.

    This old squash injury got really sore near the end of last week. I suspect this was from doing some of your tasks as above, together with other things I have been doing such as more hard-core stretches of the right QL, some strengthening tasks for lower traps, etc. In any case, I took it as a positive sign.

    I then noticed that the right side of my neck was quite tender, and when I pressed my fingers on this, the old squash injury soreness was felt right away. The spot on the neck was like an “access point” to the squash injury area. I became convinced that these were the same muscle, and that it ran more or less vertically. These revelations led me to look online for images of muscles of the back, and I decided that the old injury might have been to the Erector spinae, in this instance on the right side of the body.

    As the soreness to both the right neck and the squash injury area quickly subsided over the course of 2 days this past weekend, I then noticed that some tightness just to the right of my lower back had disappeared as well. I had had that for many months if not longer, and I would feel it most noticeably when doing mild stretches for the hamstring and adductors, by sitting on a chair and crossing one leg over the other (in this case my right leg), then leaning down to touch my chin to that right leg’s shin. Since the old squash injury soreness subsided, this hamstring/adductor stretch done sitting on a chair, is just as easy to do with the right leg, as it has always been for the left. Before then, it sure wasn’t!

    A revisit to one diagram of the Erector spinae muscles which I had found online, confirmed that these do go all the way down to the lower back, and they insert into the pelvic bones there.

    From all this, I am fairly confident that the old squash injury from when I was much younger at age 26, was a tear of the right Erector spinae muscle, and I suspect that as it healed at that time, the muscle ended up too tight when it re-connected itself. This would explain a range of troubles I have suffered from ever since, including pains on the left side of the neck, which I am convinced are from my shoulders having been pulled down towards the right after the torn muscle had healed up and then been too tight on the right side. That sort of healing as too tight, might even have been contributing to the hip hike I have had on the right side, also for a long time.

    In any case, the big thing I wanted to pass on to you – which I consider a breakthrough at this stage – is that since the old squash injury soreness subsided a few days ago, the tilting of my shoulders down to the right, has improved a great deal. I have been taking comparative photographs of my standing posture from time to time over the past few months, to see whether the contralateral tiltings of pelvis and shoulders, were showing any signs of changing. Before this last weekend they had remained the same for the 2 months or so I have been working on them, and the overall “angle of discrepancy” between the tilt of the pelvis down to my left and the shoulders down to my right, had remained at around 3.5 degrees. But since the squash injury soreness cleared up a few days ago, although the pelvic tilt is about the same, the shoulders are much better, and the overall angle of discrepancy between the two tilts in opposite directions, is now only about 2 degrees! That’s nearly half as much as it was.

    One thing I have also begun in the last few days, is to try and stretch the right Erector spinae, and I have had some success in this using 3 different stretches I found online, 2 for the rhomboids and 1 for the Erector spinae. I was looking for stretches that can be done only for 1 side of the body, and this is possible with the 3 that I have been using. These may have been helping with the shoulder tilting, and if so, I will probably need to keep doing them for some time. I have been doing a stretch online from Jeff Cavaliere as in the YouTube video whose link is given below, but in my case I am only doing it using my right arm, to target the muscles to the right of the spine. The other two stretches I found online, each only work on 1 side of the body at a time, in any case.

    https://www.youtube.com/watch?v=dNOMmQARQTQ

    Anyway, this has gone on too long already. To end, I wanted to thank you for your excellent web page above concerning lateral pelvic tilting, as it has been a huge help in all this. In addition to what’s taken place with the shoulders, I am hoping that the pelvis will eventually start to improve as well. If so, I will then use your other web page to address a more mild case of anterior pelvic tilting, which I also suffer from. That has not given me any specific troubles I can put my finger on – certainly none as pronounced as those from the lateral pelvic tilting (sore left side of the neck, left hip drop when running and thus resulting turn-in of the left knee and ankle, to name a couple). But if I can fix the lateral tilting, I will move on to the anterior tilt and deal with it also.

    Any comments you might have on all this, would be appreciated.

    All the best,

    Nelson

    Reply
    • Hey Nelson,

      What a long comment! Thanks for taking the time to write it out.

      I’ll try to answer it to the best of my ability.

      It sounds like the left side of your neck in compensating for tightness on the right side.

      Since the tight muscles are pulling everything down to the right side, the left side of the neck will pull the head to a more neutral position relative to gravity.

      This is quite common if you have a right hip hike and low right shoulder. BTW – If you have these 2 postural findings, I would also feel that you feel a spine that is curving towards the RIGHT. (For more info: Scoliosis exercises)

      This would put the erector spinae, lats, Quadratus lumborum and obliques on the RIGHT side in a SHORTENED position.

      The erector spinae muscles tend to get injured when you start to bend the back forwards. (flexion).

      I think you are referring to the Longissimus muscle which has its attachments from the skull to the pelvis.

      If you believe this is quite tight, I wouldn’t be surprise if your torso is rotated as well. (See this post: Twisted spine) Or perhaps even a rotated pelvis since you have a knee that tracks inwards. (see this post: Rotated pelvis.)

      Hope this makes sense!

      Mark

      Reply
    • Thu 21 May 2020

      Hi again Mark.

      Many thanks for your very prompt reply to my comment posted here yesterday 20 May 2020, and for all your very helpful thoughts and suggestions.

      I have checked for pelvic rotation, and as you suspected, I do have this as well, rotating a little bit to the right. I will be going through the tasks from your other web page on pelvic rotation, and will be incorporating things from there, into what I am already doing for the lateral pelvic tilt.

      I may also have spinal twist as you outlined in you pelvic rotation web page, but as you recommend there, I will work on the rotated pelvis first, then see how the spine looks after the pelvic rotation is dealt with. Recent photos I have taken of the view of my back, suggest that if I am able to resolve the rotated pelvis, I may not have any spinal twisting left over – there is certainly no obvious scoliosis to be seen in the traditional sense, such as spinal joints going off the vertical one way and then coming back the other, when looking up or down the spine. But I will see how it looks once the pelvis is no longer rotating any more.

      It’s also worth mentioning that I have a very minor instance of anterior pelvic tilting, on top of everything else. That means my pelvis is “goofy” in all 3 planes. I will eventually address that as well, but it’s probably not as important in relation to the others, as I don’t seem to have had any significant troubles from that, no pains that could be attributed to it etc.

      Re what you have said about my sore left side of the neck, and about my spine curving to the right leading to various muscles being tight on the right side, this all makes perfect sense, and it also tallies with my own observations and conclusions up to now. That’s good.

      As for how the original squash injury took place some 38 years ago, from my recollections, I was going for a shot up in the right-hand front corner of the squash court, and as I swung the racket in my left hand (I am a “southpaw”), when the injury took place, as you have described I was indeed bent with my upper body forwards in relation to everything below my waist. I might even have hit the right side wall in the corner there, with my right shoulder – it’s a bit hazy after all this time.

      Finally, it’s good to know that you suspect it has been the Longissimus giving me these issues since that old injury. I can try and target those specifically, for stretches. One I am already doing is aimed at the Erector spinae set in general on one side of the body, and after reading your reply, I looked online again and found a text description of a possibly more effective version of another stretch I also started a few days ago, done in a door frame, and again, for one side of the body.

      It’s clear there is now much more to resolve in terms of my posture, but having been very disciplined about my usual routines of exercise at home during this strange time of lockdown, I am able to call on a reserve of useful momentum built up over the last few months. I will let you know how things go, once there is anything further of significance to report. I would think that will take a few weeks, if not longer.

      Many thanks again for all your efforts, your very comprehensive body of knowledge, and your willingness to help so many people. Keep up the good work!

      Nelson

      Reply
  101. Hi Mark!
    Thanks for sharing this amazing content to fix this problems!

    I have just one question for you, do you think the hip hike is most always on the same side of the low shoulder?

    Because I have low left shoulder and it seems that my hip hike is on the left, however when I do Trendeleburg in the right leg, my pelvis drop (and hip hike) on the right, like as my right gluteus muscle is weak. (while on left leg there’s no drop, the pelvis is stable).

    Shouldn’t the left gluteus be the weak one in a left hip hike as you say in this post?

    Maybe it has to do with the fact that I have a right rotated pelvis too?

    I already did all the checks with doctors and it’s a functional problem,not structural (no scoliosis or other problems like that)

    Thanks in advance
    Robert.

    Reply
    • Hey Robert,

      Although pretty common, the hip hike is not always on the same side as the low shoulder. (It depends what the shoulder girdle and spine is doing relative to the pelvis.)

      If you have a left hip hike on standing, but a right hip hike on single leg stance: This may suggest weakness in the right glute medius AND a preference to stand on the left hip whilst the glute med is in a lengthened state.

      In this case – train the left glute medius muscle in a more shortened position (eg. side leg raises, hitches) and the right glute med in lengthened range (eg. cross over lunges).

      Mark

      Reply
  102. Hi Mark!
    I’m a bit confused with my situation because my right shoulders are lower and my right hip is slightly higher, but my “hip hike” is on my left side. My right side is just straight, no curve. Right obliques seem to be tight. Right side has weak glutes. My left side, however, seems to have the tight hip flexor. So I’m not sure which pelvic tilt I have exactly. And I’m not sure what exact stretches/exercises I should do.. I’ve been doing workouts and yoga, and trying to stretch my right side but it’s starting to hurt..

    Thank you!!
    J

    Reply
    • Hi J,

      A right hip hike would mean that the right side is higher.

      If your said symptoms are related to the lateral pelvic tilt, then I would address a right hip hike.

      When you say you have the right side is straight, I assume you are referring to the waist crease is not as prominent as compared to the left?

      If so – I feel you may have some scoliosis in your spine.

      See this post : Scoliosis Exercises.

      Mark

      Reply
  103. Mark,

    Thank you so much for this resource. Is it possible to have a right hip hike while standing (crease on that side as well) but when I lay down on back my right leg is longer than left. Very tight knot/muscle in lower left back (QL or Erector spinae). Also when i sit, I feel like my left “sit bone” is in front of the right. Any recommendations on what to work on, stretch, strengthen? Thanks so much!!!

    Reply
    • Hey B,

      Yes – it is possible as pelvic tilts can change from a standing to lying down position.

      The question is: Is that right leg structurally longer? (Is the bone length itself longer or is it due to the pelvic tilt making it seem longer?)

      If your leg is structurally longer, it is natural for the right hip to be higher. (assuming that your pelvis in line with the middle of your feet.) In this case- you may benefit from a heel lift to make up for the difference.

      If you feel your left sit bone is more in front of the right side when you are sitting, this may suggest your pelvis is rotating towards the right. Keep in mind – the pelvis rotation can lead to a difference in hip height as well.

      For more info on this: How to fix a Rotated Pelvis.

      If most of your issues are when you are on your feet and you feel it is due to the tilt, I would address the right lateral tilt.

      Mark

      Reply
  104. Hi Mark

    quick question on the statement “Longer leg generally is on the higher hip”. I’ve read and did some research on Lateral pelvic tilt. It seems like people (PT) are saying the hiked up hip should have the shorter leg. Am I missing something here? Thanks in advance for your clarification.

    Reply
  105. Hi Mark,

    After reading this everything points towards me having a right sided hike, however my left side is slightly higher.

    I know my glute medius is weaker on my right side and my left side is very tight around the hips.

    Should I follow as if the right side is hiking, I think it’s due to my right ankle mobility is no where near my left side.

    Do you suggest that I Increase my ROM in my right ankle and work on strengthening my right might leg, while stretching out my left side.

    My gluteus and leg muscles are stronger on my left side, so I know I don’t need to strengthen them, I think it comes from me having a tight right ankle and that’s caused my body to shift weight to my left side, causing it to hike.

    What would you suggest I do to prevent this.

    thanks mark,

    Calum

    Reply
    • Hi Calum,

      If there is a large difference in ankle dorsiflexion between the left and right ankle, I would start here.

      Reason behind this is that this can affect how you walk and possibly resulting in your hip hike.

      Here are some exercises I recommend: Improve your Ankle Dorsiflexion.

      If the hip hike is only very slight, I would also recommend checking to see if the hike is actually caused by a rotation of the pelvis .
      How to fix a Rotated Pelvis.

      Mark

      Reply
    • Hi Mark, I am also somewhat confused. Like kevin above I have a higher hip on the right and a lower shoulder on the right. I tend in general to be in an anterior pelvic tilt and have had labral repair surgery on my right hip which has left me with limited external rotation on that side. My left leg always appears functionally shorter however in actual measuring both legs are equal. Bilaterally I have pain and feel tight in quadratus lumborum and erector spinae however much more prominent on the left side and it sometimes pinches with end ranges of flexion or extension even with a posterior pelvic tilt. I am confused as my chiropractor told me I have both the anterior tilt as well as a left lateral tilt but how can I be tilted to the left if my left leg is the one that appears shorter. I just want to make sure I am doing the exercises on the appropriate side

      Reply
      • Hi Lisa,

        If you have a right hip hike with legs that are structurally the same length (which I assume was measured via a CT Scan?), I would feel that you might be standing more so on the right side.

        If you have had a hip surgery, I would also check to see if you also have a rotated pelvis.

        Also make sure you right hip has full internal and external rotation. The left hip/pelvis could compensate for the right during walking, which may lead to more pain on that left side.

        Mark

  106. Hello Mark, thank you very much for providing information! Highly appreciated. I have read your article about pelvis rotation. I think there is a connection with lateral pelvic tilt and pelvis rotation, don’t you agree? I have left sided lateral pelvic tilt (left hip hike, right hip low) and based on your other article, left pelvis rotation at the same time.

    Reply
    • Hey Ana,

      Thanks for your comment.

      It’s quite common to see a hip hike on the same side the pelvis is rotating towards. (but keep in mind it can also go the other way!)

      Mark

      Reply
    • Hi mark could you help me to relieve my pain. I have a fibrous growth in my left foot arch for 15 years over time this has caused numb and stiffness to left foot and calf and a raised right hip in the last 2 years I have been diagnosed with bursitis in my right glutes an indentation or tear is noticable to see and touch? I also have soatatic pain in my lower back tail bone twitches and twinges in buttock and constant left shoulder and rota cuff I am 37 and physically feel 100 is this classed as a disability if it is chronic?

      Reply
  107. Hi Mark, thanks for this! Spent sooooooo much money trying to fix and relieve the chronic pain on right side. I’m going to follow this plan but can you please answer a question? Should I work on releasing and stretching first? Before moving to activation and strengthening?

    Reply
    • Hey Tiff,

      If you are very tight in the muscles that are holding you into this pelvis position, then I would work on stretching/releasing.

      If you are not tight, but have issues with strength/control, skip straight to the activation and strengthening exercises.

      Mark

      Reply
  108. Hi Mark,
    I’m sorry about not being clear about my symptoms. I’ve spent the last few days trying to figure out if I’m hiking my right hip or my left hip. I definitely think it’s a right hip hike, but is it possible to do both? I think I’m relatively stronger on my left side, but it needs a lot of strengthening also. Does that make sense?

    Reply
    • Hey Laurie,

      You can’t have both hips hiked at the same time, however, you can have the hip hike change from to time to time.

      This is usually due to which leg you tend to place more of your weight on.

      There will be some muscles that are relatively weaker and stronger on the left side, when compared to the right.

      Mark

      Reply
  109. Mark,
    Thank you so much for this article! Its as if so many pieces of my complicated puzzle are finally making sense! i’m curious about my sleep patterns. My symptoms are always worse when I get up in the morning. i sleep on my side with a pillow between my legs. I haven’t noticed favoring one side over the other, but I might. could there be something that I’m doing that could be making my situation worse? Thank you so much for taking the time to help.

    Reply
    • Hello Laurie,

      I’m not sure what your symptoms are but you can try placing a very small rolled up towel/pillow under the side of your mid section (just above the pelvis).

      This will help keep the spine straighter.

      Another thing you can try is performing gentle movements of the painful area to see if you can loosen it up.

      Mark

      Reply
  110. Hi Mark, I have a right hip hike, with a higher/more muscularly developed left side of my body (chest, trap, arms etc). Would you recommend following the exercises here, or on your uneven shoulders blog post.

    Thanks for the amazing content by the way, I hope you and your family are safe and well in these times.

    Alex UK

    Reply
    • Hey Alex,

      You can start with either. Try it out. See how the body responds. Adjust from there,.

      I would also suggest that you check out this post: Scoliosis exercises. This will check to see if your spine is bent to one side that might be causing your shoulders to be uneven.

      Mark

      Reply
  111. Hello Mark,

    I have a lateral pelvic tilt since childhood… one hip and one shoulder higher than the other …

    In 2010, I was diagnosed with patellar tilt in both knees…

    So basically I have laterally tilted pelvis for more than 30 years and patellar tilt for more than 10 years…

    I also have massive anterior pelvic tilt…

    Do u think my lateral pelvic tilt can be corrected with any type of exercises …. be it physio, pilates, yoga etc..

