How to Correct Your Pelvic Alignment

Your pelvis is made up of several bones that are “fused” together.  There is a group on the left side and a group on the right side.  They come together in the middle and there is cartilage in the very front called joining them together.  This is your pubic symphysis and it is located just above your penis or clitoris.  Feel it, this bone is hard and easy to find.  Each side, each collection of grouping of bones, is called an innominate.  Though I’ve known several physicians to dispute this in the past, your innominates can move.  When this happens, you are considered “out of alignment”.  A lot of people are familiar with chiropractors correcting their alignment, but guess what, physical therapists do it too.  My goal for this post is to teach you how to do this at home.

If your pelvic alignment is off, then the entire foundation that your pelvic floor muscles, nerves and ligaments are lying on is off.  For those with pelvic pain, I think this is a problem and I think it needs to be corrected.  I remember hearing in a course once that “Sometimes people are just out of alignment and that’s how they are.  If it’s not broke, don’t fix it.”  I agree to an extent.  If you’re my grandma and for fun I decide to check your alignment and you’re misaligned, but you’ve got not pelvic issues, I’m not going to fix you for kicks.  But, if you’re my patient with pelvic floor problems then I’m considering it “broke” and I’m going to fix it.  How irresponsible for someone to tell pelvic floor therapists not to correct pelvic alignment on their patients.  Why would we throw orthopedic care out the window?  This is a personal pet-peeve of mine, as you can clearly see.

I like to correct my patient’s pelvic alignment in treatment, but I also need to teach my patient’s how to do this independently at home.  You really do need someone to help you with this, so often times I even have my patient’s friend or partner come in for a pelvic alignment crash course.

Here is your crash course, but please note, this only works if your legs are the same length.  If they are different lengths, you might need a heel lift.

  1. Lie on your back and bend both knees.  Lift your hips up like you’re doing a bridge and immediately put them back down.  Have someone pull both your legs straight.  This “resets” the pelvis so you can get an accurate picture of what is going on.
  2. Place your hands high on your waist like you are an angry mother scolding a child.  Get a good firm grip of your sides and slide your hands down until you feel a bone on both sides.  This is called the iliac crest.  I call this the “top of the sides of the pelvis”.  So, go ahead and check the top of the sides of the pelvis to see if one side is higher than the other.  “Higher” means close to your head.  “Lower” means closer your feet.  The relationship is to each other – the left and the right side.  Check the front of the boney parts of the pelvis to see if one side is higher than the other.
    1. If one side is higher, have someone gently pull the leg on that side at the ankle for a few slow, gentle tugs.
    2. Recheck to see if the pelvis has been aligned by bending your knees and doing a bridge while someone pulls your legs straight. Recheck the top of the sides of the pelvis to see if they are level. If they are not, try the leg pull technique again.
    3. Steps 1 and 2 can be repeated as many times as necessary until your iliac crests are aligned.  But, I’d say after 3-5 attempts to correct this, if it’s not corrected, it could be that you need some muscle or connective tissue work done first and then your alignment will more easily be corrected.
  3. Next step is to find the anterior superior iliac spine.  Also called the ASIS.  Also called “the front of the boney parts of the pelvis”.  So, have you ever seen a picture of a really skinny girl (or boy) in really low cut jeans?  These bones are the ones that jut out like spikes on skinny people.  Heavy people, you have these too, but they are not quite “spikes”, more like a rock under a pillow.  That’s okay too.  Just want to let you know what to look for.  So…check the front of the boney parts of the pelvis to see if one side is higher than the other.  Again, “higher” means closer to your head and “lower” means closer to your feet.
    1. If one side is higher, bend the knee on that side and flex the hip to 90 degrees. Take your hand and try to push your knee away from you while your knee pushes into your hand. Do this for 8 seconds and repeat 3x. Recheck to see if your pelvis is aligned by doing step 1.
    2. If one side is lower, bend the knee on that side and flex the hip to 90 degrees. Try to bring your leg down straight while someone else resists you at your hamstrings. Do this for 8 seconds and repeat 3x. Recheck to see if your pelvis is aligned by doing the first step 1.

You’re always going to try to correct the side that hurts.  None of this should increase your pain.  It should all feel pretty good.  But, if you do these corrections and you end up with more pain, just do the opposite of what you just did and you will reverse your correction.

Why do you keep going out of alignment? Some people go out of alignment every few hours, some go out of alignment every few days, some never go out of alignment again.  If you are someone that goes out of alignment a lot, it’s important to look at what you are doing.  Do you sit with your legs crossed the same way all the time?  Do you sleep with one hip flexed and one straight all the time?  Do you stand with your weight shifted on the same leg?  Do you hang out on the couch leaning more onto one hip?  Look at the way you move your body and the positions you lounge in.  The key is to make things symmetrical.  Shift how you cross your legs.  Sleep with the other hip flexed and the other leg straight (if you can).  Shift your weight onto the other leg when standing or don’t stand with your weight shifted at all.  Get the point?  Don’t let one side do all the work, either make your movements centered or make sure your other half gets in on the action.

What can correcting alignment help with?  Theoretically, it should help with any SI joint pain (this is pain more around the center of the butt cheek on either side), some low back pain and really most pelvic floor dysfunctions.  This doesn’t mean correcting alignment resolves these problems 100%, it just helps improve them.  It’s a big claim to say it helps with most pelvic floor dysfunctions, but it’s true.  Like I said above, we are correcting the foundation that everything in the pelvic floor lies on.

Who shouldn’t correct their own alignment?  I think that you should really see a professional if you have had surgery, spinal cord issues, or any other larger condition more than just run of the mill back pain or “just” chronic pelvic pain.  What I’m saying is, if you’ve been diagnosed as just having back or pelvic pain, then it’s probably okay to correct your own alignment, but if something larger is going on, then consult your doctor or physical therapist first.

What if you go out of alignment all the time?  If you go out of alignment easily, I suggest that you make sure your pelvis is in alignment before working out and stretching.  If you go out of alignment really, really easily, like with just the transition from sitting to standing, then you might want to get a belt to apply pressure to your pelvis.  These belts are called SI belts.  SI stands for sacroiliac.  Some pregnant women wear these to keep their pelvis stable and to take the belly weight off the pelvis just a bit.  Others who are not pregnant can use it as needed.  Some need it 24 hours a day, even while sleeping.  Others need it just when they are being active or running.

How can you tell if an SI belt is right for you?  I will correct someone’s alignment and have them walk thinking about their pelvic pain levels.  Then, I’ll put them in an SI belt and have them walk thinking about their pelvic pain levels.  If there is an obvious and instant reduction in their pelvic pain, then the belt is a good option.  If they put the belt on and walk for a bit and cock their head to the side and say “Umm, it’s a little better…I think.”  – Then I don’t suggest the belt.  I personally feel that the belt is best when there is a marked and obvious improvement in pain and movement.  Think about this too – if there isn’t an obvious improvement when you put the belt on, then you probably aren’t going to wear it very much anyways.  One note about the belt – it can be a little uncomfortable if you sit a lot because the edge of the belt might dig into your hips and thighs.

What if you put the SI belt on and it makes your pain worse?  Then you probably put it on when you were out of alignment.  Re-check and correct your pelvic alignment and put the SI belt back on.  It should typically feel better.

Does this really help in the long run? I get asked about the efficacy of the SI belt a lot.  People want to know if the belt just helps to reduce pain at that moment, or if it helps their pelvis in the long run.  I’ve heard different therapists say different things about this.  Some therapists say that the SI belt is a band-aid, it just helps reduce pain in the moment that you’re having pain.  They say that the SI belt keeps you from using your own muscles to stabilize your pelvis and therefore is probably hurting you in the long run.

The other camp says that the SI belt is not only helpful in reducing pain, but it helps improve the health of the pelvis.  The ligaments that keep your pelvis aligned can become injured or too lax and that is why someone who goes out of alignment easily goes out of alignment so easily.  It takes almost a full year for these ligaments to regrow more appropriate tissue and you want this tissue to grow at the right angle to keep you from going out of alignment all over again.  Because of this, some therapists want you to wear your SI belt all the time for a year.  I sit in this camp.  The only thing is, I don’t know any patient that has actually done this.  Wearing an SI belt is kind of awkward and when you want to look good in a nice outfit, it might show a bit.  While I don’t think anyone will wear their SI belt constantly for a year, I do tell people to wear it all the time for as long as they can.  If they can align their pelvis as often as it goes out, even if they aren’t wearing their SI belt, then their ligaments will heal and regrow at an appropriate angle.

