Lateral pelvic tilt (Uneven hips)

lateral pelvic tilt

What is a Lateral pelvic tilt?

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

  • one hip higher than the other side. (Hip hike)
  • or 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.


How do I know if I have uneven hips?

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.


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

b) Whilst moving: (Dynamic)

Trendelenburg sign

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 your pelvis tilts, this may suggest that you have weakness +/- lack of control of the glute medius muscle (see below) on the side of hip hike.

Keep in mind – the side that hikes during this Trendelenberg 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 and most people prefer to stand on their stronger leg)


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Causes of a 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 fascia 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) 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!

c) 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. (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.)

d) 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 supplies the glute medius)


How to fix a 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 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.


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)

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)

Instructions:

  • Place a massage ball directly on the left Glute medius/Tensor fascia 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)

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. Stretches

a) Quadratus Lumborum/Obliques  (Right side)

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) Glute medius  (Left side)

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 1 minute.

c) Tensor fascia latae  (Left side)

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 1 minute.
  • For more stretches, check out this post: Stretches for the Tensor Fasciae Latae.

d) Adductors  (Right side)

Instructions:

  • Perform a side lunge towards the left side.
  • Aim to feel a deep stretch in the inner right thigh region.
  • Hold each stretch for 1 minute.

3. Activation exercises

a) Hip hitch (Left side)

Muscle: Quadratus Lumborum

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: Glute medius/TFL

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

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


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

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.
  • Progression: Hold for a longer period.

b) Knee to Knee (Right side up)

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.
  • Hold for 5-10 seconds.
  • Repeat 10 times.
  • Progression: Hold for a longer period.

c) Side wall push  (Stand on Right side)

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)

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.
  • Repeat 20 times.
  • Progression: Go slower!

d) 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 ~1cm side steps with each leg over a 1 meter 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)

Instructions:

  • Place your hands on your waist to make sure your pelvis is level.
  • Stand on your right leg
    • Keep it bent at ~15 degrees.
    • 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 ~1cm above the ground.
  • Return to the starting position.
  • Repeat 10 times.
  • Progression: Go slower!

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

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:

Distribute your weight evenly between both buttocks.

Do not lean to one side!

For more information: How to position your pelvis properly.

b) Standing:

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
  • Stepping up/down stairs
  • Lunging
  • Squatting

c) Address Hip Bursitis

If you have a significant amount of pain in the side of your, 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 sleeping on the same side
    • (Tip: Try placing a small rolled up towel under the waist crease to prevent the pelvis from tilting.)
  • Holding baby on side of hip

7. Fix your Scoliosis

scoliosis

It is very common to have a degree of Scoliosis with your Lateral pelvic tilt.

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


 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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896 thoughts on “Lateral pelvic tilt (Uneven hips)”

  1. 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
  2. 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

  3. 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
  4. 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

    • 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

  5. 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

  6. 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

  7. 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
  8. 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
  9. 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

  10. 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

  11. 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
  12. 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

  13. 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
  14. 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
  15. 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

  16. 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!

    • 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

  17. 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

    • 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

  18. 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
  19. 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
  20. 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

    • 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.

    • 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

    • 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

  21. 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

  22. 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

  23. 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

  24. 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

    • 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 ?

    • 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

  25. 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

    • 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

  26. 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

  27. 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

  28. 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

  29. 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
  30. 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

    • 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

    • 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

  31. 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

    • 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?

  32. 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

  33. 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

  34. 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

  35. 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

  36. 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
  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

  42. 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

  43. 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

  44. 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

  45. 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

  46. 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

    • 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

  47. 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

    • 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!!

  48. 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

    • Thanks for the reply.
      Do you think that these problem can cause that I feel left side abs less than right

  49. 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

  50. 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

    • 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

  51. 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

  52. 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

    • 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.

    • 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.

    • 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

    • 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

    • 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

  53. 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

  54. 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

    • 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!

    • 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

  55. 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

    https://pritrainer.com/left-aic-pattern/

    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

  56. 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

  57. 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
  58. 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

    • 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).

    • 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.

    • 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

  59. 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

  60. 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

    • 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

  61. 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
  62. 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
  63. 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

  64. 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

    • 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.

  65. 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
    • Hey Kiran,

      You can start on either.

      If you notice correcting one helps improve the other one, then I would start with that one first.

      Mark

  66. 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

  67. 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

  68. 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

    • 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

  69. 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

  70. 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

    • 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

  71. 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

  72. 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
  73. 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

  74. 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

    • 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

  75. 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
  76. 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

    • 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

  77. 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
  78. 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
  79. 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

  80. 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
  81. 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?

  82. 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
  83. 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
  84. 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

    • So if all of the exercises are for a right hip hike then what are the (Left) or (Right) next to the exercises noting?

  85. 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

  86. 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
  87. 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

  88. 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
  89. 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!

  90. 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
  91. 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
  92. 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

  93. 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

  94. 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
  95. 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
  96. 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
  97. 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
  98. 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
  99. 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

    • 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

  100. 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

  101. 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
  102. 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

    • 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

  103. 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

    • 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

  104. 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
    • Hey Ellen,

      If you don’t have any significant leg length issues, I would do the exercises for a right hip hike as normal.

      Mark

  105. 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

    • 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.

  106. 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

  107. 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

    • 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!

  108. 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

    • 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

  109. 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
  110. 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
    • One more thing, right leg is externally rotated, not internally as the diagram suggests.

  111. 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

  112. 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

  113. 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

    • 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

  114. 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

    • 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

  115. 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

    • 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

  116. 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!

    • 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

    • 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

  117. 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
    • Hi bro ,,I have left shoulder is up ,,and I see that my left knee is rotated inward and give me look like onek knee ,,so I am confused that which adductor muscle I have to stretch left or right ..pls help me …I have also l5 s1 slip disc..and this lateral pelvic tilt

  118. 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

    • 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

  119. 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

  120. 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

  121. 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

    • 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

  122. 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

    • 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!

  123. 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
  124. 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
  125. 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

  126. 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

  127. 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

  128. 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

  129. 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

    • 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?

  130. 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

  131. 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

  132. 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

    • 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

  133. 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

    • 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!

  134. 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

  135. 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

  136. 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

  137. 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.

  138. 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

  139. 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
  140. 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
  141. 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

  142. 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 ?

  143. 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

  144. 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
  145. 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
  146. 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

  147. 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

  148. 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
    • Hey Irena,

      You can do the same exercises mentioned on the blog post.

      You will just need to do the opposite side mentioned.

      Mark

  149. 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
  150. 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

  151. 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

    • 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

  152. 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.

  153. Hi Mark,
    Thanks a million for giving away such great value for free. I believe I have a right hip hike and have been experiencing right hamstring issues for a number of months after I strained it playing sports it has refused to heal with almost constant ache and lack of flexibility, wondering if you think it’s related to the tilt and also how long, if keeping correct posture and following stretches daily, should it usually take for the body to return to correct alignment

    Reply
    • Hello Rory,

      The tilt might be a factor to your right hamstring issue.

      I would also suggest to have a look at this blog post: Rotated pelvis. This could also explain the hamstring issue on one side.

      Mark

    • Thanks a million really appreciate it just had a look and I think you may be right, should most physios have knowledge of such rotations?

    • You have no idea how much I appreciate this value I’ve been struggling for three months now and it looks like you’ve diagnosed it better than any physio, I’m going to try the correction excercises for rotates hip thanks again

    • Hi Mark, was going to reach out on the rotated hips page but thought better to keep it on one thread, from reading descriptions on the other page I believe I have a left hip rotation ( belly button pointing left and left buttocks rotated further backwards. I have been the doing the exercises and actively keeping my pelvis facing forward when sitting and walking in good posture. My hamstring is improving however by right hip remains a bit stiff especially when I point my toes forward or try to rotate hip (and toes) inwards, this leads my right toes and hip pointing outwards when I’m not attentive. Additionally when I stand with my pelvis straight my left knee and thigh are clearly at least 2 cms ahead of my right hip and knee regardless of the straight pelvis. Sorry I know it’s a lot of information but hope you can understand, I really want to get this sorted

  154. Hi Mark, I have a hip hike on the right and that same side is rotating forward. I am also experiencing pain/tightness in the left side with the hip drop. I feel like the pain/tightness is somewhere between the groin and the joint that connects the leg and hip. I have been to a lower back doctor and a hip orthopedic and was just diagnosed with a leg length discrepancy. I am now using a heal lift in my left shoe. It seems to help me exercise better but I’m not noticing any difference in pain/tightness as well as hip rotation. I am also leaning to the left. I have been trying to find a cure for this for over a year. Please help. Thank you, Paul

    Reply
  155. Hi Mark – this is incredibly helpful, thank you!

    My right hip is hiked / left hip dropped, though I think improving now.

    I have previously been told by an osteopath that I have a shorter left leg and he told me I’d need a heel lift for life. I refused to believe this without investigating for myself and my belief now is that it’s highly unlikely I have a leg length discrepancy that isn’t correctable (it’s minor, sub 1cm) and is caused by poor posture rather than a genuine shorter set of left leg bones.

    In your experience do you see this much whereby a person doesn’t have shorter leg bones / and their hip hike and drop is caused more by poor posture?

    Thanks

    Tom

    Reply
  156. Hi Mark,

    Thank you for the post. But I’m a little confused. I have a hip hike on my left side and my right side is tilted forward.
    My left QL is always tight while my right groin/abductors are tight. But some of the strengthening and stretching seems off, Like the opposite for example it says for me I should roll out left abductors and straighten the right abductors which seem counter productive in my case?

    Reply
    • Hey Nathan,

      In a left hip hike: the left QL, left adductor and right glute med will be tight in the frontal plane.

      If you feel tightness in the right groin, you might be referring to tightness in the outer ranges of the muscle as it lengthens.

      In this case, it is completely fine to stretch both sides.

      Mark

  157. Hi Mark!

    I just want to say that your site is absolutely fabulous! And your energy is just wonderful!

    Thanks so much for what you do in helping people heal and for making the world a better place!

    I am a NASM CPT, CES, and I truly admire your confidence and abundant knowledge! I hope and pray to grow my knowledge base to be as broad and inclusive as yours, which is why I am here, lol! Imin constanr pursuit of learning so I can better help guide my clients.

    I cannot thank you enough for being so brilliant! Namasté my friend!

    With Much Love,
    Suzanne from NY

    Reply
    • Hey Suzanne,

      WOW – I like this comment.

      Thanks for leaving me a nice comment :)

      (and great to hear that you are on the constant pursuit of learning!)

      Mark

  158. Hi Mark, I have been on and off your site over the last few months. I have a number of the issues presented here and have been extremely overwhelmed with what to do to fix myself. It seems my entire body has rotated to the left (left shoulder coming forward, right hip hike) and I just cannot seem to remedy the issues. The physiotherapists I have seen have not been very helpful and do not have as much knowledge on these issues as you seem to have so I haven’t been able to see anyone physically who really understands what is happening. Over the last few months, it has started to affect my neck area too as I am having to look ever so slightly to the side to align my vision with what my brain thinks is looking straight. In reality I am just straining one side of my neck muscles and shortening the other. It has caused a mild case of neurogenic TOS (thoracic outlet syndrome) I am wondering if you have any experience with someone similar or have heard of this?

    I would really love to get in touch with you somehow or book an assessment to maybe get your opinion on it.

    Thanks heaps for all the information on the site.

    Reply
    • Hi Jonny,

      Thanks for the comment.

      I have seen quite a few people with neurogenic TOS.

      The main thing is to know exactly where the nerve is being pinched.

      Main areas being:
      – between scalenes (you may experience: tight neck muscles, forward head posture, dowager’s hump, breathing issues)
      – between clavicle and ribs (mainly seen in people with down sloping droopy shoulders)
      – under pec minor. (tight pec minor is common in people with Rounded shoulders)

      Mark

    • Thanks so much for the quick response mark. I am attempting to avoid surgery at all costs and am determined to put the work in to correct my body. with much experimentation I am quite confident that the pinching is occurring at either the scalenes or clavicle or both as I experience all of the symptoms in each case.

      The fact it occurs only on one side also leads me to believe my lateral tilt is a factor playing into the issue. Currently trying to change my breathing into diaphragmatic. Would you recommend completing these exercises to attempt to bring my hips back into alignment (and hopefully my shoulders too) ?

      Is there anything else you could recommend for me in this situation? At a bit of a loss with all the physiotherapists I have seen.

      Thanks so much, Jonny

    • Hey Jonny,

      The lateral pelvic tilt could be contributing to your shoulder symptoms, but you might want to focus in the neck/shoulder region to reduce pressure on the nerve first.

      Here are some things you can try:
      – Release/Stretch the scalenes
      – Perform upper limb nerve glides
      – Address your head posture: Forward head posture.
      – Perform shoulder shrugs ( if you have drooping shoulders)

      Best of luck!

