Having your hip go out of alignment can cause a lot of pain and discomfort. The hip is one of the largest weight-bearing joints in the body, so it’s important to address any alignment issues to prevent complications. Here are some of the key ways you can identify a hip that is out of alignment.
Pain in the Hip or Groin Area
One of the most common symptoms of a hip alignment issue is pain in the hip itself or in the surrounding groin area. This pain may range from mild to severe. It may be a sharp, shooting sensation, or it could be a dull ache. The pain may be localized in one specific spot, or it may radiate down the leg.
This pain is often caused by extra stress being placed on the joint and soft tissues of the hip due to the misalignment. When the hip socket and thigh bone aren’t properly lined up, it changes your biomechanics and gait pattern. This leads to increased friction and grinding in the joint that irritates the cartilage and causes inflammation.
Restricted Range of Motion
Limited mobility in the hip joint is another key sign that it may be out of alignment. You may notice that certain movements like bending, extending, abducting, or rotating the hip are difficult or impossible to do without pain. For example, you may not be able to bring your knee all the way up to your chest or comfortably cross your legs.
The limited range of motion occurs because the altered position of the hip bones and joint essentially acts like a block. The femoral head can’t move smoothly within the acetabulum when the alignment is off, which impairs your ability to fully flex, extend, and rotate the leg.
Muscle Imbalances
A hip out of alignment also frequently causes some of the muscles around the joint to become overactive or underactive. When the pelvis and thigh bone aren’t lined up correctly, the muscles have to strain to try to compensate.
For example, you may notice the inner thigh muscles are extremely tight and stiff while the outer hip muscles feel weaker. A physical therapist can check for muscle imbalances during an exam of your hip joint mobility and gait.
Gait Abnormalities
Paying attention to changes in your walking pattern can also help identify possible hip misalignment. Subtle alterations like limping, swinging your leg out to the side, foot dragging, or leaning heavily to one side when walking could all be signs of a hip problem.
You may also notice differences between your right and left stride length or hip/pelvis position when walking. The hip instability and muscle imbalances make it difficult to walk smoothly and symmetrically.
Leg Length Discrepancy
Your legs may appear to be different lengths if your hip is out of alignment. This leg length discrepancy isn’t necessarily because one leg bone is longer. It’s typically caused by the position of the leg bone in the hip socket being off.
For example, if the thigh bone is sitting too far forward or backward in the joint capsule, it gives the appearance of a longer or shorter leg on that side since it changes the overall leg dimensions. Clothes may also start fitting oddly, like one pant leg being tighter.
Sitting Unevenly
Noticing that you habitually sit in a lopsided position can provide clues about a hip misalignment. Your body will unconsciously try to shift and sit in a way that relieves discomfort from the hip being out of position.
For example, you may always cross your legs with the same leg on top or you might have the tendency to sit with all your weight strongly shifted to one side. Pay attention to any asymmetrical sitting postures.
Difficulty Moving from Sitting to Standing
Daily movements like transitioning from sitting to standing can also become challenging with a hip alignment problem. You may push up unevenly from a chair, relying much more heavily on one leg.
Or you may also feel pain, stiffness, or need to take extra time getting in and out of a seated position. The hip muscles and surrounding soft tissues have to work harder to compensate for the joint instability.
Popping, Clicking, or Crunching
Listen and feel for any abnormal sounds coming from your hip joint. If you hear or feel repeated clicking, popping, or crunching, it could indicate the hip bones aren’t gliding and rotating properly.
Grinding and snapping hip sensations are often a result of cartilage, bursae, tendons, or muscle getting pinched as the femoral head shifts in the misaligned socket. The sounds and sensations should be checked to rule out tears and significant damage.
Hip, Buttock, Back, or Knee Pain
Since your hip alignment impacts overall postural alignment, a problem in the hip can also cause pain to radiate up into the low back or down into the buttocks and knees. Everything is connected in the kinetic chain.
Make note of any back, buttock, thigh, or knee discomfort that could potentially be related to an underlying hip misalignment issue. The hip may be causing stress and strain on the adjoining areas of the body.
Pelvic Rotation or Tilt
Viewing your hips from both the front and back can help identify misalignments. From the front, see if one iliac crest (top of the pelvis) appears higher than the other, which indicates possible pelvic rotation. From the back, look to see if the dimples of your buttocks or back of pelvis are asymmetrical, indicating pelvic tilt.
Perform a Standing March Test
A simple at-home test that can help determine if your hip may be going out of alignment is called the standing march test:
- Stand with your feet hip-width apart with arms relaxed at your sides.
- Lift your right knee up as high as comfortably possible, keeping your pelvis level. Hold for 3 seconds.
- Lower the right leg and lift your left knee, again keeping your hips squared. Hold for 3 seconds.
- Repeat this marching in place for 10 repetitions on each side.
Take note of any hitching, dipping, or rotation in your hip during the movements. Also document any differences in range of motion between sides. Pain or difficulty lifting one leg may indicate a hip alignment problem.
See a Physical Therapist
If you suspect your hip is out of alignment based on the signs above, make an appointment with your doctor or a physical therapist for an evaluation. They will examine your hip joint mobility, muscle function, walking pattern, and range of motion.
