Do you have a twisted pelvis? If you are experiencing back, hip, or knee pain from pelvic misalignment, the good news is that you can correct it. In fact, twisted pelvis self-correction could be a great option for your pelvic tilt issues.

A large percentage of people that live with a pelvic tilt do not suffer from dramatic symptoms (if any). But for some individuals, leaving their pelvic tilt untreated can cause more issues down the road, like poor posture or chronic back pain.  

I’ve got good news for both groups of people: When accompanied by the guidance of a medical professional, and when done correctly, twisted pelvis self-correction is possible. Depending on the type of pelvic tilt you have, and the severity of the pelvic angle, the medical intervention will vary. However, for the average anterior pelvic tilt, there are a few simple things you can do to reduce and maybe even eliminate your symptoms.

But before we dive into ways to perform a twisted pelvis self-correction, let’s make sure you understand what a twisted pelvis is, and why you are experiencing it in the first place.

What is a twisted pelvis?

A twisted pelvis is an abnormal angle in the positioning of the pelvic bones. It is not one specific type of pelvic tilt or misalignment, but instead can refer to all three types of pelvic tilt.

These three types of pelvic tilt are:

1. Anterior pelvic tilt

An anterior pelvic tilt is when the front of your pelvis angles forward, pulling the front of your pelvis down. It’s commonly caused by the shortening and tightening of hip flexor muscles during everyday movements, like commuting or sitting at your desk.

The forward angle caused by anterior pelvic tilt can lead to an accentuated curvature of the lumbar spine, also known as hyperlordosis. This can cause pain in the low back and pelvic region, which is one of the reasons why twisted pelvis self-correction is important.

2. Posterior pelvic tilt

A posterior pelvic tilt is the opposite of an anterior pelvic tilt. This means your muscles are lifting the front of the pelvis and pulling down the back of the pelvis.

Since the bottom of the pelvic bone is scooping under your body to the front, it is pushing your hip bones back as well. This change in pelvic angle stretches your lower back muscles creating a flat lower spine.

Chronic muscle tightness in the hamstrings is a common cause of this type of pelvic tilt.

3. Lateral pelvic tilt

A lateral pelvic tilt is when one side of your pelvis is angled higher than the other. So, instead of tilting front to back, one side of your hip sits higher up, creating unilateral muscle imbalances. When you have this type of pelvic tilt, the erector spinae muscle group (muscles and tendons running along either side of the spine) is most impacted.  

The most common type of pelvic tilt is anterior pelvic tilt. But these symptoms can be hard to spot if the angle of the pelvis is not dramatic. In fact, even a “neutral” pelvis should have a small angle of tilt forward. Once the angle of your pelvis tilts beyond 10 degrees, however, it is considered to be a twisted pelvis. Making the diagnostic process even harder is the fact that many of the symptoms for a twisted pelvis also overlap with other anatomical issues you may be experiencing.

So if you have any of these prominent anterior pelvic tilt symptoms, it’s best to consult with a professional to understand if your back has a healthy curvature.

• Accentuated curve in lumbar spine
• Incorrect posture
• Lower back pain
• Hip and knee pain
• Forced hip and knee rotation
• Muscle imbalances in hip region

Anterior pelvic tilt symptoms often mirror the severity of the tilt. So it may be more difficult to recognize if you only have only a slight twist or misalignment in your pelvis..

Anterior pelvic tilt causes

As I mentioned above, one of the main anterior pelvic tilt causes is tight hip flexor muscles. How these muscles tighten and begin to pull the pelvis forward varies from person to person. It usually happens gradually over time as well.

Things like excessive sitting or lack of stretching after strenuous exercise/activity can cause the hip flexor muscles to shorten, tighten, and create muscle knots. As these muscles are allowed to stay in a shortened position or are “frozen” in place, they pull on neighboring muscles and connection points.

You may think of the area where you feel this the most as your hip flexors, but your hip flexors are actually made up of the two large iliacus and psoas muscles. Together, these are referred to as the iliopsoas muscles. You have two iliopsoas muscles - one to control either side of your hip - that originate from the top points of your pelvic bone and lower back.

And while both the iliacus and psoas have different starting places, they each connect to the top of the thigh bone (femur).

The psoas muscle travels from your low back, across the front of your pelvis, and then attaches to your thigh bone. The iliacus travels from your pelvis bone, crossing over the hip joint, and then attaches to your femur.

These muscles are in close proximity to some of your most vital joints. So it is easy to see how when these muscles shorten, they can begin to pull your hips out of alignment, impacting your posture.

There are other causes of a twisted pelvis, but muscle tightness and muscle imbalances are often primary causes. Having a pelvic tilt can be uncomfortable, but if muscle issues are the cause, then twisted pelvis self-correction becomes much easier.

Other causes of a twisted pelvis, like anatomical genetic issues or some kind of body trauma, may require more than just twisted pelvis self-corrections. While relatively uncommon, invasive treatments like surgery may be necessary.  

