Hips Out of Alignment

What Does it Mean When Your Hips are Out of Alignment?

Author: Dr. Rosemarie Jabbour (Chiropractor)

You may be surprised at how closely the function of your hips influence the function of your back, posture and overall biomechanics. Even a small misalignment in your hips can cause hip pain, lower back pain and injury. Pain in the hip can occur at almost any age. On this page we’ll cover the normal alignment of your hips, common causes and symptoms of hip pain, and discuss a variety of treatment options.

Hip Pain Quick Facts

  • Your hip joint is the largest joint in your body
  • Your pelvis consists of two ‘bone and socket’ hip joints with cartilage separating the bones, however this can wear down
  • Each hip bone is a large, flattened, and irregularly shaped fusion of three bones: the ilium, ischium and pubis
  • The hips can be impacted by a range of disorders such as arthritis, irritable hip syndrome and slipped capital femoral epiphysis (the head of the femur/thigh bone slips out of position)
  • Hip pain may be caused by inflammation of surrounding soft tissue or referred pain from a back problem

Your Hips and Hip Alignment

What is normal hip alignment?

It can be hard to describe ‘normal hip alignment’ in words due to the simple fact that hip alignment is often based on observation and measurement. However, there are several key factors that come together to give you normal hip alignment:

  • Your pelvis should be parallel to your shoulders and the ground
  • Your hips shouldn’t tilt forwards or backwards
  • Your hips should be on the same level horizontally, not higher or lower

The image below has been marked up to show you ideal hip alignment.


Image: Showing a neutral hip alignment vertically from the spine down to the coccyx, and horizontally for both top of hip bones and top of femur/thigh bone.


Main causes of hip misalignment

Patients commonly come into clinic and tell me about their hips “being out of whack”, thinking they have one leg shorter than the other, or self-diagnosing scoliosis. More often than not, a hip misalignment (uneven hips) may be the cause of their problems, not a shorter leg or scoliosis of the spine (even though these conditions do exist). When your hips are uneven (one higher than the other), your pelvis becomes tilted.

Your hip can be out, or feel like it’s out, for a number of reasons.

Here are some behavioural causes of hip pain:

  • Poor posture during everyday repetitive activities, such as sitting in an office all day or using incorrect lifting technique
  • Carrying a heavy bag on one shoulder, resulting in uneven pressure on one side of your pelvic joint
  • Wearing shoes that lack the support you need, including having foot pronation or collapsed arches
  • Walking, running and repetitive movements that may put a lot of stress on the joint where the femur and hip bone meet
  • Crossing your legs
  • Standing and leaning on one leg, setting up uneven weight distribution and putting excess pressure on your hip joint

Here are some other causes of hip pain:

  • Joint dislocation
  • Pinched nerves
  • Bursitis
  • Hip labral tear
  • Inguinal hernia
  • Arthritis
  • Muscle imbalances
  • Pregnancy
  • Old injuries
  • Congenital disorders

Hip out of alignment symptoms

Hip misalignment symptoms can be quite vast and can easily be misread. That’s why we recommend consulting with your healthcare practitioner to get professional advice. Hip misalignment symptoms may include:

  • Hip pain (which can also be caused by many other issues)
  • Tense muscles on one side of the legs or buttocks
  • Lower back pain
  • Upper back pain
  • Sciatica (nerve pain)
  • Knee pain
  • Foot/ankle pain

Treatment for a misaligned hip

Treatment options depend on the cause but may include:

  • Manual therapy (chiropractic, massage)
  • Exercise and core strengthening exercises
  • Splinting
  • Lifestyle adjustments, as in standing or sitting postures and daily activities
  • Weight loss
  • Surgery (usually as a last resort).

It may take some time to restore more natural alignment to your hips, especially if they have been ‘out’ for some time.

Chiropractic examination for hip pain

Chronic hip pain may be an indicator of a more serious underlying condition which is why a thorough examination may be beneficial.

A chiropractic examination for hip pain may include:

  • Taking a full health history, including history of accidents and injury
  • X-rays or other diagnostic imaging, as required
  • Different spinal and orthopedic tests to determine whether your hip pain is the result of a structural imbalance

Recommendations for Treatment

Your health team at New World Chiro are experienced in dealing with a range of musculoskeletal health issues, including hip pain and related hip problems. We aim to provide the right diagnosis to better help you manage conditions related to the spine and musculoskeletal system.

Get in touch today to find out more.

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Dr. Rosemarie Jabbour (Chiropractor) is the owner and chiropractor at New World Chiro, Parramatta. Rosemarie is an experienced and highly professional healthcare practitioner with over 25+ years experience in caring for the local community. Rosemarie was also one of the chiropractors for the Sydney 2000 Olympic games. With a keen interest in spinal health, neuroscience and sports fitness, Rosemarie is a natural health champion and advocate.

In addition to running New World Chiro, Rosemarie runs corporate health and wellness training programs, chiropractic assistant training, and networks within a variety of local business networks.


- B.Sc.(Biol.Sc.)
- B.App Sc (Clin.Sc)
- B.C.Sc.
- The International Chiropractic Sports Science Diploma 1997
- Graduate Certificate in Sports Chiropractic in 1998