      Mark

  159. Do you have video clips of the routines? Also re sitting on chair exercise and raising left glute, does this mean lifting left thigh up too, do I need to avoid leaning to right to lift left glute?
    If I have a right higher hip and a left low arch which routine is important to focus on first/more as I can’t fit both in on a working day. Re side sleeping I usually sleep on right side with pillow between knees. Should I try to alternate some nights onto left side as I find that uncomfortable.

    Reply
    • Hey Rachel,

      I don’t have videos yet. (… I do really need to start filming though!)

      In regards to the hip lift, it is fine to use your hands to balance and lean a bit into your other side.

      With sleeping position, just make sure your pelvis is as neutral as you can make it (using pillows to support). But more importantly, make sure you are comfortable!

      Mark

  160. Hello,

    Back in November I got back into exercising so I was walking a lot and running which is something I’ve always done. I started to feel tightness in my lower back but ignored it because I thought it was soreness. Fast forward to present day I now have my left hip higher than my right and cant stand for a long period with feeling exhausted and need a nap. I’ve been going to the chiropractor every other day. He said to just keep coming and it will eventually get better. I am now able to stand longer than 5 minutes without feeling exhausted, but I can’t get my hip to level out. I was also told to use ice and heat 20on/20off.
    I started doing yoga and stretching, but it seems to irritate the area more (is this soreness?). I use to have this issue before and it would go away in a day, never had it stay for this long.
    If I move too fast or miss a step I feel a sharp pain and my back feels like it’s going to give out and this is the part that worries me. Hurts when I cough or sneeze also and can’t get comfortable while sleeping.

    So here are my questions…
    1. Should I continue going to the chiropractor?
    2. Should I continue yoga?
    3. How long does this usually take to go away?
    4. What is happening when I feel the sharp pain?

    Thank you in advance for your help

    Reply
    • Hi Anthony,

      1. Should I continue going to the chiropractor?

      Yes – if it is helping you.

      2. Should I continue yoga?

      As above. Any movement that you can perform without making things worse is always going to help you.

      3. How long does this usually take to go away?

      It really depends and is determined by multiple factors. Hard to say!

      4. What is happening when I feel the sharp pain?

      You may be placing extra stress on a sensitive structure. Have you had any scans to the area?

      Mark

  161. Hi mark, please reply me! Im so confused, my right side hip is higher than left, so i assuming i have a hip hike on my right side or hip drop on my left side,i only feel the uncomfort from my right side though, BUT my right leg is shorter also shoulder is slightly higher, it doent make sense, so what this mean? Do i have a right side hip hike?

    Reply
  162. Hello Mark
    I couldn’t believe it when I saw you had replied to me. Yeah!. I left a message on your Facebook page but I’m not sure that is correct. Hope to connect.
    If others are reading this I would encourage everyone to go to the donation page and give a little something. This man takes time from his practice and family to provide alot of information not available other places and for free!. I don’t know Mark or even live in the same continent but sure appreciate his knowledge and hope others recognize how valuable it is.
    Christa

    Reply
    • Nice to hear the appreciation! I have multiple issues with my spine, hips and knees. Have scoliosis – left-sided and lumbar, degenerative disc disease (this commenced as a young adult – I’m now 60. Have osteoarthritis, which I’ve had for a long time and more recently – 18 months – left-sided sciatica. I have a left-sided hip hike. Had a fusion at C4/5 to relieve the pressure on the two discs below which were impinging on the spinal cord, 21 years ago – has held off until a couple of years ago, when I started feeling the same symptoms in my left arm and hand. Have tried chiropractic treatment, clinical pilates, cauterisation of the small nerves in the lower lumbar spine with injections into the facet joints for around a year – nothing helped. Am awaiting fusion of L5/SI, bilateral, total knee replacements and bilateral total hip replacements. On top of this, I have, in my search for an accurate diagnosis, had other medical issues uncovered! I’m in chronic on acute pain and only get some relief in sitting in certain positions and lying flat on my back with a pillow beneath my knees and a reasonably sized pillow beneath my head. My mobility is very compromised – can walk a few steps, unaided; use a wheelie walker around the house and a wheel chair for longer stretches. I am fortunate in having a physio come around to my home – he has mostly been helping me with exercises to reduce the sciatica and manual physiotherapy. but I feel I now need (hadn’t even considered it before!) to show him the results of the most recent EOS scan I’ve had done and get his advice on the several unearthed problems. I’m so grateful I’ve found this site – whilst looking for answers – and will check in every so often to see if I can benefit from the suggestions made in answer to the problems of others. Thank you for your helpfulness to all.
      Regards, Denise
      PS – I don’t currently have an email address, so am borrowing my son’s! Though, it’s just as a requirement, not to be used – hopefully will have mine sorted out soon.

  163. Hi Mark,

    I had surgery at L5-s1 last January 2018. Post-op developed sciatica on right leg and after 3 months I had upper back pain amd shoulder tightness and spasms. Doctor tub several test however they cannot understand why I am having upper back symptoms. 6 months post-op developed low back pain and gluteal/tailbone pain after doing the knee to chest, single knee to chest and piriformis stretching (was adviced since my low back severly tight (I have hyperlodosis due to tightness) . To this date Feb 2019, I still suffer from pain, tightness and discomforts. My left glutes is always in pain as well as my tailbone when lying down, low back is extremely tight and my upper back/mid back eill tightened when I am upright. Last xray of my spine shows DDD of L5-s1 and some central herniation. Done tons of PT and chiro care amd feels frustrated and I want my life back. One of my PT checked my posture and my left hip is higher than my right. My right shoulder is higher than my left. My low back is arching doing the knee to chest will lessen the tightness but will increase pain on my glutes. I want to do this exercise but i don’t know if my problem is just postural of muscle imbalance or because of my DDD. My neck also aches. Doctor recommend fusion and I am thinking if I can still rehab my self out.

    Reply
    • Hi Christine,

      If they just shaved the disc and/or cut the bone around the nerve (which is essentially removing the amount of structural support in the lower back), it is pretty common for the nerve symptoms to arise after some time. L5/S1 issues can refer pain to the tailbone, into the glutes and even down the leg)

      Back issues can also affect the neck/shoulder region as pain will generally change the whole posture as it tries to avoid pain.

      I would prioritize reducing your sciatic symptoms first.

      Have you tried exercises like McKenzie Lower back extensions? They are great for reduce nerve pain down the leg. (just make sure not to go too far as you are already hyperlordotic)

      Your lateral pelvic tilt may be the body trying to avoid pain in the lower back. (but could also compound issues if left for too long)

      Mark

    • Hello Christine!
      Seems we have several common problems! I hope yours improves and eventually disappears. I’ll look out for your posts to see how you’re doing!
      PS – I saw a surgeon 13 years ago. He was going to remove the remainder of the disc at L4/5, insert an artificial one with the rods, screws, etc, holding everything in place, and fuse L5/SI. There were also problems with L3/4, but after 2 inconclusive discograms, he decided not to operate. I was told to ‘seek alternative treatments’ (which I already had)- I genuinely felt he didn’t want to risk his reputation by not providing a completely successful solution – something I was willing to chance. I’m so grateful that someone referred me to the surgeon I’m currently seeing!
      Hope your condition improves!

  164. Hello Mark,

    I think that in the side wall push exercise you meant to say stand on the left leg and push with the right one to the wall. Am I right?

    Reply
  165. Hello Mark,
    Thank you for this wonderful website, explanations and solutuions to all these varied problems. I’m dealing with anterior tilt, lateral pelvic tilt (right hip drops), and I believe a right rotated pelvis which then causes the opposite direction twist at the thorax lumbar junction. I do know more of my weight is on the right side( ilium backward rotation , addductors, piriformis, internal rotators hamstrings , QL very tight and don’t want to budge plus right shoulder seems to wing, I always list to the right when sitting and my right hip drops with every step especially up stairs. Could be from reptitive motion and or an old injury. I’m told this pelvic torsion is not uncommon but hard to fix and not much info out there until I found your site.Help it’s overwhelming and I don’t know where to start. Which issue do I address first with so many things to work on. I feel a sense of hope having found this website.Thank you again and I see you have a donation area to keep this insightful help going. Going there next.

    Reply
    • Hi Christa,

      Firstly – my apologies for a slow reply!

      Secondly – thank you so much for you donate :) I see it.

      Contact me via private message.

      I am going to help you personally!

      Mark

  166. Hey Mark! Great site, thanks for all the info!
    I am having a lot of those issues you are mentioning here (lateral tilt, hip hike, one foot pronating as a compensation, etc). To me it indeed looks like bad posture acquired over the years but if you google those kinds symptoms or go visit a chiropractor, they ll always tell you it is an “atlas misalignemnent” showing you the same drawing you posted (the crooked skeleton) and tell you they must crack your neck to put things into order. Is that total BS?
    I ld rather give a good try to the exercises but they seem to think it can’t work without their neck cracking skills… Would love the opinion of a physio on that.
    Thanks in advance,

    Best,

    Chris

    Reply
    • Hey Sven,

      The position of the neck and head do play a big role in posture, but it isn’t ALWAYS the root cause of everything. (cause vs effect)

      Also – You can address your neck alignment without cracking it :)

      Mark

  167. Hi Mark. I was wondering if you would be able to help me with an issue I have been experiencing. When I squat, I lean to my right, therefore taking more load on that side. When I shift to my right, on the way up my butt makes a question mark looking figuring going farther to the right then back to more centered. I have an xray showing that I have a lateral pelvic tilt sloping downward on the right side. I am extremely frustrated as my body being out of position has effected my bench and deadlift too and I cannot get in the correct position in any of the lifts.

    I was wondering what I can do to start making my squat (and body) symmetrical? I have a video of squatting if there is a way I can send it to you for better understanding of the issue.

    Thank you

    Reply
    • Hi Charlie,

      I wouldn’t be too concerned about the lateral pelvic tilt. It is quite minimal. If anything – it may be due to a twist in the pelvis.

      A rotated pelvis could possibly explain why you tend to deviate to the right side in your squat.

      (For more information: How to fix a Rotated pelvis)

      Another thing I noticed in your xray is that your ribs 8-10 on the left side tend to be more translated to the left side. This might cause a shift in your centre of gravity. This could be a factor in your squat deviation.

      Feel free to link your squat video in that comments.

      Mark

    • Thank you very much for your reply. I will take this into consideration and look into your rotated pelvis article.

  168. Hi Mark,

    Great website. Thank you for all the work you do.
    I have a ‘shorter right leg’- would it be the right hip hike? Sorry but I got a bit confused looking at your photos. Also, I have a deep thoracic kyphosis. Which should I address first? Levelling the pelvis or kyphosis? My right part of the body is all tight and I have a gnawing pain in the middle of the sternum. What do you think it might be? I also have some osteophites on my thoracic spine. Could they give me pains?
    Thanks a lot. If I could, I would contact you via an e-mail.
    Tomas

    Reply
    • Hey Tomas,

      The hip hike can be on the long or short leg. It depends how you are standing.

      If you lean to the side of the short leg, then the hike will likely be on the same side.

      If you stand equally, the hip hike will be on the longer side.

      In terms of which area to start off with: it really doesn’t matter. You can start at either.

      A pain in the sternum is probably related to the ribs and the shape of your thoracic spine. Given this piece of information, it might be better if you start on the kyphosis.

      Mark

  169. Hi Mark, Thank you for the very detailed and layman friendly article. My apologies if you have already answered this question. I have recently taken up long distance running in a move from cycling, and have experienced increased pain in my right ankle. In my last run I actually felt that my alignment wasn’t right, and proceeded to investigate it in the mirror. What I noticed was that my left hip was hiked, but in attempting to lift the right hip in order to see them in a balanced position, the right leg appears shorter. Is this combination out of the norm, and can this discrepancy be down to hip tilt only? In addition, I have always had very tight hamstrings, but I have noticed over the years that the hamstring on my left side (hiked hip) has become even tighter than on my right. Could this be a result of the pelvic tilt, or part of the cause. Thank you again for your good work,

    Reply
  170. Hi Mark,

    I’m a 30 y/o active woman who has been having issues with my right hip for about two years now. It started will a popping sound coming from the inner right groin area. All I have to do is raise my right leg (when doing yoga for example) and it makes a loud noise as if there’s a tendon going over my right hip bone. I started noticing some pain after doing squats or any exercises where I was using my glutes. It started with a numbing sensation and now, depending on what I do, it can go from numbing to sharp pain.
    I went to a chiro who took an X-ray and noticed that I have a forward tilt on my right hip. I went for a few months and didn’t notice any difference. I also now have popping knees, my right side more than left.
    My questions are:
    How frequently should I do these exercises?
    Should I do them on both side or just my right side?
    Should I abstain from exercising?
    On average, how long would you say it takes to correct this issue?

    Thank you for any feedback!

    Reply
    • Hello Kendra,

      I find popping/clicking/snapping is either due to your:
      a) hip joint
      b) tendon snapping over a bony prominence in your hip.

      I feel that it may be the latter, but I would only be guessing!

