Pelvic obliquity refers to a condition where the pelvis is uneven or tilted, with one side sitting higher than the other. This imbalance can affect an individual’s posture and overall body mechanics.
Defining Pelvic Obliquity
Pelvic obliquity describes a lateral tilt of the pelvis, where one side is elevated compared to the other. This differs from anterior or posterior pelvic tilt, which involves forward or backward rotation. Obliquity focuses on side-to-side imbalances.
This condition can be classified as either functional or fixed. Functional pelvic obliquity is flexible and often results from muscle imbalances or compensatory postures. Fixed pelvic obliquity involves structural changes, making it less flexible and more challenging to correct. An uneven pelvis often leads to the body compensating, which can shift the spinal column and other joints.
Common Causes
Various factors can contribute to pelvic obliquity. A significant cause is a leg length discrepancy (LLD), where one leg is genuinely shorter than the other due to anatomical differences. Even small discrepancies can lead to pelvic tilting. Functional LLD can also occur, where legs appear different lengths due to muscle contractures or joint restrictions in the hip or sacroiliac joint, rather than an actual bone length difference.
Muscle imbalances around the trunk and pelvis are another frequent contributor. Tightness in certain muscles, like the quadratus lumborum, or weakness in gluteal muscles, can pull the pelvis out of alignment. Spinal conditions like scoliosis, an abnormal curvature of the spine, can directly lead to pelvic obliquity.
Poor postural habits, especially prolonged sitting, can contribute to pelvic misalignment. Past injuries or trauma to the hip, such as a dislocation or subluxation, may also predispose an individual to developing pelvic obliquity. Abnormal muscle tone and limitations in hip range of movement are other contributing factors.
Recognizing the Signs
Individuals experiencing pelvic obliquity often report pain in the lower back, hips, knees, and even extending to the neck and shoulders due to the body’s compensatory adjustments. Leg pain and discomfort in the buttocks are also common.
Observable physical signs include uneven shoulder height, a visibly tilted pelvis where one hip appears higher, and an altered gait pattern, such as difficulty walking or an uneven stride. One leg might also appear shorter.
Healthcare professionals diagnose pelvic obliquity through physical examination, evaluating hip height, leg lengths, and walking patterns. Imaging studies, such as X-rays, are often utilized to confirm the lateral tilt and measure the degree of obliquity.
Treatment Approaches
Treatment for pelvic obliquity is individualized, focusing on the underlying causes. Physical therapy is a primary approach, incorporating exercises to strengthen and stretch muscles around the pelvis and hips. Manual therapy techniques are also used to mobilize tissues and improve joint function, aiming to improve range of motion and correct muscle imbalances.
For cases involving leg length discrepancies, orthotics such as shoe lifts or custom inserts can be prescribed. These devices help to equalize leg lengths, which can help level the pelvis and improve overall body alignment.
Pain management strategies include nonsteroidal anti-inflammatory medications or targeted injections. For fixed pelvic obliquity due to structural issues, specialized seating solutions can accommodate posture and distribute pressure evenly. In complex cases with significant structural deformities or large leg length differences that do not respond to conservative measures, surgical intervention may be considered.