If one hip sits higher, one leg feels longer or your body simply feels uneven, you may have a Lateral Pelvic Tilt.
In this blog post – you’ll learn what causes a Lateral Pelvic Tilt, how to tell if you have it and the best exercises and stretches to restore the ideal pelvic alignment.
In This Blog Post:
- What Is A Lateral Pelvic Tilt?
- How To Determine If You Have It
- Is It Dangerous?
- Causes
- Exercises To Fix Lateral Pelvic Tilt
What is Lateral pelvic tilt?
A Lateral Pelvic Tilt is the asymmetric positioning of the pelvis where there is a:
- Hip Hike: One hip higher than the other and a
- Hip Drop: One hip lower than the other.
It is also known as having Uneven Hips.
Lateral Pelvic Tilt Test
Perform the following quick tests to determine if your hips are uneven.
Standing Position (Static)
Instructions:
- Stand in front of a mirror.
- March on the spot for 5 seconds.
- Assume a comfortable standing position.
- Place your hands flat on the highest point on both sides of your waist line.
- Compare the level of your hands.
Waist Crease
Instructions:
- Take a photo of your standing posture from the back view.
- Observe the waist crease.
Standing X-Ray
Instructions:
- Get an X-ray whilst in the standing position.
- Compare the height of the Iliac Crest on either side.
Trendelenburg Sign (Dynamic)
This test determines if you have a lateral pelvic tilt whilst you are moving.
Instructions:
- Stand in front of a mirror.
- Place your hands flat on the highest point on both sides of your waist line.
- Stand on one leg for 10 seconds.
- Perform a single leg squat.
- Observe for any tilt in the pelvis throughout this test.
- Compare both sides.
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 hip hike on the other side in the standing static position as most people prefer to stand on their stronger leg!)
Is It Dangerous?
Having one hip higher than the other in not inherently dangerous.
Many people have a Lateral Pelvic Tilt and experience no symptoms at all.
However, when the pelvis is not in an optimal position, it can influence the rest of the body.
This may contribute to issues such:
- One sided tightness/pain
- Uneven Shoulders
- Scoliosis
- Strength Imbalances
- Hip Bursitis
- Outer Thigh Pain
Causes
Here are some of the main causes of a Lateral Pelvic Tilt:
Muscular Imbalance (Sagittal plane)
A Lateral Pelvic Tilt can result from an imbalance between the following muscles:
- Quadratus Lumborum
- Adductors
- Gluteus Medius
- Other muscles involved: Obliques, Tensor Fasciae Latae
(I would recommend that you have a look at the location of these muscles on Google.)
- There will be a HIP HIKE on the side of the relatively weak Glute Medius, tight Quadratus Lumborum and tight Adductor.
- There will be a HIP DROP on the side of the relatively tight Glute Medius, weak Quadratus Lumborum and weak/elongated Adductor.
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 towards the stronger side.
In this scenario – it is likely that you will get more improvement by performing single leg exercises on the weaker side to encourage the weaker side to receive your body weight.
These exercises might include:
- Step up/down
- Single leg hinges
- Single leg squats
- Single leg balance
(Check out the Single Leg Exercise section in this blog post for more information.)
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?
- Do you have groin pain?
If you do… then you have postural habits that may encourage the tilting of the pelvis!
Leg Length Discrepancy
Having one leg that is structurally longer than the other side will result in one hip being higher than the other.
Which side will have the higher hip?
- If the body weight is evenly distributed between each leg, the side of the longer leg will generally have the higher hip.
- If you tend to lean your body weight on the shorter leg, the hip will be higher on this side.
How to measure the length of your legs:
Instructions:
- Lie on your back.
- Measure the distance from the Anterior Superior Iliac Spine to the Medial Malleolus.
- You might need to Google these land marks if you do not know what they are.
- Compare both sides.
(Alternatively – you can get a CT scan to measure it.)
Note: If there is a significant difference in the length of the legs, using a heel insert to make up the difference may be helpful.
Neurological Conditions
Any condition that impacts the nerves that supply the control of the pelvic musculature may result in a laterally tilted pelvis.
(For Example: The Superior Gluteal Nerve (L4-S1) supplies the Glute Medius.)