Special tests like leg length checks in different positions can help pinpoint where and how your hip is misaligned. X-rays may also be used to determine the exact position of the femoral head in the hip socket.
| Signs of Hip Misalignment | Description |
|---|---|
| Pain in the hip or groin area | Can range from mild to severe. May be sharp and shooting or a dull ache. |
| Restricted range of motion | Difficulty bending, extending, abducting or rotating hip fully. |
| Muscle imbalances | Some muscles overactive while others are underactive. Physical exam can check. |
| Gait abnormalities | Limping, leaning to one side, foot dragging, uneven stride length. |
| Leg length discrepancy | Legs appear different lengths due to hip position. |
| Sitting unevenly | Favoring one side while seated. Weight often shifted to one side. |
| Difficulty with sit to stand | Need to push up unevenly. May take extra time or have pain/stiffness. |
| Popping, clicking, crunching | Abnormal sounds from hip. May indicate bones not gliding smoothly. |
| Radiating pain | Hip issues can cause pain into the back, buttocks, or knees. |
| Pelvic tilt or rotation | Iliac crests appear uneven from front view. Dimples uneven from back. |
Medical Treatment
Once the cause and severity of your hip misalignment is diagnosed, the doctor will recommend appropriate treatment. For mild cases, physical therapy aimed at strengthening muscles, improving flexibility, and normalizing gait pattern may be sufficient. There are also bracing options that help stabilize the hip position.
If conservative treatment fails to alleviate your symptoms after a few months, surgical options like arthroscopy or osteotomy may be considered. Arthroscopy involves trimming or repairing damaged cartilage and tissues in the hip joint. Osteotomy is a procedure that repositions the hip socket or femur to improve alignment.
Full hip replacement may also become necessary in cases of severe osteoarthritis, injuries, or joint damage that can’t be fixed with other methods. This surgery replaces the femoral head and acetabulum with prosthetic components.
Physical Therapy Exercises
A physical therapist can prescribe specific stretches and exercises tailored to realign your hip and restore proper function. Here are some examples of commonly used hip alignment exercises:
Gluteal Sets
Lie on back with knees bent and arms at your sides. Squeeze glutes for 5 seconds then relax. Repeat 10 times.
Clamshells
Lie on side with knees bent at 90 degrees, keeping ankles together. Slowly open top knee out to the side, keeping feet touching. Return to start position. Repeat 10 times.
Fire Hydrants
Get on hands and knees with a flat back. Keeping knee bent, slowly lift one leg out to the side, mimicking a dog peeing. Return to start and switch legs. Repeat 5-10 times on each leg.
Hip Abduction
Lie on side with both legs straight, resting top leg on bottom leg. Raise top leg up, leading with the heel. Slowly lower back to start position. Repeat 10 times on each side.
Bridge
Lie on back with knees bent and feet flat. Squeeze glutes and hamstrings to lift hips up off the floor into a bridge. Hold briefly then lower hips down slowly. Repeat 10 times.
Bracing Options
Wearing a supportive brace or taping the hip area can help stabilize a mildly misaligned joint. Braces block extreme hip motions to keep the joint in better positioning. Tape does not physically stop hip movement but provides gentle cues to avoid overly straining the joint.
Braces and tape are most effective when combined with targeted exercises that strengthen the muscles around the hip. Proper taping technique is important to provide hip support without restricting range of motion too severely. Consult a physical therapist or athletic trainer if considering hip bracing or taping.
Prevention
There are steps you can take to help prevent your hip from going out of alignment in the first place. Here are some tips:
- Maintain proper posture and hip/pelvic alignment with upright standing and sitting.
- Stretch and strengthen the muscles surrounding the hip joint through regular exercise.
- Warm up adequately before physical activity using dynamic stretches.
- Limit activities that place high force through the hip joints, like running on angled surfaces.
- Wear supportive footwear with adequate shock absorption.
- Lose excess body weight to avoid overloading the hip joints.
- Consider physical therapy to assess hip biomechanics if you have a history of misalignment issues.
When to See a Doctor
See your primary care physician or orthopedic doctor if you have persistent hip pain or symptoms of misalignment. Many cases of mild hip joint instability can be corrected with physical therapy. But prompt medical attention is key to prevent complications or accelerated joint degeneration.
Seeking early treatment helps avoid reaching the point where surgical hip repair or replacement becomes necessary. Call your doctor if you experience:
- Unexplained hip pain that persists more than several days
- Significant limitation in hip mobility or functioning
- Popping, clicking, crunching, or other worrisome hip noises
- Locking, catching, or giving way of the hip joint
- Swelling around the hip or groin area
- Injury caused by a fall, accident, or high impact on the hip
Never try to forcibly jerk your hip back into alignment or “pop” it yourself. This can damage tissues and make the problem worse. Let a trained medical professional properly realign your hip joint.
Conclusion
Noticing signs of hip misalignment early is important to get effective treatment before it progresses. Pay attention to symptoms like uneven sitting, gait changes, limited mobility, and hip area pain. See a doctor or physical therapist to diagnose the cause of the alignment problem and get specialized exercises and bracing if needed.
With proper therapy and joint care, many cases of mild to moderate hip instability can be corrected non-surgically. Stay active but reduce high impact activities that strain the hip. Proper strength training, flexibility, and biomechanics training can help keep your hips aligned and pain-free long term.