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Managing and Working with Uneven Hip

By: Stephanie Ruopp

Do you think you might be working with uneven hips? Maybe you know for certain.

Don’t worry. It’s not as uncommon as you think. Uneven hips can be the result of many different situations. 

In an ideal world, your pelvis is positioned so that it’s parallel to your shoulders and ground. But when you have one hip higher than the other, it’s known as a lateral pelvic tilt. 

Some muscles tense while others grow weak. And while it’s not a dangerous condition, it can create bigger problems if you don’t work to realign them. 

Fortunately, Pilates is an excellent option when it comes to managing this condition. Plus, there are several exercises you can do at home.

Are You Working with Uneven Hips?

If you’re not entirely sure about whether you have a lateral pelvic tilt, you can do the following: 

1. Stand in front of a full-body mirror with your feet shoulder-width apart.

2. Place the heels of your hands on the front of your hip bones.

3. Imagine a horizontal line between your hands. Better yet, hold a piece of string stretched between your hands.

4. If the imagined or real string line between your hands isn’t parallel to the ground, but rather tilted up or down, then you may have a lateral pelvic tilt.

If you’re still uncertain after performing this exercise, have a certified physical therapist examine you. They are trained to quickly spot this condition.

Reasons for a Lateral Pelvic Tilt

As we mentioned above, there are many reasons for uneven hips.

More often than not, there’s a difference in leg length as a result of posture or stance. For instance, if you tend to always lean into one leg while standing, or you always prop a small child on the same hip, you’re actually lengthening one side of the body while shortening the other. 

Sometimes there is a physical or structural difference in leg length. That means you were born with one leg longer than the other. Since the body is always striving toward balance, the pelvis will compensate by tilting. 

Then there are other conditions such a scoliosis which can become more severe over time. 

In the case of pronounced structural leg difference or a condition like scoliosis, performing approved exercises and working with a physical therapist can definitely help to ward off negative effects.

But for the rest of us dealing with postural imbalances, it helps to have a deeper understanding of how improper posture affects the structure of the pelvis and contributes to uneven hips. 

The Structure of the Pelvis

Sitting atop your thigh bones (a.k.a. your femurs) is the pelvic bone. It’s supported by a network of muscles and ligaments such as:

You don’t need to memorize these. Just know that these muscles and ligaments help to stabilize the hips and allow for a full range of movement of the legs.

Now, when you’re dealing with an injury, weakness, overuse or general tightness, a muscle imbalance occurs between these muscles.

More specifically, when your adductors, gluteus medius and quadratus lumborum shorten on one side of the body, they lengthen on the other side. 

And a lateral pelvic tilt is born.

Symptoms of a Lateral Tilt

Your body isn’t perfectly symmetrical. Congratulations. You’re just like everybody else.

And as we mentioned above, some of the asymmetry is your birthright. But how you move through your every day life impacts these asymmetries as well.

And if a lateral pelvic tilt becomes too pronounced, you will be more prone to injury and reduced mobility. If left untreated, it can even lead to disc degeneration or herniation. 

No need to panic though. Most cases a lateral pelvic tilt can be managed through many of the corrective exercises found in Pilates, or, in more advanced cases, by working with a physical therapist.

Exercises That Help Correct the Condition

We’ve provided some exercise options below that you can do at home to help even out your hips. Variations of these are often done in Pilates – either with or without machines.

If your condition is more advanced, it’s best to consult with a physical therapist first before attempting any exercises on your own. 

1. Clamshell

This exercise strengthens your gluteus muscles and helps improve hip mobility:

1. Lie down on your side with both legs bent at a 90-degree angle, and your bottom arm supporting your head.

2. Before you start, roll your top hip slightly forward toward the ground, making sure your spine is relaxed and stable.

3. Lift your top knee up, but keep your feet together.

4. Hold for 5 seconds, and then lower your knee.

5. Do 12 repetitions.

6. Switch sides.

Keep movements slow and controlled. And be careful to not rotate your spine so as not to cause additional tension and back pain. 

Over time, you can adjust how close or far your legs are to your body to help work all of the muscles in that area.

2. Reverse Leg Raises

This exercise can be a bit challenging at first. And you’ll likely notice that the hip that sits lower has weaker muscles. This exercise will work to strengthen them.

1. Lie on your stomach with your legs resting on the ground. Stack your hands and let your forehead rest on them.

2. Lift one leg while keeping your knees straight and gluteus muscles tightened. Keep the other hip on the floor.

3. Hold for 2 to 5 seconds, and then lower your leg.

4. Do 12 more on the same side before switching legs.

Be sure to squeeze your abdominal muscles so that you don’t arch your back. Arching creates stress where the pelvis and spine meet, as well as in other joints of the spine. The top of the pelvis tilting forward also increases the stress on the hip joint.

3. Side Leg Lift 

The first part of this exercise targets the gluteus medius, while the adductors are the focus on the second part.

1. Lie on your left side with your right leg straight and left leg either bent or straight.

2. Create as much length as possible in your right leg by pushing your foot away from you.

3. Keeping your pelvis completely still, lift your right leg.

4. Hold at this top position for 3-5 seconds – until you feel the right hip muscle activate. 

5. Lower the leg, keeping the pelvis still.

6. Repeat this action 10 more times.

7. Staying on your right side, place your right foot flat in front of your left leg. 

8. Just as you did with the top leg, raise the left leg (your bottom leg) toward the ceiling – being careful to not rotate the pelvis. 

9. Hold at the top position for 3-5 seconds, until you feel the left inner thigh active. You’re working the adductors now.

10. Repeat this action 10 more times before flipping to lying on your right side and starting the exercise again. 

Once you feel like you’re building strength, you can utilize resistance bands or ankle weights to take it up a few notches.

Find Balance

If you’re working with uneven hips, you may be hoping they’ll just click back into balance. Unfortunately, it doesn’t work that way. 

These exercises are a great place to start though. Adding them to a regular Pilates practice that focuses on alignment will definitely help.

Don’t let the condition get worse. 

Contact us today to find out how to get started on getting those uneven hips back into alignment. 

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