If you have an issue with the nerves, you will need to address this 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.
STEP 1: Releases
STEP 2: Stretches
STEP 3: Activation
STEP 4: Strengthening Exercises
STEP 5: Single Leg Exercises
STEP 6: Fixing Bad Habits
STEP 7: Addressing Scoliosis
If you have a hip hike on the LEFT side, do the exact same exercises but on the opposite side mentioned in the instructions.
sTEP 1: Releases
The first step is to release the tight muscles that may be holding your pelvis in a sideways tilt.
These muscles include:
- Quadratus Lumborum
- Gluteus Medius
- Tensor Fasciae Latae
- Adductors
(You may need to Google the location of the mentioned muscles if you are not sure where they are.)
Quadratus Lumborum
Instructions:
- Place a massage ball directly underneath the RIGHT SIDE of the lower back.
- Apply an appropriate amount of body weight on top of the massage ball.
- Roll your body over the entire length of the muscle.
- Continue for 1 minute.
Glute Medius/Tensor Fasciae Latae
Instructions:
- Place a foam roller directly underneath the outer hip of the LEFT SIDE.
- Apply an appropriate amount of body weight on top of the foam roller.
- Make sure to cover the entire side of hip region.
- Do not place the bony part of the hip on the foam roller.
- Continue for 1 minute.
Adductors
Instructions:
- Place a foam roller directly underneath the inner thigh region on the RIGHT SIDE.
- Apply the weight of your right leg on top of the foam roller.
- Make sure to cover the entire length of the muscle.
- Continue for 1 minute.
STEP 2: Stretches
The next step is to stretch the tight muscles that are holding your pelvis in the tilted position.
Quadratus Lumborum/Obliques
Instructions:
- Stand on your left leg
- Hold onto something for balance.
- Lean your torso towards the left side.
- Allow your right leg to lift off the floor. Keep this leg completely relaxed.
- Allow gravity to pull your right leg down.
- Do not let your pelvis rotate.
- Aim to feel a stretch in the RIGHT SIDE of the lower back.
- Hold for 60 seconds.
(For more stretches: Quadratus Lumborum Stretches)
Gluteus Medius
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 60 seconds.
(See also: Gluteus Medius Stretches)
Tensor Fascia Latae
Instructions:
- Assume the kneeling 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.
- Push your hips out towards the left.
- Lean your torso towards your right side.
- Aim to feel a stretch on the front/outer side of the LEFT hip.
- Hold for 60 seconds.
(See also: Tensor Fasciae Latae Stretches)
Adductors
Instructions:
- Assume the side lunge position.
- Perform a side lunge towards the left side.
- Aim to feel a deep stretch in the inner RIGHT thigh region.
- Hold for 60 seconds.
… Is your groin really tight? Check out this blog post for 14 different ways to stretch the Adductors.
sTEP 3: Activation exercises
The next step is to activate the muscles can help bring the pelvis into a more level alignment.
Hip Hitch
Target Muscle: Quadratus Lumborum (Left Side)
Instructions:
- Sit tall on a chair.
- Place your hands on the chair on either side of the body.
- Slightly lean your body weight onto the right hip.
- Lift your left buttock off the chair.
- Aim to feel the muscles activate in the LEFT lower back.
- Hold contraction for 3-5 seconds.
- Perform 10-20 repetitions.
Leg Lift In Side Lie
Target Muscles: Gluteus Medius and Tensor Fasciae Latae (Right Side)
Instructions:
- Lie down with your left side on the floor.
- Keep the right leg completely straight throughout this exercise.
- 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 the activation of the muscles on the side of the RIGHT hip.
- Hold this top position for 3-5 seconds.
- Perform 10-20 repetitions.
- Progression:
- Apply a resistance band between the ankles.
(For more exercise targeting this muscle: Gluteus Medius Strengthening Exercises)
Bottom Leg Lift
Target Muscles: Adductors (Left Side)
Instructions:
- Lie down with your left side on the floor.
- Keep the left leg completely straight throughout this exercise.
- Place the right foot on the floor in front of you to stabilize your body. (See above)
- Lift your left leg upwards.
- Keep your pelvis completely still as you move the leg.
