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Posture Series #2: What's Up With An Elevated Hip?

Posture Series #2: What's Up With An Elevated Hip?

Billy Pratt, BA, CPT, PAS, GIPS, CFSMP

Yes, the pun in the title was intentional – and if you’re groaning and shaking your head feel free to reach out and complain :D  In the meantime, for the benefit of those who may not have seen my first posture series article, here is my copy-and-pasted caveat regarding asymmetries:  Everyone is asymmetrical, but not always in the same ways.  Let’s face it, we’re asymmetrical beings – most of us write with one hand, are stronger on one side, and habitually move and operate in ways that emphasize using one side more than the other for different tasks.  It is not the presence of asymmetry that is a concern, it is the degree of asymmetry that we have to look at.  This is true of posture as much as it is of movement and I would like to continue this series of postural articles looking at another very common postural asymmetry:  lateral pelvic tilts.

Let’s begin by having you march in place while standing in front of a mirror.  Pick your knees up to hip height or as high as you can go if you can’t bring them that high and do five or six marches on each leg (ten to twelve total) before standing still.  This loosens you up a little bit and “breaks the pattern” to allow your body to settle into its natural stance.  Now while keeping your lower body perfectly still take the first two fingers of each hand and place them on the ASIS (anterior superior iliac spine) on each side of the front of your pelvis.  You can find this by pressing into the front of your hip (about the level of your naval and near to where the side of your waist begins) and feeling around until you feel a little bony protrusion.  Those who carry substantial belly fat may need to go up and underneath where the fat hangs down in order to locate it.  Once you find the ASIS on each side, keep your fingers there and look in the mirror.  Note how level they are to one another.  If your fingers are even with each other then congratulations!  You don’t have a lateral pelvic tilt and the rest of this article does not pertain to you (at least for now; posture does change over time and can vary day to day).

If one side is higher than the other then you have a lateral pelvic tilt.  Why do these things exist?  As with the shoulder tilts I went over last month, there are a lot of different factors that can go into why one hip may be higher than the other.  You could have one leg longer than the other, one of your QL (quadratus lumborum) muscles could be tight, scoliosis even of a mild variety can contribute to it, etc.  Regardless of the cause even a minor tilt should typically be addressed since our hips are loaded in every vertical position we maintain, whether we are standing, jumping, stepping, even sitting.  Here are a couple of stretches you can do to help ease any excess tension in the muscles that may surround an elevated hip (bear in mind these stretches are only to be done on the side that is higher):

QL Stretch – Go to a stairway and step up onto one step.  Holding the railing or wall with both hands let the foot of your elevated side hang off the edge of the step.  Allow the weight of your leg & foot to pull your hip down and hold that for 15-60 seconds.  If you don’t feel a stretch, try pulling the toes of the hanging foot back toward your shin (dorsiflexion). 

Standing Side Bend – Stand about a foot away from a wall, with the nonelevated side facing the wall (for example if your right hip is elevated you would stand with your left side facing the wall).  Reach out with the arm closest to the wall and place your hand about head height on the wall.  Now take your other arm and reach it overhead and across towards the wall – if you can’t touch the wall with that hand just step closer to the wall.  You should feel a stretch along the side of your body that has the elevated hip, usually felt more in the waist area.  To intensify the stretch push your hips away from the wall but make sure not to twist when doing so.  Hold this for 15-60 seconds.

Our goal is not necessarily to “fix the pelvic tilt” (there can be many variables that go into why it is there in the first place, including genetic), but to take appropriate steps to address it should you have one.  A more detailed approach would require a book-length manuscript to address, so if anything here is unclear or unhelpful I urge you to contact a movement specialist or fitness coach who is schooled in postural work to give a more complete screen. 

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