Correcting your own alignment is huge in helping to reduce your pelvic pain.  However, this in itself doesn’t replace the professional help of a physical therapist.  Your alignment may be stuck. You may try and try to use the suggestions I’ve given, but your alignment doesn’t improve.  You might need some work done by a therapist before your pelvis is ready to work with you.  In addition, like I said before, if your legs are different lengths, it’s very possible that you need a therapist to help you determine if you need a heel lift.  Lastly, something I’m not teaching in this post is how to correct an issue with the sacrum – which is the little cupped part of the pelvis on your backside.  This is half of what we call the sacroiliac joint – better known as the SI joint.  Only a skilled clinician can really address this, I do not think this is something that a post can or should teach because it’s not that cut and dry.

I’ve now created a video for correcting pelvic alignment at home.  It is for purchase here: VIDEO 

If you have any questions, please email me at [email protected] or leave them in the comment section below.

153 thoughts on “How to Correct Your Pelvic Alignment”

  1. Fantastic post, and great reminders about treatment protocols for ME now that I’ve been out of clinical practice for several years. Thanks! Will be sharing with my tribe!

      1. Glad you liked the post. I really don’t have a handle on how Pinterest works, but I have no issue with you creating a “pin”.

  2. Thank you for this, it’s a great help. My pelvis has been going out of alignment constantly for years now, even going out of alignment a few days after it has been realigned by a chiropractor, and this will help me reduce my visits.

    1. Hi Billie,

      Glad this was helpful. I understand that learning to correct alignment is confusing, even I’m not able to break it down in a simple way, but I do wish that more professionals just taught their patients how to do this. I have many a patient that has avoided a pain flare by correcting their alignment at home.


  3. Hi Sara,
    Great post, I’ve been struggling with pelvic disorders caused by misalignment of hips, symptoms mainly urgency, frequency with bladder, physio assessed and it was basically down to right hip being forward rotated, left is fine, thoracic spine is very immobile, how can I adapt these exercises at home? The exercises above cover if hip is higher, but my right side is lower, left is ok, I’ve done loads on lengthening hip flexors, strengthening glutes but hip still forward rotates, also my core was very weak and have classic protruding skinny man’s belly, so have done core work. My problem is finding way to align at home as can’t always get an appt


    1. Hi Steve,

      Have you asked your physic to teach you how to correct your alignment at home? He can spend an entire session going over that, it’s super useful information and well worth the time.

      So, I’d say that if your right hip is “lower”, then that means the right side of your pelvis is lower as well. You say the left is “ok”, but when you compare the sides, the left side must be “higher” because you are always comparing the left to the right side. If I had a patient with a hip that was higher on one side and they did not have different length legs, I’d gently tug the left leg to bring the left hip lower. It would be good to have a good assessment of your posture too because bad posture can effect what happens at the whole spine, the hip flexors, the pelvis and effect pelvic pain.

      While sometimes the hip flexors are sorely the source of a problem in pelvic pain, sometimes the hip flexors are not tight. These can be tested by your physio very quickly. The quadratus lumborum in the back can be tight or short and this can make one side of your pelvis/hip higher on that side. This can be stretched and worked on in therapy as well. I’d make sure to have the physio examine the quadratus lumborum and all the connective tissue on your back, abdomen and inner thighs in order to truly take care of your pelvic alignment and symptoms of urgency and frequency.

      Hope this was helpful and informative,


      1. Sara, where are you located because everything you said is my problem right now and I need to find someone who can help me please.

  4. thanks for the information. I find it tough to feel if one side is higher than the other. I cannot tell my looking in a mirror with hands on hips either. I go out of alignment easily and can feel the slightest bit of misalignment. The P/T usually helps with that. I’ve asked what I can do at home but have gotten nothing from him. What I have is what I have found on the internet, it is helpful, I’ll need to work more on being sensitive to which side is off. I was told that it could be due to loose tendons & ligaments.

    1. Hi Josie,

      It is difficult to tell if there is a subtle difference in sides. You are not the only one. Being “off” can be due to loose tendons and ligaments, but it also can be due to maintaining certain postures or sleeping a certain way or one group of muscles not activating enough.


  5. I am in a lot of pain in my left hip, have been told by chiro that my pelvis is twisted, it’s been going on for years and I didn’t realise until now, crunch time, is there any treatment for the pain, it’s got to the point where it is unbearable, effecting sleep and I just can’t relieve it. I am unable to do the exercises through pain and just inability to lift my leg, I’m desparate!

    1. Hi Karen,

      Reading your comment, my first thought is that you should get an exam from an orthopedic specialist. If you can’t lift your leg, I’m concerned that you need a really good orthopedic exam first.


  6. This is really helpful info. I’ve struggled with alignment issues for quite some time and have had a lot of PT. I have severe lower back pain and moderate pain in both hips. The best thing that has worked for me besides exercises is the SI belt, it removes so much pressure and pain. Obviously, the belt makes no fashion statement, so it’s understandable why patients don’t want to wear it all the time. Do alignment issues make hip bursitis worse and can it cause pain in the front of your pelvis as well?

    1. Hi Laina,

      You know, some people don’t even believe in hip bursitis as a source of hip pain – but that’s neither here nor there. I’m going to say that yes, alignment issues can make hip pain and pain in the front of the pelvis better or worse. Absolutely.


  7. Hello Sara,

    Thank you for the information about the hips exercises and the explanation on how to figure out if you are out of alignment! They are both helping me termendously!
    Thank you again

  8. Hi Sara,

    Thanks for your post. I have also read your post on pregnancy and I know it’s not your thing so I’m sorry in advance! I am 38 weeks pregnant and suddenly have quite extreme pain which is preventing me from putting all my weight on my right leg which means I am clinging to walls and furniture just to walk/not collapse. It started as just painful and progressed to this level over a period of a day (two days ago). I have tried acupuncture (just once so far) and a bit of massage and rolling it out etc at home but nothing is working. I need fast results cos I really don’t want to go into labour like this!!! Do you think I should prioritise a chiropractor or a physiotherapist or both to help fix this for me? The pain feels like what you have described above originating from the centre of my right butt cheek. I am thinking now that it’s fairly likely it’s due to me being out of alignment.

    1. Hi Katie,

      Glad you like the post and you are right, pregnancy is not for me! Katie, I recommend you get in to see a PT and go to one that knows how to correct pelvic alignment. You need to ask this question before you go in. Pelvic floor and orthopedic PT’s both should know how to do this, but depending on their training, they might not be practicing with pelvic alignment corrections – which is just a dirty shame in my opinion.


  9. Hey Sara,
    For the past 6 months I have suffered with a muscle imbalance in my legs/glutes. I’ve seen a back doctor and someone for my hips as well. To make this as short as possible, I do have both scoliosis and kyphosis which I’m trying to correct as much as possible. I started going to PT for my hip (I have activation on my left side and no pain) my right side NO activation and have pain in my hip on my right side. My PT said my illium was out of alignment and we corrected that, also my pelvis which I’m still working on. I got an MRI and it showed in my right hip has borderline pincer deformity and borderline cranial acetabular retroversion. I haven’t had my follow up appt yet, but I don’t feel like my doctor will really help me with this much more. My ultimate goal is to pin point what’s going on so I can weight train and build my dream body, which will require me to train legs and glutes a lot! Any advise or tips I would GREATLY appreciate!

    1. Hi Kasandra,

      I’m really sorry, this is one of those situations where I really can’t give much advice without examining you first. In general, your spinal and pelvic alignment should be addressed and it should maintain as best as can be expected with scoliosis. Though, once your alignment has been corrected, it can go out again. It happens to most people. It’s not a hopeless thing, it’s just something to know so you can recognize when you need to correct it yourself or have someone else correct it. Do you have a leg length difference at all? If you have no activation of hip muscles on your right side, then you wouldn’t be able to walk. I imagine you have some activation going on there and in general, it makes sense that you would try to balance out your muscle strength and function. If you have a muscle imbalance, in terms of strength, then it is likely because another muscle is doing way too much work. Is your PT working on re-training the way you fire your muscles or the way you move? If your doctor isn’t giving you the impression they are going to be able to help you, don’t feel bad about getting another doctor. Also, what does your PT say about your situation? Your PT should be a musculoskeletal expert and should be able to offer a lot of good tips because he or she has evaluated you. Does this make sense?