    1) I just make sure I do each move on both sides equally…Can u please guide …if this type of approach will cure my condition?

    2) as I have lateral pelvic tilt and patellar tilt for a long time…..

    is it possible that bone structure might have changed and that any type of exercise done equally on both sides might not cure this postural imbalances??

    Thanks…

    Reply
  112. Went to a chiropractor and had an x-ray, in which I found out I have a rotated pelvis with major lateral pelvic tilt. I’m a white water raft guide, and have to favor a side to sit on and brace into in order to do my job.
    I’ve lived with back pain for years, and recently have had a major flare up (no apparent reason) which has caused me to lose a few days sleep. (I am writing this at 2am)
    I’m a yoga teacher so daily stretching is my regular, and it seems the whole area between my gluteus medius and thoracolumbar fascia is majorly tender and inflamed, including my psoas, making a dull and radiating pain around the right side of spinal column, about 2-3 inches up from my tailbone.
    I regularly do glute tennis ball & foam roller stretches, which usually helps take away the pain, but now it barely seems to touch it, and I can almost never fully relax into it anymore.
    Any suggestions are welcome.
    And thank you so much for the wonderfully put together article! Such a rarely discussed issue but hugely common!

    Reply
    • Hi Ren Q,

      It sounds like you are referring to the area where the erector spinae muscle group (also thoracolumbar fascia) attaches to the sacrum and top of iliac crest.

      This is a common area to have back pain and can be complicated with a lateral pelvic tilt.

      If this is the case – the massage release and stretches should have helped!

      If it is not your muscles, the next layer deep in that area would be the joint/discs. (possible L5/S1 which is about 3 inches above the tail bone)

      If this is the case – you would to find a movement that if performed repeatedly, will reduce the symptoms.

      You can try bending backwards (or cobra pose in yoga) to see if that helps, or trying bending forwards. You will need to see how your body reacts to the repeated motions. Stay away from any sudden increase in pain or reproduction of any new symptoms.

      If everything is super sensitive, I would feel that there is an excessive amount of inflammation which would mean a course of NSAIds might help (see your doctor first).

      Mark

      Reply
  113. Hi Mark,

    been looking for some answers and stumbled upon your site, hope you can help me. ive had some symptoms for some time but i couldnt identify what is the cause. maybe ill list them down so you can understand what im going thru

    1. i have a mild scoliosis. Lower on the right side, so my spine curves to the right. about 24-26 degrees. had this since 15 years ago no progression

    2. since about 1 plus years ago i started feeling my left leg is shorter

    3. also experienced my right side butt bulging bigger than my left butt, if im looking at myself from the top i can see my right butt bulge out at least half inch.

    4. Having pain and tension in my right groin.

    5. Pain in my right hip if i sit or sleep on hard surface

    6. My right leg glutes are sore almost always but i never had any sore on my left leg even if i carry out focussed workourt on my left glutes.

    These symptoms, started since after i felt the leg shortening. so, i thought it might be because my left glute is weaker but your article says otherwise so, im a little confused. can you please advice on what most probably i should focus on. Hope you can assist me and i really appreciate it.

    When consulted my scoliosis doctor and physiotherapist, both of them told me that i have to focus on stregthening my core but none told me about focussing on my leg muscles which,, after much research online i find is important in reducing hip pains as well.

    i hope you can enlighten me a little and guide me onhow i should proceed.

    Reply
    • Hello Joe,

      Sounds like you are SHIFTING most of your weight onto your right leg.

      If this is the case, you probably have a right hip that is higher?

      The left glute med would be in a shortened position compared to the right.

      If your left glute med is weaker, then I would encourage you to activate it in a more lengthened position (as shown in the blog post)

      Mark

      Reply
  114. Ok thankyou?.
    So if I have a right rotated pelvis and My trunks rotating around to the left, will the trunk just correct itself once the pelvis rotation has been corrected or do you have to incorporate trunk exercises aswel?

    Reply
    • Hey Brad,

      If you correct your rotated pelvis, this could potentially improve the torso orientation.

      However , if your torso is already facing the left (with a right rotated pelvis), this means your torso has over rotated in a clockwise direction.

      If that is the case – check out this post: Exercises for a Twisted spine.

      Mark

      Reply
  115. Hello Mark,

    Is it possible to have a right shifted torso and a right hip hike ? Or is it always gonna be towards the left that a torso shifts if the hip hike is on the right.
    And also, is the pelvis rotation systematically linked to the tilt side ( do all people with a right pelvis tilt also have their pelvis turned in the same direction? ) ? If so could you explain to me how ?

    Thank for your time and this website.

    Reply
    • Hello Pjholl,

      Yes – you can have a right shifted torso with a right hip hike. This likely means that you have a double curve scoliosis. (Right lumbar concavity + Left thoracic concavity)

      See this post: Scoliosis exercises.

      And no – pelvis rotation can happen with either sided tilts. It really depends how your body is compensating. (esp. in the torso)

      Mark

      Reply
  116. Hi Mark,

    I really appreciate all this help. Do you think having this issue could cause pain in the upper right back/neck trapezius area?

    Also, does a right hip hike generally cause left pelvis rotation? I noticed my right thigh is more forward than my left and my belly button points to the left (going by the evaluation you had in your “how to fix rotated pelvis” article.

    Thanks,

    Justin

    Reply
    • Hey Justin,

      A lateral pelvic tilt may lead to the upper right back/neck/trap area it can influence the position of your ribcage and shoulder complex.

      If you are referring to pain between the shoulder blade region, check out this blog post: Shoulder blade pain.

      Right hip hike can occur with either a left, right or neutral pelvis. It really depends on what else is happening on in the rest of the body.

      Mark

      Reply
  117. Hi Mark.

    Thanks for the advice on trying scoliosis. I am not sure if this is the issue, it is certainly not as bad as demonstrated on the pictures of it is.

    Would I possibly be able to set up a Skype meeting with you to talk through some stuff?

    I would pay you for your time of course.

    I have been in chronic pain for 3 years now and I am desperate to get this sorted.

    Kind regards
    Mike

    Reply
    • Hey Mike,

      Unfortunately – I currently do not have any time to do online consultations.

      If you list some of your issues, I might be able to point you in the right direction.

      Mark

      Reply
  118. Is it possible to have a very noticeable left hip hike(in standing position), but for the left hip also to drop when you stand on the right leg? From what I read, it sounds like that wouldn’t be the case.

    Reply
    • Hi Gibson,

      Yes – it is definitely possible.

      Looking at just the hips/pelvis: A dropping left hip in right stance may indicate a weakened right glute medius and/or dominant right adductor/QL (… Which I understand why you might be getting confused as to which exercises to do when the left hip is hiked when standing on 2 legs). Keep in mind, a SLIGHT drop in the left hip when standing on the right side is normal.

      If there is a significant drop in the left hip – You would still want to work on controlling the right hip doing the suggested glute medius exercises.

      As for the standing left hip hike (and assuming you don’t have a structural leg length issue), I would say your left glute med is relatively weaker than the right. (Ie both sides are weak)

      Mark

      Reply
  119. Hi Mark,

    Thank you so much for this article! 30m former athlete. I’ve been bouncing around PT’s for years now and I’m honing in on a narrative that makes sense. I’m thinking I need to do all the stretches/exercises in this article, but on the opposite side. Can you help tell me if I’m thinking of this correctly? My main symptoms are:
    -Severe right anterior hip pain, right knee pain (present similar to hip flexor strain and quadricep tendonosis). Hip flexor stretching aggravates.
    -overactive or tight left quadratus lamburum?
    -more developed left trap. left neck pain
    -right should rotator cuff tendonitis
    -limited left ankle dorsiflexion (pain/easy to strain) when weighted exercise

    Most bothersome symptom is by far right anterior hip. Hurts all the time. Sitting and walking. No obvious leg length discrepancy. Do not drastically fail any tests (such as thomas, etc). I have tested slightly decreased internal rotation strength on both legs (right moreso). When performing clambshells, right glute medius feels weaker, but may just be tight? Thanks for any response!

    Reply
    • Hey Seth,

      Any chance that you have a pelvis that is rotated to the RIGHT?

      For more info: Rotated pelvis.

      A right rotated pelvis could lead to a right rotated torso which may explain a lot of the things you stated.

      Also – do you know if your long standing right hip pain apart of an impingement issue?

      For more information: Hip impingement exercises.

      Mark

      Reply
  120. Hi..I feel more weight on left side while sitting automatically and my right shoulder bends down.
    While driving scooty also whole weight shifts to the left side.
    Is that due to tilted pelvis?

    Reply
    • Hi Sakshi,

      Sounds like your pelvis is tilting with the hip hike on the right side.

      This would push your Left side down into the chair.

      I usually find this is due to your torso being shifted towards the left side. This will make the left shoulder higher and the right shoulder lower.

      Try shifting your torso in line with your pelvis using exercise #13 on this blog post: Thoracic spine exercises.

      Mark

      Reply
  121. Hi Mark

    Great exercises. I have one question.

    How often am I suppose to do these exercises on a daily basis to see some results? I do both exercises: pelvic rotation and uneven hips , and do notice some visual results the same day, but always the morning after the hips and pelvic uneven.

    Reply
    • Hi Niklas,

      I recommend 2-3/week if your focusing on strengthening exercises.

      You can do stretches every day.

      You will need to prioritize the strengthening to produce last results.

      Mark

      Reply
    • HI Mark,

      Please could you let me know if you think the below would be a result of having a lateral pelvic tilt?

      1. Lower back muscles are always tight (regardless of regular stretching)
      2. Hamstrings in both legs always tight (regardless of regular stretching)
      3. Continual ‘pulled’ sensation deep inside abdomen which I believe is my psoas (Doctors have confirmed there are no issues with any organs, etc). This feeling affects only the left side of abdomen
      4. Weak glutes which are hard to strengthen, on left hand side (right glutes seem fine)
      5. Right shoulder is always raised (if stretched out returns to being raised the next day)
      6. Right hand side neck muscles are always tight despite stretching
      7. Whilst my lower lumbar spine does seem a bit flat and tight, my pelvis does NOT seem to have an anterior or posterior tilt.

      Any help is greatly appreciated
      Many thanks

      Reply
  122. Hello mark. I have been doing you LTP exercises for a LONG time now and I am still having issues.

    Could I have torn something or caused some damage that will not repair without an operation?

    Many thanks for you help! You do great work.

    Reply
    • Hey Mike,

      Time to re-evaluate the situation.

      If you have persisted with the lateral pelvic tilt exercises (and you don’t have a structural leg length discrepancy) and getting no where, it might be that you need to work on another area that might be predisposing your pelvis to tilt.

      The next area I would look is the spine. See blog post: Scoliosis Exercises.

      Mark

      Reply
    • Mark, I have notice that my LPT can flare up after sitting for 5 minutes.

      Would that mean that it is my Psoas that is the problem with it being simply sitting?

      I think my original problem was a glute tear. I have had my glute strength tested recently and they are ok apparently.
      Could this start as a glute issue and then become a psoas issue?

      Many thanks!!

      Reply
  123. Hi Mark
    Thanks for this article it is very helpful.
    My right hip is hight and left shoulder is higher than right.I have big problem because I going to gym and muscles on right side are more developed. When doing abs I just cant feel left side even when I bend to right side to activate them and same thing is for lower back muscles.My gluteus is more developed on right side also and because of that I am confused when I see here exercises to strenght right gluteus.
    Can I do all this exercises to fix my problem. I dont have scoliosis and I fell like my right leg is longer or I just lean on it more and I dont notice it.

    Reply
    • Hi Tomislav,

      Your glute medius (hip abduction) can be weak and the glute max (hip extension) can be strong on the SAME side.

      Perhaps this is what is happening with you.

      You can try these exercises to help address your lateral pelvic tilt.

      Mark

      Reply
  124. Hello Mark.

    I have knees pain, and nobody can find root cause until now. I have High left pelvis , Very tight QL. Can High Lateral Hip cause patella femoral syndrome? I am so tired to do exercises with no improvement. I live with pain every day.
    Do you have any idea what I have to do?
    Thanks

    Reply
    • Hi Aly,

      It is possible for a lateral pelvic tilt to affect how your knee moves, which then can lead to patellofemoral pain syndrome.

      Are you able to do any knee exercises like 1/2 squats, step ups, lunges etc to strengthen the knee itself?

      Main thing to remember is to keep the knees and feet pointing in the same direction as you do knee exercises.

      Mark

      Reply
  125. Hey mate I’m just contacting you regarding a muscle imbalance that is keeping me out of the gym, basically my right hip is hiked and my right shoulder is lower and my pelvis has rotated around to the left and my right oblique / abdominal seem really tight and my left oblique and abdominal seems more lengthened are you able to tell me my problem or?

    Reply
    • I’m not exactly sure if it’s my torso or my hips that are rotated but I can definitely say my right shoulder sits a lot lower and forward and my left shoulder sits up higher and more retracted

      Reply
      • Hey Brad,

        If you have a right hip hike, lower/forward right shoulder, higher/retracted shoulder, tightness on right oblique area and stretch feeling on the left abdominal area:

        It sounds like your torso is rotating towards the left. This might imply that your pelvis might be rotated to the right. (Counter rotation of the torso towards the left over the pelvis which is rotated to the right)

        (Keep in mind – there may be other factors influencing this which I can not assess online)

        To check if your pelvis is rotated, Check out this blog post:

        Rotated Pelvis.

        Mark

  126. Hi Mark
    My right hip is hight and left shoulder is higher than right.I have big problem because I going to gym and muscles on right side are more developed. When doing abs I just cant feel left side even when I bend to right side to activate them and same thing is for lower back muscles.My gluteus is more developed on right side also and because of that I am confused when I see here exercises to strenght right gluteus.
    Can I do all this exercises to fix my problem. I dont have scoliosis and I fell like my right leg is longer or I just lean on it more and I dont notice it.
    Thanks for this article it is very helpful.

    Reply
    • Hey Tomislav,

      Firstly – quickly have a look at this post: Rotated pelvis. Does this apply to you? This is common with a lateral pelvic tilt.

      If your right glutes are more developed on one side and you have a right hip hike, you are probably placing most of your body weight on that right side. (common)

      I would still say the mentioned exercises on this blog post will be suitable for your right hip hike.

      Mark

      Reply
  127. Hi Mark,

    Thanks for the phenomenal website and all the effort you’ve put into it. It’s very helpful!

    I have a left lateral pelvic tilt (left side higher), and a right rotated pelvis.

    One snippet here confuses me and was wondering if you can help me understand:

    “The pelvis will HIP HIKE to the side of relative weak glute medius, tight quadratus lumborum and tight adductors.”

    In my case I definitely have a weaker glute medius on the left so that’s consistent. However my right ql seems to be the tight one (in fact it’s full of muscle knots). This has confused me particularly because some of the recommended exercises involve releasing the ql on the side of the hip hike. I read somewhere else that usually the ql is tight on the opposite side of a weak glute medius as a compensation.

    Do you think you can shed some light for me on this? And perhaps explain to me whether I need to adjust the exercises to accommodate my issues?

    Thank you so much!

    Reply
    • Hey Ziad,

      Glad you like the website!

      Statically – It sounds like your torso might be influencing the Right QL.

      Do you happen to have a higher left shoulder by any chance?

      Dynamically – In gait, the opposite QL can compensate for the weak glute medius. If this is your situation – I would focus on getting glute medius to stabilize your pelvis when your walking.

      Mark

      Reply
    • Thanks for getting back to me! :)

      “Do you happen to have a higher left shoulder by any chance?”

      Hmm… so I can’t visually tell. I just had a look at the mirror and I sort-of convinced myself that my left shoulder is ever so slightly higher, but it’s not pronounced enough for me to speak with any certainty. However, I have noticed that when running on a treadmill my tshirt’s hem would gradually slide down to the right shoulder every few minutes and I’d have to readjust it.

      “In gait, the opposite QL can compensate for the weak glute medius.”

      Ah, I see, thanks for explaining. Does this affect the recommended exercises above at all? Should I still do as it says, i.e: release and stretch the QL on the side of the hip hike, or do the opposite one that’s tight for me, or perhaps this is just an indication I need to be doing that on both sides?

      Thanks a ton! It’s so awesome that you take the time to reply to people. I hope you and your family are doing well in those trying times.

      Reply
      • Hey Ziad,

        If your shirt always slides down towards the right side, that might indicating that the left shoulder might be elevating and/or the right shoulder is depressing.(This appearance of uneven shoulders might not be as obvious when you are just standing still)

        The reason why I ask this is that the position of the shoulder can reflect what the torso is doing.

        Even if your have a left hip hike, you could have a tight LOWER QL on the left, and the tighter UPPER QL on right. (gets a bit confusing!)

        However – it sounds like your issues is stemming from your walking pattern.

        IN this case – I would prioritize strengthening your left glute med in exercises that mimic your walking ( you can use the same strengthening exercises on this blog post). If the Right QL is quite tight, then you can release that as well, esp if it is quite painful.

