Uneven Hips and Abnormal Pelvic Tilt

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A guide for anyone who believes their hips are out of alignment. Learn about the signs and symptoms of misaligned hips. Find out how this condition relates to your pelvis, spine and posture. See the ways physical therapy can help you get realigned and get back to functional, pain free life

What Does It Mean When Your Hips Are Out Of Alignment?

When it comes to having uneven hips, it is essential to understand that your pelvis and spine are also affected. Having uneven hips is often associated with an anterior pelvic tilt. These two can drastically change a person’s back health, posture, and overall biomechanics. A slight misalignment can cause pain and discomfort in the hip and lower back regions. Over time this small problem can have compounding effects that reach up into the shoulders and neck. To help you avoid these type of complications, we will go over:
  1. How you can determine if your hips and pelvis are properly aligned
  2. Common symptoms and causes of uneven hips and abnormal pelvic tilts
  3. Physical Therapy Treatment for uneven hips and abnormal pelvic tilts

What Is A Normal Hip Alignment?

To determine whether or not you have proper hip and pelvis alignment, a physical therapist would need to observe and measure multiple factors around the hip, pelvis, and spine. As always, it is best to seek a professional opinion from your primary care physician, physical therapist, spine specialist, or chiropractor.  If you haven’t gone to see your doctor or physical therapist and would like to self-check your hip alignment, you should look out for three things:
  1. Your pelvis should be parallel to your shoulders and the ground
  2. Your hips should stay neutral and not be tilted forward or backward
  3. Your hips should be on the same level horizontally, not one higher and one lower
Uneven Hip and Pelvis Alignment
Hip and Pelvis Alignment Comparison via Runners World
An excellent way to check all three is to stand in front of a full-body mirror to observe your posture thoroughly.  First, take notice if your shoulders are even. A shoulder that sits higher than the other may present a lower, misaligned hip on the same side. A shoulder blade that sticks out can also help you determine the hip and pelvis’s misalignment on the same side.  Next, take a look at how your spine is aligned. A curved “C” or “S” shape of your spine can help you determine if the cause of your uneven hips is scoliosis-related.  It can also help to imagine a straight line from your nose to the belly button. If the line doesn’t touch, this would also indicate a spinal misalignment, possibly related to your hips or pelvis. Suppose you do not have access to a full-body mirror or have trouble visualizing the proper hip and pelvic alignment. In that case, it can help understand some common symptoms associated with misaligned hips and pelvis.

Signs And Symptoms Of Misaligned Hips or Pelvis

People with misaligned hips or abnormal pelvic tilts often experience symptoms that progress from minor and unnoticeable to significant and life-altering.  Minor symptoms that often go unnoticed for long periods include:
  • General low backache
  • Pain in the hip and buttocks area that increases during or after walking
  • Pain in the hip and low back after standing in place for long periods
  • Unbalanced walking or gait
  • Achy feeling in the lower back or hip while laying down
If these minor symptoms go untreated for too long, they can progress into more severe complications such as:
  • Pain that goes down into the thigh towards the knee
  • Pain in and around the groin
  • Inability to stand in place or walk
  • Poor spine alignment

What Causes Uneven Hips and Abnormal Pelvic Tilts?

To get back to a pain-free and active life, it is always best to understand why your hips and pelvis are misaligned. We recommend everyone see their primary care physician, spine doctor, or physical therapist as soon as symptoms begin to show. A medical professional can evaluate posture, gait, measure each leg’s length, prescribe an X-Ray or CT scan for the most accurate diagnosis.  Your health care professional can diagnose the cause of misaligned hips or abnormal pelvic tilts, which may include:
  1. A functional Leg Length Discrepancy: You can think of this as poor posture for prolonged amounts of time that result in muscular imbalance. When bad posture becomes a habit (in sitting or standing), the muscles surrounding the hip and can become tight and shorten, causing the hip to pull upwards. Also, on the other side of the body, muscles can become weaker and looser, causes the hip to sit lower.
  2. Structural Leg Length Discrepancy: You can think of this as one leg being shorter/longer than the other, outside the commonly accepted range. Most people have a slight difference in leg lengths, but significant differences (4cm or more) can cause hip and pelvic misalignment. These leg length discrepancies can be congenital (naturally from birth). Other causes include growth plate injuries (Salter-Harris fracture is common amongst children and adolescents), poor healing after bone breaks, joint conditions such as arthritis, or bone diseases such as neurofibromatosis.
  3. Scoliosis: This abnormal “S” or “C” curve in the spine is a prevalent cause of hip and pelvic misalignment. Scoliosis is more common amongst young females and can run in the family. 
Once a medical professional confirm a diagnosis, people with misaligned hips and pelvis can begin the recovery process. One of the best and most common ways to correct these issues is physical therapy.

Treating Uneven Hips and Misaligned Pelvis With Physical Therapy

Physical therapy is typically one of the best non-surgical treatment options for misaligned hips and abnormal pelvic tilts. Your physical therapist can help diagnose the cause of your pain and misalignment. They can also assist you with pain management, stretching, strengthening exercises, and biofeedback to prevent and eliminate symptoms. Some techniques and practices that are effective include:
  • Muscular release to tight hip flexors, quadriceps, hamstrings, and glutes.
  • Corrective exercises that address your specific diagnosis. Each type of pelvic tilt (Anterior, Posterior, and Lateral Pelvic Tilts) requires different treatment plans to realign.
  • Help fix bad habits related to posture when standing and sitting.
  • Assist and educate patients on the best way to sleep with as little pain as possible.
Early treatment can help speed up the recovery and prevent significant complications. If you believe your hips are misaligned, you have an abnormal pelvic tilt, or unsure about the cause of your back pain, please contact us at (586) 741-5806 today to make an appointment
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