  10. I just wanted to thank you for this post. I have ehlers danlos syndrome and have been suffering from pelvic hypermobility. I was able to do this by myself, by straightening my leg out on my own. It worked!!! Now I don’t have to worry about not having someone around to help me fix it

    1. Hi my name is Sammy I keep on feeling pain in the right knee and its sharp and very hard to move I have Williams syndrome and I fell on it 2 years ago and has Benin painful ever since

  11. I have degenerative disk disease as well as occasional pelvic mis-alignment. My pain management ortho doc wants me to consider Prolotherapy to strengthen the tendons/ligaments/whatevers to hold the pelvis correctly. This is not covered by insurance. How is one to know if the pain is coming from out-of-alignment pelvis or degenerating & bulging disks? I do not have pain extending down my leg but often (daily) a sense of ice water on the outer side of my right foot, same side as pelvis in question. Thank you.

    1. Hi Shirley,

      The most conservative first step that you can take is to have your pelvis aligned (have your lumbar spine aligned as well) and put on an SI belt and see if your symptoms improve or completely go away. A good PT can do this, but not all PT’s have the skills to do this, so you need to call and talk to them on the phone in advance to make sure they know how to do this. If you see an orthopedic PT who is also a “fellow” (this means advanced orthopedic training), they should be able to do a good job correcting alignment issues. If your symptoms improve, then you’ve got a lot of information telling you that the pelvis and lumbar spine could be huge culprits, if not the entire source of your symptoms.


  12. So today I have about a 1/2 an inch out of alignment and I’m 16 and no longer an athlete. I’ve been out of alignment before but that was after a lumbar injury. I had crippling right hip pain and bad pain in my lower back so I went to my AT and he realigned it. Now I’m in the same amount of pain that I was in before it was realigned. Could it have popped back out in a span of 6 hours?

    1. Hi Allie,

      Yes, it is totally possible to go out of alignment multiple times in a day. You are a good candidate to see a really knowledgeable orthopedic physical therapist (if you don’t have any pelvic pain right now). They can help you stay in alignment, perhaps suggest an SI belt and teach you appropriate stabilization exercises to help your muscles stay strong enough so that you don’t keep going out of alignment.


  13. Dear Sara,
    I have Multiple Sclerosis (24 years) Recently my hips have moved drastically causing a great deal of pain and has set off excruciating spasms. The right side has dropped and the right leg has given up, leaving the left leg to do everything. This new development has made me even more disabled than I have ever been. I can’t even stand up straight any more. What can I do?

    1. Hi Heather,

      Thank you for your compliment!

      I get nervous adding pictures because I hear you can get in a lot of trouble, so I don’t add pictures much. Some people have pinned to Pinterest using my bio picture. I know that’s kind of weird, but I looked and I can’t really find a good free pelvic photo. Maybe this means I need to start taking my own pictures?


    2. I also was going to ask for photos. Been to an amazing PT and they did this after realizing when others didnt see my problems. They showed me these methods But I forgot. I am a picture hands on person. ANyway we could get pictures would be sooo helpful.

  14. I suffer what i thought was a intermitant muscle spasum in my left lower lumber/glute area, which caused me to look twisted, and once onset was agravated by sitting down for long periods (like driving) but slightly relived through long periods of standing. It is uncomfortable most of the time, and painfull through certain motions when it’s happening and takes about a week of light dutys and stretching to go away. After reading your post and trying the exercise, I know think i might be suffering from intermittent pelvic allignment problems. i will keep doing these exercises and see if it fixes my problem

    1. Hi Matt,

      I’m so happy that you saw yourself in the pelvic alignment post. It’s been a few weeks since you posted your comment, any changes?


  15. On Monday, two and a half weeks ago, I woke up in horrible pain on both sides of my back above the waist and also lower butt area! I went to see my PT friend and she informed me that my pelvis had slipped lower on my left side by almost an inch. She did what you were writing about and it hasn’t happened again but I am still in a lot of pain. We are doing therapy three times a week but I still get this burning aching discomfort on both sides. I do wear a lift on my right, but I haden’t been wearing it for some time because I didn’t have any pain. Does all this seem normal? My daughters are all lovingly bugging me to see an Orthopedist and get an MRI but I think thsat is over kill. What is your opinion? Thank you!

    1. Hi Patricia,

      If you are wearing a lift on your right, is it because you have legs that are different lengths? Did you get your sacral alignment checked? That is something I haven’t discussed in the blog because I think that it can’t be taught well in writing. You also need to have your lumbar spine checked by a PT. The fourth and fifth lumbar segments can affect the entirety of the pelvis.


  16. In your write up you mention iliac crest and also
    anterior superior iliac spine. Wouldnt these be the
    same? If not, how much lower than the iliac crest is the

    Would a half cm in leg length be significant?

    Thank you.

    1. Hi Jill,

      The iliac crest is part of the same bone that also makes up the anterior superior iliac spine. It’s like saying Houston and Dallas are both parts of Texas, but they are different locations in Texas. Does that make sense? The ASIS is the pointy part of the pelvis that points forward. The iliac spine is more on the sides of the pelvis and it eventually becomes the ASIS. But, it’s important to assess these separately because if you don’t, you could miss a rotation.

      A half centimeter leg length is a good question. It’s probably not very significant, but if all else fails and someone is still having a lot of back or hip or pelvic pain, you could try a short heel lift.


    1. Hi Joe,

      If your legs are the same length, then an unnecessary heel lift can cause the pelvis or hip to appear higher on one side. It’s not necessarily going to cause a twist or rotation of the pelvis.


  17. Hi Sara,

    I have two questions.

    1) I had a physical therapist last fall who noticed a considerable amount of muscle weakness on my left hip/leg, and she was constantly putting my pelvic bone back into alignment. She aligned me from the front (while I was on my back just like ow you described it in the post) but my chiropractor currently alignes me while I am on my back (while I am laying on my stomach). Is laying on your back or front better for proper alignment in your opinion?

    2) Do you believe that there are any kind of pelvic muscle workouts/ exercises that could help stabilize that area to prevent my pelvic bone from moving? If so would you be able to post about them?

    1. Hi Shannon,

      Thanks for your questions.

      1. You can correct alignment a lot of different ways, but you must be face down (on your stomach) in order for your sacral alignment to be corrected. You can’t do this while you are lying face up (on your back). It sounds like your physical therapist was correcting some pelvic alignment issues, but might not have addressed the sacrum.

      2. Oh yes, definitely there are pelvic muscle exercises to stabilize the pelvis that keeps going out of alignment. I think this makes for a great post. Thank you for the idea. I will work on that.


  18. Hi Sara

    Thank you for your interesting post.

    I had my daughter 11 yrs ago and believe I had a twisted pelvis throughout the pregnancy that wasn’t picked up until post delivery. I have had regular realignments ever since and have suffered with lower back pain since my teens. For the past three years I have tenderness all down the exterior of my left thigh, hip to knee area, (hip bursitis has been mentioned) this tenderness goes from extreme to moderate and I can not sleep on the left side, I wake during the night if I happen to roll onto my left in the night, I am really sleep deprived. I also experience sharp intermittent pain in the groin on the same side. This pain is worse when sitting in the car for long periods of time, it used to flare up when walking but since being realigned regularly that has settled. My concern now is I am experiencing pain in my right calf and right ankle. When I walk I feel like my right leg is shorter or my hip isn’t rotating fully when walking. Does this mean anything to you? The ankle pain is frustrating. It seems worse when bending forward with a straight leg or when raising my foot off the accelerator when driving. Can I be confident regular realignment will eventually solve this and my hip/groin pain?. Can it stop the claf/ankle pain or should I see a specialist?