- Aim to feel the activation of the muscles in the LEFT inner thigh.
- Hold the top position for 3-5 seconds.
- Perform 10-20 repetitions.
- Progression:
STEP 4: Strengthening exercises
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.
Standing Weight Shifts
Instructions:
- Stand up right.
- Have your feet shoulder-width apart.
- Shift your weight towards the left side.
- Perform 20 repetitions.
Pelvic Shift
Instructions:
- Lie down on your back.
- Keep your legs locked completely straight throughout this exercise.
- Reach your right foot away from you.
- Push the inner side of the left leg into your right leg.
- Aim to feel a muscular contraction in the left inner thigh and right outer hip.
- Hold for 5 seconds.
- Repeat 20 times.
Side Wall Push
Instructions:
- Stand sideways with left side closest to a wall.
- Stand on your right leg with your knee slightly bent.
- Lift your left knee to waist height and push the side of the knee against the wall.
- Make sure that your left waist is higher than the right side.
- Aim to feel the activation of the muscles in the right outer hip and left lower back.
- Hold this position for 5-10 seconds.
- Repeat 10 times.
- Progression:
- Hold for a longer period
- Push harder into the wall
Standing Hip Hitch
Instructions:
- Stand on your right leg on the edge of a step.
- Keep your stance leg fairly straight throughout the exercise.
- Alternate between lifting and dropping your left hip.
- Aim to feel the activation of the muscles in the right outer hip and left lower back.
- Repeat 20 times.
- Progression:
- Move slower.
Modified Copenhagen Exercise
Instructions:
- Lie down on the side with the right side closer to the floor.
- Bend your left knee to 90 degrees.
- Place your inner left knee on top of a chair.
- Push the inner region of the left knee into the chair.
- Lift your torso upwards.
- Reach your right leg away from you.
- Aim to feel the activation of the muscles in the right outer hip and left inner thigh.
- Perform 5-10 repetitions.
Crab Walk
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 a muscular contraction in the outer region of both hips.
- Continue for 1 minute.
- Progression:
- Use more resistance in the band.
Single Leg Tap
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 foot 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.
- Repeat on the other side.
- Progression:
- Reach further
- Tap your foot softer.
- Move slower.
Side Plank (With Upper Leg Lift)
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.
STEP 5: Single Leg Exercises
Perform the following exercises on both sides. Focus on keeping the pelvis level.
(Note: If you have one leg that is generally weaker than the other side, it is common to distribute more body weight onto the stronger leg. This can shift the pelvis towards the strong leg and result in a higher hip on that side. To address this – focus on single leg exercises that load the weaker side.)
Single Leg Balance
Instructions:
- Stand on one leg.
- Shift your pelvis sideways towards this side.
- Make sure to keep your pelvis level throughout this exercise.
- Maintain your balance.
- Aim to keep your body as still as possible.
- Continue for 1 minute.
- Repeat on the other side.
Single Leg Squat
Instructions:
- Stand on one leg.
- (You can hold onto something for balance if required.)
- Place your hands on each side of your hips.
- Maintain level pelvis throughout this exercise.
- Perform a single leg squat.
- Make sure to keep your foot and knees facing forwards.
- Repeat 10 times.
- Repeat on the other side.
Single Leg Hinge
Instructions:
- Stand on one leg.
- Keep your pelvis levelled throughout this exercise.
- Hinge forwards.
- Make sure to keep your foot and knees facing forwards.
- Repeat 10 times.
- Repeat on the other side.
Step Up
Instructions:
- Place one foot onto a step.
- Shift your body weight onto the foot.
- Without using momentum, step up onto the step.
- Keep your pelvis levelled throughout this exercise.
- Repeat 20 times.
- (If required – You can hold onto something for balance.)
- Repeat on the other side.
Step Down
Instructions:
- Stand on top of a step.
- Hold onto a stationary object for support.
- For the leg that is on the step, keep the knee in line with your toes throughout this exercise.
- Slowly reach your other foot down to the floor.
- Keep your pelvis levelled throughout this exercise.
- Return to starting position.
- Perform 20 repetitions.
- Repeat on the other side.
- Progression:
- Perform the exercise slower.
- Use a higher step.
- Use less arm support.