        Hope this helps, Ziad,

        Mark

    • You’re more than welcome! The content on your website alone is worth it – let alone your willingness to take the time to respond to the hundreds of comments you get.

      I’ll take your recommendations to heart and try to prioritize strengthening my left glute medius as much as possible.

      Thanks again, all the best.

      Reply
    • Hi again, Mark,

      Hope I’m not pushing this too much by asking more questions still. Just wanted to let you know you were in fact spot-on with your guess regarding my shoulders. Earlier I told you that visually it doesn’t seem like my left shoulder is higher than my right. However, after reading your article on the topic I re-evaluated it taking into account the level of my collar bone and now it’s clear as day! The left shoulder is definitely higher. Great read by you.

      Q1) Does that change your recommendations at all for how I should approach this? (Re: focus on strengthening left glute medius)

      Here’s a summary of my situation:
      Main complaint is significant lower back pain on the right side.
      Postural issues identified: Lateral pelvic tilt (left hip hike), right rotated pelvis, uneven shoulders (left shoulder higher), and I believe I have a degree of anterior pelvic tilt (Yes, unfortunately my work and hobbies means I sit A LOT)
      Other symptoms: Really tight and uncomfortable right QL

      Q2) I’m considering either cycling through your recommended exercises on a daily basis between those 4 (eg, Monday: lateral, Tuesday: shoulders, Wednesday: rotated etc…), or choosing one/two of those issues and focusing on them until they’ve improved then moving on to something else. What approach would you recommend?

      Q3) I imagine there’s a possibility that the big list of postural issues I have might mean that certain exercises aimed at resolving one issue might counter-act the advice for resolving another issue. Is this something I should be concerned about or should I just adhere to the recommended exercises as is?

      Apologies for the number of questions, I hope you don’t mind. If this is too much for the comments section and you’d prefer a different way of discussing this like a consultation please let me know.

      Thanks a ton again,
      Ziad

      Reply
      • Hi Ziad,

        More questions the merrier! This could help other people with a similar issue as you.

        1) If you have a left hip hike, I would still recommend left glute med (hip abduction) strengthening. This will help with the pelvis sitting more level on your legs.

        It may or may not address the right lower back pain depending on what exactly your torso is doing.

        2) Pick one. The most significant one. If you spread yourself to thinly, you might not get the right results. Keep in mind – addressing one area might AUTOMATICALLY improve other areas!

        Which is the most significant? Hard to say, but only way is to start one, and see what happens over time. Review and adjust accordingly.

        3) There would definitely be some exercise that you might have to adjust to prevent other areas getting worse. In your case – just keep the exercises suggested for now.

        Hope it helps! It’s a bit hard to give specific recommendations without an assessment.

        Mark

    • That’s super helpful, Mark! I’ll keep my attention focused on one issue at a time like you said.

      I also totally understand that your ability to give advice is limited without a proper assessment. I just followed your facebook page (also cool content there!) and it seems like you can give online assessments? Can you let me know how I can schedule one? I tried searching for the information but didn’t find it.

      Thanks again, have a great day!

      Ziad

      Reply
      • Hi Ziad,

        I don’t do paid online consultations at the moment.

        However – I do hold a free posture contest (as often as I can) where I answer all questions, do a posture assessment and exercise recommendation for the winner.

        Mark

  128. Mark, First of all thank you for the instructions on how to fix a lateral pelvic tilt. My left is higher. Question is when you talk about the strengthening exercises after the release, stretch and activate exercises. These strengthening exercises are done on both sides as instructed right? So for example on the 90/90 hip shift:
    Instructions:

    Lie on the floor.
    Place your feet on the wall with your hips and knees bent at 90 degrees.
    Dig your feels into the wall and lift your tail bone off the floor.
    Keep your back flat on the ground.
    Without moving your feet:
    push out your right knee forward
    pull in your left knee towards you.
    Feel then tension in your left inner thigh and right outer thigh.
    Hold for 10-15 seconds.
    Repeat 3 times.

    We would also repeat the same instructions pushing out our left knee forward and pulling in our right knee toward us. Is that correct? We want to exercise both sides following instructions to create a balance!

    Reply
    • Hello Penny,

      I like to get people to do one side first.

      With something like lateral pelvic tilt, chances are that the other side might already be over-used/strong etc, so we need to the other side, in essence, to catch up.

      But yes – end goal would be to do both sides equally!

      Mark

      Reply
  129. Hi Mark,

    Thank you for this really helpful post.
    I’m 37 and have a right side hip hike.
    I started running 3-4 months ago.
    When I run, my right hip starts hurting a lot which prevents me from running longer.
    Presently I run 5-7 km twice a week. After about 3-4 kms my right hip starts hurting quite a bit, so I have to cut my run short and just force myself to run as far as I can. I finish rest of my run while limping. I can easily run 2-3 kms more if my right hip doesn’t hurt.
    I saw your post about a couple of weeks ago and have been performing the exercises almost every day and always before running. The pelvis seems to get a bit even (right hip gets a bit lower) after performing the exercises but it gets uneven again after some time. I understand that it will take a lot of time to see permanent effects and I will continue the exercises for as long as needed.
    Can you please share your thoughts on how to prevent or minimise the pain in right hip while running so that I can run longer? I really love running and want to run longer.
    I would be very grateful for your suggestions.
    Many thanks again for this post.

    Reply
    • Hey Samir,

      If the right hip gets lowered from the hip hike position after the exercises, this is a great sign that the exercises are helping.

      It sounds like you will need to work on the endurance of these muscles (namely the glute med) to help you last longer in the run.

      I would focus on exercises where you need to hold the neutral position for as long as you can. The side wall push (exercise 4c) will be great for runners. You could even perhaps maintain this contraction against the wall as you perform small hinges from the hip forwards and backwards. (to mimic hip function in running)

      Mark

      Reply
      • Hi Mark,

        Many thanks for the prompt response and your valuable suggestions, really appreciate it!

        I will try your suggestions for 2-3 weeks and will share the results.

        Thanks again!

    • Hey Jess,

      Glad you like the blog post!

      You can start the routine 1-2/week and see how the body responds.

      If possible, ramp it up to 3/week

      Mark

      ps. thanks for the donation :) I appreciate it!

      Reply
      • Thanks you and you’re welcome.

        There’s so much kind of generic advice out there, but nothing this specific.

        What do you think of the broom stick method of re-adjusting the pelvis?

        I couldn’t find a pic, but basically I lie on my back with my legs raised and knees bent in a 90 degree angle. ( like a crunch). I hold the ends of a broom stick (it runs parallel to the floor) in between my thighs. I push the back of my left thigh against the broom stick, while simultaneously pulling the front of my right thigh towards me- against the broomstick.

        Supposedly this is supposed to help, have you heard of this?

        Sorry for the poor description.

      • Hi Jess,

        Not too sure what the broom stick method is, but it kind of sounds like this pelvis reset I use in this blog post: How to fix a Rotated pelvis.

        I’ll copy/paste it for your convenience:

        Pelvis Reset
        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.

        I use this more for rotation rather than tilting of the pelvis however.

        Mark

  130. Hi Mark!
    I had been going through this lateral tilt for quite a long time and only really got to know, that i have it, a few days ago. So i would like to inquire you about this Neal Hallinan, whose videos you can find on YouTube and he also has website detailing this condition. I would like you to read this

    And just authenticate what he says is indeed right. And it may also pique your interest.
    Regards,
    Abdullah.

    Reply
    • Hey Abdullah,

      I’ve completed all 3 home modules of the PRI course.

      I agree with a good majority of what they say!

      Hopefully it will help you with your lateral pelvic tilt (which according to PRI, you have a right hip hike + right rotated pelvis)

      Mark

      Reply
  131. hi mark

    The pelvis will HIP HIKE to the side of relative weak glute medius, tight quadratus lumborum and tight adductors.
    The pelvis will HIP DROP to the side of relative tight glute medius, weak quadratus lumborum and weak/elongated adductors.
    What about other muscles? quads and hamstirings?

    Reply
    • Hey Wassini,

      If you are looking at the lateral pelvic tilt from a purely frontal plane issue:

      To an extent – the outer quads/hamstrings will be like the glute med and the annd the inner quads/hamstrings will be like the adductor group.

      Mark

      Reply
  132. Hi Mark
    i have Left hip hike ,does that mean left hamstrings is tight ?
    And Lower right hip ,does that means right hamstrings is weak?
    Thanks.

    Reply
  133. Hello and thank you for this info. I have mild scoliosis diagnosed around 6 years ago and did some therapy on it. I also have anterior pelvic tilt associated with chronic low back pain and recently I’ve discovered I have lateral pelvic tilt too. I always tended to lean on the left side on a chair.My left hip is hiked but also the left leg looks longer too.
    The fact that I became a Dentist didn’t help with my posture. I’m also a natural bodybuilder as my hobby, I workout 4-5 times a week with clean eating. Because of this, I have plenty of knowledge on human body.
    I’m having problems choosing what I should do (concrete repetitive program) to address both the anterior pelvic tilt and also the lateral pelvic tilt on a daily basis.
    I’d love if you could help. Sorry for the long comment. Thank you.

    Reply
    • Hi Steve,

      My recommendation would be to focus on one aspect at a time. It can get a bit overwhelming if you do everything at once.

      You may find that addressing one area might in fact help with other areas!

      In most people, the thoracic spine is quite tight and can influence the position of the pelvis. For this reason – it might be an idea to address this issue.

      For mild scoliosis, you can try these exercises: Scoliosis Exercises. This may potentially balance out the lateral pelvic tilt but you will need to monitor this.

      If you tend to hunch over (as commonly seen in people in your profession), I would recommend these exercises: Hunchback posture exercises. This may help with your anterior pelvic tilt.

      All the best.

      Mark

      Reply
    • Hi Mark thank you for this detailed article. I have a left side hip hike (left hip is higher than the right, right side dropped due to me tilting to the left to avoid pain on the right from chronic pain that flares up on the right due to an old injury and repetitive movements on the right related to jobs I have had. I recently saw a physio therapist who confirmed all this. He suggested some exercise – yours are more thorough. So for my situation I should follow all the exercises listed above but switch the words ‘left’ and ‘right’ whenever I see them? Also I’ve been doing yoga which may be causing repetitive building and stretching of the wrong muscles (Ashtanga vinyasa).

      Reply
    • Hello again,

      You mention that the gluteus medius muscles on the side of the hip hike may be weak. I have a hip drop – on the right side. My right side gluteus muscle is weaker I can feel it. Is your article only for hip hikes? Because I have a hip drop, is there a difference? If you are strengthening the side that is higher that is not what I need – I have a hip drop and a weaker right side – do these exercises still apply? Thank you.

      Reply
      • Hey Ed,

        In a lateral pelvic tilt, there will be a side that is elevated (hip hike) and a side the is lower (hip drop).

        You can still do the exercises mentioned in this blog post.

        If you have a weaker glute med on the lower side, it might be just that it is relatively tighter (AND weak) in your case. IN this case, you will want to strengthen the glute med in a more neutral (relatively lengthened) position

        Mark

  134. Hi Mark, Thanks for sharing such an important information.
    My legs are of uneven length with right leg longer than left one by apmost 2cm. Would these exercises really help my hip tilt? I am not able to understand how strengthening my glutes could fix the leg length discrepancy.

    Reply
    • Hey Riks,

      If your leg bone is STRUCTURALLY longer by 2cm, then I would recommend a heel lift.

      If your leg bone is FUNCTIONALLY longer, then fixing your lateral pelvic tilt will help improve the leg length.

      Mark

      Reply
  135. Hi Mark, Your information about lateral pelvic tilt is very good and useful. Thank you. My left hip is higher, and I often have slight pain in that area, limiting my movement. My question is; when I do the stretches for QL for my left side (bending to my right) it’s not too bad; I can feel a little pulling on the pelvis. But when I bend to my left, that’s when my range of movement is limited and the pain in the hip becomes more pronounced. Does that make sense for pelvic imbalance? Or do you think there’s something else going on? (PS: I try to engage hamstrings and have correct alignment when I do the stretches.) Thank you!

    Reply
    • Hey there John,

      It sounds like your pain might be coming from the joints in the left lower back region.

      If you already have a left hip hike, the joint in the lower back may already be compressed. By bending towards the left can compress them even more!

      On top of addressing the lateral pelvic tilt, I would be doing stretches towards the right to open the joints in the left.

      Mark

      Reply
      • What you say makes sense. I’ll stretch to the right, open up the left side and feel if that helps. But when you say “joints in the left lower back” do you mean joints in the actual spine (vertebrae)? Or the SI joint? Or? Either way, I’ll do the stretching, just interested in knowing my body. You are a wonderful resource!

      • Hey John,

        A common area of joint compression is in the facet joints of the lumbar spine. This is what I am referring to when I say “joints in the left lower back”.

        Keep in mind- it really depends WHERE you are feeling your symptoms. It could also be the SI joint.

        Mark

  136. Hi Mark.
    ITs okay to have some pain in the tilt side? I have many of this sintoms, but offen also i feel some cold in my leg, i made an mri and nothnig is wrong with my spine. The doctor could not tell me anything.

    So a disorden in the muscles of psoas could be the cause of this? What do you think?
    Thank you Mark

    Reply
  137. Hello Mark You are awesome ni medic coukd told me my back pain. But this explain a LOT
    I have a question the exercises that you gave us.
    Is all enterily for right side tight?

    Because i dont understand why some exercises say right side or left side.
    Do you mean that if i had left side tight i should do the exercise in the exactly same way you show if it says left side. But if it says right side, I should do in the opposite side(left side)?

    Reply
  138. Hi Mark,

    Great article! Thanks for being thorough and informative!

    I’ve been going to a PT for a month-ish now and have been told that my left glute medius is weak causing my left hip to track inward. This has caused a lot of strain on my vastus medialis (over a long period of time) causing knee pain when flexed. Also I have a constant click in the left knee when I flex and relax my leg, but there is no pain associated with the click.

    I’ve been doing the exercisers recommended by the PT(and now have incorporated the stretches etc in your article), I do feel better but at times i still do feel pain in the knee(caused by the medialis). Especially when I wake up in the mornings and flex my left knee to kick the blankets off. I also have a tendency to sleep on the right side with my left hip hoisted onto a bolster.

    Is sleeping in this manner, exacerbating the strain on the medialis? Will the clicking be “fixed” if the hip alignment is as it should be? Would you recommend a chiropractor?

    Thanks so much for your input!

    Reply
    • Hi Dee,

      When you say “left hip tracking inwards”, this sounds like the left hip joint is internally rotating.

      This can happen if the muscles of the hip are not controlling the hip position (eg. glute weakness)

      Hip internal rotation can cause the knee to collapse inwards (Knee valgus). This knee position can affect the relative knee cap position (which might explain your non painful clicking)

      The pain in the medial side of your knee might improve with better hip alignment. If this is the case – you would want to work on hip external rotation based exercises such as clam shells, banded (between knees) squats, crab walks with band between knee or foot) etc.

      Good luck!

      Mark

      Reply
  139. Hi Mark,

    Really appreciate the detailed instructions on diagnosing and correcting a lateral pelvic tilt (in addition to your other entry on a rotated pelvis)!

    I’ve been dealing with a lower back injury since the end of July ’19, stemming from a deadlifting injury (pain was felt during the lifting portion). Initial condition was pain in lower back, unable to bend forward, and a lateral shift to the left (pain felt on right side). I let this linger for about a month before consulting my first physiotherapist whose opinion was a strained QL and ‘stuck’ SI joint. I was given some basic QL and SI stretches meeting on a weekly basis for about 3 weeks, but saw no progression and stopped consulting this physio.

    I then switched to weekly RMT appointments (month of September), which provided some relief but did not alleviate the pain felt in my SI joint in addition to my left lumbar shift.

    In more recent times, I’ve been seeing a new physiotherapist (starting Nov ’19) and an Osteopath (starting Jan ’20), where the physio has me doing exercises similiar to a herniated disc correction (Mckenzie side glides and back extension), and the osteo similar to the stretches mentioned for a lateral pelvic tilt (stretching the QL, and posterior chain on the right side)

    Hoping you can clarify some questions:
    – when I stand facing a mirror with my feet together, my right hip is 100% higher, my lumbar tilts to the left, and my belly button points to the left. This would be a right hip hike with a left pelvic rotation [in that case continue doing the exercises mentioned above?]
    – When my feet are together and looking from behind, the left part of my lumbar is flat, whereas the right lumbar side is curved. Would this be an indication of an anterior tilt in my right hip and posterior tilt in my left hip?
    – When i sit down, i feel like my right sit bone is lower, such that when i try to sit with both sit bones touching the chair, i fall to the left (would this be the anterior/posterior hips mentioned above?)
    – When doing McKenzie side glides, i feel pain in my right hip (around the glute med area) and a tingling/numbness in my right calf (not necessarily pain). Is this normal and should I continue with the side glides?

    Really appreciate any insights you may have!