Your twisted pelvis self correction options

Once you know you have a twisted pelvis, you can try some treatment options outside of physical therapy (with the permission of your therapist). These may include targeted pelvic exercises, hip flexor strengthening exercises, and hip flexor stretches.

Since the cause of your pelvic tilt is likely either muscle tightness or muscle imbalance, the primary goal of a twisted pelvis self-correction practice (even under the guidance of a medical professional) is to correct alignment by balancing the muscles.

Depending on the severity of the misalignment, working with a chiropractor may also help jumpstart your treatment. However, a chiropractor cannot solely fix the problem, because the problem does not lie within the bones, it is caused by your muscles.

So, let’s talk about how you can make those muscles happy!

Muscle pressure release

Creating a daily twisted pelvis self-correction routine will be your first step. This routine will more than likely include a combination of exercises, stretches, and a pressure release of the iliopsoas muscles.

Let’s talk about that last point, first: Releasing the tight hip flexor muscle.

This starts with stopping the muscle contraction.

If you have to sit a lot for work, then be conscious of the position you sit in. You may not be able to avoid being at a desk all day, but you can physically get up from your chair once an hour and stretch a little each day to counteract the effects.

Once your muscles are already tight, you’ll need to get them to release. And that requires relaxing your hip flexors and then lengthening them - which is why stretching alone won’t do the trick.

To release your iliopsoas, you want to apply prolonged pressure to the point where the muscle connects to your pelvic bone. Muscle and fascia are very sensitive to changes in pressure. Prolonged pressure gives your body’s mechanoreceptors within the muscle and fascia time to send signals to your brain so the muscles can stop holding tension.

But the problem with your iliopsoas muscles is that this important release point is in a very hard-to-reach area. Your hands or standard muscle pressure release tools won’t cut it. Fortunately, the Hip Hook is a tool specially designed for safe iliopsoas muscle release.

The Hip Hook makes it easy to release the hard-to-reach iliacus at home, and when used in combination with the Hip Release Ball, you will be ready to add pressure release, stretching, and realignment exercises into your routine for the most effective twisted pelvis self-correction treatment program.

Twisted pelvis realignment exercise

Even if you perform a muscle tension release with the Hip Hook and the Hip Release Ball daily, your pelvis will likely still need to be realigned.

Releasing the tension in the iliopsoas muscles is a critical first step. And a chiropractor and/or at-home realignment exercises are the final piece of a proper twisted pelvis self-correction. Practicing the following pelvic realignment exercises in conjunction with the use of the Hip Hook has proven to be very effective for the clients I’ve worked with.

Here is how to perform a twisted pelvis realignment exercise:

1. Identify the side of your hip that is rotated forward. This will be the side you perform the realignment exercise on (you do not perform it on both sides of your hip)
2. Lay down on the floor on your back.
3. Bring both knees up so your feet are off the floor and your legs are bent.
4. Put your hands behind the knee of the leg that has the anterior tilt. The other leg will continue to sit up off the floor, bent.
5. As you hold onto the back of your knee, push against your hands as if you are trying to put your foot down onto the ground. Be mindful to move your foot down towards the floor, not out towards the wall.
6. Hold this position for two seconds with a moderate amount of force (not as hard as you can). It should be enough pressure so that you can get a contraction of your hamstring and glute muscles. Repeat 10 times.
7. Slowly lower your legs back to the floor, and feel free to perform other exercises like a glute bridge.

The contraction and relaxation of the hip muscles while performing this exercise is important, which is why you hold and release the tension repetitively to ensure a successful twisted pelvis self-correction.

Frequently asked questions about how to correct a twisted pelvis

Is there a good way to sleep with a misaligned pelvis?

When you have a pelvic tilt, you may experience hip, knee, and lower back pain. Depending on the type of pelvic tilt you have, using a pillow to elevate your knees (either on your side or your back) can help to reduce the pull on your muscles, which in turn alleviates pain.

While this can help you to sleep through the night, getting to the root of the problem and correcting a twisted pelvis is the best way to address any sleep issues that arise due to hip misalignment. Lucky for you, you now have all the tools you need for twisted pelvis self correction!

What happens without a twisted pelvis self correction?

If you leave your pelvic tilt to worsen without treatment, your symptoms will likely get worse as well. Usually, this will visibly impact your posture, and also cause some uncomfortable wear and tear on certain joints like your hips and knees.

When your body is out of alignment, it makes it difficult and painful to do activities that you love and can even impact your quality of life. That’s why twisted pelvis self correction (or correction with the help of a physical therapist) is so important.

Can a twisted pelvis cause sciatica pain?

In some cases, yes, a twisted pelvis can cause sciatica pain.

The severity of the pelvic angle and the type of pelvic tilt will influence where you experience pain - but because of the muscle and soft tissue connections within your pelvis, tension is highly possible on the sciatic nerve.