      Out of curiosity, do you happen to have a rotated pelvis? This could play a role.

      Answers to your questions:
      1. You can do the exercises every 2-3 days to begin with, then depending on how your body responds, you can increase/decrease frequency.

      2. Exercise both sides, but there are different exercises for either side.

      3. Try to continue to exercise. You might need to pick and choose which exercise that are less likely aggravate your symptoms.

      4. Very hard to say how long it will take to correct as everyone is quite different.

      Mark

  171. Hi Mark,

    I’ve noticed that I frequently put a lot of weight through my left leg, but my right hip is the one hiked higher. Is that the normal/expected behavior? Thanks for your help!

    Reply
    • Hey Matt,

      If your right hip is structurally longer? This may explain why.

      I generally find that people have a higher hip on the side they tend to put more weight through.

      Mark

  172. Hey Mark, I broke by right leg 2 and a half years ago. The past year though I’ve started to sleep on the right side and my right hip is giving me pain especially when laying down. Furthermore when I lay down on my back I always feel the need to kick my leg out to stretch the right. When I wake up in the morning it is very tight. Also, when I play football it it’s always tight before and after.

    Any suggestions on what’s happening?

    Reply
  173. Hi! So I have lateral pelvic tilt, and its a weird kind though. I play badminton, and lunge a lot- think of the fencing lunge. The side of my non-dominant hand relies on my QL, lower back, and even the transverse abs and lower abs ALL ON THE RIGHT SIDE of me. So all those muscles got stronger and tighter over time.
    The closest I can get to “replicate” the action is a side plank for my left side, but my TFL is very overactive on my left leg and it gets sore after side planking and further increases the hiked hip. I am at a loss of what to do. My entire body, upper and lower, is affected by this.

    Reply
  174. How did my severe osteoarthritis of the left hip cause my lateral pelvic tilt. I’m a tow walker on my left foot and have a 1-2 inch lift in my left shoe. I’ve had no surgery ever and go once a week for deep laser therapy on my left hip for the previous five years.

    Reply
  175. Hey just a question! On the side of my hip hike my quadratus lumborum is smaller on this side than on the other. Does that still mean that its right instead of weak on that side? I’m asking bc it sais above the excersises that it will hip hike to the side of a tight quadratus lumborum and drop to the side of the weak one and I dont want to accidentally do the wrong sides excersises

    Reply
    • Hi Caleb,

      The size of a muscle does not always give a good indication if a muscle is tight/weak/strong etc.

      If you have a hip hike on one side, then the QL on that side will be tighter relative to the other side.

      Mark

  176. Hey Marc, during the summer of 2017 i injured my bad right ankle and heard a pop. Ever since than i feel a slight tinderness on the inside of my ankle. I played college basketball that same year with the injury in my ankle. I later did physio and learned i have a lateral pelvic tilt. I then injured my right ankle once again the past summer 2018 playing basketball again. This time i felt weird side effects, my ankle became flat and i realized i’ve had muscle imbalancement since i heard the pop in 2017 except this time the pain became much worse. I didn’t play on the basketball team because of my muscle imbalances and initially an ortheopedic surgeon believe i needed surgery. I sat down doing nothing for 4 months between September to December until i met with the surgeon again and he told me the MRI shows my ankle is fine so recently i’ve doing physio again. I believe i’m slowing improving but i feel muscle imbalancement everywhere on my right side. I have a flat right foot (overpronation), right knee tucked in, right pelvic drop, right leg slightly longer, right arm and wrist slightly turned inwards, shoulder and kneck tension as well. I’m tired of the pain i’ve been feeling, would following the lateral pelvic tilt, knee vulgus and flat foot excercises get me back to a 100 percent? I’m sorry to be a bother i’m just tired of feeling like shit and not being able to play basketball or lift weights. My knee aches when i run or jump and i’m not sure if lifting weights benefit me or make my imbalancement even worse because i can’t even maintain a straight wrist or arm whenever i lift weights. This site is amazing btw, but i’m curious to see what you think about my imbalancement and why the pop in my ankle started all of this. I’ve also always had a bad right ankle.

    Reply
    • Hey Georgio,

      Your ankle injury in 2017 could have definitely been the first domino piece that was knocked over, leading to all the other symptoms you mentioned.

      The exercises for flat feet, knee valgus and lateral pelvic tilt should.

      You possibly have a rotated pelvis as well. (here is the blog post for that)

      Try to stay active with your gym exercises. You might need to reduce the weights that you use so that you can focus on symmetry.

      Mark

    • Walking in simmi g pool and swimming can help to.fix lateral pelvic tilt ???

    • Hi Erica,

      I would prioritize the rehab exercises if possible.

      You can still do weight training, but just make sure you are not doing it with a hip hike.

      MARK

  177. Hello, Thanks for this wonderful material. I am 65 and broke my left hip in Jan of 2016. Healing started well and then I began to have pain under my left knee, glute and in the left groin area. I have pain upon walking. It does not seem to be bone pain, so I don’t know how to gain strength and stability in my left leg again. It is about just under 1/2″ shorter now, and I think this is where all the pain is coming from. It seems excercise does not really help; just makes me more sore. Should I stretch or do some of your light exercises and be patient? Please help.

    Reply
    • Hi Tracey,

      It sounds like your walking pattern has changed. (probably due to the injury)

      Have you scanned the other areas of your leg. This might be a good place to start to rule out anything serious.

      If all clear, I would just keep trying to strengthen up your leg at an intensity you are comfortable with. (Exercises in the pool might help if your pain is easily exacerbated)

      Mark

  178. Hi Mark. Quick question for you. I have flat feet and a lateral pelvic tilt on my right side (right hip hike). It’s pretty bad and causing a pain in the right side of my upper back when standing up for long periods of time. I have recently started exercises similar to the ones on your website to help correct this. I have also put a heel raise in my left shoe. Although the heel raise seems to help with the back pain, I have noticed that my left QL is extremely tight and painful. Is this because of the heel raise? Should I keep the heel raise in or get rid of it?

    Reply
    • Hi Louis,

      Here are some things I can think of:

      1. The body needs to time to adapt to the new position. This can make certain areas hurt for a short while.

      2. The heel raise is not the correct height.

      3. The heel raise is altering the way that you move which may be placing more stress on the Left QL.

      4. You may not have a structural leg length discrepancy.

      I generally don’t advise my patients to get a heel raise unless they have a significant amount of difference in their leg lengths.

      If you are doing the exercises AND have a heel insert, your pelvis may over shoot.

      Mark

  179. Hi! My right hip / pelvis is always rotated forward and my right leg is always longer than the left when going to my chiro. I’ve been having low LEFT back pain though. Is it possible to be the opposite? I’m not sure what side to focus on more now. Any insight?

    Reply
    • Hi Kristen,

      It is possible to have pain pretty much anywhere with any postural deviation.

      (it depends how the body moves, activities that you do, your compensation strategies etc)

      When you stand, which side is your hip hike?

      Mark

  180. Hello Mark, thank you very much for making this and everything else you’ve done. For the gluteus medius stretch in this guide I can’t keep my lower back straight, it stays rounded with my leg straight out. Can you recommend another gluteus medius stretch for me? What about laying on my back and bringing my left knee towards my right shoulder (with knee bent). I also suffer from APT, is that why I can’t straighten my lower back with my leg(s) straight out?

    Thank you again, this website is amazing.

    Reply
    • Hello Kyler,

      You can just do the stretch whilst sitting on a chair. That should make it easier.

      You can do it lying down as well.

      Or you can do something like this.

      You might have tight posterior hip preventing you from keeping your back straight when legs are straight out.

      Mark

    • Thank you. I have a right hip hike, lower right shoulder, and flat left foot, I don’t seem to have a rotated pelvis, but my right butt aches when I ‘m sitting and sometimes my right lower back. Could it also be that my right posterior hip is very tight? Thank you again.

    • Hey Kyler,

      That could be a potential reason.

      What you need to probably look at is your sitting posture as this will give you a better idea what’s happening with your muscles.

      Mark

  181. LOVE your posts!! I have a right lateral hip hike and a left rotated pelvis and a right foot low arch (which prob contributes to left rotated pelvis). When doing the left rotated pelvis exercises, a lot of them contradict the right lateral hip hike exercises. Where do I start? I started doing the left rotated pelvis exercises but I almost think it contributed more to my right lateral hip hike. Is that possible? I mainly have left hip /S.I. joint pain- but it moves around a lot so I don’t know which problem to tackle first.
    Thanks so much!!
    April

    Reply
    • Hi April,

      If addressing the rotated pelvis made things worse, you can try starting with the lateral pelvic tilt.

      If you have SIJ pain, just go easy and gentle to begin with. Let the body get used to the new exercises.

      Mark

  182. Hi Mark,
    This is so useful, thanks so much. Couple of questions:
    1. Should I do these exercises in this order? (I guess I always thought you do strengthening first, stretching second, which is opposite of what you have here, so just confirming.)
    2. I have a slight drop in my left hip. But I also have severe sciatica in my left buttocks/leg, which is worse when I’m standing. The pain is alleviated a little when I shift my weight off of my left leg—so I do stand unbalanced, but it helps with the pain. Could my sciatica be causing my hip imbalance. Or is it possible that my hip imbalance is causing my sciatica? (I’m hoping that if I do these exercises, it will fix my sciatica!)
    Thanks!

    Reply
    • Hi there Lauren,

      Yes – I would recommend doing them in order. (but it is not a solid rule that you have to.)

      The lateral pelvic tilt may have predisposed you to getting the sciatica. But it’s also true that shifting away from your left leg could have lead to the lateral tilt as well.

      Good luck!

      Mark

  183. Mark,
    It appears as if I have a pronated flat left foot and a right hip hike. This is where it gets interesting… I believe I also have a left rotated pelvis. Is that even possible? You said with a right hip hike usually comes a right rotation. I saw a chiroproctor three times a week for two months and every time I went in for an appointment my pelvis was out of alignment. Would that mean the pronated flat left foot is the culprit for my misalignment?

    Thanks for the response,
    Brady

    Reply
    • Hi Brady,

      It is definitely possible to have a pronated foot on the left even with a rotated pelvis to the left.

      If you have a right hip hike, chances are that your pelvis may be sitting more towards the right of your feet. This alone could explain the pronation in your left foot.

      If the chiropractor has focused on the pelvis and the problem still persists, it might be an idea to give the foot a try.

      Mark

  184. Hello Mark,

    Thanks for this informative post! I want to start trying these ideas, but want to make sure I understand something correctly about which hip is actually hiked vs dropped…essentially what I want to know is are you basing all this on which hip is hiked/dropped when the person is standing? Does the hiked/dropped difference show up when the person is lying on their back? (If so, are the same sides hiked/dropped as when they’re standing?). Maybe it doesn’t even matter and we only care about what’s happening when they stand and gravity takes over?

    Here’s why I ask…
    I have pain on the left side of my back. It’s worst when I push my hips out to the left (opposite of what you show in the first photo in this post). Standing postural X-ray shows my left hip is about ~17mm “shorter” than my right hip. So when I stand, my body compensates by leaning my hips out to the left and my right shoulder dropping down like the skeleton photo in the “Why is this a bad thing?” section of this post. However, I’m not sure what my hips are technically doing when lying down (or if it matters). Based on my situation, I’d follow your directions as they’re written in this post because it says they’re written for “right hip hike”, correct? I just want to confirm.

    Reply
    • Hey Nick,

      You can have a lateral pelvic tilt whilst in a lying down position.

      It is more likely to have the same hip hike in standing and in lying, but can also go the other way (it really depends how your body reacts to gravity)

      If you have a right hip hike, I would stick to the exercises a mentioned on the blog post :)

      Mark

  185. Hi mark, cracking post. I have right hip hike for the last 5 months. It’s been checked by a physio. However strangely to my eyes it looks as if my left side is higher than my right as I get pulled quite dramatically to the left and I have major muscle tightness in my left QL region of my back. I also appear to have a longer left leg tho they’ve been measured and are the same. My right glute is weak and my right QL is restricted but not painful. All my pain is on the left. Is this normal? Or is there something else going on in your opinion. Cheers for your help.

    Clare

    Reply
    • Hi Clare,

      If your physio did a thorough assessment on you and found that you have a right lateral pelvic tilt, then I would probably say this is what you have!

      When you have a right hip hike, the torso can compensate by side bending to the left (tight UPPER left QL). This can give the illusion of a higher hip on the left due to the waist crease.

      You can have pain on either side with a lateral pelvic tilt, depending on how your body is compensating.

      Mark

  186. Hey Mark,
    I have an obvious hip hike and shoulder drop on my right side and was just wondering why not do the stretches for both sides? The reason I ask this is because my QL and adductors on my left side actually seem to be tighter/stronger/bigger than on the side with the actual hip hike.

    Thanks!!

    Reply
    • Hi Anthony,

      If you want to fix an asymmetrical postural issue, you will need to apply different exercises/stretches on either side initially.

