A human’s pelvis is naturally level, sitting parallel to the ground. When one’s pelvis is aligned, the whole body is aligned. There are many situations that can cause a tilted pelvis, including trauma, obesity, pregnancy, and repetitive stress from staying active. Once your pelvis is out of alignment, the body starts to compensate, shifting other things out of their natural position as well. Pelvic tilt leads to side-to-side instability, due to one side of the body becoming weaker than the other. This weakness and instability can cause you to injure yourself even in ordinary situations.
How to Address a Tilted Pelvis. There are many stretches and strengthening exercises you can do on a regular basis to bring your pelvis back into alignment and strengthen the muscles that keep it in place in order to prevent future pain and injury. The core of the body is the center of strength and includes the pelvic floor muscles, abdominal muscles, paraspinal muscles (on either side of the spine), and the diaphragm (which controls your breathing). These muscles align the spine, ribs, and pelvis.
- Stretches for a Level Pelvis. This series is inspired by yoga stretches that help to bring the pelvis back into alignment. Begin by lying flat on your back. Bend the knee of the affected side and pull it into your chest and toward the opposite shoulder. For those with sensitive knees, you can hold the leg under the knee on the back of the thigh, rather than grabbing the shin. Hold this position for at least ten seconds, and slowly release the leg back down to the ground. Release all tension in the leg. Repeat this two more times.
At the end of the third set, continue holding your knee in with the opposite arm and bring it across your body. Release your other arm out to the side. If it’s comfortable for your neck, look in the opposite direction of the bent knee. Hold this position for at least ten seconds before repeating the series on the other side. Do these stretches before getting out of bed in the morning, before you go to bed in the evenings, and several times throughout your day.
- Core Planks. Holding your body in a plank position is also a great exercise for engaging the core and stabilizing the pelvis. Begin on all-fours with your wrists under your shoulders and your knees under your hips. Pressing through the hands, tuck the toes under and straighten the legs. The goal is to keep your torso and legs in a straight “plank” position. Hold for as long you can, rest, and repeat two times. If this is too difficult at first, you can practice with your knees lowered; just remember to focus on the muscles of your core.
- Core Stabilizing Bridges. Another exercise sometimes seen in yoga classes is a back bridge. Start by lying flat on the floor with your arms at your sides. Bend your legs and position your feet under your knees. Raise your back and bottom off the floor, pressing through the feet and shoulders, lifting the hips towards the ceiling. Try to keep your neck in a neutral position, gently pressing the back of the skull into the floor. This helps to avoid constriction in the neck or strain on the cervical spine. Hold for at least ten seconds, and repeat several times.
- Hip Rotations Combined with Toe Touches. This is an easy range-of-motion exercise combined with a simple stretch that has proven helpful for patients. Begin by standing with your feet hip-distance apart with your arms by your side. Rotate your hips in a circular motion, as if you were hula-hooping very slowly. After completing five rotations, complete five more rotating the hips in the opposite direction. Then stand in a neutral position and reach for your toes, hinging at the hips. Try to maintain a relatively straight spine when folding forward. Repeat this series several times throughout the day.
- Wall Resistance Exercises. You can also use a wall and a pillow to help stabilize and strengthen the muscles around your pelvis. Stand with your hip and shoulder against a wall, holding a pillow in the other hand. Lift the leg that is closest to the wall so that your torso and thigh create a 90 degree angle. Place the pillow between the bent leg and the wall, pressing it into the wall to keep it from falling. Hold this position for as long as you can before coming down to rest. This exercise stabilizes your pelvis on the side opposite of the bent leg. Repeat three times on each side.