STEP 6: Fix bad habits
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.
Sitting
Whilst sitting – Distribute your body weight evenly between both buttocks.
… DO NOT lean to one side!
This is commonly seen when you rest your arm onto one arm rest.
Standing
Distribute your weight evenly between both feet.
… DO NOT favor one side when standing.
If you are not sure if you stand evenly between your two feet, 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.
Sleeping Position
If you tend to sleep on the side, 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.
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.
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)
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.
Pillow for Waist
- Place a small pillow underneath your waist crease.
- This will help minimize side bending of your torso and pelvis
STEP 7: Fix your Scoliosis
Scoliosis involves side bending on of the spine.
It is very common to have a degree of Scoliosis with a 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 the spinal alignment:
See Post: Scoliosis Exercises
Conclusion
A Lateral Pelvic Tilt is where the pelvis is in an asymmetrical position where one hip is higher than the other.
It is a common postural distortion that can make the body feel uneven, tight and imbalanced.
To improve the position of the pelvis, it is important to focus on:
- Releasing and stretching tight muscles
- Activating and strengthening weak muscles
- Improve pelvic control and balance
- Correct daily habit and daily movements
Follow the steps mentioned in this blog post to address your uneven hips.
What to do next
- Any questions?… (Leave me a comment down below.)
- Join me:
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- Start doing the exercises!
Medical Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content on this blog post is at your sole risk. Please seek medical guidance before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.
Thank you for creating this guide, it is super helpful!
I’ve been trying to improve my right hip shift and right hip hike for years and keep hitting a wall. And it’s progressed to the point now where my right glute and heel are often in pain, taking so much of the load. Would you still recommend these same exercises for someone also dealing with right shift? And what else might you add to the routine?
Hey John,
Here are some suggestions that you might want to consider:
– If you have active pain in the right glute and heel, you might need to address that first. It will be challenging to perform the appropriate exercises to address lateral pelvic tilt if you are pain.
– Focus on the left dominant hip exercises for now to give the right side a bit of rest. See post: Single leg exercises.
– Focus more on exercises that activate the left adductor for now. This will help you shift back on to the left side without relying on the right glute pushing you towards the left.
– If your heel pain is underneath the heel, you might have plantar fasciitis. For a full guide on this: Exercises for Plantar Fasciitis.
– Consider stretching out the glutes with these exercises.
All the best, John!
Mark
Thanks for the tips, Mark!
Hi Mark! What about rotational exercises like the sheriff exercise like mentioned in the link
Because I found that since I have a left side higher hip naturally my hips or body is turned to my left a little (belly button facing left side)
When I try to squeeze my left glutes and turn to my right everything feels balanced.
However I have a bouncy gait, when I try to step forwards with my right my left pelvis seems to stay high and I think that causes my left leg to be pulled to be shorter and that causes bouncy gait
What do you think of all that?
I also have APT so…
Should I stretch my left tight muscles but strengthen where? Or do these rotational exercises help at all as promised? Or should I stretch hip flexors and strengthen core and glute muscles for Anterior pelvic tilt?
Hey Dorian,
I checked out the video you shared. It looks like it is trying to encourage internal rotation of the hip at the front (as well as engaging the core in a rotational movement). If your pelvis is rotated towards the left, you would likely benefit from this exercise with the right leg in front.
When you say you have a bouncy gait, do you mean your hips tends to jut towards the side as you place your body weight on that leg? If so, you may have poor control of your hip.
The main muscle I would focus is the Gluteus Medius. Check out this blog post: Gluteus Medius Strengthening Exercises. One of the roles of this muscle is to keep your pelvis stable as you place weight on that same side foot.
In regards to the APT, you can start to address this as well. See Post: Anterior Pelvic Tilt Exercises. If you have time constraints, perhaps pick one thing to work on first
Mark
Hello again Mark, to not further execarbate the problem I contacted the owner of the video and explained the situation.
Here is his response:
From what you described , I assume you have excessive external rotation (lack of internal rotation) on the left pelvis and the opposite on the right pelvis.
this in addition to overactive left QL which hiked your left hip.
Left shoulder likely to be compensated somehow also
Rib cage likely to rotate to the right , Do you have rib flare on the left side?
