If keeping healthy is important for you, it’s vital to pay attention to the signals our bodies give us, as ignoring them can lead to big problems down the road.
One such signal is a feeling like your hip is out of alignment. How do we tell if that’s happening?
These are the signs to look out for.
Hip out of alignment symptoms
- Functional leg length discrepancy
- A tilted pelvis
- Lower back pain
- Muscle imbalances
- Pain in the thigh, groin, or buttock area
- Hip Bursitis
- Pinching pain in the hip
- Difficulty standing up from sitting
- Limited range of motion in the hip joint
- A sensation of the hip joint being “out of place” or abnormally loose
- Hip pain that worsens during physical activity, but improves with rest
- Leg weakness on one side
- Knee pain on the same side as the misaligned hip
- Numbness or tingling sensation in the leg or foot
- Poor balance and coordination on the affected side.
What is a “Hip out of alignment”?
Most people think their hip joint is located on the side or back of their body. If you have pain in these areas, your issue is likely in the pelvis or spine.
The ‘hip bone’ is a common term we all know as the being on the side of our body, above the buttocks, but the hip joints are located near the front, deep inside the groin area as shown below.
It’s uncommon for your hip joints to become out of alignment unless injured – you would have known about it earlier in life. Or, you’d be having a lot of issues with leg stability, and probably a lot of pain!
Some reasons for uneven hips (femoroacetabular joints) include:
- Hip dysplasia – a condition where the hip joints do not form properly before birth. Usually corrected with a hip brace during infancy, so generally isn’t an issue unless not treated.
- Slipped femoral capital epiphysis – where the ball of the femur (thigh bone) slips off and backward. Occurs in kids and teens.
- Hip dislocation
- Hip Osteoarthritis
- A fractured pelvis that healed with misalignment
If that doesn’t sound like you, you are likely experiencing a misaligned pelvis, which we sometimes refer to as the “hips” because that’s where our jeans sit upon!
Let’s explore a few of the above symptoms that are the most misunderstood.
Functional leg length discrepancy
This is when one of your legs is shorter than the other, due to structural and biomechanical factors. Every-day poor postures and habits can create this. Other causes can include trauma to the hip joint, injuries to the lower back and pelvis, uneven muscle development, and more.
This differs from structural leg length deficiency, which is an actual shortening of one of the legs, either genetic or acquired.
A tilted pelvis
A tilted pelvis comes in two varieties and can be the result of many causes. Muscle tightness, poor posture, or sports injury are good examples. Sitting at a desk all day tightens our hip and back muscles, like the hip flexors and hamstrings.
An important muscle involved in pelvic tilt is the quadratus lumborum (QL).
The QL is a muscle that runs along the lower side of your torso and helps to stabilize your back. If this muscle is tight, it can pull your pelvis out of alignment and cause you to tilt to one side.
The other type of pelvic ’tilt’ is in the front-to-back plane, where your hips are either in:
- anterior pelvic tilt: too far forward (exaggerating your lower back curve)
- posterior pelvic tilt: too far backward (flattening the lower back curve and rounding the upper back)
There’s no ‘correct tilt’ that is the optimal amount. Rather, we all have a range. There is a concept called pelvic neutral which is roughly the midway distance between tilting your pelvis all the way under, and all the way back.
It’s good to know where your neutral position is, so you don’t suffer abnormal pelvic tilts, creating symptoms of your hips being out of alignment from being too much tilted either way.
Pilates, yoga, and physical therapy are great starting points to learn to find your pelvic neutral
Muscle imbalances
Muscle imbalances are a common symptom of having a misaligned pelvis. Your nervous system controls muscle activity, as it sends signals to the muscles telling them when to contract and relax.
When your hip joint or pelvis is out of alignment, these neuron signals can only do their best to keep you upright, via muscle contraction. Imbalances then form in your structure as compensations.
In addition to causing pain and discomfort, muscle imbalances can also lead to further misalignment of the pelvis, creating a vicious cycle. Fortunately, chiropractic care can usually help to realign the pelvis and restore balance to the muscles.
By correcting the root cause of the problem, chiropractic care can provide lasting relief from muscle imbalances and their effects on our bodies.
Hip Bursitis
When the hip is out of alignment, it puts pressure on the soft tissues around it, including the bursa. The bursa is a small sac of fluid that takes friction off tissues like bone and tendon.