      Once you are more balanced, feel free to stretch both sides.

      In a right hip hike, the right QL and adductor may actually make the left QL/adductors work harder. This can result in the points you mention.

      Keep in mind:
      – “feeling” tight is not the same as actual muscular tightness.
      – Elongated muscles usually feel more tight.
      – Tight muscles does not always mean that they are strong muscles.

      Mark

  187. Hi Mark, thanks to your blog, i am now feeling better on swayback, hunch back and rounder shoulder. In the block i saw exercises for hip drop and shoulder drop on alternate sides. But i am having same side drop of hip and shoulder. the reason is i am right handed, lean towards right side for computer mouse handling due to my work nature. can you please post exercises for same side hip+Shoulder drop/hike. thanks a lot for you service.

    Reply
  188. Hello Mark,

    I have lateral pelvic tilt (hip hike/hip drop). How can that be possible if my legs are the same length? The hip joints must be at the same level, if the legs are the same length, right? Then the waist bones ought to be at the same level, since they are rigidly attached to the hip joint?

    I am sure I don’t understand something.

    Reply
  189. Hey Mark,
    So I had a serious right ankle injury about two years ago, and ever since then I’ve been leaning to the left side when I do most things. When I walk I lean to the left side, when I get up from a chair I’m getting up from my left side etc.. My right side feels like its along for the ride and not doing much but this has caused issues I’m pretty sure when I run. After running constantly I started to get pain in my heel area mostly on the right side which is the side I don’t lean on likely I’m guessing from leaning to the left side. Because before my injury I never had these issues after running. Everything I do I tend to lean to the left side so I’m just wondering will the exercises up above fix this and force me to get more balanced again?

    Reply
    • Hey Trevor,

      If you are leaning to the left side after your right ankle injury, it sounds like your body has learnt to avoid placing weight on that right side.

      This can change the position of the pelvis.

      Check to see if you have a rotated pelvis as this can cause you to stay on one side more so.

      In terms of getting more weight on the right side, you need to do more single leg work to force the muscles/joints to be okay with receiving the weight of your body. (eg. lunges, step ups, balance exercises etc)

      Mark

  190. Hi Mark, I suffer from a Lateral Pelvic Tilt and I am so happy I came across your blog. I see the exercises you shared to fix the issue. Do you recommend doing them everyday? Also, I want to start running and weight lifting, do you recommend that I fix my tilt first? Can I do both at the same time? Please let me know what you recommend. Thank you very much!!

    Reply
    • Hi Abdel,

      You can do them every day if your body is able to handle that frequency.

      Before you start running and weight lifting, it might be an idea to do these exercises for awhile until you are confident you can control your pelvic tilt.

      Mark

  191. Hi Mark,

    Thanks for the article. I had a few questions…

    Would this cause some loss of muscle in the right side lower back/glute medius/ and even pec (pec is much smaller on right side)

    Seems as though the pronation of the right foot is also causing me an IT band syndrome.

    Thanks

    Reply
  192. Hey Mark, my friend has had lingering R hip pain for the last few months. She went to PT but it’s not helping. I’m an OT student and asked my professor about it and she said to see if her shoulders are uneven to see if it could be another issue. I checked, and sure enough, her right shoulder is noticeably higher than the L shoulder. Any suggestions or a particular sustained pressure exercise from above that would work best to help? Thank you!

    Reply
  193. Hey mark. Ive been to a lot of different specialists, had Mri scans, physio treatment, CT scan, osteopath and chiro… I believe i have a pelvic tilt or forward tilt of my right or left pelvis but it must be so little that i can not tell with my own eyes.. I had a x ray of my hips 1 year ago which told me that my right hip was 8 millimeters lower than my left hip, doctor told me i have a leg length discrepency but its a rare thing to have and i can not believe him, what do you think man?! I have pain around my right SI join and since the last time i also started getting nerve pain in my left glute area down to my upper leg, something like sciatica, please i beg you for some help… thanks

    Reply
  194. Hi Mark! I am so thankful to have found your website and posts. I think I have a rotated pelvis (left pelvis rotation) with lateral tilt (right hip hike/left hip drop). It has caused me pain in my hip, down my leg, and I have a muscle knot on the outer edge of my left foot due to my gait. If I start your exercises, how often should I do them and how quickly should I see results? Also, how long should I continue after the results? This has caused me severe pain for awhile. I am hoping that your suggestions provide relief! Many thanks!

    Reply
    • Hey Jill,

      You can try to do them every 2 or 3 days and see how your body responds.

      If you can handle it, try to do it more frequently.

      Mark

  195. Hello Mark,

    Thanks for sharing your knowledge on later pelvic tilt. I had a total hip replacement (anterior) approximately 1 year ago and I have a 5/16” leg length discrepancy. Will this correct my leg length discrepancy and if so, how long will it take before I’ll see some improvement?

    Best regards,
    Keith

    Reply
    • Hi Keith,

      It depends if the lateral pelvic tilt is due to the actual structural component of the hip replacement or if it is due to compensations occurring at the pelvis following the surgery. (or maybe even a bit of a blend between the 2)

      If the length of the actual bone is different (due to the replacement), then the tilt will be difficult to correct.

      However- if is due to an imbalance of the muscles around the pelvis, then the exercises will work great for you.

      Mark

    • Hello Mark,
      Thanks for the reply. My surgeon told me that he guarantees me that my leg length discrepancy is due to pelvic tilt and not structural. He told me that my leg lengths are within 1/64” of each other. The x-rays show that my left side is tilted down, that’s why my left leg is longer. Do you have an estimated timeframe on how long will it take to see some improvement?

      Thanks,
      Keith

  196. Hi Mark :)
    Great article. Few questions here. My right pelvs is sticking out to the right side and is slightly pulled back (rotated pelvis?) and my right shoulder is lower than my left. Clear symptoms of LPT. Also I have pain in my left side of my low back, probably tight QL. Shouldnt my right QL be tight? Should I do the stretches above before my workouts? And should I stretch both sides or just the side where is my LPT? Is it save to lift weights with this bad posture? I went to PT but they told me just to do general stretches for entire body. Can chiropractic care help me with LPT? Thank you for your time.

    Reply
    • Hello Peter,

      The tightness you feel in your left lower back may be due to your erector spinae group as opposed to the QL. This would make sense if you pelvis is rotated to the right (right pelvis backwards)

      You can do the exercises before your workout.

      Stretching the muscles that are holding your pelvis into a lateral pelvic tilt are going to give you best results in terms of fixing the tilt.

      It is fine to lift weights. Just aim to hold your best and natural posture as possible. (Don’t force it)

      Chiropractors can help you with your lateral pelvic tilt.

      Thanks for your questions, Peter.

      Mark

  197. Hi Mark!
    Great page you’ve got here!
    I’ve got a problem that seems to be pretty equal to what you’ve described in the article, but as far as I’ve noticed, I only get it while squatting (hip drop on my left side). It’s been bugging me for a while, but I just recently discovered that pelvic tilt was the issue. It’s caused some back pain in the left side of my lower back that can vary both in location and intensity. On some days I can’t even feel it. I’ve been powerlifting for some years now and when I squat, I can’t feel the tilt. I only see it when I record from the back. The bar also tilts to the right (opposite from the hips).
    What are your thoughts on this?

    Thanks

    Even

    Reply
    • Hi Even,

      Lots of things could be happening here with your squat.

      I am going to brainstorm with you right now.

      1. Asymmetrical amount of ankle dorsiflexion between your feet. This can cause the pelvis to tilt.

      2. injury to your lower limb in the past which your body subconsciously does not want to load equally.

      3. Lack of fill hip flexion to hit the bottom of the squat evenly. The hip drop is usually on the side that has less hip flexion.

      4. Scoliosis in the spine. If you have a hip hike on the right (hip drop on left) in your squat and your bar drops to the right, it is likely the spine is bending on the right side.

      In regards to your left sided back pain, I would also check if your are ROTATING your pelvis during your squat. Here is a great post for you: Fix your rotated pelvis. I find it is common to have left back pain with a right rotated pelvis.

      Mark

  198. Hi Mark,

    If I have a left hip hike, I should do all the exercises shown but on the opposite side – that I know. Does it hinder my progress if I do the exercises for BOTH sides?

    Reply
    • Hi James,

      If the goal is to address your lateral pelvic tilt, you would want to do the specific exercises on the relative side.

      Keep in mind, you still are exercising BOTH sides, but the exercises will be different.

      Mark

    • The reason I ask is that I think I have a rotated pelvis as well as a left hip hike. Also, my right shoulder is higher than my left and I’ve had sciatica on my left leg for the past 2.5 years now from a disc bulge. I just don’t want the muscles to be unbalanced or lead to anymore injuries; and I heard if I stretch one side of my body, I should stretch the other equally.

      Please forgive if my comment is ignorant. I seek your advice. Thank you!

  199. Hi Mark. I have a right side hip hike and my right leg is slightly longer (0.85cm). This is causing chronic back pain and muscle spasms. My doctor did an X-ray and said my spine is straight, so he thinks the leg length is to blame and has given me an insole to be worn in my left shoe but it’s agony to walk with it, any idea why? Could an insole help or it will just make certain muscles even weaker?

    Reply
    • Hey Lindy,

      I generally don’t recommend insoles straight away as it won’t give the opportunity for the body to adapt.

      It is best to focus on the muscles and joints with exercises.

      Mark

  200. Hi Mark-this post looks super helpful but I’m also 30 weeks pregnant so I can’t do many of these exercises. Do you have any that would be best to help fix a lateral pelvic tilt during pregnancy? I have a left hip hike and I can hardly get into/out of my bed or a recliner and it hurts to make pretty much any movement. I just don’t know what would be the best use of my exercise time.

    Reply
    • Hey Tami,

      Pregnancy will tend to play around with the pelvis. (usually due to a mixture of your ligaments being extra stretchy, extra weight on your structures and a disruption to your normal centre of gravity)

      Whilst you are still pregnant – My suggestion would be to focus on gentle stretches such as Knee side to side, single knee to chest, pelvic tilts in 4 point kneel, strengthening the glutes and core etc.

      If your lateral pelvic tilt persists after your delivery, then it would be more beneficial to start with these exercises on the blog post.

      Mark

  201. Hi Mark..First off thank you very much for this resource! I recently read your post about lateral pelvic tilt. I am wondering if you take any online clients. I have had issues with back pulls and spasms periodically. I have worked with various therapists and I have been very diligent and disciplined with their programs but none have helped. I have made several observations about imbalances I have but do not know how to fix them. My instinct tells me fixing them will help towards lessening my back issues. Your article resonated with me as it described the observations I’ve made. Left hip hike, left inner thigh tight, left ql tight, lower right back atrophied… however my confusion on how to correct this comes because I also have a right forward rotated pelvis. Wondering if you do any online coaching and if not, any guidance you can point me to when dealing with both the hip hike and rotation. I’d love to challenge my assumptions that correcting those may help my back issues.

    TLDR; if one is dealing with a right forward rotated pelvis as well as left hip hike how would I approach rehabbing… also, when do you stop doing the “one sided” therapy? Thank you very much.

    Reply
    • Hey Chad,

      Thanks for the TLDR, it helps! :)

      If you have a left lateral pelvic tilt AND a Left rotated pelvis (right side more forward), you can address them one at a time, or even together.

      It doesn’t really matter which one you start off with first.

      I am a big fan of one sided exercises as it exposes weaknesses/compensations. But if you wanted to know when you can start bilateral exercises, it is when you can control a neutral pelvis.

      Mark

  202. Hey Mark,

    So I have a slight lateral pelvic tilt but on the right side, as in my right hip is lower than my left hip to the point where my right leg is longer. I really struggled to find something this helpful, that I can perform on my own. Although I am quite confused and have a few questions. First, are these exercises supposed to be done on both legs or just my right leg to level it up ? Second, how often should I do these exercises ? And third, how long will it take to level my hips ?

    Reply
    • Hey Emmanuel,

      1. You will need to do the exercises on both legs for best results.

      2. You can try to do these exercises every 2-3 days to begin with. From here – you can increase the frequency if necessary.

      3. It really depends!

      Mark

  203. Hello Mark,

    It was a fantastic thing for me to discover your website. Thanks for sharing your knowledge for free.

    I have been following the regime you have laid out diligently since 2 weeks. Please help me for 2 Qs
    1. I get pain in left butt and left side below rib cage, above pelvic bone. I have left hip drop. Is this part of LPT?
    2. I want to start a strength training. Can I continue your exercises and got to gym as well? I understand I shouldnt stretch weak muscle not strengthen tight muscles.

    I was a cyclist but due to bad technique of breaking using left foot while sitting on saddle elongated or rotated my left side leading to pain. mRI showed cartilage tilt.