    1. Hi Bec,

      Your pain sounds pretty severe. Though it’s certainly possible your pain could be coming from a non-threatening place like a need to assess and correct the lumbar spine (which can affect the pelvis), I do think you should see a specialist for sure. Your pain is intense and you’re not sleeping well. Get this issue checked out thoroughly.

      I wish you the best,

  19. Hi Sara, thanks for this post, I’ve had a twisted pelvis now since I was 18 and recently discovered this was the reason for my 14yrs of hip pain. The doctors never found the reason to my long time pain,nor did they bother with scans etc. I recently start receiving treatment to get this fixed, and your post has really helped with this. However Saturday night when I went bed, I was laying straight on my back and my pelvis started move slightly, moving both my legs up & down. Throughout the week my whole body started moving by itself and I don’t have control over what it’s doing. All my body structure is moving by itself with NO control from me and is doing stretches, yogo, swimming, rowing movements and a lot of twisting/untwisted all its self. From sitting on the sofa I end up on the floor and my body starts doing all these stretches and movements all it self and I can’t get up until it naturally stops it’s self. Yes, I know very weird, I’ve been to my GP & hospital and no one has ever heard of this & are not sending me any scans or test to find out why this is happening, they don’t care. I really thought my body was naturally just trying to untwist itself and move back its original position (as that’s how it’s feels to me) however this apparently impossible and never heard of. Any suggestions would be very helpful. Many thanks. G

  20. HI Sara, my pelvis is lower on my left side by approx. 12mm , I have measured this by using different sizes of books placed under my right foot when standing straight with knees not bent. if I stand straight and normal with nothing under my right foot, my left knee is bent forward , because my left leg is reaching the floor before my right. all this happened 10 years ago. I saw two consultants at the orthopaedic dept of my local hospital, who advised I made up the difference by adding 12mm to the sole of my right foot. this was carried out by me, I revisited the consultant who examined me and he agreed this was correct. once I had the extra difference on my right shoe , I have been able to walk correctly and not lean to the right, my weight is evenly distributed when I walk. The reason, therefore , I am contacting you is I am now having lower back pain and this l believe can be caused by my pelvis being out of line. At the time of my visit to the orthopaedic dept. I was never told that this could have been fixed by the exercises you have described.My question is … am I to late to start these exercises since my muscles have been in this position for so many years. The initial pelvis slip was caused by a collision when playing sport. my legs are both the same length . Hi was told by two different ot my added length should be on my left leg!!! I strongly disagree , I don’t think two orthopaedic consultants are wrong.. What do you think , and should I , now try to rectify the problem with exercises. thanks for any advise you can give me.

    1. Hi Archibald,

      I can’t give you medical advice specifically, but I can say that I am a bit confused by the description. If your legs are the same length, they truly are the same length, then yeah, you can make changes to the muscles that have compensated. You might have a week or two of discomfort as your body adjusts. But, the other part of a picture like this is that a person could have a lot of other spinal and pelvic alignment issues going on in addition to some height difference (real or compensatory). There might be a rotation, inflare/outflare of one side of the pelvis and there might be a weird sidebend of the sacrum going on. The lumbar spine really needs to be assessed well too. These are all factors to consider. Usually the answer isn’t just getting a heel lift and calling it a day. Can you get someone to do a super thorough pelvic and spinal assessment?


  21. Hi Sara, this is a wonderful bit of information! Almost 2 years ago, after trying for 10 years to get pregnant, I found an Advanced Kinesiologist who understood pubic bone misalignment. Three months after seeing her about once every one to two weeks, I was pregnant!! My alignment goes off quite easily, which most of the time I can tell by pain in my left hip and left knee. We are trying for another baby, and this is a wonderful way to keep myself aligned as much as possible between visits to my therapist.

    I’m wondering if you can just explain a bit more about what you mean, “flex the hip 90 degrees”? Thank you so much!

    1. Hi Elaine,

      How cool that alignment corrections helped you start a family. Yes – the hip at 90 degrees means that if you were to lie down, the thigh bone would be up at an angle that is 90 degrees from the rest of your body. So, lie on your back, bring your knee towards the direction of your head and have your bent knee facing the ceiling, directly facing the ceiling. As if there was a stamp on your bent knee and if the ceiling came straight down on your knee then the stamp would be perfectly placed on the ceiling.


  22. Hi Sara,
    Thanks for the post. I read much of what you wrote, but then you wrote that, if the legs are not the same length, I would need a heel lift. I am not sure what I should do, since I have had xrays that show a crooked hip and I have a longer right leg. I have worn a heel lift for about a month now, and go to a chiropractor twice a week. My right leg is still shorter, I still have an isolated point of pain in my low back/hip joint. I also have lots of pain in my upper right leg/groin area when doing certain stretches that I have read helps correct my hip/leg issue. This pain seems to be muscular, but still seems associated with my rotated hip and short leg.
    Are there certain things I can be doing to help correct this issue? Should I switch from a chiropractor to a physical therapist?
    Any bit of advice you may have would be appreciated!

    1. Hi Bob,

      If you decide to switch from a chirporactor to a physical therapist, make sure to vet your physical therapist over the phone or over email first. You want to make sure they know how to determine if someone has a leg length difference. I have to say that in my experience treating patients, many patients have been told that their legs are different lengths, but in fact, they are not different lengths. I have taken many people off heel lifts. I don’t trust xrays either because there is too much variance in how they are performed. Also, if your legs are indeed different lengths, nothing will make them the same length, you just have to substitute for the height difference with a heel lift.


  23. This was very helpful will show my pt ty. I have ot pain issues.i think this core my problems.had s1 l5 removed 07 2013 got hit by car in powerchair shove .y left hip up.been tbetapy 2.5 year every week suffering in inco ti iate bowel issue now .

    1. Hi Kelly,

      I’m very sorry to hear this. Hopefully your therapist is able to make some great changes for you to reduce your pain.


  24. 07 lumar s15 removed hit by car in powerchair .in desperate pain .w pt 2.5 year every week nothin lastest pain comes pt this she try get in clinic that do this work .she said internally has be released scared pain out control my whole left side.hopeless

  25. Hi had a 2 discectomy operations a few yeas ago, over past few months I have been struggling at work with severe stiffness I’m a painter and decorator so very active all day. I have noticed my right hip and shoulder are higher than the left. Very stiff in the mornings but loosen up as day goes on then start to tighten up towards end of the day. Just wondering what would be the best course of action as to seeing a physio or chiropractor or even just exercise at home that would help.


    1. Hi Isaac,

      I recommend you see either an amazing PT or an amazing chiropractor. You might want to call and talk with them on the phone before going in to get a feel for whether or not they have seen symptoms like yours and can treat them well. You can question them over the phone. I do not think exercise at home will be enough until you do at least one treatment with someone really good.

      You might also want to pay attention to how you paint. Right hand dominant? Posture? Weird right sided habits with the brush? Think about your movements and try to make them more symmetrical in ways that are still functional to you. Definitely consider your posture, no matter what.


    1. Hi Kelly,

      So, there are things like fusions that fuse joints, but I don’t know of anyone doing that for the pelvis – or, if I have heard of it, I cannot remember and I do not agree with it at all. I might have made that up. You never know.

      What I hear about more commonly is prolotherapy for SI joint hypermobility. This is sugar injections that create a healing process that is supposed to reduce hypermobility at the SI joint. Typically a physical medicine and rehab doctor does this. They are also known as physiatrists.


    1. Hi Jen,

      I have patients report pressure on the bowels/pelvis and urinary incontinence for several different reasons. One reason is prolapse. Another reason is pelvic floor muscle overactivity. One culprit for either a prolapse or muscle overactivity can be a pelvic alignment issue, but the trickle affect of what has happened over time also now needs to be treated. Does that make sense?


  26. This is exactly what my PT does to me every time and it works like a charm! Then i have them do 15 min of soft tissue massage in my QL area and i feel so much better. THEN I just have to very carefully move so i dont lift and twist and ruin the alignment all over again–which is really hard with a toddler and being pregnant!

    1. Hi This is awesome!,

      Hopefully you are only constantly going out of alignment because you are pregnant and hopefully you are doing some stabilization exercises to keep you in alignment. Awesome that your PT knows to correct your alignment. This is considered controversial in the PT world, but I don’t give two flips about that.


