The body is designed to stay upright. The spine, stacked with bony vertebrae and vertebral discs, and supported by a network of muscles, ligaments and other connective tissues, allows it to maintain a uniform posture from head to toe. In a perfect world, the left and right sides of your body would be perfectly aligned with each other.
Unfortunately, our bodies are not perfect and sometimes the body becomes misaligned. Over time, you may find that one of your hips feels higher than the other. When the hips are uneven, with one hip higher than the other, it means that the pelvis is tilted. This is also called lateral pelvic tilt, and only a few things cause it. Symptoms and treatment depend on why your hips are uneven. In this article, I shall be looking at how to fix uneven hips.
What is a Lateral Pelvic Tilt?
A lateral pelvic tilt (LPT) is a common postural misalignment characterized by tilting the pelvis to the side.
People with this condition will appear to have unbalanced hips, with one side lower than the other.
There are several known causes of lateral pelvic tilt including scoliosis and a leg length gap. But one of the most common causes of uneven hips is poor posture.
To understand how poor posture contributes to a lateral pelvic tilt, it is important to consider the structure of the pelvis.
The pelvic bone is located in the upper part of the thigh bones (femurs) and is supported by a network of muscles that help stabilize the hips and allow for a full range of leg movements.
These muscles and ligaments include:
- Gluteus medius
- Quadratus lumborum (QL)
- Tensor of fascia lata (TFL)
When a muscle imbalance occurs between these muscles, whether due to injury, tension, weakness, or excessive use, a lateral pelvic tilt can develop.
More specifically, a lateral pelvic tilt is the result of the hardening and shortening of the adductors, the middle gluteus and the square lumbar region on one side of the body, and the simultaneous weakening and lengthening of the same muscles on the other side of the body.
This imbalance causes the hips to rise on one side and fall on the other, hence the term lateral pelvic tilt. To fix uneven hips we need to understand its causes.
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Here are some symptoms of Uneven Hips
- Uneven Hips & Gait
- Uneven Shoulder Heights
- Apparent Leg Length Discrepancies
- Internal Rotation of the Leg
- Disc degeneration
- Disc herniation.
- Sacroiliac joint pain
Causes of Lateral Pelvic Tilt
The main reasons for uneven hips are:
In this condition, your spine has an “S” or “C” shape curve which is slightly turned. It is the most common cause of uneven hips.
Scoliosis can be caused by the incorrect formation of the spine before birth, usually for unknown reasons. It can also have a neuromuscular cause, such as muscular dystrophy, cerebral palsy, polio, spina bifida, and Marfan syndrome.
Scoliosis affects girls more often than boys and can occur in families. It usually stops progressing when the bones stop growing. The curve is more likely to get worse when
- the curve is large
- it is in the form of “S” instead of “C”
- the curve is in the middle of the spine instead of the top or bottom
Functional Leg Length Deviation
In this condition, one leg seems longer than the other but has the same length when measured. It is caused by poor posture. Poor posture causes an imbalance in muscle strength and tension.
When poor posture becomes a habit and you stand or sit in the same position daily for months or years, your muscles become used to that position. Some muscles become shorter and tighter and lift the hip, and the muscles attached to the lower hip weaken, lengthen and relax.
This can also happen if you stay in one position for a long time with one hip higher than the other. This can happen if you always sleep on one side. Furthermore, it happens if you arch your back while sitting for a long time, or always lean on the same side while sitting or standing.
Structural Leg Length Deviation
In this condition, one leg is longer than the other when measured. Most people have legs that are slightly different in length, but it is rare for the legs to be so different in length that the hips are uneven.
According to the American Academy of Orthopedic Surgeons, a difference of about 4 centimeters can cause difficulty in walking or even lameness.
Sometimes it is congenital, which means that a person was born with it. In this case, the cause is usually unknown. In other cases, it is caused by:
- Injury to the growth plate on the leg during childhood or adolescence, a Salter-Harris fracture.
- A broken bone in the leg that heals poorly in a child.
- Severe infection in a leg bone during infancy or childhood.
- Certain bone diseases, such as neurofibromatosis.
- Conditions that cause the joints to swell, such as juvenile arthritis.
The good thing is that, in most cases, one can fix uneven hips by self-massage, stretching, and basic corrective exercises that anyone can do from home. In the next section, we will see how to fix uneven hips.
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How to Fix Uneven Hips
Treatments Based on Cause
Here are some things that can be done to fix uneven hips caused by scoliosis
- A slight vertebral curve in children is usually followed by x-rays of the back every four to six months. It is only treated if the curve gets worse. Only about 10% of people with scoliosis have a disease serious enough to require treatment.
- Doctors may recommend braces for children over 10 years of age while their bones are growing. It will not correct the vertebral curve but will prevent it from moving forward. It is generally used all day and all night, except when it interferes with participation in sports and other activities.
- In severe or rapidly worsening scoliosis, doctors may recommend surgery to merge the vertebrae with an artificial rod or bone to stop the progression of the curve.
Functional Deviation of Leg Length
There are several things you can do to fix the uneven hips when the measured length of your legs is the same:
- Massage can help eliminate knots and relax muscles.
- Exercises that stretch the side with tight muscles can improve mobility and range of motion of the legs and hips. These are the main treatments for uneven hips.
- Exercises that strengthen your muscles are also useful.
- It is also important to correct any bad posture so that the problem does not reappear.
Structural Deviation of Leg Length
To fix uneven hips is more difficult when the measured leg length is uneven. According to the Pediatric Orthopedic Society of North America, treatment is based on the difference in leg length:
- Young children and teenagers who are still growing will be put under observation until bone growth stops.