    Reply
    • Hey Rahul,

      Thanks for the questions:

      1. Yes – one sided pain can be due to a lateral pelvic tilt.

      2. You can go to the gym, however, I would try to prioritise the exercises in the blog post.

      Mark

  204. Hi Mark, I have a lateral pelvic tilt and Ive decided to do something about it, so my question is how many times a week should I be doing these and in what order? And does going to the gym and doing squats, deadlifts etc. make it worse? While Im doing squats I tend to lean to my right side and it is probably because of this. To put it briefly how does doing corrective exercises correspond with doing heavy lifts at the gym?

    Reply
    • Hey Petar,

      If fixing your lateral pelvic tilt is your goal, try to maintain level pelvis whilst performing the squats/deadlifts etc at the gym.

      If you can’t control it very well, you will need to stick with the exercises mentioned in the blog post until you can.

      You want to work your way up to heavy weight as long as you can control your pelvis

      Mark

    • Hi mark ,i’ve been a lateral pelvic couple of years and very hard to fix.Try a lot of any exercise but still not going to work.Can you help me because i always feel unbalanced when walking.Thank you

  205. Hello Mark. I’ve been using my left hand and leg a lot more because my left shoulder is higher than my right one. Today I started experiencing sharp terrible pain in my left side of the back when I move. Is that normal?

    Reply
  206. Hi Mark,
    I have a lateral pelvic tilt, but how many months or weeks to corrects my pelvis. And how many times a week should I do this

    Reply
    • Hi mark,
      I have a lateral pelvic tilt but I have many questions. How many monthes does it take to fix your hips. And how many times am I supposed to do these excersises in a week?

  207. Dear Mark, I came across your page and would like to check if I can be doing these exercises. I went to a hip specialist he says I have arthritis of the left hip. I went to a chiro and she told me my pelvis is tilted or something and X-rays of my spine and other muscoskeletal system looks awful. Both of these professionals are expensive for follow up and so I have decided to do exercises on my own. I am now relying on a walking stick after I keep feeling like I’m going to fall when my hip joint snaps when I walk too much. (This came about when I tried stretching on my own without engaging the correct muscles :-(
    That picture of a man standing with one leg straight and the other bent – that’s me. I can’t stand straight – my right leg holds me up but my left leg just droops and the knee faces down and it’s hard to straighten it. Do you think I can get started on these exercises? Please advise.

    Reply
    • Hi Elise,

      It would be a good idea to focus on strengthening the hip first. If weight bearing is an issue, hydrotherapy (pool exercises) are great for arthritic hips.

      Then from here, you can move onto these exercises for your lateral pelvic tilt.

      Mark

  208. hey Mark, since my back issue – with a lateral pelvic tilt – have been having issues with my gait/feet. My hike is on the right and the main issues have been with my right foot – though my left is also impacted. Any idea what is happening and what I can do as I work to get straightened out, to keep walking okay? It’s pretty scary. Thx ahead of time, Mark.

    Pam

    Reply
    • Hey Pam,

      What kind of foot issues are you getting?

      I have a blog on flat feet that might help. Check it out here.

      You might need to focus on the foot as well as your Lateral pelvic tilt.

      Mark

    • Hi, no, I have fairly narrow, high-arched feet (my whole family does), and the problems began soon after the back issue – lot of metatarsal issues, general instability with the foot, and it appears that my feet are both collapsing in a bit now when I walk and stand – which never happened before.

    • Hi Pam,

      Sounds like you are losing control of your arch.

      The higher your arch starts, the more room is has to fall. The further it drops without control, the more likely a foot problem can occur.

      I would still suggest the “SHORT FOOT” exercises on that blog post.

      If you have a high arch, you would want to activate the short foot, stand on that foot, then twist your body away from that foot. Try to maintain the short foot activation through the movement.

      Mark

    • Okay, thx very much for that. One last question…am really looking to understand what’s happening – from the pelvis down – to be creating this situation? Which muscles might be weak, which ones pulling things out of whack, etc. It all began with my back injury. Last question from this desperate Canadian, I promise! (She said with fingers crossed behind her back) 😊

  209. Hey Mark!

    Been through 10 months of hell with my left SI joint. I had always felt off balance. I experienced 3 lumbar disc bulges in feb 2018. Did PT for SI joint dysfunction. Now in chiropractic where they said I had a lateral pelvic tilt. They said my left hip is higher than the right hip. My left hip is posterior tilt and right is anterior. Wouldn’t that make it a rotated pelvis? Also, I do have some pretty bad knee pain and I told them my feel are flat but, they said knee paid should resolve once the pelvis is restored. Can this be corrected or is something I will have to live with forever? I’m trying to find the best way to fix this mess.
    Thank you!

    Reply
    • Hey Ben,

      It seems you have described a:
      – Left lateral pelvic tilt (left hip hike)
      – Left pelvis rotation

      If your pelvis is driving all of your issues, fixing the pelvis will have a flow on effect on your SIJ and Knees. If not, you may need to address other areas as well.

      Mark

  210. Hi Mark,

    I am facing lower back pain for 5 months now and even multiple doctors and chiropractor visits did not help. I am on PT now and working one my Hip flexors and glutes for 1 month but not much progress. I have left slide hip hike and I feel left size pelvis is forward and the right side is backward. Do I have both lateral and rotated pelvis?
    As per PT my hip flexors / PSOAS on the left side is very tight and that is pulling my pelvis up.
    I am so confused and not able to understand what is wrong and where should I focus.
    Thanks for the great post.
    Gurvinder

    Reply
    • Hi Gurvinder,

      By your description – it sounds like a left lateral pelvic tilt + Right rotated pelvis.

      If you have the opportunity to see a PT in person, they should be able to provide you with a more accurate assessment.

      There are multiple factors that could be contributing to your lower back pain.

      Mark

    • Thanks Mark

      I am sharing one pic to be sure as my PT is only working on Hip flexors and also did the dry needling but I am not getting results. Thanks for your help and detailed article.

    • Hi Gurvinder,

      The hip flexors may only be on part of the puzzle.

      It would be a good idea to assess other muscles such as the QL, adductors and glute med.

      Other muscles you can look at are the obliques and TFL.

      Mark

  211. First of all, THANKS! It’s awesome to see someone that cares for others!
    I was in PT for 2 years with 2 different PT. I did improve but not to the point of understanding what my issue was or been able to exercise. So, I decided to continue my PT exercises by myself. I am doing better but I have some questions I hope you can answer to me:
    I think I have left side hip hike. Is it normal to constantly have left calf and left gluteus pain?
    If yes, what can I do? I get a lot of nuts in my left calf.
    Is it safe to bike with left side hip hike?

    Reply
    • Hi Ana,

      If you have a left hip hike, chances are the you tend to lean on that left leg more than your right (during standing, walking, exercise etc)

      This means more load to some of your muscles in the left leg which may explain your left glute and calf pain.

      Addressing your lateral pelvic tilt will help!

      In the mean time, you can focus on releasing your painful areas to help with the pain.

      Mark

    • Mark,
      I absolutely have right calf and gluteus pain not left. I’m sorry I wrote it incorrectly. What should I do and can I spin?
      Thanks again!

    • It is the Gastrocnemius and the gluteus. The Gastrocnemius gets very tight and I can feel the nuts…very painful.

  212. Hey Mark, great post. I have my left hip higher than the right one, and evidently viceversa. What’s to do? Lower the left hip? Make the right hip higher? As a consequence, my right shoulder is also lower and feels weird compared to the left shoulder. What can I do to fix?

    Reply
  213. Hi mark . I have right hip hike and I feel that my right obliques are weak and right glutius medius too. I m training my glutes so can I do side plank for obliques? When I walk I m leaning to right side .thanks

    Reply
    • Hi Hardeep,

      Try out the mentioned exercises on this blog post to help get your pelvis more neutral.

      Restoring your pelvis may help with your weak obliques and glute medius.

      Mark

    • Thanks mark! I m doing all your exercises you mentioned above . Just wanna make sure is my back muscles on high hip side weaker than the other stretched side?

  214. Hi again, Mark, just found this page, and was wondering if I should do these exercises as well…I have a tilted and rotated pelvis. I was asking you questions on your rotation page, but I have both, so wondering how to best approach this – exercise-wise? Do I do work on correcting one before the other? I.e., do the rotation exercises for a while, then do the tilt ones, or the opposite?

    Thx!

    Pam

    Reply
    • Hi Pam,

      You can start with either.

      Pick one and see how far the exercises get you. Once you feel you have gone as far as you can with the exercises over a set amount of time, you can then introduce the other exercises.

      Try not to overwhelm yourself :)

      Mark

  215. Hi Mark, your article is excellent . I am an orthopedic doctor , I have operated a young female with DDH ( total hip replacement done ) pre-operatively she had lateral pelvic tilt toward the diseased hip to compensate for the shortening , this has lead to apparent lengthening of the same limb post surgery specially after inaccurate physiotherapy which had lead to increased tilting ( as the pelvis is tilted more toward the operated side with hip in normal position now ). Do you think it is possible to correct pelvic tilti in such cases. Regards

    Reply
    • Hey Ali,

      If the tilt is purely due an imbalance of muscular pull around the pelvis and not due to structure restriction, then the lateral pelvic tilt should respond well to the exercises.

      Mark

  216. Hi Mark, I developed lateral pelvic tilt from inactivity due to being in a cast for 2.5 months for right ankle surgery. My left abductors have become weak especially since walking again and it has caused weak glutes, soreness in my back and left shoulder, and weak core. Would this program be a good place to start correcting my mechanics and doing my ankle physical therapy at the Same time?

    Reply
    • Hi Tim,

      Your ankle rehab should take priority as this is likely driving your lateral pelvic tilt.

      If you wanted to do hip exercises as well, then it is fine to do the mentioned exercises as well.

      Mark

  217. Hey man … I love this page thanks for the tips… I have an issue with squatting and groin strains on left side… I do feel like I have a lateral pelvic tilt as when I squat I lean n put more pressure on my right… I can externally rotate my right hip but not much internal and my left cannot externally rotate at all and if I try it I hear this cracking sound….idk if it’s hip impingment or lateral pelvic tilt or what but man this is very annoying especially the groin strains as I can’t put the weight up anymore past 435 lbs

    Reply
    • Hey Zain,

      When there is a opposite difference in External/Internal rotation when comparing the hips, I tend to suspect a PELVIS ROTATION.

      Check out this post : How to fix a Rotated pelvis.

      In regards to the cracking sound, this could be related to your hip joint itself. Have you had any scans to check out the structural integrity of the hip joint? If it is all clear, then it is likely a matter of a balancing out the hips to help centrate that hip joint so that nothing is grinding.

      If you have a left groin pain and you feel you weight bear more on your right side during a squat, you may be letting your pelvis deviate to the right side. This in turn will place more eccentric load on your left groin.

      You can do some groin rehab on this area, but at the end of the day, I would focus on centering the pelvis over the legs. This can be achieved with the same exercises here but with emphasis on shifting to a stacked position.

      Mark

  218. Hi mark,

    After a twisting injury I have had difficulty breathing left side, and had discomfort when replicating the motion that initially caused slight pain. This was 8 years ago. Now I have an onset of scary symptoms. I compensate to breathe and can’t take deep breaths, I have back and front abdominal pain, air in abdomen, neck pain, head inflammation, abdomen know does not look symmetrical, and I developed recently digestive issues. Doctors can not find anything. I found I have this. Could this potentially have kicked off this onset? I noticed I feel better when I’m certain positions especially lateral pelvic tilting to my left. Also muscles don’t feel right on my left side. Could this cause such a crazy amount of chaos to a healthy body?

    Reply
    • Hi Tico,

      It sounds like you’ve done something to the ribs. They can often lead to issues related to the gut, breathing, abdominal bloat, sweating, etc.

      I would recommend you see a therapist who is trained in the Thoracic Ring approach.

      Mark

  219. Hi Mark,

    Thank you for your posts about addressing the lateral pelvic tilt and a pelvic rotation. I now realize that I have a left-side pelvic rotation, and a right-side hip-hitch or lateral pelvic rotation. These exercises and releases have been very helpful, and I’ve noticed improvement in the month that I have been focusing on them regularly. Just had 2 more follow-up questions:

    1. How do I address weak obliques in a careful way? My right side obliques with the hip hike are very weak and I tend to collapse on that side very easily and have balance issues. Everywhere recommends side-planks but that hasn’t been too helpful for me, the lift doesn’t seem to be coming out of my obliques and I feel a little more twisted after doing them.

    2. Do you have any recommendations for upper back/shoulder exercises? I’ve noticed that my shoulders (deltoids?) and trapezius are bent forward giving me a kind of hunch and I want to bring those back.

    Thank you very much, appreciate your work.

