Lateral Pelvic Tilt: What Is It And How To Get Rid Of It?

Proper biomechanics demands many things, one of which is a person’s ability to maintain proper muscle tension and length relationships. As is the case with any joint, a postural abnormality and pain can develop when one muscle is tight while its antagonist is elongated and weak. The pelvis involves a number of muscles that allow it to tilt forward, backward, and sideways. If a significant disparity arises in these length and tension relationships, pain can range from persistent low back pain to something more severe, such as stabbing or radiating pain in the buttocks and legs. In this article, I will specifically explore how the pelvis can become fixed in a lateral tilt and what can be done to identify and correct the problem.

So what is lateral pelvic tilt and how is it best identified? The lateral pelvic tilt can best be described as simultaneously involving two movements: raising and lowering the hip. Compared to a neutral pelvic position, where the iliac crests appear to be level, hip movement requires the hip on one side to rise above a neutral position, while the other iliac crest must drop below a neutral level. . By standing as evenly as possible, one should be able to determine with a mirror or another set of eyes whether or not their iliac crests appear to be level. But where are these iliac crests, you ask? The iliac crest is a term used to describe the pelvic brim that extends from the anterior superior iliac spine to the posterior superior iliac spine. Part of the anterior portion can be felt as the bony point of the pelvis below the oblique, while the posterior portion is displaced laterally from the base of the spine. If necessary, practice tilting your pelvis forward and backward with your hands on your hips to determine their respective locations.

Another important detection method, although indirect, requires examining the way of walking. If there is weakness in the gluteus medius or tensor fasciae latae, gait is characterized by a lateral displacement of the trunk when the opposite leg swings forward. A similar conclusion could be reached by standing on one leg with the opposite leg flexed 90 degrees at the knee and hip and then assessing the position of the opposite hip. If the hip drops, the abductors are likely to be weak. Now let’s take a closer look at some of the common dysfunctions that accompany hip rise and fall.

First of all, for hip walking to happen, you most likely have a tight quadratus lumborum, which is a muscle that connects the lumbar vertebrae to the iliac crest and is used primarily in extension and lateral flexion of the spine. lumbar. As a result, the raised side should adduct the hip, which probably means the adductors are tight as well. Consequently, the hip abductors, i.e. the gluteus medius, are likely to be in a lengthened and possibly weakened position.

On the other hand, the dropped hip is likely to have an elongated quadratus lumborum and a tight gluteus medius, which connects the ilium to the top of the femur. Due to this position, the dropped hip should be in abduction. This then places the hip adductors in a lengthened and possibly weakened position. Another potential contributor to hip drop could be a tight tensor fasciae latae muscle, which connects the iliac crest to the IT band. Now that the typical dysfunctions have been clarified, what is recommended in terms of treatment?

Before proceeding, I advise anyone with marked pain to consult a physician before beginning any self-treatment program. That said, the simplest solution for those with a mild disability might require only a subtle alteration in posture and walking mechanics. In other words, practice standing with your weight evenly distributed on your feet and with your pelvis in a neutral position. This may seem painfully obvious, but too many people don’t know that they’re standing in “postural adduction,” which is when the hips roll outward and the weight-bearing leg sits below the raised, displaced hip. If the symptoms are a bit more pronounced, then further provisions including stretching and strengthening will be necessary. When walking, one must use a cane or cane in an effort to support the weak gluteus medius. This should only be necessary in the initial stages of treatment to better control pain. If sleeping in an adducted position is painful, then a pillow between the knees might be adequate. On the drop hip side, the tensor fasciae latae should be stretched by standing on one foot on a sturdy 2- to 4-inch-thick platform and the other foot on the ground. Make sure your knees and feet are facing forward. Next, tilt your pelvis and hold it there for 20-30 seconds. Corrective exercise is certainly a vital component in removing any impediments to movement. Those who have experienced any pronounced pain are advised to start conservatively in their corrective exercise. Hip abduction exercises from a prone or supine position are recommended initially. Progress to a side-lying position once 20 repetitions can be performed without pain with full range of motion in the introductory positions. Eventually one should move on to standing exercises where one places one leg on a 2-4 inch platform to practice dropping the hip so the foot touches the floor and then coming back up to a neutral position recruiting the gluteus medius.

Hopefully, this article has helped clarify ways to identify and understand lateral pelvic tilt and what can best be done to correct it. I am confident that with a little diligence and patience, your lateral pelvic tilt will soon be a thing of the past.