Hip discomfort can arise from your muscles getting tight and shortened, as well as your joints changing, which can lead to back and knee pain. Yes, that sounds excessive, but as our joints and muscles become tight and stiff, they tend to do their own thing. For example, your hip flexors and quadratus lumborum (QL) are frequently to blame for your hips and pelvis shifting, resulting in hip pain.
Why do your hips shift into various positions?
“When the hip flexors become tight, they pull on the pelvis, rotating it forward into an anterior pelvic tilt,” says Theresa Marko, PT, DPT, MS, a board-certified clinical specialist in orthopaedic physical therapy. If you have an arch in your lower back or lumbar spine, your glutes protrude forward, and your ribs protrude forward, you may have an anterior pelvic tilt.
Because this tilt moves your spine out of its neutral position, the tension pulls on your pelvic joints, particularly the sacroiliac joint, also known as the SI joint. You may feel your SI joint by placing your hands on your hips and pressing your thumbs into the area below your spine and above your tailbone. “This is when one can begin to feel pain and possibly some nerve pain down their leg manifested as tingling or numbness,” Dr. Marko adds.
The QL is another muscle that can cause a movement in the pelvis or hips. This muscle, according to Dr. Marko, is the body’s powerhouse, helping to maintain the lumbar spine as well as moving the pelvis and hip during activities like walking. However, it is prone to becoming tight and becoming caught in a shorter position. According to Dr. Marko, this can pull your pelvis up, similar to what happens when your hip flexors tighten and shorten, causing lower back or lumbar spine pain and nerve pain down the leg.
There’s no reason to be concerned if you go from zero to one hundred when diagnosing discomfort; your joints aren’t displaced. According to Dr. Marko, they’ve simply relocated into a different position for the time being. The good news is that this displacement can be corrected and they can return to their ideal location.
How can you know if your hips or pelvis have shifted?
If you feel pain in your SI joint, you may suspect that your hips or pelvis have changed. According to Dr. Marko, depending on how in tune you are with your body, you may also feel like one leg is longer than the other (this is produced by the pelvic shift).
“The simplest approach to examine your pelvis is to lie down on the floor with your legs bent, place your hands on top of your pelvis, and feel if one side is higher than the other. If this is the case, your QL is on the tight side “Dr. Marko says.
You can also straighten your legs and have someone check the level of the bones on the inside of your ankles. If they aren’t level, it’s likely that one of your hip flexors is tight, causing the imbalance.
How to reposition your hips and pelvis in the correct position
There’s no need to be concerned if your hips or pelvis have shifted out of alignment. “This is a very normal position that the body may move into, and it can also move out of,” Dr. Marko explains. Dr. Marko recommends releasing trigger points in the iliopsoas and iliacus (your hip flexors), extending your hip flexors, and strengthening your glutes to get them back into the appropriate posture and relieve any stiffness and pain.
According to Dr. Marko, strengthening your glutes will help to keep your hips and pelvis from shifting by preventing tight hip flexors and allowing you to fully extend the hip and rotate the pelvis posteriorly.
Targeting your QL is a little more difficult, and releasing it requires the assistance of a professional, such as a physical therapist. In the meanwhile, Dr. Marko suggests strengthening the lateral hip stabilisers and glute medius to avoid overworking the QL muscle and to allow it to spontaneously release.
The conventional glute bridge is a basic movement that works on all of the above and can help you get your hips and pelvis in the appropriate position in no time. Dr. Marko advises seeing a physical therapist if you’ve been in pain for a long time. A physical therapist can build a personalised treatment plan for you.
If your hips are extremely tight, try this 24-minute yoga flow to loosen them up:
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