    Reply
    • Hello Jayson,

      When I stand facing a mirror with my feet together, my right hip is 100% higher, my lumbar tilts to the left, and my belly button points to the left. This would be a right hip hike with a left pelvic rotation [in that case continue doing the exercises mentioned above?]

      Yes – this is consistent with a Right hip hike and a left pelvic rotation. Keep in mind the pelvis may also be Orientated to the left due to pronation of the right + supination of the left ankle.

      If your lumbar spine is tilting towards the left with a right hip hike, you are probably counter tilting towards the right somewhere along the thoracic spine +/- head.

      When my feet are together and looking from behind, the left part of my lumbar is flat, whereas the right lumbar side is curved. Would this be an indication of an anterior tilt in my right hip and posterior tilt in my left hip?

      If you mean the left side of the lumbar spine is relatively more flexed and the right side is more extended, then this would be consistent with a left rotated pelvis (anterior right + posterior left) with a counter rotation of the torso to the right and/or the torso counter tilting to the right.

      When i sit down, i feel like my right sit bone is lower, such that when i try to sit with both sit bones touching the chair, i fall to the left (would this be the anterior/posterior hips mentioned above?)?

      I feel this would be more related to what is happening with the torso. If you fall to the left, I would feel your torso is translating/shifting more towards the left side.

      When doing McKenzie side glides, i feel pain in my right hip (around the glute med area) and a tingling/numbness in my right calf (not necessarily pain). Is this normal and should I continue with the side glides?

      Tingling in the calf region may suggest some sort of nerve irritation. (possibly L4,5,S1 or s2). I would stay away from(or modify) any exercise that reproduces neurological symptoms. If you are following McKenzie Protocol, the glides should eventually see a reduction + centralisation of your pain towards the nerve root.

      Hope this helps! I’ve tried to be as detailed as I Can but it can be a bit difficult when I haven’t assessed you.

      Mark

      Reply
      • Hi Mark,

        thanks again for the thorough and detailed explanations on my queries! I’ll continue with the exercises for the lateral pelvic tilt and rotated pelvis. The McKenzie side glides I’ll stop for now since there is sees to be a feeling of nerve pain around my hip (glute med) area when attempting the glides.

  140. Hello Mark. I have a left hip hike which is causing lower back pain, and my PT told me it was due to a tight left quadratus lumborum. I have carried heavy weight on my right side for my entire life (because I am right handed), which I believe has strengthened my left QT moreso than my right. I have been doing stretching exercises on the left side to loosen it up as well as doing some strengthening exercises for my abdominals and lower back. I have a few questions about this article:

    Can you explain why the pelvis will hip drop to the side of weak/elongated adductors and how using the foam roller on the side with hip hike helps?  How does stretching the left glute medius help a right hip hike?  Shouldn’t it be exercised/strengthened in order to tighten it up and pull the pelvis downward? You side wall push exercise says to stand on your right side, but the side view shows you standing on the left leg. This is confusing. What muscle(s) does the step down exercise work and how does it help to correct a hip hike? 

    Reply
  141. Hi Mark

    I have suffered with a pelvic tilt (right side hike) for years and have had pain/felt tight in my right Quadratus Lumborum for as long as I can remember and not one physio has mentioned to release this to reduce the hip hike… very frustrating

    I have been following these exercises but was wondering if concentrating on building the muscles on the right side would cause more imbalance? What should I be doing to ensure all my muscles are equally balanced. Physios have always said I have weak glutes which has caused these problems but over activating my glutes causes painful trigger points which I then have to roll out with a ball or foam roller. This obviously then causes set backs as in pain with every day activities.
    Can you please give me some advice on how I can keep my muscle strength even whilst correcting my imbalance and pelvic tilt.

    Thank you so much for this post.

    Reply
    • Hey Natalie,

      It is important to address both sides when addressing a hip hike.

      If glute exercises on the right side cause spasms, you might want to reduce the intensity of the exercises and/or focus more on the exercises on the other side for now.

      Mark

      Reply
  142. Hi Mark

    With using these exercises daily how long do you think it would take to balance everything out? Also do you think the scoliosis that is caused by this will correct itself too? thanks!

    Reply
    • Hey Job,

      If the Scoliosis is directly related to the lateral pelvic tilt, then fixing the tilt will fix the scoliosis.

      However, keep in mind, the scoliosis has likely been there fore awhile, so there might be muscles in the spine that need to be released as well to get the full correction.

      In terms of how long, it really depends on how tight you are.

      Mark

      Reply
  143. Hi Mark,
    You have a fantastic website, and you are a blessing to those of us suffering these debilitating conditions!

    Mark, I have both a Lateral Pelvic Tilt (with the obvious waist crease), but also, have a Right-Rotated Pelvis.

    My first question is this: For several years, I have been wearing a waist-slimming belt, fairly snug, day, night, and even overnight, with a rotation of 7 belts so I can put on a new one each day. I am wondering if that has been a major contributor to my condition?

    Second question is this: You have a very specific exercise page for Lateral Pelvic Tilt, and you have a very specific exercise page for a Rotated Pelvis. But what if you have both? Do I do all of these, or can some of them be eliminated because they would be duplicated in one way or another?

    I have my daughter’s wedding coming up this year and this has been so debilitating…I’m relatively fit, but this condition gets me out of breath for walking even a short distance. I’m worried I’ll have a hard time dancing with my baby at her wedding.

    Hoping you can help

    Kind Regards,
    Rob

    Reply
    • Hi Rob,

      Compression from the waist belt can influence how the muscles in the area function.

      If you have both Lateral pelvic tilt and a Rotated pelvis (very common), I generally would recommend to address the one that appears to be effecting your symptoms the most to begin with.

      It would take quite a lot of time doing all of the exercises for both postural deviations. Once you feel you have improved as much as you can with the exercises, start to implement the exercises for the other pelvis issue.

      Also keep in in mind – prolonged compression in the torso can lead to:
      – weakness of many of the important muscles that support your body (core muscles)
      – pelvic floor issues and
      – breathing issues.

      Mark

      Reply
      • Hi Mark,
        Thanks so much for your very kind and detailed response. I have started by cutting down wearing the belt only during the day vs 24/7 (I was sleeping with it on!). So right there, I’ve gone down by 8 hours a day with it on.

        I will slowly cut down that time, but it has (in an odd way), become an addiction, because I feel slimmer by wearing it. But at least by cutting down the time I wear it by 8 hours a day should make somewhat of a difference (I hope?)

        Mark, I did have to correct one thing I mentioned, which after re-confirming my diagnosis with my doctor, they called my condition a “Right Spinal List”. Based on that, would that be considered a “Lateral Pelvic Tilt”, because I do have the obvious waist crease, or a “Right-Rotated Pelvis”? I just want to make sure so I know which set of exercises I should work on, or if these is a different link with completely different exercises I should be doing?

        Best Regards,
        Rob

      • Hey Rob,

        Spinal list would refer to how your spine is shifting towards the side.

        It is not uncommon to have a lateral pelvic tilt with some sort of spinal list.

        Have a read of this post: Scoliosis exercises. (the blog post might not 100% apply to your situation, but there are some nice exercises there to help with the listing)

        Mark

  144. Hi Mark,
    This is by far the most informative and thorough article I’ve read in regards to tilted/rotated pelvis! Great work!
    I’ve been experiencing pain in my lower back for the last year, primarily tightness on the right side but not always. My pain started the following day after doing legs at the gym. After healing a few weeks and returning to they gym I had minimal pain squatting when at the bottom of a squat but the next day was followed by extreme back pain. I then waited a few weeks & tried body weight squats which didn’t bother me at the time while doing them but once again the following day I was in pain. The last 2 months I’ve been in pain but only when bending or moving at the lower back when my muscles are engaged. For example it’s painful to do a pelvic tuck/tilt or bring knees to chest. I’ve tried yoga but the pain flares up during poses & the next day. Ive also been doing QL release and stretches on the right side but no relief yet. Do you think my ongoing pain is related to extreme hip hike? How long does it typically take to train the pelvis back into a neutral stance? My next step is to complete your recommended training above 1-2x daily.
    Thank you for your help!

    Reply
    • Hi Amanda,

      Sounds like your back is a bit sensitive to lower lumbar spine flexion/posterior pelvic tilt.

      This generally pulls on the muscles that connect to the border of your pelvis (iliac crest).

      Muscles that come to mind are longissimus/iliocostalis/multifidus are the usually the repeat offenders. (might be different for you)

      You might need to consider reduce the depth of your squats/leg press for now so that the pelvis stays somewhat still whilst you do your exercises.

      Hip hike can play a role here, but so can other pelvis postures such as : anterior pelvic tilt.

      Mark

      Reply
  145. I am very impressed with the thoroughness of this post.
    Thank you for your time!
    My question is what muscles are out of balance when I see an X ray of a pelvis where the ilium appears to look winged out wide on one side, and narrow on the other side?

    Reply
    • Hey Jeff,

      This is an interesting question.

      I’m not 100% sure but I would think this would correlate with some sort of rotation of the pelvis + torsion between the iliac/sacral bone.

      I believe that the “Winging” of the ilium is usually due to the over activity of the glute max/piriformis/coccygeus + inhibition of the iliacus on the same side.

      Mark

      Reply
      • I have a right hip hike. I would like to know the cause of it. Is it maybe because I stand too much on my right leg? If so, is leaning on my left side more than my right a good idea to balance my pelvis?

      • Hey Ramy,

        Habitual leaning towards one leg can give you a right hip hike.

        I would recommend minimizing this habit and standing with weight distributed more equally.

        Mark

  146. wow…amazing blog and info! thanks so much.
    I have lateral-pelvic-tilt, right hip hike; and stuctural flat feet.
    I have developed severe left knee and ankle pain the past 3 months, after using the stair-climber at the gym…trying to get healthy lol!
    I started seeing a physiotherapist 2 weeks ago.
    Any suggestions?
    ps…I am no longer using the stair-climber lol!

    Reply
      • Hey Jean,

        I would focus on getting the left knee and ankle pain free first.

        All about strengthening it in as many different positions as you can comfortably tolerate.

        Once your pain is under control, start to address the postural issues if they are directly causing you issues.

        Mark

  147. Hello Mark,

    I love your blog btw. I injured my back last spring and have been dealing with issues since, was diagnosed with SI joint dysfunction (but I also suspect some degree of bulge / hernia from the last disc on top of the sacrum).

    Anyway, I’ve got all the info / resources I need for therapy in terms of back exercises and SI joint stabilizations, and I suspect the root cause is hip imbalance, which I’ve been aware of since my early twenties (I’m 37). Although, I know I also need to lose weight and improve my upper body posture as well.

    But, to my question – I am pretty sure that I have a left pelvis rotation and a right lateral pelvic tilt. I definitely know the right tilt is correct since it’s been corroborated by a therapist. And 2 of the tests for the left rotation are positive I think. But, is that a normal combination? I really appreciate your time.

    Thanks,
    Sheryl

    Reply
  148. Hello Mark
    I really appreciate you work. I have a right hip hike, since my right iliac crest is about 1 cm higher than the left one. I feel quite more weight on my left leg when I am walking or working out. I have a question about about the Hip hitch (Standing) and the Step down/up: both of them have to be done with my RIGHT side on step?

    Many thanks, greetings from Italy!

    Reply
    • Hi Sal,

      If we are assuming that there is no structural leg length discrepancy, then Yes – I would do the Right side as this will engage the Right glute medius muscle to help raise the left side.

      Mark

      Reply
  149. Hi Mark…
    I have a question.. Will I need to do strength exercises on the opposite side aswell or just one side as I fear it might make things worse as I’m. Only doing one side, like muscle imbalances. I have chronic lower back pain due to lateral pelvic tilt

    Reply
    • Hey Tony,

      Might be an idea to start on one side to begin with.

      .. But with the aim of progressing to both sides as soon as you can without encouraging the tilt.

      Mark

      Reply
    • Hey Ryan,

      You don’t have to do all of the exercises.

      For example, if you are not tight in any muscle, you can skip straight to the strengthening muscles.

      Or conversely, if you are very tight, just do the releases and stretches for now.

      Another way of going about it is to try every exercise, see how your body responds, and stick to the ones you feel give you the most benefit.

      Mark

      Reply
  150. Hi Mark, I’m unable to judge how many exercises should I do and for what duration per day? Should I start from releases to strengthening exercises per day or should I divide them for other days?
    Secondly, I first felt relieved after doing a couple of exercises from the list but later the day I felt weak. After a couple of days, it seemed like my nerves were unable to fire properly and the exercises were causing gentle burning sensations in the muscles. My shoulders and lower back were causing pain. I guess I have neurological condition causing muscle imbalances. What would you advice in both the cases? Thanks.

    Reply
  151. Hi,

    I’ve looked a bunch of sources concerning lateral pelvic tilt and many of them address hamstring weakness to play critical role. According to many PRI practitioners, hamstring is told to be weaker on the side where the hip is lower. My physiotherapist found my hamstring to be inactive.

    What are your thoughts on this? How do you activate your hamstring when walking running, cycling doing exersise etc? When I take a walk for example, my pelvis is tilted when I get where I’m going.

    I found sleeping to be challenging also, because i’m a side sleeper. Any tips?

    Reply
    • Hi Samuli,

      I am not a PRI practioner, but from my understanding, the pelvis is generally in a position of Right pelvis rotation.

      Looking purely at this position, this would actually mean that the left hamstring would theoretically be ‘weaker’ as it’s in a more lengthened position.

      In your case, your right side is weaker which definitely be the case, but would probably be short and weak. If you follow PRI principles, then facilitating the left hamstring to bring the pelvis into a more neutral position will allow the right hamstring to engage properly.

      In regards to a lateral pelvic tilt: Since the body tends to place more weight through the right leg (due to assymetrical loading coming from the organs), the pelvis would tend to have a hip hike on the right side.

      My Advice: Balance out the pelvis (release tight muscles keeping you in the rotation/tilt, and then engage the muscles to pull you into neutral, then train the pelvis in neutral.)

      Mark

      Reply
      • Hi Mark,

        Thanks for the answer.

        I’m however confused. My physiotherapist told me it’s more like a shift than a tilt. He recommended to strengthen my right gluteus medius. My shift is to the right. But there seem to be a lot muscles involved in this and i can’t get a holistic view. I can’t find any programs that holistically fixes the shift. Your program fixes tilt, does it fix the shift? Are there exercises in this program that are irrelevant fixing shift. You once responded that i have to strengthen adductors on the left side and abductors on the right. Stretching goes vice versa.

        For example stepping up / down is confusing. Is it suitable fixing the shift?

      • Hey Sam,

        You can still do the same exercises for a shift.

        If your pelvis is shifted to the right, you probably place more weight on the right leg.

        You will want to do single leg exercises on the left side (like steps ups) to teach that said side to bear weight.

        If there are lack of results using the exercises mentioned, I would think you are shifting in the torso and the pelvis is trying to balance you out.

        Mark

      • Hi Mark! Just wanted to say big thank you for a really informative article. I’ve been in PT for quite some time due to knee knee valgus caused by my hip hike. I used to not be able to contract my left gluteus maximus at all AND had a weak right gluteus medius. I’ve strengthened both of them tremendously but I’m still quite a bit away from being able to doing heavily weighted squats with a neutral pelvis.

        Even though I’ve already addressed the primary issue I wanna say your article has given me some food for thought, especially involving the left Quadratus Lumborum!! I always thought my left side was inactive (and right was more active) due to an ab asymmetry but now I realize I should probably work on strengthening my lower back.

        Can’t wait to check out your other shoulder and back stuff!! I also have winged scapula from carrying my backpack on my right shoulder for too long— didn’t realize I could have so many issues @ 23y/o!! Keep up the good work!!

      • Hi Mark
        My right hip is high and my r
        Right hamstring hurt so badly I can not straight my right knee and leg. One of the muscle is behind my eight icmjng line rubber. While my right side of muscle above the pvix and below the pelvic so right I do not have any extension as.comere to my left knee so high side and which exercise and stretch I will do. I tried chiropractic physio. All they say you have different leg length but I normally sleep on my left side throughout my life.please help I am in really suffering since October 2017

  152. Hi Mark,

    And thanks again for your posts.

    I have been diagnosed with multiple issues: Right rotated pelvis with a right lateral shift. I also have left lumbar scoliosis that creates a compensatory S curve to my thoracic spine. Tinnitus, dizziness and muscle spasms. And some days I just feel normal. How can I organize a weekly program with so many issues?

    If I want to fix my shift, Can I use this program or should I leave something out / add something? It’s not a tilt, it’s a shift.

    I also have a functional leg length discrepancy. In comments, you recommended single leg squats for “the leg” but forgot to mention, which one? the longer or the shorter?

    Reply
  153. im just wondering which side of my waist should i strengthen and which side should i stretch if my left side is higher than the right side

    Reply
  154. Hi Mark,

    I have just been diagnosed with a leg length discrepancy. My right leg is shorter than my left. I have noticed that my abdomen sticks out more on the right side compared to the left. Would the leg length discrepancy cause this? I have no ovarian or bowel issues to cause it otherwise.

