pelvis tilted laterallySimply put, the lateral pelvic tilt is a condition causing one side of your hip to appear higher or lower when compared to the normal hip position.Medicine identifies these two conditions as:

  • Hip hiking – where, on one side, hip is raised above the neutral position and
  • Hip dropping – where the hip drops lower than neutral position

In today’s article, we will be talking about proper muscular biomechanics, lateral pelvic tilt self-diagnosis, most common conditions leading to it and best exercises to correct it.

Proper Muscular Biomechanics

A proper relationship between muscular length and tension is one of the core foundations of proper body biomechanics. When this relationship is disrupted – when a muscle is tight and his antagonist (“a muscle that opposes the action of another” – Source:TheFreeDictionary) becomes weak – a postural abnormality may occur.

As you might already know, our pelvis involves a number of different muscles which allow movement in all directions – anterior, posterior and lateral (front, back and to the side). If the relationship between any of these muscles is disrupted, it may lead to pelvic tilting, mild low back pain, or a more intense, piercing pain felt in the lower back and down the affected leg.

Lateral Pelvic Tilt Assessment

Most of the time we recommend seeing your doctor for a correct diagnosis, but pelvic tilt is a condition you could easily diagnose yourself, at home. All you need is a mirror, a good set of eyes and knowing where your iliac crest is located. Once you’ve located the iliac crests on either side, facing the mirror stand as evenly as possible and try to determine if they appear level.

So what is iliac crest and how do we find it?

The iliac crest is a bony ridge stretching across from the anterior superior iliac spine to the posterior superior iliac spine. It can be easily felt below the oblique muscle on the side of the torso. You can just slide your hands up and down this region until you hit this bony ridge. The image below will also help pinpoint it:

location of the iliac crest
Iliac crest location – (c)

Lateral pelvic tilt can also be diagnosed indirectly in patients with spastic gait. A spastic gait is a condition where the foot becomes stiff, gluteus medius and tensor fasciae latae become weaken and the sufferer is forced to shift his entire trunk when swinging their leg forward. Moving like this will cause muscle imbalance and cause the pelvis to tilt.

Why Lateral Pelvic Tilting Is Bad For You?

Of course, we all know that pelvic tilting is bad since it will disrupt the muscle balance in our body, cause posture problems and lower back pain. But exactly happens to the muscles?

When the hip is raised above its natural position (in hip hiking), quadratus lumborum muscle becomes tight. Quadratus lumborum is a muscle that connects vertebrae to the iliac crest, so when you think about it, it makes perfect sense that tension in this muscle will raise the hip.

Now, to in order to compensate hip hiking, our body will create hip adduction (“adduction is a movement towards the mid-line of the body” – Source: IvyRose), so adductor muscles will become tight as well. Consequently, adductor muscle antagonists (abductors, namely gluteus medius), will become lengthened and possibly even weaker.

On the other hand, when the hip drops, chances are quadratus lumborum muscle becomes weaker and lengthened and gluteus medius muscle becomes tight. This then leads to weakness in adductor muscles.

Patients with lateral pelvic tilt may also be subject to:

  • Disc degeneration
  • Disc herniation
  • Sacroiliac joint pain
  • Spasms etc.

Treatment And CorrectionExercises For Lateral Pelvic Tilting

Correcting the pelvic tilt may seem easy but the most important thing that needs to be done prior exercises is to pinpoint its exact cause (and access the damage that has already been done). This is the main reason we recommend first seeing your physician, then start devising a self-treatment plan.

Mild Cases

The majority of people will “catch” lateral pelvic tilt in its early stages, where correcting it will be relatively simple. Mild cases usually require only posture and walking mechanics correction.

This is, of course, dead simple but dead effective; most of the time we don’t even pay attention to the way we walk and the way we position our spine when sitting or standing. So, what you need to be doing is practice standing in front of your mirror and trying to distribute your weight evenly across the both sides of your body, while keeping your pelvis in neutral position (correct dropping and hiking).

More Severe Cases

Even the more severe cases should pay attention to their posture and walking mechanics… Unfortunately, their condition has progressed more, caused more damage, so these simple corrections are just not enough. These cases also require stretching and strengthening exercises.

Hip Hiking

Just to freshen up, hip hiking is caused by tense quadratus lumborum, hip flexors, and hip adductors. So what we need to do is stretch QL, hip flexors, and lower back; and strengthen the hip abductors.

Dropped Hip

Dropped hip is caused by weakened QL and hip flexors, where abductors are tight and adductors are weak as well. Here we need to strengthen hip flexor and adductor muscles while aiming for stretching abductors and tensor fasciae latae.