  27. Good morning! I have a question. I had a chiropractic manipulation last week (manipulated my left SI/pelvis). I now am having a lot of pain in my right side around my SI joint. When I went back, he told me that my sacrum is out of place and wanted to do another adjustment, which I refused out of fear/confusion. What are your thoughts on this? Should I allow him to do that or get a second opinion? Is there a way that I can put my sacrum back in place?

    1. Hi TF,

      I’m sorry you didn’t have a great experience. I really can’t give any advice without examining you myself. It is possible to feel flared after an adjustment, though the goal is to feel better, not worse. It is certainly possible to take a sacrum that is out of alignment and manipulate it back into alignment.


  28. I’ve seen 4 physical therapists,including the 1 I’m seeing now. The 1st was because of right lower back pain after having a baby. (Felt like a “ball” back there ). Then a year later I noticed pelvic floor issues and decided to go again(different ) and I felt much better afterwards. They used different techniques, exercises, massage, stim, pelvic floor “massage” internally, heat, etc.
    Then a few years later I started having pain in my right ankle, knee, hip, back. I went to a different pt. I unfortunately had to stop going due to insurance issues however I noticed it didn’t help much going to this place. They didn’t use all of the techniques as the other place. We’ll I had another baby abd currently I’m seeing a pt for extreme pain in my hips. I think she called it an SI problem. I forgot the diagnosis. I’m in so much pain I can’t sleep. I’ve been going to this place for a while and I’m still in pain with not much improvement. Do you think I need to see someone who specializes in pelvic floor because my thoughts are that addressing everything except the pelvic floor isn’t the way to go. Also, why aren’t they using stim, massage, etc?
    I’m upset because I feel like I’ve wasted my time there.

    1. Hi Serenity,

      Can you go back to the second PT that you saw that did pelvic floor work? It makes sense that a pelvic floor PT should do a great job with SI joint issues, but…….. orthopedic physical therapists are really good at that too, but……….. they don’t address all of the pelvic floor. So I’m suggesting you go to someone that is really good at treating the SI joint and is totally pelvic floor minded as well. We should all be that PT, but we are not all there yet.


  29. Oh yes, I forgot to mention that I went to see a chiropractor when I was pregnant (2nd) and it was for the technique to flip the baby (she was breech). So you feel like that was probably a bad choice. I just realized it could’ve been him that made me worse.

  30. Hi Dr. Sauder,

    I’m currently going to school (about to finish my undergrad) for pt. I’ve learned a lot and I gotta say you really made this very simple for readers to understand the why’s and what’s of this topic. I do have a quick question that I have been working on for a while. Currently I seem to have leg length issues (fellow students have used the technique of doing the bridge and pulling the leg and looking at the malleolus). My left side is a bit longer than my right and my left lower back hurts as well. I feel it hurt most when I do squats (I do have proper form as I am a trainer and I also asked several other trainers to video tape me), and I even start hurting during prolonged sitting. I’ve been really working on trying to strengthen my accessory muscles of my hip as well as stretching everything lower extremity and also I have been trying to align myself. I have had no success. I have had no success. I do believe that it’s either SI joint dysfunction or possibly just very tight muscles that aren’t being stretched enough and the constant tension is pulling on my pelvis. Any suggestions on what you would do for one of your patients?

    Thank you,

    1. Hi ER,

      You need to make sure that your leg is measured because it can appear to be longer when in fact it might not be a structural leg length difference. I measure from the belly button to the medial malleolus and compare both sides only after I’ve corrected for a potential upslip. Does that make sense? Many people argue with me on this, but to them I say “write your own blog”. The improvement in my patient’s function and pain speaks for itself.

      If you have a true leg length difference, then you might consider a heel lift if the difference warrants it.


  31. Hey Dr Sauder my name is James Tyson Ive been strugglingoing with pelvic floor dysfunction and it has debilitated me for over a year now. I recently have been seeing a chiropractor I have literally tried everything. I was experiencing some hiP and knee cracking and literally bone popping the last week and I’ve almost noticed my pelvic floor weakness symptoms kind of on the back burner for once . Now I’m not having as many urgent bowels and freglquent trips I’m just experieningredients hip and low back pain . My chiro told me that it is good that it is changing but I’m getting nerveos because now I’m as tite as I’ve ever been and my back and my hip are killing me . I hope you get back to me and I don’t really know how this works but If you could email me at [email protected] I would love your output on treatment I’m desperate !! I’m only 25 years old I had to drop out of all my classes at college and and I couldn’t hold jobs . Thanks alot I hope I hear from you

  32. Dr. Sauder, I’ve had PT for 6 weeks. My PT says I’m out of alignment in two ways: one, my left leg is longer and I’m rotated where my left is higher, closer to the ceiling when I’m on my back. I went in originally to see why the middle right side of my back gets a sharp shooting pain when I lay flat on my back. If I lay mostly on my right butt cheek i don’t get the sharp pain. It seems like it’s related but I don’t have the SI pinch that I normally have when I’m out of alignment. Can you shed some light on this. Any exercise or stretch that you might recommend. Can you email me?

  33. Thanks for the post. In my case, I have almost no hip or back pain at all, but have pain in my calf and hamstring area, which I assume is referred pain. The pain happens most when bending forward. I have a friend who is a Physical Therapist who did a quick evaluation and said that I do have one hip that is higher than the other, and that, on the right side, tends to rotate and slip over towards the left – something about things being too loose on the right. When lying down, my legs are very close to being even in length (less that 1/2 difference, but standing it is more pronounced. Just wondering what can be done to “tighten” the right side so it is more stable and correct the rotation and slipping that seems to be causing the pain. Any suggestions would be helpful. (Extra note: I am a runner, though I have not been running for the last 6-8 weeks since this flared up – but walking briskly seems to pull things into alignment and greatly reduces the pain. I wonder if resuming running might also be helpful – a stopped only as a precaution, not wanting to further complicate whatever was going on)

    1. Hi Ken,

      It’s really hard for me to give any advice in your situation because I would really need to examine you. I’d want to know if you actually have a leg length difference or if your pelvis is rotated so that it only appears that your legs are different lengths. This can affect your spine either way and might possibly refer pain. However, it’s entirely possible that this is not the case. You should get assessed and treated by a really good physical therapist.


  34. Hi Sara,
    Fantastic blog explaining things. I saw an osteo specialising in women’s health yesterday after severe pelvis pain. I’m 22 weeks pregnant (suffered during first pregnancy too but not as bad). She did all you recommended above.
    I had the right hip twisted forward while left was normal. Very tight hip flexor on the right due to over compensation.
    Also the pelvic bone at the front is higher (as in further away from my body) which is causing most of my pain. She helped this by putting pressure on that side of the pelvic bone. Ive worn an SI belt and back to see the osteo next week.
    I forgot to ask if there was things I can do at home to help?

    I’m based in Australia.


  35. Hi Sarah,

    All I want to say is thank you!! The left side of my pelvis has been higher then my right for the past few weeks. I felt a HUGE difference/RELIEF after trying your method.


    1. Hi Sandra,

      So cool! Hopefully you can keep correcting it and if it continues to go out of alignment, please consider seeing a very good therapist to teach you what you need to strengthen in order to stay in alignment.


  36. Hi sarah
    my right hip is higher than my left hip, due to years of bad posture and it has made my right side develop more than my left side. It is really embarrasing. My right butt is bigger than my left. what exercises can i do at home to correct the posture?