I would actually do the exercise in the opposite direction to what you did.
So you push with the right side toward the left side, left leg front.
By pushing towards the left, your left adductors ( internal rotation ) on the left leg will be activated to not make you fall on the left.
Also try to engage your left core when rotating to the left. Pause at the end of the rotation and exhale heavily ( like you are blowing a balloon) .
What do you think of this?
Hi Dorian,
I think it really depends which way your pelvis is rotating towards.
If towards the right, then perform exercise with left leg in front to engage the inner left hip muscles.
If towards the left, then perform exercise with right leg in front to engage the inner right hip muscles.
Maybe try both, see which feels easier/harder.
What if you found this out when you had hip surgery?
Hey Linda,
It should still be fine to do the exercises mentioned on this blog post even after a surgery provided that your surgeon has not placed any restrictions on you.
If in doubt, please consult your doctor before commencing any exercise following a surgery.
What kind of surgery was it?
Mark
Hey Mark, I want to incorparate single leg exercises like lunges or split squats but have the fear of exacerbating the pelvic tilt even more, normally I have left side is higher with a bouncy gait (i think it is the left leg pulled up higher creating a gait as if the left leg is shorter -my assumption-) I am doing the glute medius exercises on my left side (like hip hikes drops etc.) as stated. But I can’t exactly say which side of leg is weaker so should I perform single leg exercises on left leg?
Hello Dillan,
Yes – Even though the hip hike is on one side, I would still strongly encourage you to do single leg biased exercises.
This will help strengthen the leg as a whole.
If your hip hikes up on the left side, you may need to do additional hip hike exercises on this side.
Mark
Hi Mark,
My left side is higher…
1- Should these be performed daily or can the exercises be divided for example one day 2 strength exercises and other they another 2?
2- Can I use weighted versions of hip hikes and drops?
3- Should I do these before or after runs or for the sake of simplicity can I do releases and stretches before run and strength exercises after run?
4- Do clamshells help?
5- Can I reduct one or two exercises like foot tapping or copenhagen plank?
Hey Jocko,
1. You can split them up as you mentioned.
2. Yes – if the non-weighted version is not challenging, feel free to use weights.
3. I would do releases and stretches after. Or perhaps on a completely separate time/day. However, priming the correct muscles might help you to control your pelvis better whilst you run.
4. Yes – they are good. But they don’t fix everything.
5. Yes – if you feel like you are not getting any benefit from then, you can omit it if you like.
Mark
Hi Mark,
My left side with hip hike is tight but also weaker. My left shoulder appears higher, shorter and tighter. My right hip is lower, right shoulder appears lower, wider and more open, lax. What do you recommend? I’m stretching my entire left side and exercises like the “Hip Hitch” you suggested. When I’m sitting or standing still, if I can I keep my weight my left leg and my torso to the right/centered. Specifically, I have a slight mandibular deviation to the left, with a more protruding right jaw. As you can see, the entire right side of my body is dominant with hip drop, perhaps overcompensation over time.
Thanks for this helpful guide!
I don’t know if this exercise ‘Hit Hitch’ or ‘move the higher side lower’ is wrong in my case because the QL (Right side) is already stronger. Maybe the muscles on the left are weaker and in defense.
Should I do a variation of Hip Hitch, shitfing the weight on my left glute and not lifting the right glute?
Hi Simon,
You might need to focus on getting your body weight more on the right leg. It sounds like your pelvis is shifted more towards the left and to counter balance, your torso is leaning relatively right to the position of the pelvis. If your torso leans towards the right, the left side muscles will try to pull you back to balance leading to increased tension in the left shoulder/neck/shoulder blade region.
Try performing exercise where you load the right side more. See post: single leg exercises. Aim to keep your pelvis shifted more towards the right or directly on top of the right leg.
In addition, do you have any scoliosis in the spine? See post: Scoliosis Exercises. This may have some influence on the tightness experienced on the left side of the body.
Mark
Hi Mark!
Thanks for this post. I have all the visual flags that indicate that I have a hiked hip, plus the bad habits and sleeping to only one side, etc so I’m pretty sure I have this.
However, my pain/tension is mostly felt on my jaw/shoulders and mostly the neck and just barely on the right side of my torso, a bit of tension with some stretching.