    Reply
    • Hi Emma,

      If there are no organ issues causing the shape of the abdomen, the fist place I would look would be a rotated Pelvis.

      You can read more about it here: Rotated pelvis.

      It is common to have both a lateral pelvic tilt and rotated pelvis together.

      Mark

      Reply
  155. Hi Mark,

    I had a chiropractic assessment done 2 years ago. It freaked me out so I haven’t gone back but recently a fitness instructor mentioned my curved spine so I thought I should look back at correcting it. The assessment I had done said I had a 25% curve and my head & shoulders were shifted to the left with no tilt. And ,y rib cage is shifted to the left. And my hips are also shifted to the left with a tilt. I also shift my head & shoulders forward. Would these exercises be good (just on the other side?) Also would Osteopathy or Physio be better to help fix this problem?

    thank you so much for you post!

    Reply
  156. Hey Mark,

    I recently went to a chiropractor who noticed I had a lateral pelvic tilt which misaligned my spine slightly and my shoulders. She said this could be fixed through proper adjustments over time.

    Thinking about it I’ve never really had great posture and always stand or lean to a side. I also have been lifting weights for about 5-6 years mostly heavy and notice the erectors on my left side are 1.5x the side of the right.
    Does this problem sound more of a job for a physical therapist than a chiropractor?
    Thanks!
    Shane

    Reply
      • Mr. Mark,
        Thank you for explaining it well.
        Four years ago I had a cramp in my left muscle a bit under my rib cage, and my body became uneven. And after this, I started having nerve pain in the chest area, and again cramps. It would take me weeks to get myself abit even and nerve and muscle pain free.
        So now I noticed that my shoulders and pelvis are uneven. But the strange thing is that the shorter leg is on the Hip down side. And on the Hip up side my leg is longer and a bit turned as in the picture of the sckeleton you posted. I dont understand why it is the opposite?

        And could the nerve and mucle cramp in my under rib cage, which is one the overstreched side be because of my shoulders and pelvis are uneven?
        And if I go to a physical therapy will I be healed?

  157. Hi Mark,thanks for your post, i am having right side QL pain and left side upper glut muscle pain, sometimes even my belt slide down to right side.. not sure if it is lateral pelvic tilt. But your post explains my problem.. Other symptoms are if i lie down on my back on a hard surface for more than 10 minutes, my low back hurts. (no major issues from the MRI of my sacral and lumbar region).

    From the above symptoms, is it a lateral pelvic tilt? Thank you so much again for your post and support to many of us in this situation.

    Reply
  158. Hello,

    Your information has been wildly helpful. My hip shift (to the right) has been the cause of countless injuries. Most notably a hernia, (eventually a bi-lateral hernia) that has led to complications with on going scar tissue pain, groin pain, testicular pain, and a general sense of unease. Very stressful. While the exercises and stretches have helped, I have found myself about 80% corrected. Gaining that 80% has allowed me to recognize how these seemingly acute injuries have come about. My squat still needs work along with my gait. When I walk my weight only shifts to the right BUT I cant bring my pelvis underneath myself square when I consciously activate my left lower ab (about an inch away and down from my belly button) and when I engage my left QL, but I ONLY find relief when I intentionally activate these. This is assuming that all other factors are taken care of such as released adductors, realeased right QL activated left adductor and so forth. I have tried a few things to make this subconscious like direct strength training, isometric holds and beyond. I am wondering if you have any final tips to bring a corrected posture to be more consistent AND more so if electrical stimulation would be of benefit to my lower left ab and left QL. I have a TENS unit but of course that is just nerve stimulation. Any advice would be appreciated, but I have to really thank you for sharing this information because I thought I would never find a solution to this problem. I have been dealing with it for literally 8 or so these past 5 months of so have been amazing, comparatively.

    Reply
  159. Hi Mark,

    I find your article very beneficial for my case, I have my left hip is higher than my right.

    Anyways, in the pictures you posted you wrote ”right side and left side” what do you mean by that? It is better to say high side and lower side because I don’t know if you ment the higher side when you wrote right side?

    Thanx

    Reply
    • Hey Raghad,

      I am explaining the exercises in terms of a RIGHT HIP HIKE, hence I have mentioned the (left) or (right) on the exercises.

      Please see:

      “*** READ THIS ***

      I will be explaining the following exercises in terms of fixing a Right sided lateral pelvic tilt (Right hip hike).

      If you have a LEFT sided tilt, then do the exact same exercises but on the opposite side mentioned.”

      Mark

      Reply
  160. Hi Mark, I don’t think I have a lateral pelvic tilt in general but I am a runner and when I look at myself on running photos then I can often see the difference in my hips. So in this instance would I still benefit from doing all the exercises and if so shall I do them on both my left and right side? Thanks Rachel

    Reply
    • Hey Rachel,

      If you hip hike every time you plant your foot down on both sides, I would focus on the strengthening exercises on both the left and right sides.

      Mark

      Reply
  161. Hey! Thanks for your post! I have had problems with my hips for a very long time, FAI like symptoms and tight etc.

    But my hip actually drops on BOTH sides when I do for example a lunge stretch with my right leg forward, my right hip will go upwards drastically and if I lunge with left leg forward, my left hip will go upward and right will drop.

    Do you know what this imbalance means? Sometimes if I rotate my hip a certain way before doing it (it feels in place) and it wont tilt but my hip will not go far enough into the lunge to stretch.

    Thanks

    Emma

    Reply
  162. Hi mark
    I put two points below my back and found that the right psis were 0.7 centimeters higher than the left. Does this indicate that the right hip is higher than the left? Or is the opposite.
    Thank you.

    Reply
      • Hey Mark
        I realised last year that my right hip is bigger and higher than the left.It had made walking hard and made me self conscious. I’m a busy student .Is there a faster remedy for me?
        Thanks

      • Hi mark my right hip is higher than the left, which means the right hip is the problem? And also I work out, and I lift heavy weight, not really much, so you think is ok to work out? Thank you

  163. Hi mark!
    I have leg length inconsistency.My right leg is slightly short.there was no such thing before.I’ve been doing fitness for a long time.some muscles are short and weak.but.which muscles should be treated?which muscles are weak?which muscles are short?left G.med, right G.med-Q.lumbo? I have a little lordosis. i guess my pelvis is a little scattered.. thanks !!!

    Reply
  164. Hey mark! Thank you for all your useful information!!! In a tough spot here. HUGE into lifting weights and fitness. The past two years have been really hard for me. Been unable to lift chest/shoulders/legs for the past year and it’s getting really tough. Started out deadlifting I had a very sharp pain in the front of my right hip flexor/lower Ab. Then a month later my left shoulder got impinged and now my lower right back is agony when I stand. Turns out I used to stand with a VERY dramatic “booty pop” on my right leg. Basically putting that leg into adduction. I get a ton of burning fatigue tightness feeling in my right QL, tightness and discomfort in my right psoas, adducter, obliques and TFL. I notice and have a HUGE feeling my right pelvis sits in FRONT AND HIGHER than the left. Standing dramatically hip pop shifting my pelvis forward and hikes. As a restaurant server it made these issues worse carrying heavy trays on my right shoulders. Now my right obliques feel so tight and my abdominals are more defined and larger. I’m confused tho as I would think carrying in my right hand or on my right shoulder would make my left obliques stronger? Would you think my obliques are tight on that right side or weaker? I have what seems to be a dent in my lower front ribs on that side. And I can feel my right obliques are way “harder” with less space between my pelvis and lower ribs than my left side. So I know I need to externally rotate my right pelvis and internally rotate my left. I can feel my adducter on my right side is way stronger as my inseam of my pants rip on that side and not my left. My questions basically is I’m having trouble isolating the glute medius enough to make it sore because it seems my TFL takes on the majority of the load. And trying to figure out should I be doing side planks on my left or right obliques? My right is tighter and gets really tight uncomfortable symptoms. But the rib dent makes me feel like it’s missing muscle even tho it is prominently bigger. I always sat leaning on my right side when I drove, but when I did side bends it hurts my right pelvis when I do left oblique side bends and my right obliques almost shake when I do right oblique side bendsThanks mark! Hopefully you can give me some insight on what to do and what to focus on. Right now my rehabs are scapula work, rear delt work, and I do clams on my right hip, adductors on my left leg, abducters on the right and obliques on the left.

    Reply
    • I have paid stretch therapists, chiropractors, massage therapists, and physical therapists. (Mostly for my shoulders) and now I’m starting to believe my shoulders won’t get better until I address my hips. My back discomfort and tightness is becoming the most annoying thing as my left shoulder pain has slowed down even tho it still is nowhere near ready to start doingheavy chest press or lateral raises or shoulder presses. I am now about to switch from shoulder rehab at my PT place to getting a new assessment for my hips. The funny thing, With my right hip being higher and forward rotates. Does that make sense why my left shoulder has a painful click as I come down from a pressing movement or over head, and my rightht shoulder clicks/discomfort when going forward and back like a chest press movement. It would make sense to me that if my left shoulder is higher that’s why it has uncomfort from being above my head and my right shoulder (since my right hip is in front) is more forwardly rotated and gets symptoms when I go forward and back. Basically wondering if that makes sense and wondering if my shoulders won’t get better until I address my hips first! Thanks again. Sorry I typed a lot for two comments. Really really hope I can hear from you!

      Reply
  165. Hey mark,
    I have right hip hike, i am trying to treat it, but when i walk my right hip starts to hike more and muscles behind the shoulder and neck start to get even more tighten and stiffen up which brings back to the same place, also when i do stretches my breathing gets disturb and that is causing me muscle spasm, condition is very tense for me.
    Also please suggest me some ways to get my breathe back in place and also for my other persisting conditions
    Please help me with whatever possible ways you can

    Reply
  166. Hi Mark,
    Thanks for the great articles, I’m planning on trying some of the exercises as apparently my pelvis is tilted, rotated and twisted (a bit corkscrewed!) after a nasty L5S1 disc rupture 4 years ago that wasn’t treated at the time (they said come back if you still have pain in 6 wks, I had pain, pins & needles, numbness and difficulty passing water!) I’ve really pushed and pushed to get referred to a physio as I’m still in pain despite some impressive abs strengthening (still pretty fit at 51) and when I saw the physio last week he yanked the leg on the side tilted up so hard he bruised my ankle then said, ‘yeah, that looks more even’. So here I am on the hunt for some effective diy physio. Apols for the waffle, my question is, should he have been yanking on my leg and can it help / damage or worsen the problem?
    Many thanks, and thanks for the clear, concise articles.
    Lu W

    Reply
  167. Is it possible to have tight QL on the side of hip drop? When I did Trandelenburg Test I saw that my right hip drops. So I guess I have hip hike on my left. But als I feel tigthness on my right lower back (guess it is QL). What could be your suggestions about this?

    One last question. Is it possible that this kind of tilt also rotation can weaken one of the legs (the one with the stronger glute) VMO muscle. As I feel whatever I did to strengthen I never managed a positive result also if I did not rotate back (into balance) VMO tendon snaps when extending leg fully (I thought that it remains in stretched position because of my pelvis position). Am I correct? Do you also have any suggestions regarding how to efficiently work and make hypertrophy on VMO while doing your suggested rotation/tilt exercises?

    It would be great if you could help me. Many thanks…

    Reply
    • Hey Mert,

      It is possible to have a tighter UPPER QL on the hip drop side if your torso tends to bend towards that side.

      Keep in mind, “feeling” tight does not always mean the muscle is tight (physically shortened).

      Another idea is that you might not actually be feeling the QL. Could be another muscle!

      Mark

      Reply
  168. On the initial diagram it shows the left QL as tight, and the right Glute Medius, Adductors, and TFL as tight. However, in your instructions you suggest stretching the QL and the Adductors on the same side. Is this correct, am I misinterpreting? Or was this an error?

    Reply
    • Hi mark

      My left side hip hike left low back pain and right side hip drop knee inward foot pronation right side pls tell me this exercies help?and pls send your emil id….Thnku

      Reply
  169. Hey Mark,

    If I know I have a certain habit (leaning when driving) that was a large contributor to my pelvic shift, would it speed up the process to lean in the opposite direction until I find an equilibrium? Or should I focus on good sitting posture and perform the exercises?

    Reply
  170. What’s the difference if I’m trying to fix a pelvic SHIFT vs TILT? How can I now which one I have.

    My right foot is supinated and left is pronated so the weight has shifted to the right leg.

    I’m also fixing rotated pelvis. It’s rotated to the left. Programs for lateral pelvic tilt and rotated pelvis include pratically same moves. If I have a right hip hike with left pelvis rotation, will i do 90/90-shift on both sides?

    Reply
  171. hi mark, my left back muzzle i.e.,quadratus lumborum grown more than normal and right was less ,and my pelvis be like moved out to right side ,which stretches i have to do, right hike or left hike.pls rply.

    Reply
  172. Hi Mark, so I’ve got a plethora of problems. I have a right hip hike because of my scoliosis which I’ve know about for a bit. As of recent my lower back has been really weak (hard to walk longer than 10 minutes) and I’ve been getting these muscle cramps/spasms in the side of my butt on both sides (could this be weak glutes) also as of recent I can now feel the middle of my spine jutting against the back of my chair . I’ve been doing partial crunches and bridges as well as my regular pt. What do you think the issue is ?

    Reply
  173. Hi Mark

    How are you? I found your site recently and it’s great! Thanks for all the great information.

    I have been suffering from hip/back pain for about 3 years and no doctor has been able to help me. You seem to be such an expert so I was wondering if you did individual consulting. I live in Germany so I wouldn’t be able to see you in person. But I was hoping that i could send pictures and describe my problems and you could put together an exercise program for me. If you do this sort of thing then please let me know how much you charge and how to proceed.

    Regards
    Jesse

    Reply
  174. Hi Mark,

    If I have a right lateral pelvic shift (hips shifted to the right, crooked back so to speak), What do I need to strengthen?

    Br. Samuli

    Reply
    • Hi Samuli,

      You can strengthen the right glute abductors and left adductors, and loosen up the right adductors and left abductors.

      On top of this – single leg exercises on the leg side to encourage weight bearing.

      Mark

      Reply
      • Hi Mark i’ve been suffering for 4 months now i have sciatica on my left leg going from my lower back to my toe i had an MRI done couple days ago and found a bulging disc on L4 L5 but the big problem is that i have a tilted hip to the right and i think this is what caused my bulging disc and sciatica pain can you tell me what i can do about that ?

      • Hi Mark,

        It’s weird, my upper body is leaning left but my hip hike is on the right. My short leg is on the left. When I lean to the right, my pelvis starts to straighten.

        When I put a heel lift under my left leg, my pelvis straightens. Waiting results from x-ray. Maybe structural discrepancy.

      • Seems I have a 4mm structural difference according to x-ray. What can this cause?

        My upper body is leaning to the left but my hip hike is on the right. My shorter leg is on the left.

        Is the program for lateral pelvic tilt suitable for this or does SHIFT require different type of approach.

      • Hi Mark,
        I was wondering since I have a left hip hike why on the step downs should I be standing on my left leg and driving my right foot down? I would think it would be the opposite way due to my left leg being slightly shorter, but I’m not exactly sure. Hopefully you can provide me with further insight, thank you.

      • Hey Brent,

        This is just one way to challenge the left hip to bring itself out of a left hip hiked position.

        You can also perform the exercise with level hips.

        Mark

      • Have both lateral tilt and rotated pelvis both stopping me from playing sport for the last 6 months. Which would you advise trying to fix first

      • Hey Rory,

        You can start addressing either one. Ideally you would address the one that is affecting your sport the most.

        If you’re not sure which one to go for, just pick one and see how you respond.

        Sometimes addressing one, might actually help the other,.

        Mark

      • Hi mark
        Thanks for your response. Is there risks of causing more imbalances by doing the exercises on one side only

  175. Hi Mark, thank you for another comprehensive post, it’s so easy to follow.

    I have righ hip hike and left hip drop but at the same time I was told that my pelvis is alto rotated , left is forward and right is back.

    Would exercise on this post should help me?

    Also how long does it take to see results? I have been doing exercises for a week and have not seen changes yet.

    Reply
    • Hey Anna,

      If you have a rotated pelvis, check out this blog post:

      How to Fix a Rotated Pelvis.

      Persist with the exercises! If you are struggling, you might find better results addressing the rotation first.

      Mark

      Reply
  176. Hi Mark!

    My name is Emanuele, 28 yo.

    I am confused about my issue and what to do about itand I hope you have time to help me. I am really struggling…

    The fact is that I have a HIP HIKE on the LEFT side of about 1,5 cm and my pelvis tends to ROTATE TO THE RIGHT.

    All my body issues I feel on the left side, infact I often feel tension in the left QL, left adductor, left quad and hip flexor. I used to have left knee pain too. My Left foot is slightly rotated outward and the left foot arch feels higher than the right. I have limited IR of the femur on the LEFT side. My right side feels healty, I am right handed.

