Lateral Pelvic Tilt (Hip Drop)
Lumbar/Pelvis - Postural
Lateral pelvic tilt (hip drop) is a frontal-plane pelvic deviation often seen during single-leg stance or gait, typically due to hip abductor weakness.
Biomechanical Mechanism
Weak gluteus medius and lateral core stability allow the pelvis to drop on the contralateral side, increasing valgus stress at the knee.
Clinical Rationale
Hip drop increases knee valgus and lumbar strain. Restoring lateral hip control reduces compensations.
Practical Solution
Progress from isolated activation to single-leg control drills and gait integration.
Common Compensations
- Trendelenburg gait
- Lateral trunk lean
- Knee valgus
Progression
- Level 1: Side-lying activation
- Level 2: Lateral band walks
- Level 3: Single-leg control
- Level 4: Gait and plyometric integration
Regression
- Use support
- Reduce load
- Shorten hold times
Red Flags
- Severe hip pain
- Neurological symptoms
- Acute trauma
Differential Diagnosis
- Hip abductor tendinopathy
- L5 radiculopathy
- Hip joint pathology
Related Patterns
- knee valgus
- gluteal amnesia
Related Exercises
- hip hitch
- side lying hip abduction
- lateral step band
- modified side plank band
- side plank
- clamshell
- monster walk
- single leg balance
- single leg hip thrust
Related Assessments
- trendelenburg assessment
- single leg squat assessment
- hip abduction strength assessment
Evidence
Level: strong
Systematic reviews and meta-analyses (level 1) show that hip hitch and pelvic drop exercises generate high gluteus medius activity across segments. Gluteus medius strengthening and progressive loading exercises (side-lying abduction, lateral step, single-leg bridge, resisted side-step) improve pain, function, and single-leg control; frontal plane pelvic control is linked to abductor activation and knee loading.
Sources:
- systematic review/meta-analysis: A systematic review and meta-analysis of common therapeutic exercises that generate highest muscle activity in the gluteus medius and gluteus minimus segments. (link)
- systematic review: A systematic review of rehabilitation exercises to progressively load the gluteus medius. (link)