  37. Hi there thanks for all the tips

    I unfortunately have tried and do all daily with exception for the belt. My malalingment went in properly diagnosed for 14 months. I go out constantly and am in constant pain sometimes different depending I get upslip, forward rotation and outflare. It’s bad when I’m sitting too I have to literally feel like I’m putting all my weight on the left to have my back bones aligned. My pain is so bad I haven’t worked for over a year and a half as I can’t even walk around the grocery store comfortably and am on perception pills daily. Perhaps I should mention I’m a 33 year old female and before this was healthy and active bit worked a very physically demanding job. I’m so tired of all this I’ve been seeing 2 physio therapists who specialize in malalingment but so far haven’t noticed leaps and bounds only a small small improvement. I also wear the insole on my right side recently for noted leg length discrepancy. Is this normal? Do you know other people who have such bad pain with their they aren’t able to sit long periods work or walk/ stand distances at all. I do nightly physio and 5x daily adjustments form my specialist physio people. I feel like I’ve tried everything! Thanks for th support

  38. Hi Sara, this is a fabulous post! I was treated for back pain with mostly core work on and off for years without much success. I now suspect the problem may have been related to my hips. I finally found a PT that specialized in pelvic floor pain when I was felt like I was being split down the middle during a pregnancy. She found one side was much higher than the other and I had issues with rotation too. She used many of the techniques you described to pop me back into place, and I’ve kept some of them up over the years. It’s great to be able to adjust them back, but now I find myself thinking more about root causes. I’ve had a lot of luck using trigger points to treat lots of aches and pains, and I was wondering if you think there are any points that lead to chronic hip misalignment. I’ve always had piriformis issues, and I can imagine that that being tight could have caused my rotation. Could a knot in the thigh (rectus femoris or vastus lateralis?) pull the hip down, while one in the back (quadratus lumborum?) or glutes pull it up or tip it? If so, is there any chance you could put together a blog about that? Thank you for all the useful information!

  39. hello
    i’m from india.9 month ago my acetabular was crack in accident after the operation i can’t move my leg from hip,i can’t sit in toilet now.what can i do? please reply

    1. Hi hitesh,

      I’m not sure if you can’t move your leg from your hip only when you are on the toilet or at all. Are you able to walk?


  40. Hello Sara. I live in Ontario 2 hrs north of Toronto. Guelph and Kitchener Waterloo are nearby, do u have any suggestions on who I could see? I’ve been seeing a chiropractor and my official release therapist for 2 yrs now. My leg length is continually going off. For awhile my sacrum was rotating as well. I lost all. My core strength but have been building it up and seeing a personal trainer. We have only been able to work on my upper body. My gluteus and hamstrings cannot handle any strengthening..puts me in severe pain with radiculopathy. Sitting and standing can only be done for short periods. I am 49 yrs old and this is debilitating. Any of your insight would be appreciated. Where do u work out of? I would love to be able to see you for an assessment? Cathy

    1. Hi Cathy,

      I don’t know Canada well, but you might contact Nelly Faghani about some suggestions in your area. It’s hard to give any advice without assessing you. I work out of Austin, Texas, but there are many people closer to you whom Nelly could likely recommend if Austin is too far.


  41. Hey there! I am more confident about correcting my posture and less worried about my misalignment. I do, however, have a question. How does the person helping me straighten my legs if i am bending them during a bridge? Do they lift my legs off the ground and pull to straighten it or do they just straighten my legs without lifting them off the ground so i am doing a bridge with straight legs?

    1. Hi James,

      After completing the bridge, when your bottom is on the ground, then someone pulls to straighten your legs.


  42. Sara I dislocated my pelvis 6 years ago showing my son a wrestling move. Had my left hip scoped a year and a half after injury because my hip didn’t heal so I had it scoped again about eight months later. Still no relief. So almost two years ago I found out I had damaged L4,L5 and S1. Had fusion surgery, unfortunately, only to discover my pelvis twisted 9 degrees, all that has done is move the pain which actually moves. None of my Dr.s caught it. Trying to convince surgeon I wasn’t born that way. Had CTs and MRIs. Any suggestions on convincing him to do an osteotomy and square me up and refuse. In constant pain.

    1. Hi Robert,

      The question is: Did your son learn the wrestling move???

      The best way to talk to doctors is by handing them research articles. This is literally the only language for physicians, unfortunately. You can find articles by searching online. There is a resource called PubMed that has medical articles. Some are free and available in full length, others are not. Have you seen a really good physical therapist, like an orthopedic fellow about this? They might be able to help. I wish doctors didn’t do fusions so quickly.



  43. Hi there,

    Lets see if u can guess what is wrong going to be difficult to explain so bare with me ols 🙂 ok so I’m a runner and early last year i developed this pain in my lower back, the exact place is the two indentations that woman have at the back around that area. Ive been to physio that didn’t help, went to a chiro and she said i have a sprained hip ligament on my left side, i went to her often but the pain hast still not gone, she adviced that i do no exercise for 3 weeks to give my hip ligament time to heal it didn’t work sadly so ditched that and now i just bare with the pain. The pain im experiencing is if i move in any direction it feels like something is pulling and if u press on the spot its really sore feels bruised. So i have recently gone to a Stress Release person, i was very out of line and leg muscles running the wrong way, arm twitsed but that is all fixed now, i went weekly to give mybody time to heal but i still have this pain, my lady is baffled but on my last appointment she told me that my pelvic bone is out of alignment, they supposed to meet on the middle, my left one is facing up, can this be what is causing this pain cos its starting to get very sore. I showed her how i slept and she was mortified cos its so bad for yr hip area so now I’m trying to sleep on my back and fetal position on my side with pillow in front of me to see if we can get it back into place. Can u help me and tell me what u think this pain is? Or should i be going for an ex ray, im really desperate. The pain is manageable but constantly there. Thanks Des. Ps sorry for any typos, doing this on my phone 🙂

    1. Hi Desre,

      I would suggest you see a therapist that can correct your pelvic alignment, test your lumbo-pelvic hip strength, assess what exercises are appropriate for you to keep your pelvis aligned and teach you to correct your own alignment at home. I’d also want them looking at your hip joint range of motion and mobilizing it appropriately.


  44. Hi Sara, It’s Connie from Abilene. Phillip and I used these instructions so many times to get me in alignment and it worked so well. It’s been well over a year since I visited you and I have been well or Phillip was my stand in therapist and could get me back on track. Phillip passed away in mid June and now I’m dealing with pelvic pain again without my home therapist, my sweet Phillip. Here’s my deal. My right side is canted out in the front. Is there anything I can do to help this issue. I was on the floor doing CPR for 30 minutes and at a weird angle. This happened then. As always, connie

  45. Excellent information! I have been planning on having my SI joints fused because they are constantly getting “stuck” and causing a lot of pain. Maybe it’s a good thing my insurance denied the surgery and although I’m appealing their decision I just might be able to avoid the surgery if I can get my pelvis aligned properly. I did just meet a physical therapist yesterday who is familiar with SI joint problems and I was able to do the number of exercises that I should have been doing for the last year for the first time with her because she knows how to get my joints “unstuck” so I could keep exercising after she fixed them. It took about 4-5 times longer than a normal session because they took turns getting stuck and it must have gapped at least 8 times in a half hour. With your information here I can try to get myself aligned so that I can help myself when the joints get stuck and be able to do the amount of exercises that I need to do to get strength back in that area. I started wearing an SI belt A couple of months ago and it does help with the frequency of getting stuck being less. The problem was once I was stuck it was no good to continue wearing it while in the wrong alignment. Now with your help Gil instructions to get myself realigned I’ll be able to keep it on more often. Maybe I won’t need the surgery after all! Do you have a video showing this adjustment? I have the general idea but I am better at actually seeing something done if I want to be sure I do it correctly.

    1. Hi Betty,

      I’m glad you are seeing a therapist to help you with this. I have not made a video of this, but I know there is demand for one.


  46. My mid hip section, one bone feels like it’s stuck out abit, on my right side, and when I go to bed, it sticks out abit more, I tried everything, and it’s not working, please, help, is their anything else that I should do.

  47. My mid hip section, one bone feels like it’s stuck out abit, on my right side, and when I go to bed, it sticks out abit more, I tried everything, and it’s not working, please, help, is their anything else that I should do. I need help, maybe it out of place, and I don’t know how to fix it. Please help, I’m abit afraid.