    I see that you have written about both these issues but a couple things are confusing me
    becasue they are opposite to each other, for example:

    LEFT HIP HIKE: You wrote to RELEASE and STRETCH LEFT ADDUCTOR

    RIGHT ROTATED PELVIS: You wrote to RELEASE and STRETCH RIGHT ADDUCTOR AND INTERNAL ROTATORS.

    Can you explain if my sympotoms are reflecting these patterns and what I should really do please?

    Kind regard,
    Emanuele

    Reply
  177. Hi Mark,
    This post regarding pelvic tilt is so helpful!! I have a lateral pelvic tilt with right side hiked. QL on the right always feels tight like it needs releasing, as well as right adductors, as well as right hamstring. However, it is also my right glute med that feels really really tight and angry, and super sensitive to release work.
    My question is: would it work to follow your program as it is, with the exception of swapping your suggested work for a tight left glute med to my right glute?
    Thanks, Carolina

    Reply
    • Hi Carolina,

      If you have a right hip hike, the glute med on that right side should be in a more relatively lengthened position as compared to the left side.

      If you feel more “tightness” in the area, you may be describing “tension” as opposed to tightness.

      Think of a elastic band. Stretch the rubber band. Now, from here, stretch it even more. Is this band “tight” or is that there is just a whole lot of tension going through it?

      Mark

      Reply
      • Hi Mark,

        I’m just following up on Carolina’s question, as I feel the same thing (right hip hiked, but also with pain the in right glute med). Since you were saying that the glute med is lengthened on the right side, does that mean I should avoid doing any exercises that stretch this, (such as rolling with a therapy ball, or stretches like half pigeon) regardless of if it feels good to do these exercises?

        Also, I was wondering if the stretch you showed for the tensor fascia latae would be a bad idea to do on my right side as well as the left. The muscles in front of my right hip, as well as my upper right leg, constantly feel like they are in some type of pain (not sure if this is tightness or tension). This stretch would definitely feel great, but I don’t want to cause a further problem.

        Thank you!
        Michelle

  178. Hi Mark. So because of my scolisos my right hip is hiked and no amount of phyiscal therapy or chiropractic adjustments have seemed to helped. Im 4 months into phyisical therapy and chiropractic and it’s only gotten worse. I can’t even walk for 10 minutes without my lower back killing me and and have a feeling of collapsing. I’m getting a heel lift on Monday it I don’t think it will do much. Do you think I need surgery at this point? I’m only 28 years old by the way.

    Reply
    • Hey Allen,

      It is extremely rare for surgery to be absolutely required.

      If physical therapy and chiro isn’t helping, it might be time to focus on other causes of your symptoms.

      It would be best to discuss this with your health practitioner. Try a different approach.

      There is no point doing the same thing and expecting a different result.

      Mark

      Reply
      • Hi Mark. I was wondering if I could possibly talk to you personally. I’m at the point now where I don’t have a job, no insurance and I can’t even walk for 10 minites. Could you help me with some basic excercises to help strengthen my back so that I can do something to actually progress ? I know it’s an unusual request but I have literally $0 right now and I’m desperate. Thanks Mark

      • Could you help me with some strength excercises for my lower back / back in general? It’s hard for me to get on the floor so if there are some that I could do in bed or while sitting that would be great. I don’t have an appointment with an orthopedic until next month and I wanna do something that will help me get stronger. Your help would be greatly appreciated. I can message you on Facebook if you’d like and let you check out my x-ray and give you more details if youd like?

      • What core excersises can I do to help strengthen my lower back and back in general can I do in a seated position? It’s hard for me to get on the floor. I recently picked up partial crunches as I can actually do them. Do you recommend these to help strengthen the back and core ?

      • Here are some sitting core exercises.

        1. Go to this post and scroll to “Breathing and the Core”. Learn how to do this in sitting.

        2. Pelvic tilts

        3. Seated hip flexion

        Mark

      • Thank you for the excercises. Would it possibly to talk to you personally through Facebook? I just have a few questions for you and can’t currently see a physical therapist. It would be greatly appreciated.

      • Hey Christopher,

        That might be hard for me.

        I have a thousands of back logged private messages on Facebook and have had to stop responding to the vast majority of them (otherwise I wouldn’t have any time do work on the blog!)

        Through the comments is the best way to ensure that you get a reply.

        Mark

  179. I have had a lateral pelvic shift for a year now. Right hip sits higher, however my left leg is shorter (no leg length discrepancy). I had surgery 3 months ago for herniated disc at L3-4, but shift didn’t correct itself. PT is not helping, and I’m unsure which exercises/side to focus on since shorter leg is opposite hip hike?

    Reply
  180. Hello Mark

    Thank you for giving us good idea about posture correction.
    I did excercise for lateral pelvic tilt. But as I progress I am facing some serious problems. Please advice. I will explain my scenario below.

    Few years back I injured my left ankle while playing basketball. It turned out to be a ligament tear on lateral aspect of ankle. It was only a clinical diagnosis and no scans were done to confirm it. I wore a below knee POP cast for around 1month time. Ankle rehab excercise were advised but couldn’t follow it properly. After doing for few days I regained somewhat function of ankle , but no complete. I immediately started playing basketball with this half functioning ankle eventhough I had pain and minimal swelling.

    It’s been 5 years now. Eventually due to more weight bearing onto my right leg, My pelvis seems to be tilted laterally toward left. There is a hip hike on left side. And almost all the features of pelvic tilt given above are there for me now. I’m afraid there is some torso twist and hunch back also. I had an hyperlorsosis even before I had ankle injury. Now after reading the post I started doing the correction excercises. I did for 1 week and now all of a sudden I feel a suffocation in upper chest close to neck. Feels like my upper body is getting compressed top to bottom. It’s more prominent when I sit on chair. I fell dizzy when sitting in chair for long time due to this feeling. I feel a strain in mid spine region like something is stuck. Is this the body trying to become normal or something else. Kindly advice.

    Reply
    • Hi Kenneth,

      If exercises are causing that reaction, I would recommend to stop and see if you can find the exact exercises that might be causing it all.

      Here are 3 potential explanations that I can think of:

      1. Your torso might be used to having a lateral pelvic tilt. In this case – slowly and gently go through the exercises. Small changes will be better than drastic changes here.

      2. You might need to work on another area before addressing the lateral pelvic tilt. You mentioned other postural deviations which might be impacting the exercises. (eg. the torso, ankle, hyperlordosis)

      3. Too much exercises in such a short time. You may have pushed yourself more than what the body was ready for. Slow it down, cut back the intensity. Don’t force anything.

      If in doubt – I would consider getting assessed by a health practitioner to make sure you are on the right way.

      Mark

      Reply
    • Did you ever find out what was causing your dizziness? I also have dizziness primarily when sitting down and since then I’ve found that I’ve been sitting on the left side of butt instead of distributing my weight evenly and the reason for that is because I have a true leg length discrepancy.

      Reply
  181. Hi Mark!

    I just want to first say how amazing the work you do is and how inspiring it is to an aspiring PT like myself!

    I have a right hip hike and left rotated pelvis. Now, I tackled both issues relatively at the same time yet focused on the lateral tilt as per your responses to other comments. Now it seems like my left pelvis is almost more rotated, yet the right hip hike has improved dramatically. I would just like some help on which exercises to focus on to correct both issues simultaneously.

    Thanks again for everything

    Alex

    Reply
    • Hey Alex,

      I would take out these 2 exercises:

      1. 9090 hip shift
      2. Knee to Knee.

      These will tend to rotate the pelvis to the right side.

      Every other exercises will be fine to continue :)

      Mark

      Reply
  182. Hi mark! Great page. I think I have a right lateral pelvic tilt (right hip is higher) but I tend to jut my hip to the left when I hold a baby and when not standing up straight I preferentially just my hip to the left. Does that make sense or is it likely rotated or some other kind of alignment?

    Reply
    • Hey Beth,

      It is possible to have a right hip hike in standing, but then prefer to hip hike the left side when carrying your baby.

      There may be some rotation as well, but what you are describing is more so a lateral pelvic tilt.

      Mark

      Reply
      • Hi mark, been struggling for a while with what I’ve been told is a pelvic imbalance but nothing I have been given to do is helping. I’ve just come across your page and it has so much info but I was wondering what I’m best working on? My left ql, hip, quad and shoulder are super tight and sore quite a lot. Pretty sure my left hip is hiked but it also looks like it may be forward too. The other thing to mention is my right quad gets bigger muscular gains then my left and the inner left quad seems smaller/kind of bows in. Any help would be great as I’m going crazy from physio to physio. Thanks!

  183. Hi Mark,I have a question regarding if a lateral pelvic tilt can cause tailbone pain,glute pain,pelvic pain that comes and goes with accompanying spasms I’d appreciate the feedback please and thank you.

    Reply
    • Hey there Isabel,

      It is quite possible that a lateral pelvic tilt may be contributing to your symptoms. (But so could a lot of other things!)

      You can try these exercises and see if it helps your symptoms, but realistically I feel you might need further assessment to find the root cause of your issue.

      Mark

      Reply
      • My doctor said me that I have lateral pelvic tilt due to Atlas bone imbalance ,means central nervous system .can I fix it permanently by this exercise

  184. Hi Mark, I am trading for a marathon in November and have noticed I have a hop drop. If I start to do these exercises how long will it take to see a) an improvement and b) complete recovery. Thank you for your article and time.

    Reply
  185. Hi Mark,
    I’ve been dealing with some issues for 7 years or so and seen several PTs, Chiros, PRI Consultants, nothing has really helped.
    My primary issue is that I have a lot of right glute pain when sitting. Other symptoms that come and go:
    – Right upper back cramping
    – Left Lower back (QL) feels over used
    – Right quad/knee pain (seems to be referral from a tight right psoas)
    – Right heel pain when standing
    – Protruding front right hip when standing
    I have been told that I have a hip hike on my right side and that I am heavy to the right when squating. I can’t see/feel the hike when standing, but when sitting my rips and hip on the right side are closer together for sure than the left. I also feel my sit bone on my right much more than my left.
    Should I follow the suggest program above? Do I preform the entire circuit in one continuous session? I saw somewhere you mentioned 2-3 times per week.
    Do you provide consultation remote or through a clinic?

    Reply
  186. I shattered the left side of my pelvis in 2001, and it was repaired surgically with no pain now. However the incision and infection i obtained in the incision while in the hospital left my left gluteus medius very weak (i still can barely hike my left hip when not cheating with other muscles). I also am a master of compensating with other stronger muscles as i am an athletic person even now. I have some definite pelvic tilt and also some rotation from years of compensating for the gluteus medius weakness.

    – Can a pelvic tilt make it appear as if one leg is shorter than the other when this is not the case? The surgeon who repaired the hip said there was no actual length descrepcency, but a physical therapist told me later that my injured side is a little shorter.

    Reply
    • Hey Erik,

      If you have a weak left glute med, it is more likely that you have a left hip hike.

      If the left hip is raised, then this will naturally “pull up” the left leg . This can give the illusion of having a shorter left leg.

      Mark

      Reply
  187. I was going to physical therapy for a lateral pelvic tilt (my right hip is significantly higher than my left), and I was assigned a few at-home exercises to partake in:
    1. 90-90 supported hip lift with hemibridge
    2. Right sidelying respiratory left adductor pull back
    3. Left sidelying resisted right glute max.
    At first I noticed a positive difference in my posture, but after a couple of weeks doing the exercises, I have found that my right hip is now pushed forward rather than even with my other hip. It’s more noticeable after I have completed the exercise routine set by my physical therapist. I notice it in my gait that my right leg takes longer strides than my left, and when naturally standing, my right leg is “more forward” than my left. It’s not painful, but its uncomfortable and I feel as if I’ve backtracked.I’m no longer seeing the Physical therapist because my insurance only approved so many appointments. I’m curious as to whether or not these exercises should stop, or maybe there’s something I could possibly use in conjunction with them to assist in my therapy and recovery. Any suggestions or input is appreciated.Thanks!Rebekah

    Reply
    • Hi Rebekah,

      Sounds like your physical therapist is trained in the PRI approach.

      The said exercises will rotate the pelvis towards the left side. This might explain why your right hip is now more forwards.

      You can try adding the exercises mentioned on this blog post to see if that helps too.

      Mark

      Reply
  188. Hi Mark , I did the test and my right hip is slightly higher than the left , however it’s my right knee that has started to internally rotate giving it the valgus look.
    My biggest problem is constant right lower back pain kind of feeling like something is out of place and tight ; when I try to crack my lower back by rotating to the left it feels like something is stuck ( on the right side ). Also recently I noticed my right knee is rotating inward and also my feet feels different to stand on . I suspected I have lateral pelvic tilt but it doesn’t make sense why my right knee is rotating inward if the right hip is higher . ( my legs are same length , i started having this pain about 2 years ago following a Thai massage )

    Reply
    • Hi Mark,
      Thanks this is helpful! I am 28 year old male and have been confirmed to have a lateral pelvic tilt- my right side hikes up. I also get some pain in my knees and foot- is this probably the reason? I also have been diagnosed with wear and tear of my sacroiliac joint on the right side- could this be caused by years of a pelvic hike on the right side putting pressure on my pelvis? And which of the exercises would you recommend?
      Many thanks! Steve

      Reply
      • Hey Steve,

        If the lateral pelvic tilt has led to your said issues, then all of the exercises mention on the blog post will certainly help!

        If those areas are quite painful, you might need to focus on doing isolated exercises for them first.

        Mark

  189. Hi Mark,
    Please help, I have lower right hip with shorter right leg. What is that problem and what muscle should I work on? Thanks.

    Reply
    • Hi Brian,

      If you have a Right hip hike with a structural short right leg, then you should do the exercises for a Right lateral pelvic tilt (hip hike on right side).

      If the true leg length discrepancy is significant, I would consider using a heel insert.

      Mark

      Reply
      • Hi Mark, love your website and appreciate all the information there. I would like your advice if possible and apologize for my english level… I have pelvis and lower back pain and am in the process of being diagnosed. My phisiotherapist noticed that my pelvis tilts to the right and my right side pelvis is lower than the left one. Also, when lying on the back with legs bent, my left knee is higher. She succeeded on showing this to me. And when we put something a little higher then 1 cm under my right leg it seemed to straighten the whole posture. She recommended I go to walking lab, I did so. still haven’t received the analysis full results, but the phisical measure with meter of leg lengh discrepancy by both walking lab manager and ortoped showed there is no difference. Walking lab manager said it seemed like i would need to use some lifting. And the ortoped said that according to previous mri of pelvis and lower back it looks like i have osteopenia and thought it had to do with my pain. 2 doctors before him who saw the mri didn’t say anything about osteopenia. I dont know how to understand my situation.. . Can legs be at different height though meter measure shows they have the same length? How can osteopenia be related to this? I would like to hear any suggestion you may have related the subject. Thanks a lot. Meytal

      • Hi Mark,
        I am happy that I have found your page. I am 49 and and because of bending/leaning/bracing myself improperly at work for 30+ years I look like your example picture at the top of your page. Even worse, my left shoulder has been up and tight for so long it has affected so many things. I get dizziness, light headed, imbalance, and a drunkenness feeling. Trying to level myself for years has been a difficult, miserable, daily challenge. Chiropractors have kept me aligned but it doesn’t “fix” my problem. Your page looks more useful than any I have come across. I have started your methods today. Fingers crossed, I hope this works. I will definitely follow up. Thank you!

      • Hi mark my whole right body is rotated forward and right side foot is pronated and right side leg is also internally rotated whereas my spine is moved towards left slightly..dont know what should be done please guide me

  190. Great website btw. A quick question please. If I am pulled into a lateral shift of the hips to the left (i.e. with left hip higher) when I posterior tilt my hips, what muscles do I need to stretch?

    Reply
    • Hey Jonathan,

      If you have a posterior pelvic tilt + Left lateral pelvic SHIFT cause by muscular tightness, then you will need to stretch the: (generally speaking)
      – Left adductors
      – Left QL (and possibly the other muscles between the ribs and pelvis)
      – Right abductors
      – both hamstrings and lower abdominals (for posterior pelvic tilt)

      Mark

      Reply
      • Just to make sure.

        Left lateral pelvic shift means that pelvis has shifted to the left, correct? And shift and tilt are different issues. You don’t address pelvic SHIFT on your website.

      • Hey Samuli,

        A lateral shift is different to a tilt, but can occur together.

        I might need to put a blog post on lateral pelvic shift soon!

        Thanks for the idea.

        Mark

  191. Hey Mark,
    I’ve had recurring lowerback pain since I was 17 (it started as right lower back pain). Since I was 13 I’ve felt that I carry more of my weight on my right leg. Doing physiotherapy and stretches has helped a lot, but for the last 5 months I’ve had lots of pain in my left lower back and left glute. I’ve been told my left shoulder is higher than the right.