Do you think that’s “normal”? Do other people experience jaw-neck issues with tilted hips?
Thanks!
Hi Jon,
A lateral pelvic tilt that may influence symptoms in the jaw and shoulder. However, it doesn’t necessarily mean that it the position of the hips is the direct cause of the symptoms.
Mark
Hey Mark! Thanks for your services, it is very much appreciated… I have a lateral pelvic tilt with left side is higher. From my research I have found out that if left side is higher it means left side has more anterior rotation, is it true? If so, how should I approach this. Second question is I can’t seem to grasp which side needs more internal rotation and which side needs more external rotation? What exercises or stretches should I focus on to correct these? Thanks in advance, much love!!!
Hi Bob,
Having a higher hip on the left does not necessarily mean that that same side of pelvis is more forwards relative to the other side.
If you have both, I generally suggest addressing one and see if it has any effect on the other. In some people, if you address the rotation, this may improve the lateral tilt automatically.
If you are trying to determine which side needs more relative internal/external rotation, you will need to determine which way the pelvis is rotated towards. For more in depth information, please check out this blog post: Rotated Pelvis.
Mark
Thanks so much! Let me try to be more clear, I heard that high side pelvis is more back while right side is more forward. But my question actually was that if I have a left side higher tilt which side needs more internal rotation and which side needs more external rotation. I want to implement this information into split squats to strengthen the muscles not just correcting them.
Hey Bob,
If your legs are in a symmetrical position (i.e. no pronation/supination in foot and no rotation in knees) and you have a higher left hip, then it is more likely that your left hip will be a degree of internal rotation already. If this is the case, then you will need more relative external rotation in that left side (and more internal rotation on right hip).
However – If your lacking absolute rotation in the hip (as in you don’t have full end range hip rotation, then you may benefit from these blog posts:
– How to increase internal rotation in the hip
– How to increase external rotation in the hip
Mark
Hi Mark, I have a 12° Scoliosis which does not affect my daily life in terms of back muscles. However I have a left hip hike and it causes a bouncy gait, and left side lower back pain and discomfort while walking etc. I started doing your exercises, it’s been 1 week yet. I can already see that my left glute medius is not holding properly during walking -like it is slightly collapsing- I will strenghten both sides using single leg squats, banded glute med exercises in addition to your exercises. Since it is a complicated matter considering scoliosis involved, how would (outside your exercises) just strengthening and stretching both sides of muscles of the body aiming to achieve identical strength and mobility work? I really want to improve that bouncy gait and what would your opinion be on that -as a professional- in terms of the improvement of said gait?
Hi Jack,
If you have a bouncy gait with a left hip hike, it sounds like you have a Trendelenburg sign which is usually a sign that there’s an issue with the Gluteus Medius muscle. This can lead to over activity of the Left Quadratus Lumborum muscle in the left lower side of the back when you walk.
It is good that you are starting to strengthen both sides with single leg biased exercises. (Check out these exercise for more single leg based exercises.) This will encourage symmetry in strength and control between the sides which is generally important (and potentially more so with Scoliosis.)
However – If you are only bouncing on the one left side, you may need to focus more attention on this side.
Mark
Hello Mark,
I recently read your article on lateral pelvic tilt and found it very helpful — thank you for sharing such detailed guidance!
I have a few questions regarding which side to release, stretch, or strengthen, particularly for a left-high hip (left hip hike) pattern:
1. Gluteus Medius — Some sources say the left glute medius is weak and should be strengthened, while others recommend the right side because it cannot hold the pelvis properly. Should all fibers be treated the same, or should the posterior fibers be strengthened while anterior/TFL-dominant fibers are released?
2. Tensor Fasciae Latae (TFL) — In your article, it is recommended to release the right side, but in a left-high hip, shouldn’t it be the left side? Should any strengthening be done, and if so, on which side?
3. Hip Flexors — Some sources suggest stretching the left (high side) and strengthening the right (low side). Could you clarify the correct approach?
4. Obliques and Quadratus Lumborum (QL) — For a left-high hip, the left QL and external oblique are typically tight and should be stretched, while the right QL and internal oblique are weak and should be strengthened. Is this correct?