    Reply
  220. Hi Mark!
    Initially I thought I had a pelvic rotation but I think it might be a lateral pelvic tilt at this point (per my comment on your other post, sorry)… My right glute and medius are much stronger than the left, while my left quad and hamstrings are stronger than the right. My right hip flexor is very tight and much less flexible than my left. When I am walking I feel like my left hip is catching. I also tried the standing test and when I stand on my right leg I feel like my body weight tries to shift as my foot starts to cave inwards. When I am supine my right hip bone sticks up quite a bit further than my left. Would these be signs of a lateral pelvic tilt and if so, to what side? I really want to figure it out so I can get it solved :(

    Reply
  221. Hi I am a taxi driver who sits for long periods of the day, my physio said he thinks I have adductor tendonathopy, and slight pelvic imbalance. problem is after I have excercised my area in question becomes sore. If this is degenerative can this be corrected in some way or am I doomed forever? How long would Need to take off work to decrease the inflammation from the repetative action of pressing on the accelator/brake and start my rehab programme from the beginning again

    Reply
    • Hey Ben,

      If your adductor is the issue, I would focus on getting that tendon as strong as possible.

      From here – then you can look at getting the pelvis balanced out.

      In terms of how long you will need to take off, that really depends on how much of your sitting is aggravating your symptoms. It might just be a matter of taking more breaks frequently, changing seat height, doing exercises within the car etc.

      Mark

  222. Hello Mark, many thank for your work . I must go through all this comments and also many more times through your page. So all this exercises here are for higher right side. I think this is my problem… right side. I have sitting job and my sport is cycling (aprox 5.000km per season). I think I lean on left sideod the bike and I don’t seat good on my left but .
    Question. I am affraid of massage my right QL because of muscle spasm and lower back muscles lock. This lock is sooooo painful. Can I try anyway ?
    Sorry for my english. Bojan from Slovenia (EU)

    Reply
    • Hi Bojan,

      You can start with just very gentle releases with a foam roller. As you become used to it, you can progress to a harder massage ball.

      Mark

    • Mark, thanks. I will try. What about sitting on the chair in office? Is there a solution to put something under left sitting bone to bring left pelvis higher. BR, Bojan

  223. Hi Mark!

    Thank you for sharing your exercises for free, it helps me tremendously to understand what’s wrong with my body and how to fix it!
    I have a rotated pelvis to the right with a lateral pelvic tilt and a slight scoliosis to the left so I have a lot to work on. I’m wondering how often should I do these pelvic exercises and stretches to see results quick?
    ( I have been dealing with this issue over a year and been doing a lot of exercises (sadly for a long time I was misdiagnosed, and therefore was doing the wrong ones) I did them most days of the week- and I figured I was probably constantly sore as I left no time for muscles to repair and rest.
    How many times a week is ideal? Should I also continue swimming?
    Thank you for your advise in advance!

    Agnes

    Reply
  224. Hey Mark,
    I have a question regarding diagnosing the correct “problem” leg
    In the picture of the skeleton underneath the heading “Why is it a bad thing?”
    that exact same thing is occurring with my right leg when I stand.

    For some reason no matter how hard I think I am evening both sides my left leg becomes locked out but my right knee curves inwards. which leaves me leaning towards the right and not putting enough pressure on my left leg.

    Which leg would I have to stretch in the exercises? My left or right leg?

    -Thank you

    Reply
  225. Hello Mark,
    I’m so glad I found this article after 6 years of searching for hope and relief from my back pain. In 2012, I fell off a skateboard and landed really hard on my tailbone area that I even felt my legs go numb for a day, but ever since then my lower back kills me if I sit in class or stand for a while. In 2014, I was diagnosed with scoliosis at age 14, and I believe it was from my fall causing my pelvis to have issues. Do you think this can be possible? I know from my 2011 check up that my spine was straight, but after that fall my entire posture is gradually getting worse. My tailbone/sacrum still hurts so bad even when I touch the area, but all the doctors blame my scoliosis for making it hurt saying “your pain is because of scoliosis of course” rather than considering my injury when I explain it’s a different type of pain. Thank you so much for these exercises to help my hip unevenness. I really appreciate it :)

    Reply
    • Hello Zara,

      It is possible that your scoliosis is as a result of your fall… especially when pain changes the way you walk/stand/sit habitually.

      Did the doctors order an scans to the tail bone and lower back region?

      Mark

      PS. Scoliosis blog post coming out soon. Make sure to follow me on Facebook :)

    • Hello Mark,
      It’s so nice to hear that someone agrees with me by saying it can be a possibility. Unfortunately, I didn’t get any imaging after my fall until 2014 when I got X-rays, and then 2016 for my spine MRIs just to see more detail. Some radiologists didn’t mention much about my sacrum and just saying it’s not broken, but when I mentioned to the orthopedic doctors that my sacrum feels like it’s bulging out and before the fall it wasn’t, all they said was “well you have scoliosis so…” I feel like my situation is complicated and that’s why I googled how to fix my pelvis myself because I just know this pain is different on top of the scoliosis pains. Is this a good start for me? I don’t have Facebook, but I will always come to your blog to check for updates. :) Thank you so much for replying me!

  226. Hey mark! I have lateral pelvic tilt but The only thing that is confusing to me is that I have hip hike on my right side and that’s where my shoulder is lower than the otherside. Everything you have explained is point. Plz help me out

    Reply
    • Hi Safia,

      If you have a right hip hike, the right shoulder will tend to drop to compensate for the pelvis position.

      Addressing your lateral pelvic tilt may help out with the shoulder position as well!

      Mark

  227. Really informative article, but I’m not sure if this works for me as well because the muscular imbalances you mentioned don’t match mine exactly.

    My right hip hikes up, but my left lower back is stronger than my right. My left glute works property, but my right glute doesn’t fire. My hip bone also has a slight twist clockwise and the rest of my upper body twists in the opposite direction.

    Do I have a completely different problem?

    Reply
  228. Hey Mark! Thanks for the post. I’ve got a question regarding the Hip Hitch. Am I correct in understanding that if the hip hike is right-sided, it is the left buttock that one should lift?

    Reply
  229. Hey Mark, I have high hip on right side, which has resulted in sciatica pain on left side. Although I am peacticing these exercices from 1 month, my sciatica pain hasnt decreased. How much time will it require to fully adjust my high hip?
    Thank u

    Reply
    • Hi Akshay,

      Initially – Try to prioritize your sciatic pain on the left side as opposed to addressing your pelvic tilt.

      Have you tried stretching TOWARDS the right side? This will help open up the hole as to which the nerve passes through.

      See more stretches here:
      Quadratus lumborum stretches

      Mark

    • Mark hi I just started your exercises. I have had a hip hike right for years and am 2 years post a lumber fusion L5S1 Issue is my right oblique and ql attachments cause pain Also lying down Alfred being on feet all day make my QLs scream And hard to even get up Forget bending over Coughing or sneezing kill By the morning things calm down I just think I’ve had this dysfunction for 30 years Question how many times a week do all these movements ? Everyday ? Thanks for your thoughts

  230. Hello Mark,

    I am 20 years old man suffering from twisted pelvis. I am planning to go for a checkup with PT next month. My question is , will lateral pelvic tilt causes my body to get a permanent scoliosis? I’m quite stressed because I cant play sports like I used to play since 17 years old. I have noticed that my left rib cage is a little bit in front of the other one (left hip hike). Please kindly answer me Mark. Im hoping to hear something from you .

    Thank you

    Reply
    • Hi Hafiz,

      A lateral pelvic tilt may result in side bends of your spine (as compensation). If you don’t have scoliosis now, any new presentation will not likely be permanent.

      The rib cage will tend to follow what the spine is doing. The spine moves in relation to what the pelvis is doing. Getting that neutral pelvis would be the priority.

      Mark

  231. You say the “fix it section” is for a right pelvic hike. Reading the directions I noticed some of the pictures do not portray what the description says. For example flute mead rolling for fixing right hip hike says to roll out the left side of the body but the picture shows rolling out the right side. Do I follow the pictures or the descriptions. I would hate to perform the wrong stretch as I have a right pelvic hike.

    Reply
    • Hi Carl,

      Follow the Text in regards to the appropriate side.

      I had to recycle some old pictures from other posts and haven’t had time to take new ones.

      Sorry for the confusion.

      Mark

  232. Hi Mark,
    Thanks so much for such a useful post. I have been having lateral pelvic tilt (Right Hike) for so many years. I am going to follow your instructions starting from today. I have a few questions though.
    1. How long would it usually take to fix this condition?
    2. I have been having pain on my right knee for many years. When I do any of the below actions I feel pain
    a. When I try to do squads.
    b. When I climb up or down the stairs.
    c. When I try to stand on my right leg alone.
    As a result of this pain, subconsciously, I have been predominately using my left leg for all my activities to a point where my right leg has become thinner compared to the left. I have consulted a host of Physiotherapist so far, but no luck. Could this pain be because of my pelvic tilt?
    I am 30 years old and fairly muscular. I have been working out at the gym on and off for the last 10 years now.

    Reply
  233. HI Mark, your postural stretching guides have been immensely useful for my pelvic tilt and rounded shoulders. I have a strange situation where my left side around the chest and shoulder becomes extremely tight after a couple of weeks and this results in numbness of the pinky and ring fingers from the ulnar nerve. I have been getting active release massages to loosen up the muscles currently and this immediately brings relief and stops the numbness in my fingers. I am wondering why the tightness would be much more prevalent on a single side of the body? I would assume rounded shoulders would cause the same level of tightness in each side of the chest and shoulders. In your experience, have you heard of the combination of pelvic tilt and rounded shoulders causing muscle tightness on a single side of the body? More specifically, the tightness occurs on the left side, I have a hip hike on the right side.

    Reply
  234. Hi mark
    I’m Rohan I’m 16 years old but I’m suffering from many postural issues at the same time in this age, I did researches and found that I’m suffering from
    1. Nerd neck
    2. Rounded shoulders
    3. Rounded back
    4. Anterior pelvic tilt
    5. Lateral pelvic tilt
    6. Twisted pelvis
    7. Uneven shoulders
    And I think that there is some serious issue with my pelvis because when I observe lower body and my legs my knee caps were not in parallel position and my left leg appeared bigger than my right
    I’m really confused now what to do and where should I start from
    I need an immediate guidance asap please mark help me out here

    Reply
  235. Dear Mr Mark
    I have a herniated disc in the lumbar spine L4–L5 and I have a Scoliosis in the lumbar column fortunately the angle of it its too small around 6 i think i did an X-ray
    these days i feel that my left shoulder is higher than the right one and there is a pain in it(lift side) sometimes not all the time and there is a pain in the lift waist
    i think its muscles problem
    how could i avoid this pain and feel okay
    what about swimming is it help?
    if yes are there any exercise in the pool should i do
    what about swedish exercises?

    sincerely yours;

    Reply
    • Hi Mohamad,

      Swimming is fine as it is very gentle.

      If your issues are due to your lateral pelvic tilt, then performing the exercises on the blog post will help you out.

      I am not sure what swedish exercises are?

      Mark

  236. Hi Mark,

    I’m a little confused. You say the “The side of the longer leg will generally have the higher hip”. Personally, it would make more sense for the hip with the shorter leg to be higher. I was diagnosed with iliopsoas tendinitis, and I’m pretty positive it was a tear, anyways… I’m positive my right leg is longer. I constantly feel twisted, I have an anterior pelvic tilt, and a sway back. I’m constantly leaning forward. I’m just wondering, because I love your posts so much, if you can elaborate somewhat on why the side with the higher hip has the longer leg. Also, I’m curious, if it’s opposite in some cases, such as where your longer leg is the lower hip.

    Reply
    • Hey Nick,

      You can have the hip hike on the long or shorter side. It really depends how you are standing.

      If you tend to lean more towards the shorter leg, then the hike will be on that shorter side.

      Whereas – if you are standing equally, the structurally longer leg will have the hip hike.

      Hope this clears it up. If not , let me know.

      Mark

  237. Thank you so much for this site! It’s been super helpful while I wait for a PT in my area.

    I wanted to ask you – I have pain/inflammation on the side of the hip hike (right) and the strengthening exercises seem to trigger an increase in pain. Should I not be doing these exercises?

    Thanks very much again,
    Kate

    Reply
    • Hi Kate,

      You will need to address the inflammation first. When there is an excessive amount of inflammation, the area will easily be irritated even if you do the right exercise.

      Consider:
      – reduces exposure to aggravating factors
      – take anti-inflammatory medication
      – gentle and pain free hip movements
      – and worse case scenario which I tell most patients to avoid… cortisone injection.

      Mark

    • Thanks Mark! I’ve been resting and only doing the stretching and rolling part of this list for now. Have an osteopath appt next week and then will probably find a or that will take me sooner.

  238. Great article, looking forward to starting some of these exercises. See the x-ray if you can!

    Long story short, active 36 yo, severe hip arthritis, short leg due to tilt opposite of the hip hike, hip replacement scheduled for January. Dr said the tilt could be my body compensating to the arthritis, etc. Only time my lower back doesn’t hurt is when I’m continuously active, not allowing my body to be sedentary…. too much activity hurts my hip joint… it’s a viscous cycle!

    I’m in St. Louis, MO. Any chance you’re local? If I’m going to be seeing a therapist, it would be nice to see someone as familiar as you!