    I went to the physiotherapist 4 months ago and it has helped a lot, and he told me that my legs were the same length and that my uneven hips were causing the pain. He also said that exercise (he told me to work my abs and left glute specifically) and stretching should fix it. Ive been doing both everyday for 4 months.

    A couple of days ago I went to a chiropractor to see if he could speed things up, he looked at an x-ray of my hips (I could tell clearly my right hip is lower) and said that I should use an insert on my right shoe to compensate the 1 cm discrepancy in leg length.

    I think both of them are helping me, since I feel better after visiting both, but I dont know who to listen to. Should I use the insert? If the physio is right, and it’s just uneven hips, will it make things worse?

    Thanks!

    Reply
    • I forgot to mention, I’ve been told by a doctor who viewed an x-ray of my hips that my left hip is rotated inwards, so my left thigh is more forward. I’m 21, can I fix these things with exercise and stretching alone?

      Again, thanks a lot for the content!

      Reply
    • Hello Nicolas,

      If you do not have a significant leg length discrepancy, I would not use the shoe insert to begin with.

      If you have uneven hips and equal length, you just need to balance out the muscular pulls.

      Mark

      Reply
      • Thanks a lot for the response!

        My physiotherapist said I could try using the insert for a while, and when my left hip returns to neutral position it will feel awkward to have it on. However, I believe using the insert could make my progress slower.
        On the other hand, the chiro says that he would be a scammer if I went to him for an adjustment and then not use it, because my back would go back to a bad position.
        Is it possible to use an insert for a while, sort of like a crutch?

        Thanks again,
        Nicolas

      • Hi Nicolas,

        You can give it a try.

        But keep in mind that your corrections will all be based on wearing that orthotic.

        Once you take it off, it’ll cause changes throughout the posture.

        Mark

  192. Hi Mark,

    I’ve had tight hips and weak abductors for many years. It has just now gotten to the point where my daily life is affected. My entire body feels like it’s being pulled to the right. I favor my right leg when I stand and lean to the right with my hips. I push my right hip down in my car and lean to the right when I drive and at my desk.

    The last few YEARS I’ve always had my shirts kind of fit a little differently. Almost like one portion of my body was bigger than the other. I could never put a finger on it till now. My right shoulder is dipped a bit and actually sits differently than my left.

    I pronate my right foot more than my left as well. I’ve seen a sports medicine doctor and he’ll adjust me and tell me to roll certain muscle areas. At this point, I feel like it has progressed too far for that to make any difference.

    This has been getting worse over the course of the last year, feeling pretty helpless. Would you recommend I go back to the sports medicine doctor and really focus on the movements he recommends? I feel somewhat better now that I have connected all the dots.

    If it helps at all, I used to wear shoe inserts for arch support but lost them both many years ago.

    Any advice would be AMAZING, I have no one to talk to about all this and feel like I’m going insane.

    Reply
  193. Hi there mark, I am not sure whether I have anterior pelvic tilt or lateeal lelvic tilt, at the moment my left side seems always slouched and I constantly lean to that maybe due to bad sleeping positions. Everytime I move my left foot up I constantly hear a click and my psoas is always tight on the left. I am off balance most of the time and I do have a protruding stomach. Could you advise me if these exercises will benefit me or the anterior pelvic ones.

    Reply
    • Hi Omar,

      To determine which exercises you should do, I recommend looking at the tests in the blog post to see what kind of pelvis position you have.

      Protruding stomach may be due to an anterior pelvic tilt.

      Mark

      Reply
      • Thank you for the reply, even though I have viewed both posts about tests I am still confused and still find it hard to determine which problem I have. Could recommend any suggestions, should I try both exercises

  194. Hi Mark,

    This is some really great information. I’m really happy I stumbled on it tonight.

    I’ve dealt with imbalance issues for about 8 years now, which spiraled out of control after starting to work office jobs about 7 years back. I’ve seen countless specialists, none of which seem to really care to address what the actual cause of my issues are. I actually got to the point of completely giving up, but have recently enthused myself to continue my search for a pain free life. I feel off balance sitting, standing, walking, running..etc. and no matter what general stretches I do I can’t seem to figure it all out.

    Based on the information you’ve provided (and my suspicions that led me to your page tonight) I’m quite confident I have a lateral pelvic tilt, where my left side is higher and my pelvis is shifted forward to the left. Although I may have other stuff going on related to past injuries, I just wanted to list a few symptoms to see if you think your exercises/stretches would help me, and if you may have anything else to add specific to me. Sorry for writing such a long comment, lol.

    My main issues are crazy pain/numbness on the right side of my neck after activities like playing b-ball and regularly throughout the day, my left arm doesn’t feel like it’s set in properly (i.e. I’m unable to perform simple weightlifting exercises or even to reach out both arms in front without feeling ‘gunk’ in my shoulders). My right pelvis also shoots out backwards- if I run my hands down my lower back down over my pelvis towards my glutes there’s a big bone pushing out on the right side. Also doesn’t feel like my right foot connects with the ground well (I previously had a bad patch of plantars warts for a couple years, years back, on my right foot) and when I sit my right sit bone is shifted to where I can only sit on my left sit bone at work now. I’ve done the opposite of the instructions you posted above since I think my example is for the other leg, and a lot of it makes sense to me. The stretches feel good, activating my lower back on the right feels like something that hasn’t happened in a long time…etc.

    Sorry again for the long message, but I hope if you have some time you’ll be able to read and give me your advice. Even if not, thanks very much for taking he time to put this information online.

    Ryan

    Reply
    • Hey Ryan,

      Sounds like you have a left hip hike + Right rotated pelvis in the standing position.

      As your pelvis is the foundation as to what the rest of your posture is based on, this can cause a domino effect throughout the whole body.

      Pain/numbness in the neck can possibly mean a nerve is being involved. If the issue is only on that side (and given your lateral pelvic tilt), you may have Scoliosis, uneven shoulders and/or a tilted head that may be placing more stress in that right area specifically. These issues can also influence your left shoulder girdle position.

      If you can’t connect your right foot with the ground, you might be favoring that left side. You can check this is you stand on 2 weighing scales.

      I would start addressing the pelvis first , but I feel you probably need to be addressing other areas of your body eventually too.

      Mark

      Reply
  195. Hi mark.
    Left hip height and left shoulder height. Does this make sense?
    when i walk my right knee moves inward !
    I think I have a high left side with right pelvic rotation.
    What sould i do?

    Reply
    • Hey Djon,

      If you have a left hip hike which directly impacts the shoulder position, then correcting the lateral pelvic tilt will help.

      Mark

      Reply
  196. hey! mark do you think it will be more beneficial to do this routine on both sides just incase one gets weaker as one gets stronger or that will be counter productive i was to do it to both sides from the releases to stretches to excersizes

    Reply
    • Hey Ali,

      You eventually want to be doing both sides.

      Perhaps focus more so on the muscles that will help balance your pelvis out.

      Mark

      Reply
      • do you mean i can do both but maybe do a bit extra on the weaker side?. reason is i powerlift so i want to do the best i can to correct what i can so i can train correctly.

      • Yes – Or you can do both sides, but make sure you are doing equal amounts. (this means the weaker side is relatively doing extra work)

        Mark

      • so if i do both sides. should i also include the stretches on both sides or is it best to just do the exercises on both side but the stretches only for the side that needs to be stretched

  197. Hi Mark, I enjoyed reading your articles on pelvic tilt and pelvic rotation. Thank you for your thoroughness!

    Question: I’ve been having left knee pain (runners knee) for a couples years and hadn’t been able to find the root cause. After reading your articles, it appears I have a left rotated pelvis (belly button and pelvis angle towards my left) and a right side hip hike. So, my right hip seems to sit more forward and higher than my left hip. I’m confused about how to proceed as the stretches and exercises for these seem to oppose each other. Any guidance would be much appreciated!

    Reply
    • Hey Mike,

      I would get the specific area treated first. It is also very important to know exactly where it is hurting (and what structures are involved).

      After this – you will need to determine which part of your running mechanics is causing your pain. (eg. is it the initial contact, mid stance, toe off). This will help you be more specific with your exercises.

      Then you will need to see how your pelvis is affecting the running mechanics at this particular point in your run.

      If you have a right lateral pelvic tilt + Left pelvic rotation, you can start addressing either one really.

      Is your pain more on the OUTSIDE of your left knee under the knee cap?

      Mark

      Reply
      • Thanks for the reply Mark. I was diagnosed with Patellofemoral Pain Syndrome. The pain is under the kneecap and occurs in the mid stance into the push off stage. I have noticed that when running my left foot turns inward slightly. I’ve been able to keep the pain mostly at bay through glute and abductor strengthening exercises, but once I increase my activity level with running and biking it flares up more. So, now i’m curious how pelvic tilt and rotation may play into this. I had always noted that my right hip bone sticks out to the side more than my left and after reading your articles is when I noticed the tilt and rotation. I had my wife attempt to measure my leg lengths from the ASIS to the medial malleolus. The right leg was about a half inch longer (although I know there is plenty of room for error in leg length measuring).

        What I meant by opposing exercises was that the right hip hike seemed to indicate a weak right glute medius, while the left rotation indicated a tight right glute medius. So I wasn’t sure whether to stretch or strengthen? (same with the adductors).

        Thanks so much!

  198. Hi Mark,

    Amazing article !!!

    Thanks for putting every fine details for everyone!!
    i have developed lot of issues like.. left hip is high.. left shoulder is down.. backbone curve is gone and its almost flat.. neck is tilted forward and i am not able to do any exercise because my lip hip always hurts.. it hurts at sit bone alot and when i sit in lotus pose my left leg is so stiff it doesnt go even half way down.. also when i lie on ground and try to bring my knee to my chest for a stretch i cant do it because of pain and also knee never comes in direction of chest and it turns outwards.. what should i do for this left leg because of this i am not able to do any other exercises. on right leg i am good… i can feel stretches without pain.. but left hip hurts almost in every direction..

    please help :(

    Reply
  199. Hi Mark,

    Is it possible to have a both a lateral pelvic tilt and a rotated pelvis??

    A combination of these conditions is what I seem to have but I’m not sure it’s possible.

    Reply
  200. Hi Mark,

    I’ve been feeling tenderness in my left hip around the greater trochanter area. It feels like a tendon is being “caught” underneath there if that makes any sense. The sensation is exacerbated during exercises like kettlebell swings. I believe the source is a lateral pelvic tilt. Do these symptoms make any sense to you?

    Thanks,
    Omar

    Reply
    • Hey Omar,

      Definitely possible!

      You might have some gluteal tendon issue going on around the greater trochanter. This can be aggravated by having a lateral pelvic tilt for sure.

      If you lean more into the right leg when doing a kettle bell swing, does it feel any better in the left hip?

      Mark

      Reply
  201. Hi Mark, awesome content as always! I have a right hip hike (tight right QL, weak right Glute Medius, etc) while I have a left rotated pelvis. Which one should I address first? (I’ve read your other article about the pelvis rotation, just wondering which exercises to start first). Thanks!

    Reply
    • Hi Vassi,

      You can start with either!

      Take the exercises as far as they can.

      Once you feel that you have reached your maximum benefit from them, start doing the exercises for the other postural deviation.

      Mark

      Reply
  202. What exercises should I do if I have compensated trendelenburg. When I stand on my left leg my right hip raises up. But it is because I excessively lean on my stance/left leg. If I do the same exercises as you mentioned which would be the tight and weak muscles. I would think my stance side would need to strengthen my gluteus medius, but it feels very tight all of the time. Thank you in advance!

    Reply
    • Hi Victor,

      I would still recommend to strengthen that left gluteus medius. A weak muscle can still feel tight.

      Your Left QL is probably working really heard to get your torso over that left stance leg so make sure you release/stretch that.

      Mark

      Reply
  203. Hey mark. so my left hip is higher and after doing some unilateral work iv noticed my right glute feels weaker not my left. is that odd? or is that common because for example i did single leg deadlifts to improve my glutes too but i felt way more off balance and weak on my right leg than my left and even split squats my left leg felt more balanced and stronger. im not sure if i should just strengthen both sides in general or stick to this. please would love a reply

    Reply
    • Hey Bob,

      The glute complex is what we refer to as being “tri-planar”.

      This means it functions in 3 different planes of the body.

      It is possible for the glute to be weak in one plane, yet strong in the other.

      This is what I think is happening with you.

      Hip extension is weak on your right side, but perhaps hip abduction is strong?

      If your goal is to fix your lateral pelvic tilt, I would stick with these exercises.

      If your goal is to get stronger in movements, then you will need to practice those exercises that you feel weaker on.

      Mark

      Reply
  204. Hello

    Can you tell me which myofascial lines must release first with a foam roller in a right handed tennis player?

    Thanks

    Reply
    • Hello Sakis,

      It depends!

      Do you have any issues at the moment? Movement problems? Limitations?

      A big one would be the oblique slings as tennis involves a lot of rotation. (but – it really depends on what you are having issues with)

      Mark

      Reply
      • Thanks Mark for your reply.

        I have some pain in upper right neck and some pain sometimes in right scapula but these muscles is not tight the pain comes from somewhere else. In obliques i have pain with foam roller only in left side. What do you suggest me? How i start with foam roller?

  205. Hi Mark,

    I have the following issues that you address in your website:
    – I have a right hip hike of about an inch or so.
    – I have a left pelvis rotation.
    – I have scoliosis, (seems to me to be the thoracolumbar curve), with a right shoulder drop.
    – My *right* foot is flat.

    In addition I have a very flat back and weak psoas major and pectineus (assessed in person by a PT) and am currently working on these particular issues.

    So I have a lot of postural issues. Which one do you think I should try to address first? I’m starting to believe that they are caused by a true LLD. Will these exercises still address the problem?

    Reply
    • Hey Marty,

      If you feel everything is stemming from the leg length discrep, this is what you should be tackling first.

      You can consider getting a heel insert to make up the difference in leg length and see how your body responds to it.

      If all of your postural sways are due to this, this step alone should fix most of your issues.

      Mark

      Reply
  206. Mark,

    First off, thank you for making these posts – they’re very helpful and give me hope. Quick question for you, would your suggested routine differ for someone who has a true LLD? My right hip is higher, it’s my dominant side and x-rays confirm the femur is also 1.78cm longer than my left.
    Thanks again for your posts,

    – A

    Reply
    • Hey A,

      You can still do the exercises mentioned on the post for a true leg length issue.

      I would focus on getting stronger in your single leg exercises like the lunge, staggered dead lift and step up/down as well.

      Mark

      Reply
  207. Hello mark ,
    The past year I have been an emotional wreck with no quality of life. In July 2018 I had a microdisectomy 13mm broad pr protrusion L4 L5 S1 . Although I feel like I didn’t need the surgery yet it was my fault I didn’t do more research nor was guided correctly. 6 weeks after my surgery I developed a Cyst that was pressing on a nerve that caused me to severely tilt to the left I was stuck and was rushed to the hospital . It was 1 cm. After being on steroids the tilt got better the cyst went down but now Iam left with a slight lateral tilt. The doctor said give it time but it is now almost one year later and Iam now experiencing Hip pain , knee pain , and more sever and pressistant back pain. I’ve tried yoga , I’ve tried light weight and stretches and the tilt is still there. As time goes on I feel it may be getting worse. I am lost, and Iam having more problems and pain now than I did before the surgery, I completely ruined my life it feels like . Please if you have any advice or techniques it would really give me hope. Thank you

    Reply
    • Hey Natasha,

      The first thing you need to focus on is regaining full pain-free range of motion of your lumbar spine.

      This along will probably fix your tilt.

      What direction/s are you limited in? Bending to the right?

      Mark

      Reply
    • look at any imbalance you have in your body weak lats on one side can make a lot of problem in all your body the lats help stabilize thz spine also your oblique

      Reply
  208. Hey Mark, I’ve made some great improvements in improving my lateral pelvic tilt (hip hike to the right and hip drop to the left), however, I’ve noticed the exercises are becoming less effective, and my pelvic tilt slightly returns, even though the muscles I’m working with these exercises seems to be getting stronger. In other words, I feel the effect of them less when I’m walking or sitting, and wondering if this is normal. Also, I have been able to fix my posture and I no longer favor one leg or side of my pelvis when I stand or sit, but I do still spend the majority of my time on my right side when I sleep (unconsciously). Few questions:

    Is there a greater issue, like scoliosis?

    If these exercises don’t help any longer, what should I resort to?

    Also, I’ve been going to the gym for about four years, and consequently, this has affected my training resulting in uneven muscle bulk and imbalances.

    What is a long-term solution, so that I can workout and keep a balanced posture?

    Reply
    • Hey Jordan,

      If you feel like you have reached the maximum amount of improvement with the exercises, it is time to look at other areas that might be contributing to your lateral pelvic tilt. (Scoliosis of the spine would be a common one!)

      I would still work out, but try to prioritize your posture exercises.

      If you can, try to incorporate your posture rehab in with your gym exercises.

