T Nation

How to Correct Lateral Pelvic Tilt?


#1

Hello, This is my first post.

I have never been officially diagnosed, but I am pretty sure my right hip sits higher than my left. I have listed my symptoms below.

I have googled my heart out and there is just not a whole lot of information out there one how to correct this. Oh yeah, leg length discrepancy has been ruled out.

So what excercises/stretches should I do? I'll take all the info anyone can throw at me.

This is what I have so far:

Right Side:
1. Strengthen Hip Abductors
2. Stretch Hip Flexors, QL, and lower back
Left Side:
1. Stretch IT band?
2. Left Ankle mobility

My Rector Femoris is seems really tight on left side, not sure if I should stretch this or not.

Symptoms:
1. Right hip visibly sits higher. (shifting weight to left leg and pushing left hip out slightly seems to correct curvature in lower back)
2. Chronic Mid/Mid-Lower back pain for about two years - on my right side only.
3. When doing any type of abdominal work, I can't seem to get my left side abdominals to engage, it always seems that the right side is doing all the work.
4. Same as #3 for my back, right side seems constantly tense engaged all the time, left side does not seem to function nearly as much.
5. Left shoulder appears to roll forward more than right
6. Significantly weaker hip abductors on right side.
7. Less dorsi flexion on left foot.


#2

woah! I have the exact same problem and I was going to post this exactly but for my other side.

My LEFT side has a tighter tfl/often feel tightness in that IT band, slight curvature of the spine
My LEFT hip sits a bit visibly higher and the right side of my back is visibly stronger.
also my RIGHT shoulder also rolls forward more than my left.

Literally, the mirror image of what you seem to have, but the pain usually ends up in my knee rather than my back because I have stronger abs and weaker glutes that I've been working on a while.

from what I've heard the solution is to strengthen the glute medius on the weak side, but I did that for a year so that muscle is visibly really strong but still lets the IT band/TFL take over every now and then but I have no idea why....

The best thing I've found so far is yoga, but I'd love to hear what other people have to say as this has been a problem for me for a long time.

I really want to know how to fix this besides us cutting outselves in half down the middle and then putting our equal sides together.


#3

Rolfing, although expensive worth it.
Totally made me left and right sides symmetrical.

I think fixing this yourself can be very tricky.
With rolfing the guy will release tensions on some deep places in your tissue which is hard to do yourself.
Often it is the tension in the fascia tissues around the muscles and tendons that leads to these kind of imbalances.


#4

It sounds like your body has undergone a pattern of compensatory movements. This most likely explains your inability to feel certain muscle groups working and why your posture is less than symmetrical (although perfect symmetry is a myth). I don't know how the this began. It does appear that it has now dramatically affected your kinetic chain.

The IT band needs to have adhesions resolved. Stretching will not accomplish this. And don't forget to SMR as well as stretch the glute max because about 50 percent of it connects to the IT band. A common mistake many IT band sufferers make is to foam roll that area but never address the glute max.

The lumbar spine is NOT something you should foam roll as you don't excessive movement there (it's actually the thoracic spine where we should have the most mobility). That said, you can perform SMR on the Quadratus Lumborum with a tennis ball, baseball, softball, lacrosse ball (you get the idea). You'll have to experiment and see which size and density works best for you. You can also work the erector spinae AS LONG AS direct pressure is NOT placed on the lumbar spine (this is why a ball and not a foam roller or pvc pipe is recommended).

CAUTION! The quadratus lumborum (QL) inserts L2-L5 AND the 12th rib. So be very careful that you don't stab yourself when performing SMR.

Basic blue print:

Address the overactive side with SMR as well as the help of a skilled therapist. I don't know how deep your pockets are; SMR is a cost-effective solution. However, for your case, regular visits to a skilled therapist strongly appears to be in order.

Whether you choose to go with Rolfing, Art, etc. is something you will have to ascertain yourself. It's not enough to just perform SMR or get some type of deep tissue therapy; you will need to stretch as well. Conversely, it's not enough to just stretch as this does almost nothing for the trigger points (by now they are too dense); this is why doing things like yoga WITHOUT working to break up the trigger points is not something I would advise.

Strengthen the underactive side. If you're truly serious about resolving this, uni-lateral movements will be your new best friend.

If you hold a stretch at a challenging (but not painful) level for 30 seconds or more, you should activate the golgi tendon organs. Through a process called autogenic inhibition, your body will down regulate the muscles and minimize their involvement. Take advantage of this during your workouts.

I recommend SMR pre and post workout. Work in the static stretches to fit with your goals. And definitely SMR and stretch post.

All three aspects must be addressed. And don't neglect lifestyle choices as well.


#5

The more I research this - that is the limited, spotty information that is out there, the more confused I become. Thanks to all for the replies so far, any help is appreciated.

I think it would help a bunch if someone could break down what kind of movements/muscles/stretches I should work on for each side, high and low.

Which side do I stretch IT band/TFL? The high side or low side. It sounds like I should be stretching on the high side but I thought that IT band serves as a hip abductor? Shouldn't I be strengthening the abductors on the high side? The hip abduction work I have been doing does provide some relief, at least for about 15 minutes.

How about the uni-lateral leg work @56x11, so basically you mean strengthen the left leg? Could you give me some examples? What kind of movements should be my focus.


#6

Some examples of unilateral movements include (but are not limited to): Single Leg RDLs; split squats (I prefer the version where to sit back and then descend, as opposed to a forward lunge); unilateral db presses on a low incline (40 degrees or less); one arm db rows; unilateral pull downs.

As far as finding the trigger points and the over active areas, you will need to be patient and explore each part of your body carefully. The issue can often be a case of a moving target so that can add to the frustration as well; but if you know this going in, you shouldn't be as surprised. Of course, you will also most likely find persistent trigger points; and these deserve priority.

And I know this is a frustrating issue. However, you must appreciate that there is a limitation to how much help that can be given in an online forum. It really is up to you to research on this and other sites as well (I strongly recommend people such as Mike Reinold; Gray Cook; Charlie Weingroff; Stuart McGill). Also, if it's economically feasible, an in person examination by a qualified professional is something I recommend.