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Dude, Your Hip is Higher on One Side (Part 2)

8/30/2017

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If you find your pelvis does not level with legs spread wide, we need to get you fixed.  This article will demonstrate the ways you can fix your pelvis with structural and strength training methods.  

It's quite possible that if you had one pelvis higher than the other when spreading your legs wide, you unconsciously stand like the picture below.  

It's also quite possible that despite what the picture shows (which is an elevated right pelvis in standing), you have an elevated left pelvis (when trying to stand symmetrically). 
Picture
How could this be?  

What happens if you pound a really long nail into the ground?  The more force you pound with, the deeper the nail will go, right?  So, imagine you spend hours or at least everyday for 30 minutes or more standing mostly on one leg.  

Whichever leg you stand on most, the deeper that hip will go into the socket (or acetabulum), which effectively makes the leg shorter.  If one leg is shorter, this will lower the that same-sided hip toward the ground more. Consequently, the opposite pelvis will be higher.  This is why if you stand a lot, you are more likely to have a socket-caused issue rather than a postural-caused issue.  

What's the fix for a socket issue?  Assume you have an elevated left pelvis issue because you stand on your right leg like the picture above. The answer is to begin to stand on the opposite leg.  However, we don't necessarily need to continue to lower the right pelvis to get the benefit of mostly standing on the left leg.  
Picture
In my experience, even standing with a depressed right pelvis like the picture above will still lead to positive results if you have an elevated left pelvis. 

That's really about it.  Here's the thing though.  You will stand on your right leg unconsciously. It means you really need to pay attention as much as possible to standing on your left leg.  

I tell all of my clients who've had this problem that that you will not be perfect.  You will find that you find yourself standing on your right leg, and when you do, it's time to swtich, not give up . The more you practice or notice yourself - and correct yourself, the faster an effect you will get.  

Let's assume you have a client who does the wide leg stance test and finds their right pelvis is still elevated.  It's no wonder as this client stands a lot and happens to stand on their left side. Again, this makes left femur deeper into the socket of the left acetabulum.  It results in a lower left side.  

In this scenario, we want to put more pressure into the right acetabulum and distract or take away pressure from the left acetabulum.  We can accomplish this with:  
Picture
It's important to note that the left leg is not supported on anything.  It's simply hanging. That's the goal because we want the left femur not so impacted into the left acetabulum.  

As you can see, I can also focus on the likely weaker left obliques by trying to raise my left pelvis to the ceiling.  

To challenge the obliques more and to get a greater distraction for the left side, you can use a DB in the crux of your left knee.  (I find this is a good left hamstring warm up too as the left hamstrings are frequently weaker than the right hamstrings.) ​
Picture
I recommend putting this exercise before stretching and strengthening exercises.  Think of it as a realignment exercise.  After this, we can begin to address mobility and stability.  ​

Before we get into the strength training, you need to make sure that all positions you are in have at least a level pelvis. Let's assume you have an elevated right pelvis.  You could also position yourself with an elevated left pelvis to correct yourself in the short term.  Let's assume you're normal pelvic position during the plank is: 
Picture
You want to make sure that you can at least get a neutral pelvis or even an elevated left pelvis in this situation (since the right pelvis is elevated) 
Picture
The bottom line is that no matter what exercise you do, always make sure you have a level pelvis (or an elevated pelvis in the opposite direction).  

​Let's get into how you can use strength training to correct your lateral pelvic tilt. This will apply whether you have a socket-caused or a postural-caused lateral pelvic tilt. 


Whenever a lateral pelvic tilt is present, you will have abductors on the elevated side which are lengthened (and possibly weaker) and abductors on the shortened side which are shortened (and possibly stronger).  

Whenever abductors on one side are lengthened, the antagonistic adductors are shortened.  In our case, let's assume we have an elevated right pelvis (which is the opposite of what we just discussed above.)  

In this scenario, the abductors on the left side are lengthened, the adductors on the left side are shortened, the abductors on the right side are shortened, and the adductors on the right side are shortened.  

We also must contend with the abdominal musculature.  With an elevated left pelvis, the left oblique muscles are shorter. The right oblique muscles are longer. Consequently, it is wise to insure that whenever we are strengthening or stretching our hip muscles, that we coordinate these efforts with stretching or strengthening the oblique muscles.  

An appropriate go-to methodology is simply to strengthen the lengthened muscle in a shortened position and to stretch the shortened muscle in a lengthened position.  Here's how we can do that.  Again, we must be very careful to pay attention to how we place the hip depending on which side we are working on.  

Again, if I have an elevated right pelvis, I will want to work on my right side hip abductors.  I will have clients hold this position above (if it's sustainable).  Some clients you will find have cramps, so you may need to gradually increase the time you hold this position.  

Eventually, you should try to get your way up to holding it as high as they can.  I will have my clients work their way up to 30 seconds with ankle weights for at least 3 sets per day.  

However, you must make sure to not hike up your right pelvis because then, we are giving into the direction of our elevated pelvis.  At least, try to keep your pelvis level like I'm trying to do below.  ​
Picture
The next part we can focus on is the left adductors. 
Picture
I'm not doing a great job of keeping my pelvis level, but I should be more level.  Basically, my pelvis line in this position should be vertical.  

For the adductors, you should be able to hold this position for  along time.  You can build your way up to putting a 10 to 30 pound dumbbell on your mid thigh. Hold for 30 seconds in the top position for multiple sets.  

You may need to mobilize your adductors and abductors and to be honest, it usually never hurts to do this.  Even if you are hypermobile, stretching the shortened abductors and adductors can help turn these muscles off.  

In our case (as we are still working with the elevated right pelvis), I'm going to put my right leg on a wall as shown in the picture below to feel a good stretch in my adductors.  If you cannot make it to at least 45 degrees, then you definitely need to try to get to 45 degrees. Hold for 30-40 seconds.  

I don't do a great job keeping my pelvis level, but you should try to keep it level or even have the left pelvis elevated. 
Picture
Next, it's time to stretch out the left hip abductors.  To do this, we are going to make sure we have a level pelvis, then get into the stance like the picture below.  
Picture
With an elevated right pelvis, it means the left obliques may be weak.  To correct this, you can do a left side plank, but again, make sure the pelvic line is neutral or you actually have an elevated left pelvis (which is a wise correction in the short term).  

With clients in the position below, I'll even try to pull their left pelvis low so they have to keep it elevated.  ​​This challenges the obliques the way we want them to adapt which is to elevate the left pelvis.  
Picture
As you can see, there are many different ways we can attack a lateral pelvic tilt.  Make sure that you at least test the wide leg stance first to know which direction you should go with either a postural-caused or socket-caused lateral pelvic tilt.  

Regardless which you have, you should do appropriate strength training and always make sure your pelvis is level before beginning any exercise.  I'm confident that you will get out of your lateral pelvic tilt fairly quickly if you are diligent in watching your posture and using stretching and strength training together.  
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