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uneven-hips-exercises

Uneven Hips Exercises: Correct Pelvic Imbalance

Uneven hips (pelvic obliquity or lateral pelvic tilt) occur when one hip sits higher than the other. This imbalance can cause back pain, hip pain, and problems throughout the kinetic chain. While true leg length differences require different treatment, most hip imbalances are functional and respond well to targeted exercises.

Understanding Uneven Hips

Types of hip imbalance:

  • Functional: Caused by muscle tightness/weakness (correctable with exercise)
  • Structural: Due to leg length difference or bone abnormality
  • Combined: Both factors present

Common causes of functional imbalance:

  • Tight quadratus lumborum (QL) on one side
  • Tight hip flexors on one side
  • Weak hip abductors
  • Habitual standing on one leg
  • Carrying bags on one shoulder
  • Scoliosis (can be cause or effect)
  • Uneven muscle use in sports

Symptoms:

  • One hip visibly higher than other
  • Lower back pain (often one-sided)
  • Hip pain
  • SI joint pain
  • Uneven gait
  • Feeling "crooked"
  • Pants legs appearing uneven

Assessment

Standing Mirror Test

  1. Stand facing mirror, feet together
  2. Place hands on hip bones (ASIS)
  3. Note if one hand is higher
  4. Check if one shoulder is also higher

Lying Test

  1. Lie on back, legs straight
  2. Have someone compare ankle bone positions
  3. Or: Bend knees, feet flat, check if knees are level

Standing on One Leg

  1. Stand on right leg
  2. Note if left hip drops
  3. Repeat other side
  4. Weak side: hip drops when standing on that leg

Identify Your Pattern

High hip side (the "short" side):

  • Often has tight QL, tight hip flexors
  • May have weak hip abductors

Low hip side (the "long" side):

  • Often has lengthened/weak QL
  • May have tight adductors
  • Hip drop when standing on this leg

Exercises should target YOUR specific pattern.

Release and Stretch the High Hip Side

QL Release (High Side)

  1. Lie on your side, foam roller under waist
  2. Roll from ribs to hip bone
  3. Find tender spots
  4. Hold 30-60 seconds
  5. 2-3 minutes

QL Stretch (High Side)

  1. Stand, feet together
  2. Raise arm on high hip side overhead
  3. Lean away from high hip side
  4. Feel stretch along side of waist
  5. Hold 30 seconds
  6. Repeat 3 times

Hip Flexor Stretch (High Side)

  1. Half-kneeling, high hip side back
  2. Tuck pelvis
  3. Lean forward slightly
  4. Hold 30 seconds
  5. Repeat 3 times

TFL Release (High Side)

  1. Lie on foam roller or ball
  2. Position on front/outside of hip
  3. Find tight spots
  4. Hold 30-60 seconds

IT Band Stretch (High Side)

  1. Cross high hip leg behind other
  2. Lean toward low hip side
  3. Feel stretch along outer hip/thigh
  4. Hold 30 seconds

Strengthen the Low Hip Side

Hip Hike Exercise

Key exercise for pelvic leveling:

  1. Stand on step with low hip leg
  2. Other leg hanging off step
  3. Drop the hanging hip down (not bending knee)
  4. Then lift/hike the hanging hip up
  5. 3 sets of 15

Side-Lying Hip Abduction (Low Side)

  1. Lie on high hip side
  2. Lift low hip leg toward ceiling
  3. Control descent
  4. 3 sets of 15

Clamshells (Low Side)

  1. Lie on high hip side
  2. Knees bent, feet together
  3. Lift top knee (low hip leg)
  4. 3 sets of 15

Single Leg Stance (Low Side)

  1. Stand on low hip leg
  2. Don't let opposite hip drop
  3. Hold 30 seconds
  4. Progress time and add challenges

Single Leg Glute Bridge (Low Side)

  1. Lie on back
  2. Bend low hip leg, foot flat
  3. Extend high hip leg
  4. Bridge on low hip leg
  5. 3 sets of 10

Core Strengthening for Stability

Side Plank (Both Sides)

