How Do You Know If Your Hips Are Out of Alignment?

Hips play a key role in maintaining good posture and preventing lower back pain. Small misalignments can lead to hip pain, lower back pain, and further injury. Alignment issues and hip pain can affect people at almost any age.

So, how do you know if your hips are out of alignment?

Here we’ll discuss what normal hip alignment looks like, how to know if your hips are out of alignment, potential causes and symptoms, and what to do about it.

Normal hip alignment

Determining normal alignment can be a tricky issue that requires personal observation, but there are some useful techniques for you to try first. 

Several factors are involved in normal hip alignment, involving your posture and running the whole length of your body.

You will want to check each section in turn to get a better sense of your overall posture and alignment.

Beginning with your front posture: 

  • Stand in front of a mirror
  • Observe your shoulders: they should be level. If one is higher or lower than the other, there might be a muscular imbalance in your upper body.
  • Draw a line straight down from your nose: it should reach your belly button. If it doesn’t, it may indicate that your spine is not properly aligned, which will affect pressure throughout your body.

Next, your pelvis and hips:

  • Check that your pelvis is parallel to your shoulders and the ground
  • Check that your hips are horizontally level, using our next section as a guide

How to check if your hips are out of alignment

To check your hips are level, you’ll need to find two points on your front and pack: the ASIS and the PSIS. The ASIS can be found as two bony bumps on the front of your pelvis, one on either side. The PSIS are two bony bumps on the back of your pelvis, near the base of the spine, on either side.

Once you find these points, check to see if they are in a horizontal line with each other. If one is higher or lower than the other, it could be an indication that they are out of alignment

Lateral Pelvic Tilt
Lateral Pelvic Tilt

Misalignment symptoms

The symptoms of hip misalignment can be varied and are shared by a number of conditions, which is why it is always preferable to get a professional opinion from your healthcare provider. Hip misalignment symptoms can include:

  • Lower and upper back pain
  • Hip pain
  • Muscle tension on one side of the legs and buttocks
  • Nerve pain (sciatica)
  • Knee pain
  • Foot pain

Causes of misalignment

A common belief is that hip alignment is due to one leg being shorter than the other. Though this does account for some cases, there are several potential causes that relate to your posture and behaviour. Some of those causes include:

  • Carrying bags unevenly, for example carrying a heavy backpack or handbag on one shoulder
  • Wearing supportive shoes, particularly important if you have a condition like fallen arches, which can contribute to hip and back pain
  • Preferring to stand and lean on one leg, which leads to uneven weight distribution and excess pressure on your hip
  • Repetitive movements (like running) that may put stress on the femur and hip bone joint.


A healthcare provider may recommend a range of treatments depending on a successful diagnosis and the severity of the condition. These may include:

After a hip misalignment diagnosis, it may take some time to restore natural alignment to your hips.

Anterior Pelvic Tilt Headquarters