5. Adductors — Which side should be targeted for stretching or strengthening?
I would greatly appreciate your guidance on identifying tight/overactive versus weak/underactive muscles and the correct left/right application for unilateral patterns.
Thank you again for your time and for the excellent article!
Best regards…
Hello Tony,
Thanks for your questions.
1. With a left hip hike, it is possible that the left glute medius and/or the right glute medius is weak. It just depends on how the body is compensating for the weakness. In this case, you would best to strengthen both sides.
In regards to addressing the anterior and posterior fibres, this becomes more important if you are trying to address a rotation in the pelvis (transverse plane) as opposed to a more frontal plane issue like lateral pelvic tilt.
2. In the article in the Releases section, it is recommended that the LEFT TFL is released for a right hip hike. For a left hip hike, you can release the TFL on the right side.
In terms of strengthening for a left hip hike, you can strengthen/activate the left side. But similarly to the glute medius, you may also need to strengthen the other side if it is weak. It is best to assess and check if there is any apparent weakness.
3. I guess it depends on which specific hip flexor you are referring to. eg. A relatively tight rectus femoris will likely be on the lower hip side so stretching that may help.
4. Yes, generally speaking. Also depends on the position of the rib cage relative to the pelvis. For example – if there is a left hip hike, but the torso side bends to the right, then the left QL won’t be a shortened position.
5. With a left hip hike, the left adductor is in a relatively shortened position (so may benefit from stretching) and the right adductor is in a relatively lengthened position (so may benefit from activating in a more shortened position).
However, this changes if the left hip hike is purely a result from general weakness of the right side (and the body feels more stable placing most weight on the left side resulting in the hip hike). In this case, perform exercises that place more bias on the right side. This may help the right side receive more body weight and thus improving the lateral pelvic tilt.
Mark
Hi Mark
I have a left hip drop 9°. But i have left shoulder drop and pain and tightness on left ql,erector and glute. All my weight is on the left foot which rotates external. When there is a lot of tightness on left ql and erector i have numbness on left foot. Also when i trie to tilt anterior my pelvis i have pain and difficulty on my left psis -gluteus max area. Is this a lateral pelvic tilt or may be a rotated pelvis.
Hello Asterios,
Do you have a structural leg length discrepancy? This may explain the lower left hip even when placing more weight on that left foot.
If your left shoulder is lower, this may suggest that your torso may be side bending towards the left. Have you had any scans to check for foraminal stenosis on the lumbar spine? Side bending with foraminal stenosis may cause the nerve that goes from your lower back to the foot to get compressed, leading to numbness in the foot.
If you have a hip drop, there is definitely a lateral pelvic tilt. In terms of rotation, you’ll need to perform some of tests mention on this blog post: Rotated pelvis. It is very common to have a degree of pelvis rotation with a lateral pelvic tilt.
Mark
Hi
I have had lower bad pain for years. I am unable to run as I get a jarring pain through my right pelvis/ lower spine with each step. Occasionally my spine / pelvis grabs and I get a severe lateral pelvic tilt that is very painful and debilitating. It can take days to resolve. Am I on the right track – commencing just the release and stretching components? How long until I should add further exercises.
Hello Alison,
1. If your pain is acute, you might need to do very gentle pain-free back stretches to begin with. Here are some that you can try: Back Stretches.
2. Now that your pain is under control, the next step is to identify what is generating your pain. Is it a joint in the spine? Muscle? SIJ? Nerve? You may benefit from direct treatment to that area.
3. The next step is to figure out exactly WHY that structure has been over loaded.
If it is due to the lateral pelvic tilt, then performing the exercises suggested in this blog post will help with that. Try to get onto the strengthening exercises as soon as you are able to (without hurting yourself). If you are very tight, you may need to stay on the stretches/releases for the next couple of weeks before progressing.
4. If running is the main aggravator, get someone to have a look at your running technique. Making a slight change might help!
5. If problems persist, you may want to consider getting a scan to make sure there is no structural issue in the area.
6. You didn’t mention anything about your glutes or feet but for runners, I generally suggest strengthening them.
Feel free to have a look at these posts:
– Glute medius strengthening
– Foot strengthening
All the best.
Mark