    Reply
    • Hey Brad,

      Have you heard of Hip CARs? (a quick search on youtube will show you how it’s done) Give them a go. They are great for hip issues such as arthritis. (keep it pain free and comfortable throughout full movement)

      Unfortunately – I am not a resident of St.Louis :(

      Mark

  239. Hey Mark ,

    every time I squat or deadlift I feel a lot of soreness in my left quadratus lomborum. and when I stand in the mirror I can see that the bar is not straight on my back(more so at a slight diagonal). ive been strengthening my adductors and my left glute(hip hike on left side) but to no avail nothing gets better. any suggestions?

    Reply
    • Hi Chrystan,

      If you have done all that you can do for the lateral pelvic tilt, I would look for another cause of your symptoms.

      Have you checked if your pelvis is rotated or is rotating as you perform the squat/deadlift?

      Check out this post: Rotated pelvis.

      Another thing to consider is checking if your torso is in a neutral position. If your bar is tilting, it is likely that the torso is tilting the same way. ( I am working on a blog post about this problem. SHould be out soon!)

      Mark

  240. Hi Mark
    Where are you located? I am not confident in self-assessing my issue exactly as it has changed quite a lot over the last 10 years.

    Reply
  241. Hi Mark,

    I have a condition in which my Right leg appear shorter than my left leg when I lay normally on my back with my feet stretched out by around an inch(2.5cm) however, I think it is due to my right femur bone protruding out near pelvis joint . More over I cannot put my right heel on the ground involuntarily.I have to force the right heel to do so. This has also caused to create a hip hike in my right hip as I generally walk on my right toe .I have very less control over my right toe as compared to the left.

    I have this condition since birth not due to an accident.

    Please let me know if this can be fixed by physiotherapy and what steps mentioned above should I follow.

    Awaiting you reply as soon as possible. Let me know if any other details are required.
    Age 26
    Male
    Medium build

    Reply
    • Hi Medium build Tushar,

      These exercises for lateral pelvic tilt should help you out.

      If in doubt – you can also get your legs measured to check for any leg length discrepancies.

      Mark

  242. Hi Mark,

    I Forgot to ask a question in my last comment. For the step up/ step down exercises, if I have a left leg hip hike, do I lower my leg with the left leg or the right leg?

    Reply
  243. Hi Mark,

    Thanks for the helpful article! I just have a question. Since I have a left hip hike, I was a little confused by the exercises under strengthening. It seems we are working both sides. Shouldn’t I only be strngthening the side that has the hip drop and stretching and releasing the left hip which has the hip hike?

    Thank you

    Reply
    • Hi Isamar,

      It is best to do both sides as indicated in the blog post.

      Best way to explain this is that your body works in pairs. Eg. the left hip glute med will work with the right adductor muscle to bring a left hip hike to a more neutral position.

      Mark

    • By this you mean releasing the left glute med and strengthening the right adductor or the other way around? Thanks again!

  244. Hey Mark
    Thanks for all this great info it’s such a rare find u explain things so well.
    I’m alittle confused about what side I have the hip hike to be honest and I just can’t figure it out.
    When I stand my right hip appears alittle higher but when lying it’s my left hip that’s higher. My left leg is alittle shorter and I lean on this side more when standing I also have more pain in my right glute Ned and glutes in general as my right leg seems to be more dominant when moving. Oh I also have a left rotated pelvis which I’ve beeen working on but even walking puts me in pain currently.
    Looking forward to your feedback

    Romana

    Reply
    • Hi Romana,

      If your issues are due to your standing, I would suggest looking at your pelvis when it is in a standing position.

      Keep in mind – you could have a right pelvic tilt in static standing and a left pelvic tilt when walking.

      Mark

  245. Hi Mark
    I have been seeing various health professionals due to a sore lower back and left side glute-med pain especially after sitting/cycling and while running. I also have quite a significant scoliosis. The latest diagnosis was a small hemi-pelvis and I have used an small lift under my left buttock while sitting and a lift in in left shoe with immediate pain relief. However I understand that this is a very uncommon diagnoses and wondering if it is just a lateral pelvic tilt.What would be a good way to find out?

    Reply
  246. Hi Mark, i have a left lateral tilt, how many times a day should i do these stretches. And how long does it usually take to see results.

    Reply
  247. Hi Mark I have a right sided hip hike and whenever I get into position to do the TFL stretch that you have demonstrated my right hip shifts too far forward and twists my body making me unable to perform the stretch?

    Reply
  248. Hi can i please send you some of my pictures? I dont really know if have lateral pelvic tilt but my whole right side of my body hurt when i do some physical activity. I just want to ask if you can do some posture assesment from these pictures that i will send you.

    Reply
  249. THANK YOU!! My physio has never let me train one muscle and not the other, you have broken this down and explained it perfectly. My left hip hike comes on after any time sitting for longer than a couple of hours, which scares me for when i get a job where im sitting 40 hours a week. I think it might be my left adductor primarily but i know it is a combination of weak glutes/hips and my flat feet,. Orthotics have stopped walking from creating the hike but sitting still does it every time even with the right sitting posture, any tips?

    Reply
    • Hi Blake,

      Try to sit on your “sit bones”

      Keep your weight even distributed between these 2 points.

      If you tend to hip hike whilst sitting for long periods, I would see what is happening with your torso. (eg. are you leaning to one side? one leg crossed over the other?).

      Focusing on the QL muscle might be helpful in this case. (engaging vs relaxing, L vs R)

      Mark

      Mark

  250. Hi Mark
    I’m so glad I found this.
    I have had pain in my left hip on and off for a few years and now constant pain and a limp for the last 3 months. I had an x-Ray and was diagnosed with osteoarthritis. Then I noticed that my left leg appeared to be about 2 inches longer than the right and I know it wasn’t always like that. This bad posture must have been putting a lot of extra pressure on that hip. Now I have found your page and these exercises, I am hopeful I can correct it and limit any more damage and ease my pain rather than the inevitable deterioration I thought I was facing. I’ve arranged to see a physiotherapist in a few days so that should also help. I love to hike up to 8 miles in a day and I didn’t want to give that up. I was also looking at walking sticks but hopefully I won’t need one if I correct my posture and take the strain off that hip. Thanks so much for the insight into what’s going on.

    Reply
  251. Hey Mark!

    My right side hip is elevated. I went to see a PT and sure enough he said both my glute meds were weak but the right side some more. He prescribed me some band walks to strengthen them and I have been doing those. However I still am noticing the hip hike and going through your article here I was wondering if it could be my QL. I find it more natural to turn to the left. Does that mean my right side QL is considered tight? Also, should I bother adding corrective exercises for my left side to strengthen it? I already work out quite a bit and always feel it in my left for osme reason. Thanks!

    Reply
    • Hi Ben,

      Your QL is likely involved in your lateral pelvic tilt and will need to be addressed in conjunction with your glute meds.

      If you find it easier to turning your pelvis to one side more than the other, you may have a degree of pelvic rotation. Check out this post for more on that.

      If your left glute med is weak, strengthening will never go a stray. With a background of a Right hip hike however, make sure that you are not over doing it relative to the right side.

      Mark

  252. Thankyou so much for a great article. Best article on hip rotation I have ever read. Tonight was the first time I have walked and felt equally balanced for 20 yrs! I am looking forward to sorting this for good. Grateful does not nearly describe how I feel.

    Reply
  253. Hi,

    Like the other articles you have published, this is a great one.

    I have a left rotated and hiked pelvis. A quick question to make sure I implement the stretches correctly. Under the side lunge stretch to fix right hiked hip (in example above) the stretch seems to stretch the left adductors (yellow line); shouldn’t it be the other way around (i.e. stretch the right adductors)? Am I missing something?

    Thanks a lot

    Reply
    • Hi Audrey,

      You are spot on. The photo is wrong and haven’t had time to correct it yet. Follow the text and use the photos as a general guide to how to do the movement.

      Mark

  254. I look forward to trying these exercises I have been in extreme pain for over 9 months and have been unable to do many things that I enjoy such as walking, playing pickleball and enjoying a walk in the park with my dog. It is been excruciating pain and very debilitating as it has now developed into hip arthritis into my right side. I pray that this will be a solution and correction as I work hard to fix and correct the problem thank you so much for this wonderful website

    Reply
  255. Hi there my name is India I have one concern but when I read about pelvic tilt I don’t know where do my case falls under, okay so my right hip sits higher and my left side sits lower but it’s weird because my right leg appears and feels longer than my left side which sits lower, I don’t know what that would fall under knowing how usually everything I read is higher hip equals shorter leg and lower hip higher mines is opposite my higher hip has longer leg and my lower hip has shorter leg… I need some help before I decide to get any professional help since I am not sure of what my condition really is….

    Reply
    • Hi India,

      You can have a shorter or longer leg that is coupled with a high hip. Keep in mind apparent leg lengths can change in a standing vs lying position.

      Either way – you can do the same exercises for the pelvis to address the lateral pelvic tilt.

      Mark

  256. I have a left hip & knee joint repacments, so that leg is 4cm shorter but I have noticed over the last 6 months or so, it seems to be getting shorter, not so I have been to I have a lateral hip tilt, which is now making my left leg even shorter.
    I don’t have full movement in that hip, & is getting weaker, I’m 64 but I don’t want it getting to the point where I can’t walk, do you think any or all the exercises you have shown out here will help me, slow & steady. Many thanks Linda

    Reply
    • Hey Linda,

      The first thing I would consider is making sure you reclaim as much strength and mobility back in the hip and knees before correcting your tilt.

      The pelvis will sacrifice its position if your hips/knees aren’t moving as they were designed to.

      With consistent effort and time, you can improve the capacity of your joints. In terms of what to do – Are you able to see a physio for a full assessment?

      Mark

  257. Hey Mark

    Is it possible to have the shorter leg on the same side as the hip hike?
    I’m pretty sure I have a left hip hike but from reading above you say it’s more common to have the hike on the longer leg?
    Cheers

    Reply
  258. Hi Mark,
    I saw a chiropractor several years ago who suggested I use a heel lift in my dropped shoe. It has helped a ton while working long hours on my feet, but I am wondering if it will hinder my correction using the exercises? Also, is it possible to run before it is corrected? Should I use the lift for that?

    Thanks!
    Jessica

    Reply
    • Hi Jessica,

      Your body will get used to whatever positions/stress you place on it throughout the day.

      If you are using the heel lift for 8 hours a day, but only doing exercises for 1-2 a week for 10 minutes or so, the lift may hinder your progress.

      If your running is more important than correcting your tilt, you can keep running with the lift for now.

      As you improve with the exercises, you will eventually want to get to the stage where you feel uncomfortable in the heel lift. This a good sign you are getting better at controlling your pelvis!

      Mark

  259. I am currently being treated for this condition with elevation on the right side. The PT I’m seeing is great but has been massaging only the right side glute medius. When I followed your directions and rolled on the massage ball on the left side there was a significant difference in the way I felt balance in my standing posture. The left side was also fairly sore initially. Thanks so much for your complete and thorough instructions included here.

    Reply
  260. Hi Mark,
    Thank you for these exercises. I hope you can answer my question.

    I do have a right hip hike and left hip drop. I just started doing your exercises , some I cannot do very well so I only do it if I have good form until I am more stabilized. Too much muscular dysfunction going on.

    I am also doing single leg exercises(glute squeezes/one leg stands w/glute squeezes).

    My right glute is smaller more defined, the left is larger and not as defined. One PT mentioned the smaller glute would be the problem. When I do my one legged glute squeezes I start getting tightness in the hip area mostly from my left(hip drop). Should I focus doing more strengthening on whichever is the weaker glute? The problem that I have is I am only guessing which is the “weaker” glute, my right hip hike, dominant side or my seemingly weaker left side.

    I also have shoulder issues. My thinking is my right side maybe my dysfunctional side after all, b/c not only the hip hike but shoulder(lower) issues. I was always focusing on my shoulder/scap issues, but now am thinking it’s more of a hip issue/weaknesses and that is what is causing my shoulder stuff.

    Anyways, I would greatly appreciate it if you could tell me which would be the weaker glute, the hip hike or the hip drop and which or both should be stretched or strengthened more or equally?

    Thank you for your time, Lil

    Reply
    • Hi Lil,

      The tricky part is that the glute muscle is a tri-planar muscle. This basically means it is involved with many different movements.

      When referring to a “weak glute”, the question would be which movement of the glute complex is weak? (hip abduction vs hip extension vs hip external/internal rotation etc)

      In a right hip hike, the right glute MEDIUS is generally the weaker/longer side. (hip abduction)

      However – if you have pelvic rotation as well, it will affect the strength of the glute complex as well.

      With a single bridge (hip extension)- if you feel that the left side is weaker, I would check to see if your pelvis is rotated to the right and then do the recommend exercises for that.