  48. Hi my name is Hayley I have EDS type 3 which means my ligaments are to lax I can put myself straight & just out a car.go up a step.turn in bed etc & be completely twisted the other way I have tried belts but not for a long time as they have to be that tight they leave marks but now I am getting that my discs are wearing away with my pelvis keep moving whilst I walk i would love it pinned but they will not do it as they say my hips are unstable and it could make them worse????? Could u please email me with any advice

  49. Hi, my name is Angela Watson. I had a nasty fall from a horse in March and fractured my acetabulum. Apparently it has all healed. My problem has been sciatica on the left side (injured side) which is really affecting how I’m walking. I’ve now been told that my piriformus muscle is affecting the sciatic nerve. I feel all squint and in constant pain. Sitting at a desk definitely makes it worse. I’m getting severe pain in my left quad, left outer calf and often my knee. I’m sure when I fell off this leg was twisted in stirrup. My left knee and foot definitely turned outwards. I feel my whole pelvic area needs to be realigned. I’ve been going to Pilates and aqua fit classes for some time now. Still lots of pain, sick of having to take painkillers to remain mobile. I just want to be able to walk normally but this is so debilitating and getting me down. Any suggestions what I can do and what type of practitioner I should be seeing. Recent X-ray to knee is normal. I’m getting desperate. Can you please help.

    1. Hi Angela,

      I’m sorry to hear about your pain. I’m assuming you fractured your left acetabulum?

      I would advise you see a physical therapist that knows how to correct pelvic alignment and how to assess for good hip joint mobility. Not all therapists do this, so you will want to call them first to make sure they are a good fit for you.


      1. Hi Sara, thanks for reply. Yes, left side acetabulum. I’ve had to go back to my gp this week as pain been so bad. Got appt with orthopedic consultant next week as physio and gp both recommend. So hoping that he does scans to confirm problem and gives me solutions.

          1. Just to let you know I’ve ended up with a total hip replacement. Seeing physio tomorrow so hoping I’m going in right direction now.

  50. So reading these makes me wonder. I fractured my growth plate in my left ankle as a child, and a few years ago I developed an issue with severe back pain on my left side. It literally felt (to someone who doesn’t know a ton about it…) like my tail bone and spine disconnected and then when I straightened up I could feel them pop back in place. Obviously that’s not the case, but does that sound like a pelvic misalignment? If so, what would you recommend to do from here? It doesn’t bother me often, but I also don’t sleep on my back, or do a lot of exercises I would if I knew it wouldn’t happen.

  51. My right hip is pushed forward and makes running difficult. I’ve been diagnosed with anterior pelvic rotation. Been seeing A PT for 6 plus weeks and chiropractic doctor wants me to wear a show lift. I’ve never had issues with this in the past. I’m a marathoner and want to get back trimming without feeling so one sided and labored.

    1. Hi Rachel,

      A lift is only appropriate if your legs are actually different lengths. Are your providers able to correct your pelvic rotation?


  52. My right hip is pushed forward and makes running difficult. I’ve been diagnosed with anterior pelvic rotation. Been seeing A PT for 6 plus weeks and chiropractic doctor wants me to wear a shoe lift. I’ve never had issues with this in the past. I’m a marathoner and want to get back to running without feeling so one sided and labored.

  53. I’ve been to a physical therapist for 3 months, I know the exercises I can do at home to help realign my pelvic bone but they are not working currently. It also feels as if my pelvic bone is shifting consistently to the point where the right side of my pelvic bone feels as if it is on the left side (with the bones rubbing against each other). Does there happen to be a point when it stops moving over farther? Is there something else that I need to be doing?

    1. Hi Rebecca,

      Perhaps you need a second opinion on correcting your alignment. I don’t usually hear what you are saying from patients, perhaps another assessment?


  54. I have been dealing with hip issues for about 2 years now. The lower portion is the left hip/ leg and higher portion being the right hip/ leg. My alignment gets so bad to the point I feel my whole left side of my body (leg, hip, shoulder, ect.) is lower than the right side. The pain is not in the butt region but in the middle of my lower back and even drifts into the pelvic region where the top of my left hip is. Is there anything you can advise me to do to finally get some relief and hopefully keep my hips better aligned?

  55. Right hip keeps shifting forward and inwards causing extreme pubic bone pain just been corrected and hv belt on been happening for about 3 years is this normal

  56. Hi. My family doctor told me that the pain in my left hip and entire right leg was because my pelvis is out of place in three spots. Would the info you provided in this article help me put it back? My hip no longer hurts but I can’t walk for any length of time before my entire leg hurts so bad I can’t even get in a car without crying in pain. Thanks for your help

  57. thank you for sharing your expertise. My hips are moving constantly at the moment – i am female – very tall with very little body fat – particularly in the last few weeks – i have lost some body mass. Interested in the SI belt – but which one do you recommend?

  58. Hi Sara,

    My wife has lower back problems, we when to a chiropractor and he said that her hips needed to be tilted forward, so he did the adjustment abs it really help. But now her back hurts again, how can I help her tilt her hips forward again?

    Thanks much

  59. Sara, this is an excellent and easy-to-understand post. Thanks! I suffered with pelvic malalignment for 6 years until I finally found a PT trained in re-alignment; that was 8 mos ago and I’m still in alignment! I’ve been in PT since to strengthen my inner and outer core but continue to have pain issues and wonder if you could give me your thoughts on two issues.
    1. When my pelvis was out of alignment, it was left innominate raised and rotated anteriorly. Now I experience strong aching in the right “crease,” where the leg meets the hip, and sometimes parathesias down the right quad. This can happen on the left side, too, but the right is much worse.
    My current PT (not the one who put me into alignment) thinks this effect is from lumbar spine problems rather than from re-alignment. My gut feeling leans toward the latter. Your thoughts?

    2. Pre-malalignment I had very mild scoliosis that got worse due to the malalignment. Since re-alignment the muscles in the thoracic area hurt like crazy, especially on the left side. My PT doesn’t know what to add to my program for this. Thoughts?

    Many thanks!

  60. Hello, my hip area has been in pain the last two years. I have visited a chiropractor for about 40 years weekly after an motorcycle accident. The last 2 years my chiropractor has had to pull each leg while I lay face down, until each leg/hip “pops” alleviating me from the radiating pain across my lower back. He told me my ligaments work loose and it just pops out all the time due to my activity. I work with children so I do lift daily. But it has gotten so bad that just walking it seems to pop right back out after I have it treated. I can have my son pull on my legs everyday and that makes me feel better so I can continue on. They pop rather easily. I would like exercises to strengthen that area so I don’t have to depend on someone pulling my legs. I’m 59, and very active. I snowshoe, split wood and stack it, garden, do woodworking as a hobby, I am on my feet all day. And work 11 hours a day with children. I have an in version table but that does not seem to pull my legs back where they belong. your exercise does not pop them back either.My dr says walking is the best exercise, my chiropractor doesn’t know what I should do. Any direction would be greatly appreciated. Marcia

  61. Hi Sara,
    I had a pelvic upslip on right side corrected last week.

    The next day I had severe pain in my right hip when bending to the right to put my shorts on. I took muscle relaxants which has been some help. Now a week later and the pain has eased off but I do have ligament pain on right side if I walk too much ie referred pain from sacroiliac joint. I want to ask if the hip flexors should also be corrected at the same time, as I think this has caused the increased pain. I had an upslip corrected before and no pain after, but this time I have disc bulge on left side, sacroiliac hypermobility which is adding to my problems.

    My pelvis feels like it’s aligned now after doing the test you suggested. Do you think I should have another appt or just leave it all to settle?

    Kind regards,

  62. Hi Sara,
    A quick further comment. I struggle to put my socks on right foot. Just put right leg across, then bent down to put sock on and got extremely sharp pain in hip/ligament area under top right leg.

    This is the same pain I had a week ago, so concerned if I should ask physio to change his treatment so that I don’t get this sharp pain after. Am convinced it’s to do with hip flexor extension, but it may be pelvic slip adjustment which has not been adjusted enough? What are your thoughts on this.

    I have an appt tomorrow and not sure what do to. Maybe just go along and voice my concerns.

    I am in Sydney. Hoping to celebrate new year’s with less pain.

    Kind regards,

  63. Hi Sara,
    It’s so kind of you to post & share this for the public. What does it mean when one bone is bigger than another? Is there a cure for that? With pelvic misalignment, does this affect the blood flow downward and cause pain to the knees and ankles? Thanks in advance for your response.