When it becomes irritated too much, a bursa can cause pain and swelling. Hip bursitis is often treated with ice, rest, and manual therapy, and correcting the underlying cause with chiropractic care. These can be functional leg length discrepancy, muscle imbalances, or sports injuries to name a few.
Difficulty standing up from sitting
This happens with Sacroiliac joint (SIJ) Dysfunction.
The sacroiliac joint is a strong, weight-bearing structure that connects the pelvic bones to the spine. There are a number of different causes of sacroiliac joint dysfunction including:
- injury
- arthritis
- pregnancy
And of course, a misaligned hip and pelvis will destabilize the SIJ too – causing pain when your SIJ is stretched or moved, like when standing up after sitting for a while.
Stiff hip joints can also contribute, so it’s important to maintain good hip mobility to reduce your risk of sacroiliac joint dysfunction.
Knee pain on the same side as the misaligned hip
If you have knee pain, it could be from a hip out of alignment because many of the muscles around the knee also connect to your pelvis and hip.
This all links back to structural issues in your lower body causing tight muscles, abnormal pelvic tilts, and spinal misalignment.
The classic pattern we see every day is a weak gluteal muscle group and tight hip flexors, causing chronic pain at the knee joint.
Numbness or tingling sensation in the leg or foot
Numbness or tingling in the leg or foot can often be caused by hip problems. The sciatic nerve, which runs from the lower back down the leg, can become irritated or compressed from torsion in the lumbar spine or pelvic bone, leading to nerve tension.
This can be caused by a variety of conditions, including herniated discs, spinal stenosis, flat feet, and piriformis syndrome.
If you are experiencing numbness or tingling in your leg or foot, it is important to see your doctor, chiropractor, or physical therapist promptly, to rule out any underlying hip problems or a serious issue like a herniated disc, to avoid long-term risks.
Simple home tests to check your hip and pelvic tilt
- Find the outermost part of your upper thigh. This is called the greater trochanter (an outcropping of bone on your femur). With tape, measure from the middle of this bump all the way to the ground in a straight line. Compare to the other leg. If they measure differently, you may have pelvic torsion causing this hip asymmetry.
- Perform the “figure four” stretch by placing the ankle of one leg over your opposite leg and applying gentle pressure. If your right leg is different to the left, this is a sign that your pelvis may not be in line. However, this may just be from a tight hip ligament capsule on one side.
What is the treatment for misaligned hips
Misaligned hips are treated with physical therapy, chiropractic care, and strengthening programs. Physical examination may reveal asymmetry in the pelvis or hips. Chiropractic care consists of specific adjustments (spinal manipulative therapy) to free up restricted joint motion.
Strengthening programs will focus on the gluteal muscles, hip abductors and adductors, QL, and the necessary deep hip and pelvic soft tissues.
Ergonomic changes can get to the underlying cause of why your hips keep going out of alignment.
Is your footwear contributing to your hips going out all the time? Flat shoes may be the cause.
Hip and pelvis FAQ
Is my job causing my hips to go out?
Most of us tend to sit with a tilt to one side, or a leg crossed over the other. Such habits can cause hips to go out of alignment because our joints and soft tissues will change tension under these chronic loads.
If you work at a desk or drive a lot, this can absolutely be mucking around with your pelvic stability. If you do repetitive tasks (even if it’s mainly with your upper body) then it’s the same story!
Can misaligned hips be fixed?
Misaligned hips can be fixed with a combination of chiropractic care and physical therapy. The treatment protocol involves correcting restricted spinal and pelvic joints and re-balancing the relevant muscle groups.
With time and patience, you should see a significant improvement in the alignment of your hips and an increase in your overall mobility. Pilates, yoga, and exercise physiology consults are great ways to maintain hips in alignment for the long term.
Is my hip dislocated?
If you have a sudden onset of lower back, groin, and leg pain, numbness or tingling in the legs or feet, with weakness in your hip muscles and visible deformity at your pelvis, it is possible that your hip may have dislocated.
But this is almost always caused by trauma, such as a car accident or bad fall or sports injury, and you’d be in extreme pain.
Author Bio
Dr. Jason Whealing is a Chiropractor with extensive experience across the UK and Australia. He is passionate about family care and injury management. The cases Jason works with daily include back pain, neck pain, jaw pain, sciatica, knee pain, shoulder pain, headaches and migraine.
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