  1. On elbow and feet
  2. Keep body straight
  3. Hold 20-30 seconds each side
  4. May notice one side harder

Dead Bug

  1. Lie on back
  2. Arms up, knees bent 90°
  3. Lower opposite arm and leg
  4. Keep pelvis stable
  5. 3 sets of 10 each side

Bird Dog

  1. On hands and knees
  2. Extend opposite arm and leg
  3. Keep hips level
  4. 3 sets of 10 each side

Pallof Press

  1. Band at chest height
  2. Press away from body
  3. Resist rotation
  4. 3 sets of 10 each side

Bilateral Strengthening

Glute Bridges (Even)

  1. Lie on back, knees bent
  2. Lift hips evenly
  3. Don't let one side rise first
  4. 3 sets of 15

Squats with Mirror

  1. Watch for even hip descent
  2. Don't shift to one side
  3. Cue "level pelvis"
  4. 3 sets of 12

Standing Hip Circles

  1. Stand on one leg
  2. Circle opposite leg
  3. Keep pelvis level
  4. 10 each direction, each leg

Posture and Habit Corrections

Standing

  • Distribute weight evenly on both feet
  • Don't always stand on same leg
  • Unlock knees
  • Check hip level periodically

Sitting

  • Sit evenly on both sit bones
  • Don't cross legs (or alternate)
  • Both feet flat on floor
  • Don't lean to one side

Sleeping

  • Pillow between knees (side sleeper)
  • Try to vary sleeping sides
  • Supportive mattress

Carrying

  • Switch bag shoulders
  • Use backpack instead of shoulder bag
  • Don't always carry child on same hip

Daily Routine

Morning (10 minutes)

  1. QL release high side (2 min)
  2. QL stretch high side (1 min)
  3. Hip hike exercise (3 min)
  4. Side-lying abduction low side (3 min)
  5. Standing posture check (1 min)

Throughout Day

  • Posture awareness
  • Even weight distribution
  • Switch sides for carrying

Evening (15 minutes)

  1. Full stretching routine high side (5 min)
  2. Strengthening low side (6 min)
  3. Core exercises (4 min)

Progress Tracking

Weekly Check

  1. Stand in front of mirror
  2. Place hands on hips
  3. Note any improvement in levelness
  4. Take photo for comparison

Movement Quality

  • Does standing on one leg feel more balanced?
  • Is walking feeling more even?
  • Is back pain improving?

Special Considerations

If You Have Scoliosis

  • Hip imbalance and scoliosis often coexist
  • May need professional evaluation
  • Exercises still help
  • Work with physical therapist if significant

If You Have Leg Length Difference

  • True anatomical difference may need heel lift
  • Can be measured by professional
  • Functional difference responds to exercise
  • May need combination approach

For Athletes

  • Address sport-specific imbalances
  • Single-leg training important
  • Video analysis helpful
  • Cross-train to balance sides

When to Seek Help

See a physical therapist if:

  • Significant visible asymmetry
  • Persistent pain despite exercises
  • Symptoms worsening
  • History of injury or surgery
  • Scoliosis present

They can:

  • Accurately assess the cause
  • Determine if structural vs. functional
  • Create individualized program
  • Provide manual therapy

Progress Timeline

Week 1-2: Learn your pattern, begin targeted work Week 3-4: Notice muscle activation improving Month 2: Visible improvement in mirror Month 3-6: Significant correction Ongoing: Maintenance to prevent recurrence

Realistic Expectations

What exercise CAN do:

  • Correct functional imbalances
  • Reduce pain
  • Improve posture
  • Better movement quality
  • Prevent worsening

What exercise CANNOT do:

  • Change leg bone length
  • Fully correct structural issues
  • Work overnight

Most functional hip imbalances improve significantly with targeted exercise. The key is identifying YOUR specific pattern—which side is tight, which is weak—and addressing both sides appropriately.

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