How to Tell if Pelvic Misalignment Is Causing Your Athlete’s Muscle Pain

Pelvic misalignment is commonly behind lower body muscle discomfort and injuries, though it’s often overlooked. Basically, any muscle that attaches to the pelvis—low back, hamstrings, groin, hip flexors, lower abdominals, IT band, and hip internal and external rotators—is affected by the position of these bones. How could they not be?

There’s a common assumption that the bones of the pelvis naturally stay where they’re supposed to be. But when you think about the motions athletes perform—and the forces they’re exposed to—it’s not hard to see how those bones can get pulled out of alignment.

When the pelvis is misaligned, muscles are forced to work from less efficient angles. Some muscles are recruited to help with movements they normally wouldn't assist with. Some sit in a stretched position, while others stay shortened. Over time, those muscles get irritated, overstressed, and are much more likely to be injured.

Pelvic misalignment can also limit range of motion, power, and speed—so it’s not just about pain. It can directly affect performance too.

So how do you know if pelvic misalignment is contributing to your athlete’s muscle issues?

Here are 3 quick and simple ways to check:

1. Check Hip Bone Height (ASIS)

Have your athlete lie flat on their back.

Find the bony points at the front of the pelvis (called the ASIS—the spot where the hip bone curves downward).

➡️ Does one side sit higher than the other?
If yes, that’s a clear sign of pelvic misalignment.

In this photo, the right ASIS is lower than the left

2. Compare hip bone distance from the midline

Look at those same bony points again.

➡️ Is one side farther away from the belly button than the other?
If yes, that also indicates misalignment.

Here, the hip bones are not equidistant from the midline - either one is out too far, or one is in too far. It could be that both are problematic.

3. Check Leg Length

With your athlete still lying on their back, hold their legs together at the ankles and compare the leg lengths.

➡️ Do the legs look uneven?

• If the legs are uneven and one hip bone was lower in Step 1, that strongly reinforces pelvic misalignment.

• If the hip bones were level in Step 1 but the legs are still uneven, your athlete may actually have a true leg length difference—which can also contribute to muscle pain.

Here, the right leg appears to be longer than the left

What Can You Do About It?

If your athlete has pelvic misalignment, here are some options:

1. Work with a doctor who is a DO (Doctor of Osteopathic Medicine), not an MD

2. Work with a physical therapist

3. Work with a Certified Athletic Trainer

4. Work with a chiropractor (helpful for the spine, but typically not focused on repositioning the hip bones)

Important to Understand

This is not a one-time fix.

Even if the pelvis is adjusted, your athlete is still training, sprinting, cutting, and putting force through their body every day. That means misalignment will come back - often.

Another Option to Consider

You can learn how to do this yourself, rather than taking your athlete to someone else for treatment. It's actually fairly simple and straight forward, and will save you time, money and stress - not to mention it will save your athlete a lot of pain and lost playing time.

You can learn:

• How to recognize misalignment

• How to assess the position of the pelvis

• How to safely adjust it

• How to care for the muscles involved

• Maintenance and prevention strategies

Join the waitlist for my online course, The Athlete's Lower Body and Core Muscle Pain Solution below!

https://www.homesportsmed.com/waitlist