      Mark

    • Thank you Mark for taking the time to answer/help me and others. I have another question if I may, I am not sure if I have APT besides lateral pelvic tilt, if that is even possible. I have all the outlined symptoms of both lateral and anterior pelvic tilt. I also have a deep inner curve in my lumbar area but my butt doesn’t stick out nor does it look flat like in swayback. It is more noticeable when standing sideways into the mirror. Is that lordosis or hyperlordosis poss caused by weak glutes/abs etc?

      Would it benefit me just to do your lateral pelvic exercises or should I maybe do your APT exercises instead? Sorry, my head is just spinning, just not sure which group of exercises I should do.

      Thank you again.

  261. Hi Mark just wanted to ask one thing. Considering i have a left hip hike i should do the opposite sides of what you have demonstrated shouldn’t i?

    Reply
  262. I had my left hip replaced. Heterotopic bone grew in around the implant, which I had a second operation for, but they could not take out all of it. It has pushed up my hip causing a lateral pelvic tilt in addition to causing retrolisthesis in my spine. My lower back is very stiff which affects my walking and bending. Is there a way to correct this, since its caused by bone and not a “muscle retraining” issue? Most exercises I see involve heavy manipulation of my leg, which I can’t do due to the physical bone in there. I have been told, additional surgery to remove the bone may not help and just be risky.

    Reply
    • Hey Bill,

      When there are structural issues with the joints, there may be some limitations on how far you can influence the pelvis/hip position.

      That being said, there is always something that can significantly improved with exercises.

      The first thing I would focus on is getting as much movement (plus control) of that hip.

      Mark

  263. Hey Mark,

    Thank you for your posts. Ive been dealing with left sided SI joint pain for a while now. Ive been going to a PT for the past 2 months who diagnosed me with an upslipped pelvis with posterior tilt rotation (on my left side). It makes sense to me but not much of what she is having me do is improving my condition substantially. She generally resets it when I come in (tractions my left leg out, isometric psaos into her hand, then squeeze my knees together and hear a pop). After that I generally do psaos leg lifts, glute and core work. The psaos stuff usually feels good but the glute and core work do not and sometimes can cause pain. She never really has me do any stretching altho I have tried stretching that side QL but it can make it feel worse. Im getting very frustrated because the pain is still constant and doesn’t seem to be improving that much

    What stretches and exercises would you have some with my condition do?

    Reply
  264. hey Mark, i have had this for a while now, and it’s a hike in my right hip specifically, which i think caused my right leg to look different to my left, eg. curved lower leg (more than left). amd i’d just like to know if there is any hope for them to look the same one day?

    Reply
  265. Hi Mark,

    I know this is an old posting but I’m about at my wits end here. My left leg muscles seem to engage so much more than my right leg. My calf and hamstring are so much more developed than my right leg. The left leg is always tight and achy. I’m pretty active but always seem to engage the left leg muscles so much more than my right. I do feel like that left hip is higher. What can I do to alleviate the tightness and to engage my right leg just like my left?

    Reply
    • Hi Sarah,

      I would consider focusing more on single leg exercises.

      Sounds like you are placing more pressure through your left leg as compared to the right.

      Mark

    • I have the exact problem but opposite leg, my right leg. it feels when I hike or cycle that the right leg is doing all the work and the left leg is just hitching a ride. What have you found to help? I stretch the left side like crazy, and recently saw an acupuncturist whom is helping to loosen right glute external rotators and TFL and Quadratus lumborum right side. I have been labeled as having pelvic malalignment syndrome and so I think my pelvis is rotated towards faceing left and right leg is slightly shorter

  266. Hi sir,

    My left hip, when I touch my left hip bone it seems to have come out and I feel the difference between the right and the left and I have pain in my right knee and ankle and they also make popping sound while walking for some time, My left pelvic is tilted up in X-Ray, I don’t know what has happened and it has been there for more than 5 years, doctor said it is because my right leg is short by 1cm but leg has become short due to pelvic tilt, but why my left hip has come out? I don’t understand,can this be fixed? Please some one help..

    Reply
  267. Hi sir,

    My left hip, when I touch my left hip bone it seems to have come out and I feel the difference between the right and the left and I have pain in my right knee and ankle and they also make popping sound while walking for some time, My left pelvic is tilted up in X-Ray, I don’t know what has happened and it has been there for more than 5 years, doctor said it is because my left leg is short by 1cm but leg has become short due to pelvic tilt, but why my left hip has come out? I don’t understand,can this be fixed? Please some one help..

    Reply
  268. Hi Mark, I have pelvic tilt (left side hitched) and suffer significant pain in my hip just above the illiac crest and at the ASIS.
    I have beem seeing an osteopath who feels that his work isnt having any positive effect and has effectively indicated I will nees to just manage the pain.
    I am training for a marathon and the only time it doesnt hurt is when I am running or walking. Soon after stopping I get the pain.
    I have been rolling the surrounding area (glutes, legs, lumbar) but this causes increase in pain through my hip. Stretching also causes a significant increae in pain.
    Am not sure whether i should continue to roll/stretch and use NSADs to manage the pain in the hope that the continued stretching helps improve things?
    Any advice?

    Reply
    • Hi Becky,

      Sounds like there is some inflammation/tendon issue going on there. When the area is warm and moving, it will feel better. But when you are stationary and cool down, the pain usually will increase.

      Can you draw on a diagram where you are experiencing the pain.

      And also – did the osteo look at your running technique or single leg balance?

      Mark

    • Hi Mark, apologies for the late reply.
      I can’t work out how to attach the diagram with an indication of where the pain is… The pain has reduced in intensity somewhat since following your guidance above on stretching/rolling.
      My osteo hasnt got me doing any exercises for this – rather advised me to get orthotics as my arches are collapsing – both feet (which I have done).

      Many thanks, becky

  269. Hello Mark. Thank you very much for all of this detailed information for lateral pelvic tilt. I have been doing most of these every other day for a little over two weeks now but pain has developed in the right hip area (my right hip is where the hike is located) particularly in the QL and glute medius. It seems to get worse after I do the stretches & exercise. I do want to mention that I have injured this area several times during squats and deadlifts at the gym. Should I wait for several weeks for the area to heal?

    Thanks again for all the time you spend writing up these guides and responding to every question and comment!

    Reply
    • Hi Cody,

      Looks like you are engaging those muscles. You want to feel your right glute med fire off for addressing a right hip hike. Be careful not compensate with the Right QL though!

      Perhaps let the pain subside for now, and go more gentle with the exercises. You may just have to let the body get used to the exercises.

      Mark

    • Thanks for the fast reply! I iced it several times yesterday and took an NSAID and it feels better today. I will try the gentler exercises the next time I do the routine. I did want to ask how frequently do you recommend doing the exercises? Also, should I do them in the order you listed? Finally, do you recommend doing all of the listed exercise in one sitting?

    • Hi Cody,

      You can do them 3-4 times a week. But this really depends how much you push yourself.

      You don’t have to do them in order. And you don’t need to do in one sitting.

      Mark

  270. Hey mark
    I have sacroiliac dysfuntion ,The left hip is higher than the right hip by 2 mm. Do the lateral pelvic tilt exercises first or do pelvic rotation exercises or work at the same time.
    I have pain in the right knee ,ankle and sciatic nerve in the left side( piriformis syndrome)
    How to send you detailed x- ray images.
    Thank you.

    Reply
  271. Hi Mark. I have a higher right hip so Could I do these exercises that you told us just in the one side or in the both? Another question is I’ve just knew about labrum crush in the left side of my hip.. could i do more carefully in these exercises? Thanks.

    Reply
    • Hi Phelipe,

      You want to do both sides.

      You can still do these exercises with issues in your left hip, but just be weary of any pain/discomfort around the left hip.

      Mark

  272. Hi Mark,

    I have all the symptoms you describe of having a lateral pelvic tilt. I have a weak gluteus medius on the left side, A tight quadratas laborum on the left side, I’m pretty sure my psoas major needs to be strengthened on the left, etc. The weird this is, my hip hike, though slight, is on the right side. In addition, just like the skeleton pic you provided my left leg and left side has issues in general. feels like my left arch support roles inward/is collapsing. I’ve had a history of runners knee on the left knee, I’ve had sciatica symptoms on the outside of my left thigh for a few years now (numbness, tingling, burning). When I have to stand for any period of time my left upper glute hurts and feels tight.

    A little history: I was in a severe car accident back in 2000 when I was 18. I experienced a very heavy blow to my lower right side of my back, in the quadratus laborum area, causing a huge hematoma and weakened muscles on that side. My chiropractor said it appeared as though the impact had turned my pelvis a bit to the left, and she told me I would probably have issues as I got older. Well….she was right!!! I’m now 37, stay pretty active, but almost always have some type of discomfort related to this issue. I feel like I really need to start tackling it before it gets worse and worse. My current chiropractor does good spinal adjustments, but eventually the problem reverts back to exactly how it was before. She told me I have a weak and tight hip flexor on the left side, that I need to activate and strengthen it so the hip extensor (glute) starts getting activated too. The problem is, when I look up how to do this on the internet, everyone says to do different and often conflicting excerises. I’m at a loss of what to do! Perhaps my situation has added complication of having a slight lateral tilt, combined with a pelvic twist to the left.

    So my question is, should I simply follow your recommended exercises above, or should I take another approach? Any help would be greatly greatly appreciated!

    All the best,
    Jeff

    Reply
  273. Hi Mark
    It is about 5-6 months that i have noticed that at the pelvic region,my left side seems more laterally sposted than my right side.I have been frequenting gym maybe 10-12 months before noticing this problem ,and I never thought actually that it could be due to that.I wanted to ask ,is it a problem,and is it necessary for a surgery on this cases or some exercises will help as well ?
    p.s I took some photos but i’m not finding a way how to upload them

    Reply
    • Hi Denisa,

      For a large majority of people, I would not recommend surgery for this issue.

      Exercises are the way to go!

      Mark

  274. Hi mark,
    I have noticed that my right hip is higher than my left and also my right shoulder is higher. I had a shoulder reconstruction on my right shoulder six months ago and also had two hip operation 9 months ago. I have noticed I have been getting a lot of headaches and nerve pain on my left side, and often feel great tension and the left side with the lowered hip. Could this be of result of compensation from my injured shoulder which was torn for two years, as I feel the nerve pain came from that period on.

    Reply
    • Hey Nicholas,

      In the absence of any other injuries, it sounds like it may be due to compensatory changes from your shoulder recon.

      I would prioritise your nerve pain first though!

      Mark

  275. Hey Mark,
    About six years ago I had my tenth rib on the right side completely tear loose in the front where it connects to the rib above it at the end. So for six years I slept on my right side and drove leaning to the left and stood with my left hip up. Anyways, about nine months ago I got 2 and a half inches of that rib cut out to fix the problem because I have muscle imbalances everywhere now especially laterally tilted hips with the left one being the high one. Question…why does everyone say release the lower hip glute med….It is tight for sure but my problem is the left high side all the glute muscles are super tight and yes probably very weak but they are constantly flexed because of the high hip and when I exercise them it makes it feel even tighter…should I just do more release time? And as the muscle strengthens will it loosen up? thanks

    Reply
    • Hi Jared,

      You release the glute medius (hip abductor) on the LOWER side as that hip is in a position of HIP ABDUCTION.

      You can still feel tightness in your glute med in your HIGHER side, but this is likely a feeling of tension of an overworking elongated muscle. (feeling of tightness does not mean that the muscle is tight)

      Strengthening this higher side will help bring your pelvis back to a more neutral state and causing this muscle to work more efficiently.

      Mark

  276. Hello! I am so grateful to have found your guide to fixing the lateral pelvic tilt. I’ve gone to so many doctors hoping to find a way to fix my hip and everyone has told me , nope you’re going to stay like this forever sorry. I have a pretty bad right hip hike that visually really stands out – clothes don’t fit properly,finding a pair of pants that fit right is almost impossible unless they’re baggy. Being just 18 that’s kind of a big concern. The hike was most likely caused by bad posture habits- all which I’ve corrected as of now.

    Anyway, my question is, with doing these exercises 2-3 times a week or even daily, is there a probability for the hip hike to completely go away or at least diminish in appearance?

    Thank you so, so much!

    Reply
  277. Hi Mark,

    I apologize if you have already addressed this but do these exercises help with rib pain on the right/hip hiked side?

    Reply
  278. Hey Mark,

    I’ve been suffering from lower back pain (predominantly on the right side) for close to 2 years, the severity has varied through this period, including pain in the glutes and nerve pain when straighten my leg in a seated position.

    I believe the initial cause was during a bent over row, i ‘released’ my core mid rep and felt a muscle pull in my back on the right side.

    I’ve seen multiple physios during the first year of my injury who all stated my core is weak and that I needed to work on the inner core.
    I just had a quick assessment from a massage therapist today and he stated that my left hip is hitched up.

    I will try the above routines but I was wondering if I can continue training as per normal? I’ve substituted barbell squats to goblet squats and I do not dead lift. As a matter of fact, training my legs is what got rid of the pain in my glutes.

    Thanks,

    Ray

    Reply