- Attaching a lift in the shoe that is worn on the shorter leg can help reduce back pain and improve the ability to walk with a normal gait. This is the usual treatment for a slight deviation (less than 2 centimeters) in the length of the leg.
- In more severe cases, surgery to match the length of the legs can be considered. If the difference in length is 2 to 5 centimeters, surgery is usually performed to stop or slow bone growth in the longer leg. For a difference of more than 5 centimeters, a more complicated procedure is usually performed that lengthens the shorter leg.
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Also, If detected early, an uneven hip is a manageable condition that can usually be corrected with chiropractic care, massage, physiotherapy, or a personalized treatment plan that includes these three therapies.
Your doctor will decide which treatment is right to fix your uneven hips based on the severity of your condition.
Chiropractors take a holistic approach to fix uneven hips, to treat pain, and restore a full range of movement for the muscles, ligaments, and joints that surround the pelvis.
A chiropractic treatment plan can include chiropractic adjustment, massage therapy, physiotherapy, and stretching.
The goal of chiropractic treatment is to achieve better body balance without the need for drugs or injections.
A physiotherapist can not only suggest stretching and muscle-building exercises that can be done at home to relieve the discomfort associated with a lateral pelvic tilt but can also offer advice on how to control your health through lifestyle changes.
The goal of physiotherapy is to restore the symmetry of the pelvic girdle by strengthening the weak and/or elongated muscles while stretching the tense and contracted muscles.
A massage therapist will use a series of manual techniques to relax the muscles that support the pelvis.
Massage therapy also helps improve blood circulation in the affected area, which helps reduce inflammation and relieve pain.
Among the techniques used by professional massage therapists are deep tissue massage, myofascial release, and Gua Sha, a traditional Chinese therapy that involves scratching the skin with a massage tool to increase circulation.
Exercises to Help Fix Uneven Hips
Stretching exercises to relax and lengthen the muscles are used to correct the functional difference in leg length. They also help improve back pain and other symptoms.
The main muscle to stretch is called quadratus lumborum. This muscle connects the pelvis and the spine.
Any stretch that increases the distance between the hip and the shoulder on the side of the highest hip is good. Here are five exercises to help you fix uneven hips.
The 90/90 Stretch
- If your right side is tight, sit on the floor with your right leg in front of you bent at a 90-degree angle. Your knee and ankle should also be on the floor. Align your knee with your hip.
- The left leg should be on the left side, bent at the knee at a 90-degree angle. It can be uncomfortable.
- Move forward with your right hand, moving your right hip away from it.
Leg Split with Quadratus Lumborum Stretch
- Sit on the floor with your legs open as much as possible.
- Extend your right hand to try to touch your left foot. You don’t really need to touch your foot.
- Then bring your left hand to the right foot. This stretches the quadratus lumborum on both sides.
Childs Pose with Hand Reach
- To adopt the child’s posture, start with your hands and knees, then sit back onto your heels and bring your forehead to the ground to lower your head.
- From the child’s posture, where you are sitting on the floor still folded over your lap, raise one arm and extend it as far as possible. Repeat with the other arm.
- With your arms still extended, move your hands to the side. This will stretch the lower back and the hip on the opposite side.
- Stay in this position and breathe in and out while stretching.
To fix uneven hips, it can also help to strengthen weak muscles of the hip including the quadratus lumborum. Exercises that help with this include:
- Lie sideways on the floor with your feet together and raise yourself up with your forearm on the floor. Align or stack your elbow under your shoulder.
- Contract your abdominal muscles and lift your hips, so that your body forms a straight line.
- Hold this position for 15 seconds at the start. You can advance up to 4 minutes over time.
- Repeat on the other side.
- Lie on the floor on your stomach.
- Extend your arms forward and your legs back.
- Raise your arms and legs about 6 inches from the ground.
- Contract your abdominal muscles and stretch out as much as possible. Hold the position for two or three seconds.
- Relax your arms and legs back down on the floor.
Effects of Uneven Hips
Uneven hips affect everything. The pelvis is connected to the shoulders and upper back by the spine. It is also connected to your legs. Thus, the effects of uneven hips can sometimes be observed in these areas:
- Uneven shoulders: Your shoulders may also look uneven, but the side with the lower hip will usually have the highest shoulder.
- Prominent shoulder: Your shoulder blade may stand out more to the side with the lower hip.
- Curved column: Your spine can be curved into an S or C shape if the cause of your uneven hips is scoliosis.
- Difference in leg length: Uneven hips can make the leg on the side with the higher hip look and feel longer than the other, even if they are actually the same length. Having one leg that is really longer than the other can cause uneven hips.
- Prominent rib cage on one side: Uneven hips caused by severe scoliosis can cause the rib cage to twist so that the ribs on the side with the higher hip protrude more than the other.
Whatever the cause of the uneven hip or pelvic tilt, there are things you can do daily to fix it. It is also important to follow up with health professionals over time.
Checking regularly with your doctor or health care provider can help you get a good diagnosis. Your doctor may notice that you or your child have irregular hips during a routine physical exam, or you may notice this yourself and consult your doctor about it.
Scoliosis is frequently diagnosed during school assessments or during sports sessions.
Your doctor will ask you about your symptoms and do an examination, including a scoliosis check.
Your doctor will also assess your hips and shoulders to see if they are equal or not.
These examinations will help your doctor to fix or stop the progression of certain conditions that can cause uneven hips.