  64. Hello, I dont normally post stuff on the net as a lot of the info out there is in my view not helpful but am pretty desperate so here goes, 6 years ago i fell backwards down a flight of stairs and damaged one of my discs which led to severe sciatica down my right leg, i had to have a microdiscectomy to try and fix the damage the procedure unfortunately only partly worked so the doctors put me on a course of strong painkillers which to this day im still taking ( dihydrocodiene), most of my pain comes from the right pelvis at the back just above my right buttock and when its at its most painful the right side of my pelvis is very raised so much thats its visible and you can feel the bone sticking out, I do not know if there is any advice that you can give that will help, but am hoping that there is some kind of exercise or stretching that will help correct the misalignment of my pelvis, I suspect that when i had my fall it knocked it out of position, I am 6 years in now constant pain every day, sleepless nights the works, walking tends to aggravate it although I try to walk when i can and my gait is off so i have to take small steps, which makes for a funny looking walking style to say the least , I have basically been chucked on the scrapheap now and am on various disability benefits to aid in my getting about but I am screaming inside for this to be fixed or at least eased as this excruciating pain I do not want to endure for much longer, I hope you can help maybe with some advice. yours sincerely Anthony Fox.

  65. Thank you for this post. Since my last pregnancy (5 years ago) my round ligament pain has never gone away completely. I usually have to get up at night to pee several times, I feel constant pressure on my bladder and pain in my lower back. I have always thought I had one leg longer than the other but a chiro explained to me last year I had pelvic rotation. She never corrected it though and I stopped going to her. Last night after reading this, my husband helped me with this exercise. I didn’t think it helped until I started walking around and I could actually put both feet flat on the ground without teetering side to side. I have my balance back. I was able to flat on my back with no pain. I didn’t get up to use the bathroom last night and the pressure is gone. This is incredible! I’m going to continue with another physical therapist soon but in the meantime I’m actually ok for once. Thank you so much!

  66. PLEASE POST PICS or visual diagrams OF how to do THESE EXERCISES? I’m confused with the verbal description alone.

  67. To clarify more, PLEASE POST PICS of the following exercise (I’m confused with only the verbal description.):

    If one side is higher, bend the knee on that side and flex the hip to 90 degrees. Take your hand and try to push your knee away from you while your knee pushes into your hand. Do this for 8 seconds and repeat 3x. Recheck to see if your pelvis is aligned by doing step 1.

    If one side is lower, bend the knee on that side and flex the hip to 90 degrees. Try to bring your leg down straight while someone else resists you at your hamstrings. Do this for 8 seconds and repeat 3x. Recheck to see if your pelvis is aligned by doing the first step 1.

  68. He Sara,
    I emailed you. I am desperate for relief. My pelvis has gone out of alignment for years. I’ve seen chiropractors and physical therapist. Recently I got new orthotics from my foot doctor for foot pain. I believe that is what is causing the most recent flareup. However when I went back to a chiropractor I saw years ago for this issue, he told me it was arthritis in my hip. I just am at a loss what to do now. please advise on finding a physical therapist that’s knowledgeable as well as maybe an SI belt . THANK YOU!

  69. I’ve had issues with my back and pelvis for almost two years now. Imaging shows I have 2 bulging discs at L5-S1 and L5-L4. X-rays show one hip higher than the other. I’m in constant pain or discomfort. It is always its worst after sitting. I get jarring pops in my low back and sacral area that relieve discomfort from sitting. I just got it big time on both sides after playing the piano for a mere 20 minutes. I can’t work because sitting for 8 hours a day is torture. Sitting for half an hour is trouble even. I sit with terrible posture to try to avoid pain, and I’m so afraid I’m doing more damage because of it. I know my right hip is tilted forward. It clearly pops out more than my left. I’ve seen physical therapists, chiropractors, orthopedic doctors and I’m currently seeing a neurologist/spine specialist. I don’t think anyone is getting to the root cause. Everyone just wants to get me on pain meds or have me buy this or that or do these excersizes that never do ANYTHING. I want to heal so my body doesn’t continue to disintegrate. I’m only 27 and I really miss running, working out, and playing tennis. But mostly I miss feeling healthy and happy. Who should I see?? What should I do? I’ve spent a fortune trying to resolve this problem and have gotten nowhere.

  70. I’m sure my right leg is a bit longer than my left. My right pelvis is out of alignment and the pain goes across my whole lower back. I have exrays in two days and on to phy. Ther.
    My pelvis has done this before and my ther. A
    Had me do similar exercises as you suggested. I started your exert. Tonight and do feel a little relief.
    One thing, I always wake up with the misalignment and I almost always sleep on my right side. I.e. Side the pelvis hurts. I’m taking your suggestion on sleeping and also sitting. I frequently have pain when I get up from sitting in a chair at my husband’s nursing home. Also I have terrible posture. I gotta get working on myself.. your blog was very helpful. Thank you so much. One question. If I try to sleep on my left side, is it ok to put a pillow between my legs? Regards, Sue

  71. Hey,
    So my hips are always out of alignment. Almost every day my coach will adjust them back into alignment. It’s always about an inch off and which side it is will vary. I don’t trust my close friends to do it because I think they might mess up. I have some gnarly back pain too and I have a gut feeling this is the cause. This article helped a little but I still don’t know where I stand so help would be great.

  72. This is very good information. I had a wonderful physical therapist about 10 years ago or so teach me how to realign my pelvis/hips and showed my husband how to do it when I couldn’t get it.I’m pretty sure my issues are from 2 different accidents when I was younger. She specialized in pelvic pain. After years of problems and tests and x-rays or being told it was psychosomatic she was the only one that was able to tell me what was going on and how to relieve most of my pain. I had been through painful bladder and pelvic treatments and surgery before this with little relief. Those simple skills and understanding helped me for years relieve my pain. Fast forward to now, I’m having back issues and pelvic pain. I do have one disc with a 2mm bulge and some arthritis. Every single doctor and PT I have recently seen in 2 different states I have told about my pelvic alignment issues. They tell me it’s irrelevant. I have been through multiple shots in my lumbar spine over the last couple years. Now they want to do nerve ablation, spine implant or fusion. I feel like they are missing something. I feel like they are trying to treat symptoms vs. the actual problem. My husband is military, so we move often. It’s frustrating to tell a medical doctor a diagnosis and have them ignore it for invasive procedures. I’m tired of being in pain. I can literally align my pelvis and while carefully standing up it goes out again.

    1. Hi Krista,

      I’m sorry you are struggling with your current providers. Have you tried talking to a PT about getting you on a stabilization program? You can ignore that they don’t think your alignment is relevant and then you can align yourself and then do stabilization exercises.


  73. Hi

    Thank you for your post , very interesting read. I do have a quick question if that’s alright . I’ve been having pelvic floor pain on my right side from extreme tightness for around 2 years . No physio or experts have been able to help . As of late the only thing I seem to have recognised is extreme tightness in my left quad . I guess my question is would that unilateral tension if I was tight enough cause twisting of the pelvis and a pelvic floor problem ?
    Thank you for any advice

  74. Hi

    Thank you for your post , very interesting read. I do have a
    quick question if that’s alright . I’ve been having pelvic floor pain on my right side from extreme tightness for around 2 years . No physio or experts have been able to help . As of late the only thing I seem to have recognised is extreme tightness in my left quad . I guess my question is would that unilateral tension if I was tight enough cause twisting of the pelvis and a pelvic floor problem ?
    Thank you for any advice

  75. Sara, when you say in your reset instructions, ” have someone to pull both of your legs straight”, do you mean, unbend your knees, and someone pulls your whole body by your legs horizontally on the floor?

  76. Hi Sara,
    My PT has reset my pelvis several times in the past few months. Although I am following all of his instructions exactly (no high heels, no kneeling, no crossing legs etc. etc.) I keep going out of alignment. He has no suggested I consider prolotherapy to tighten/repair sacral ligaments. What do you think of this procedure? Safety? Efficacy? Also, if my problem is loose sacral ligaments why is my PT doing soft tissue work in my pelvic and hip area? Won’t this just make things looser? Thank you for any additional info.

  77. Hi all
    I am sending mesaage her just need your help.

    Feb 2018 MRI showing my left hip labral left foot can not put on the right foot when I sit.
    how much the cost for left hip in USA?By Estimate
    I am from china,I would like find the best surgeny doctor in USA ,can you recommend a suitable for me?
    best regards

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