      Mark

      Reply
      • Thank you so much! I’ve been thinking this for a while now, I hope fixing scoliosis is not too difficult of an issue to remedy. Thanks again!

  209. Hi Mark,

    Thank you for the great content you are providing us with, I have spent some time on your website for the past month and it has been really helpful and informative!

    I identified that I have lateral pelvic tilt (left hip hike) and I can easily feel that something is not okay at my left hip when doing some activities or standing still. I also think I have a slight anterior pelvic tilt. I would like to ask you a few questions to make sure I better understand what my problems are. I apologise for the long questions in advance. :)

    1. What is the logic behind your comment that the side with the longer leg will generally have the higher hip? That seems to be the case with me but I cannot completely understand the logic and I am getting confused whether I actually have a leg length discrepancy.
    2. I believe I may have rotated pelvis to the left. When I look from above, it does look like my left thigh is more forward than the right. I can also see my belly button is pointing a little bit to the right. I am wondering here if the lateral pelvic tilt may be causing some of these things and misleading me to believe I have a rotated pelvis. I can feel a kind of restriction of movement when trying to open up my left hip but not sure if that is because of the rotation ot the hip hike.
    3. With that being said, I am currently playing football regularly and going to the gym. I have read other questions regarding going to the gym with these issues and you seemed pretty clear that it is okay if I control my pelvis in the movement. Would playing football be something that could cancel out the correction work I have done or even make the problem worse?

    Thank you for your time and keep up the good work!
    Kristiyan

    Reply
    • Hi Kristiyan,

      1. If you are placing equal amount of your weight through your left and right feet (ie. standing centered over your base of support), the side with the longer leg will laterally tilt the pelvis upwards on that same side.

      2. These quick tests are not always accurate. They just give a rough guide as to where your pelvis might be sitting. Pelvic tilts and rotations can occur together and as a result, can cause a blend of findings.

      3. Keep playing football. You will eventually need to get to a stage where you are doing more advanced exercises that mimic the positions you are in whilst playing your sport.

      Mark

      Reply
  210. I have also just read that if you have a pelvic tilt you almost always have a left sided AIC so always in a right BC pattern , I do t totally understand this but basically meaning my left hip is rotated onwards and the right hip outwards . Like I would be if stood on my rught foot all the time . This conflicts what the physio says as he says I’ve shifted my weight to the left away from the pain. It’s all too confusing and starting to make me believe nobody really knows the true answers

    Reply
    • Hey Jason,

      Great to hear you have come across the PRI concepts of the L AIC and R BC pattern.

      It’s limitations (and maybe due to my own lack of understanding of the PRI concepts) is that it does not explain why ALL people follow the L aic, R bC pattern.

      I tend to treat what I see, as opposed to assume everyone is 100% the same.

      Mark

      Reply
  211. Hi mark I hope you are well, I’ve stumbled across your article on lateral pelvic tilt and hope you may be able to help me . I was a very High level champion athlete as a teenager but forced to retire due to a fracture in my ankle around age 16 (not correctly treated) at age 24 I was diagnosed with a massive herniated disc in my back (no mri but I think L5/s1) I lost muscle in my right calf and was weak and numb all down one side of my body . It took approx 8-10 years for the numbness to go away and I always suffer bad backs , now age 41 I still have a smaller weaker right calf but it has improved. Crazy or not I started trying to run again 2 years ago and after about 1 year started to get pain in my right hip, behind in the glute medius area and a little down the TfL, I have also always suffered with back pain and that comes and goes. I went to see a physiotherapist about the hip problem and he told me my hips have shifted to the right and my body have been leaning to the left away from the pain possibly for years . My right hip is noticeably higher then the left also. I get various back pain, pain in my right hip and pain in the bottom of my back that sometimes is sharp shooting pain . The exercises the physio has given me still don’t seem to have corrected the issue . What I want to ask you is do you think I should be having xrays/ mri to check what is going on in my back and hip? If I have been living with the altered posture for so many years ( 17 years ) can it be fixed and would the exercises on your blog really help me ? I also think my right hip is not only higher but maybe slightly tilted forward too.
    Any help you could give me I would be so so appreciative , I don’t know what to do for the best and I just want to regain health and would love to continue to run.
    I also seem to have a slightly flatter left foot , and my right foot is more higher a arch and intend to stand more on the outer side of that foot

    Regards Jason .

    Reply
    • Hi Jason,

      It sounds like you have some Left vs Right imbalances, Lateral pelvic tilt perhaps being the main one.

      If running is your main concern, get the physio to check:

      – what to pelvis/hip and lower limb does when you do a SINGLE LEG STANCE.
      – Running technique analysis
      – Screening tests to Lumbar spine to see if that is contributing to your symptoms
      – check thorax/rib position

      You can get a scan to the lower back if you feel like you are not making any progress. If anything ,it will just rule out anything sinister.

      Mark

      Reply
  212. Dear Mark,

    Thanks for this great post!

    I have 2 questions left:

    1. How often do you recommend doing those exercises? I am a powerlifter and train 3x a week. I don’t do any leg exercises atm because of this issue. So shall i do that exercises (also the stengthening) all day? My bodybuilding/powerlifting mind says “the muscles need regeneration”.
    2. The 90/90 hip shift: Shouldn’t it be the other direction for a right hip hike? So pulling in the right leg tordwards yourself and pushing the left leg away?

    Reply
    • Hey Thomas,

      Many thanks for your questions:

      1. You can start with 2-3/week. From here – you will need to assess how your body responds to the exercises and increase frequency if possible.

      You can continue with your power lifting, however, keep in mind, when you start to use heavier weights, you may not be able to control your pelvis.

      2. The aim of this exercise is to engage the left adductor and right glute med to help correct a right hip hike.

      Reply
  213. Hi Mark, I am so glad I found your site and post! I started having bad back pain a little more than a week ago due to what I think was over correction while sitting. I’ve been getting pain off and on for a while now which led me to be concious of how I sat and stood, but I think it led to more problems for me. 2 days ago in the evening I noticed my right hip was hiked, and that got me started on my search which led me here. If I do these exercises and watch my posture, how long can it take before I see and feel improvement? So far it seems I start off the day with no hip hike but due to pain through the day my hips start to tilt and by night time they are hiked again. It gets painful to try to keep my pelvis aligned. Thanks so much for what you are doing!

    Reply
    • Hey Cynthia,

      You might see improvement straight away, but it really depends on many factors. It’s hard to put a time frame on it.

      If it hurts to keep the pelvis aligned, you might be forcing too much for a correction.

      In the beginning, it is fine to do a partial correction of your tilt. As the body gets used to the new position, you can do a more pronounced correction.

      Mark

      Reply
  214. Hey mark, I was diagnosed with flat-back syndrome. I took medicines for 2 months and with mild stretches I nearly made a recovery until very recently i started experiencing a outward rotation in my left foot. I searched on the internet and guess what now i have a lateral tilt. My left adductor is snapping at the base where it connects to the hip, my back at the iliac is popping. The physios in my area are not qualified and the doctors always give medicine to take for months, can u help me please. I’m so worried about my health.

    Reply
  215. Hi Mark

    I started getting sciatic pain while playing racquetball couple of years ago. It never went down my leg though. It was always local in the lower back area on the left. MRI showed some disc bulges and the Dr. said that was the cause. About four months ago, I suddenly started experiencing lot of pain and tightness on my right side. My left side sciatic pain is still there but the right side pain is more severe. Standing up at one spot for more than 10 minutes makes the pain unbearable. I can walk or run without a problem though. Standing up after sitting of a long time is painful as well.
    It feels like my right size hip has hiked up. stretching my right QL does give me temporary relief but just for a few minutes. I took physiotherapy sessions for a few weeks but did not help. My physiotherapist thinks that disc bulge is not the cause of my problem. Do you think lateral tilt with right side up can cause sciatic pain on the left? What kind of exercises would you recommend?

    Thanks
    Chinmay

    Reply
  216. Hi, I’m a high schooler who got into lifting weights a while back. I’ve noticed that I definitely have a lateral pelvic tilt. I physically can’t squat with proper form because it’s so bad. Should I wait until my pelvis is fully fixed before resuming squatting, or just continue with bad form? I’ve been working on fixing it, but I’ve had very slow progress.

    Reply
    • Hey William,

      That depends on what is more important to you.

      I would recommend addressing your lateral pelvic tilt and continue your squatting at the same time (provided that you are not making your tilt worse with your squats).

      You might need to do more lunges, leg press, step ups, dead lifts etc if you can’t maintain good form on the squat.

      Mark

      Reply
  217. Hello Mark, your website is great. I have spoken to your in the past and you have given me some great advise.

    I have discovered that a big part of my problem is that my Psoas on the “dropped” side is weak. I have made great progress by strengthening this.

    Does that sound correct physically and is it worth adding something of this nature to the exercises in the above ?

    Many thanks
    Mike

    Reply
      • Hello,
        Since I’m having lower back pain and right knee pain (my right) also in mirror when i see my hips look tilted also my shoulders. After reading various stuffs on net i came to know that it is lateral pelvic tilt which happened to me because of my bad standing and sitting posture. My age is 19 at present and my question is how long it may take me to fix this ?

  218. Hey mark

    Just a quick one with a right hip hike which side oblique needs to be strengthened is it the right? Or the left ?
    I also have sway back so only wanna hit the external oblique not the internal

    Cheers
    Romana.

    Reply
    • Hi Romana,

      In a position of a RIGHT hip hike, the left oblique will need to relatively be strengthened.

      Once a neutral pelvis is attained, strengthening both will be beneficial.

      Mark

      Reply
  219. Hi…. I read ur blog….very informative….
    Actually I am a classical dancer. I do many footwork and spins while dancing… Producing sounds through bare foot is essential…
    But it is very difficult and painful to balance on my left legs… I can’t produce sound also but My right leg is not painful through out my performance… And also I lean towards left while taking spins….. What should I do to balance equally on both legs?

    Reply
  220. Dear Mark
    This is such a useful and well presented resource for those of us struggling with posture and pain issues – thank you.
    I am a 64 year old female with an osteopath-diagnosed hemipelvis – short on the left side. So I have a structural lateral pelvic tilt, high on the RHS, and mild scoliosis (upper thoracic area). I have started to feel left hip pain when walking, starting in the hip flexors, but then the whole hip hurts if I walk further.
    I have 2 questions; will these exercises help with the pain? I notice that you don’t recommend heel inserts, but should I try them to make me more level when walking, and the equivalent when sitting?
    Thank you in advance for any advice you can give.

    Reply
  221. Hi Mark,

    i have lateral pelvic tilt for the last 3 years it happened while i am getting out of bed and my hip popped with a very loud sound since that time i felt my left leg feel different pain in my knee and my ankle just feel weird.

    doctors wouldn’t believe me and kept telling me to stretch and it kept progressing till i have all the issues you mentioned in your post now (pain all over my spine ,neck, knees my whole body is misaligned) then i made a special X-ray to prove it and it came back with pelvic tilt and curve in my spine then recently i started physical therapy for 2 months but i can’t see any progress.

    do you recommend chiropractor given how the issue started ? i was perfectly aligned before that incident no pain at all.

    what other options do i have?

    Thank you

    Reply
    • Hi Magdy,

      If you feel that there hasn’t been any progress, you can see if the chiropractor can help.

      Having another set of eyes to assess you is always helpful.

      Mark

      Reply
  222. Hi Mark,
    I’m from india. And I think my right pelvic is higher than left one but it’s minor difference. I visited to orthopedic, but they said it is ok.
    I can feel it while walking and doing exercises as well.
    But I face it mainly while riding bike. Asmy whole body posture turns to left side and it gets difficult to balance it.

    Please suggest me what should I do. And how long will it take to be in perfect poster as my upper posture got bad.
    And what should be the correct solution.

    Reply
    • Hi Virender,

      Sounds like your pelvis are balanced during standing, but tend to pelvic tilt as you start to move.

      I would still do the exercises recommended on the blog post.

      Mark

      Reply
  223. Hi i am a high schooler with a lateral pelvic tilt, but i don’t know how to exactly fix it. Right now my left side is one inch higher than my right, but then my left leg is longer than my right. Should I keep stretching out my left side?

    Reply
  224. Can u plz tell me if I have this problem or not, I’ve noticed that my belly button is shifted to right a little bit, and my right shoulder is lower than my left shoulder. I can send you my pic if u give your email. Thank you.

    Reply
  225. Hi Mark,
    I feel foolish reaching out via blog but I am at a point where I do not know what else to do. In 2006 and 2007 I had two minor arthroscpic surgeries to my right knee which left me with ilitotibial band syndrome initially. Over the years, that pain progressed to Hip bursitis and piroformis syndrome. Which later contributed to trigger points in my right glute and later some hamstring issues. I’ve been to countless physical therapists, accupuncturists, chiropractors, massage therapits, fascial stretch therapy, cupping, dry needling, and even my own Yin yoga practice with nothing but minimal relief. Approximately two years ago I went for a run and immediately experienced the worst pain even in my sacroilliac joint. Not even a week after that my whole right shoulder and neck became all knoted up, still to this day which is a daily problem. I’ve recently come to learn that my left hip is higher them my right when I lay on my stomach and am curious if you think something may be out of place in which would cause all these symptoms because I literally have muscle pain from my trapezius muscle in my right arm down to my illiac crest, glute, hamstring, calf, and hip flexor of only my right side. Please help or adivse! Thank you!

    Reply
    • Hey Sarah,

      As a result of your right knee surgery, you may have altered your walking pattern.

      Usually what happens if that you will shift your body towards the opposite side of your pain. In your case, you would have shifted to the left side leading to a left hip hike.

      This mean, the muscles that push you to the left will be over active (eg. the muscles on the outside of your leg/hip).

      If you run, this means there will be more force driving through these muscles, and eventually can lead to compression of the right SIJ.

      From here, the SIJ could be causing a domino effect in areas higher in your posture (shoulder and neck issues)

      Of course – Without assessing you in person, this is just my best guess with the information you have provided.

      Does this sound plausible?

      Mark

      Reply
  226. Hi! please help! i did this routine but my hip on the left feels higher so i did basically as you said to do it on which hip has the hike. i felt tightness in my glute on the side that has the hike but every stretch/roll is on the opposite side to the hike and the excersizes are all on the hip hike which it now feels even more contracted and tight is this normal?

    Reply
    • Hi Arham,

      Just to clarify: You are saying you did the exercises for a left hip hike and it made your left hip hike worse?

      In this case – you would have to do the same exercises in the blog post, BUT on the opposite side mentioned.

      Mark

      Reply
      • No I did it on the opposite side as you said to do. So I have a left hip hike and so I did the opposite to what ever your instructions are since it’s for a right hip hike. My question is that all the release and stretching is on my right side which hasn’t got the hike and no tightness but the exercises would be on my hike hip which makes my my glutes feel more tight ? Is that correct. I was just asking because I feel as though I would have to workout the less tight hip and stretch my hike hip but I’m just asking to make sure.

      • just to clarify again. it didnt make it better or worse since iv only done it once! but i was just confused on the logic of it is all. i have a left hip hike and most of your exercises is for the right hip hike so i had to do them on my left but wouldnt that just make my left hip hike tighter in comparison to my lower hip that is fine

      • hey im feeling much better. my left hip hike is still high i havnt seen a change but theres no pain anymore so im guessing its working

      • Hi mark! i forgot to ask! is there somewhere i can donate to you for your help! also i had one more question too. i powerlift so i do train squat – deadlift – bench each week. do i do this everyday ? or what do you recommend since i obviously do get sore but i dont mind obviously doing it while sore but whats your input on it!

      • Hey Arham,

        I have a page where you can donate via paypal.

        (Click here to go there)

        In terms of how often to do the exercises, I would aim for at least 2-3/week, and depending on how you feel after that, start to increase intensity/frequency.

        Mark

  227. This is me! I am 53 and didn’t realize that I had leg length issues until I had a running injury a couple years ago. I went to physical therapy, and she told me that one of my legs is longer than the other. I was diagnosed with scoliosis when I was a teenager but didn’t do anything about it. I have been running consistently for 11 years, and run on trails. My left foot points straight, and my right foot points outward when I run. My right side is less strong, and I have some left hip issues… pain down my whole left side occasionally. I do lots of yoga and strengthening exercises. At this point in life, is it worth trying to correct the way I run? I’m afraid that if I change my alignment after running for so long, I might put stress on some other joints. Thank you for all the great information. It’s really helpful!

    Reply
    • Hi Joanne,

      It’s not easy to change running technique, especially if you have had your technique for many years.

      The question is – if you keep running with your current technique, will it cause further issues in the near (or distant) future?

      If yes – then I would consider optimising it.

      Aim for small changes over time so that the body can gradually get used to it.

      Mark

      ps. if your foot turns out , I would check out this post:

      How to fix Duck foot posture.

      Reply
  228. Hi Mark,
    Thanks a million for giving away such great value for free. I believe I have a right hip hike and have been experie