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.

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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1,031 thoughts on “Exercises for Lateral Pelvic Tilt (Uneven Hips)”

  1. 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
  2. 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…?

        Reply
        • 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

          Reply
          • 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 :(

  3. 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
  4. 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
  5. 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
  6. 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
  7. 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

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