A Twisted Pelvis, also called Pelvic Torsion, Can Be Corrected

A twisted pelvis, also known as pelvic torsion, is an extremely common distortion pattern but often remains undiagnosed. The result can be significant chronic pain that seems to have no clear explanation.

Without understanding this phenomenon, it's impossible to see the cascading muscular effects that can result. 

Back pain, hip pain, knee pain, shoulder pain, neck pain, and more can potentially be traced back to this primary root cause. 

Understanding pelvic anatomy

To help us understand what we mean by a twisted pelvis or pelvic torsion it’s helpful to have a clear sense of the bony anatomy of the pelvis.

The pelvis is composed three bones:

  • Two pelvic bones, the right ilium and left ilium
  • The sacrum

What do we mean by, Torsion?

To understand what we mean by torsion, let’s look to Miriam-Webster:


1: the twisting or wrenching of a body by the exertion of forces tending to turn one end or part about a longitudinal axis while the other is held fast or turned in the opposite direction also the state of being twisted

2: the twisting of a bodily organ or part on its own axis

3: the reactive torque that an elastic solid exerts by reason of being under torsion

Pelvic Torsion, then, is a condition in which the two pelvic bones are twisting in opposite directions.

In the example below, the arrows indicate the rotational direction of this twisting motion.

Here, the torsion is an anterior (or forward) rotation of the right pelvic bone, with the left pelvic bone in an oppositional rotation.

A NOTE ABOUT THE IMAGES - The images don't show the actual twisting motion of the pelvic bones because the imaging I’m using doesn’t have this flexibility.

Therefore the bones, here, are in a neutral position. The red arrows are meant to imply the twisting direction of the torsion pattern.

"No amount of symptomatic treatment can have any lasting value without correcting the pelvic torsion pattern."

What is the result of a twisted pelvis?

When half of the pelvis rotates in one direction, and the other half rotates in the opposite direction we call that a twisted pelvis or pelvic torsion.

This puts the hip joints at a different height from one another.

In other words, the hip joints are no longer level with one another. One hip joint is higher and the other is lower.

The result is a functional leg-length difference.

Understanding a functional leg-length difference

When a pelvis is balanced, the hip joints are level and the legs are more or less equal in length.

However, as we've said, when there’s a torsion, one hip joint is pulled up higher than the other causing a functional leg-length difference.

In this example, a right anterior (forward) rotation has the effect of pulling the right hip joint upwards.

If you look closely at the right hip joint perhaps you can visualize how this happens.

Can you see how a right rotation around the longitudinal axis would elevate the right hip joint? And how that would result in the entire right leg being pulled up shorter?

The overall result is that the entire right leg becomes functionally short.

This does not mean that one leg is actually shorter than the other.

This is an example of a functional leg-length difference, as distinct from a congenital leg-length difference.

not the same as a congenital leg-length difference

A congenital leg-length difference is one we're born with and in which the leg bones themselves are a different length. 

A congenital leg-length difference is routinely and appropriately addressed with a shoe lift of some kind.

This strategy should not be used, however, in addressing a functional leg-length difference as this would fix the imbalance, the torsion, in place.

As we will see, a functional leg-length difference can be corrected — i.e. brought back into balance — while a congenital leg-length difference can only be compensated for.

How does a leg-length difference result in pain?

When the legs are a different length, we have a balance problem whenever we’re upright in gravity.

This is one of the root causes for an array of potential problems because the body is knocked off its center of gravity and loses what we call equipoise, or overall balance.

When equipoise is lost, the body shifts from being in a neutral relationship with gravity to being in a struggle with gravity.

Our muscular system automatically strives to bring us upright, contracting certain muscles to counter the force of gravity.

But over time this can develop into a series of muscular contractions that become entrenched, resulting in chronic pain.

Certain muscles become locked short -- fixed, stuck, adhered -- while other muscles become locked long -- strained, overstretched, weakened.

Over time, these compensations can become the source of significant pain and dysfunction in the body. 

The cascade of effects resulting in pain

A twisted pelvis, pelvic torsion, results in...

A functional leg-length difference, which causes...

A strong and comprehensive muscular response in the body to keep itself upright in gravity, which results in...

An array of complex compensatory muscular contractions which, over time, can result in...

Significant overuse of these muscles causing them to become ischemic (reduced blood flow) and causing myofascial trigger points and fascial shortening resulting in...

Pain and strain in the body that cannot be accounted for by standard allopathic testing.

is there more than one pelvic torsion pattern?

I used to think the answer to this question was, yes. I used to think there were a variety of patterns.

After thirty years of evaluating and treating this problem I no longer hold that view.

I now believe that in the industrialized world -- in which sitting in chairs and on toilets, with the legs at a right angle to the body -- a single dominant pelvic torsion pattern has emerged.

This torsion pattern is characterized by an anterior rotation of the right ilium (as is indicated in the example above), and a fixing or bracing of the muscles of left pelvic region and hip.

I call this pattern the Right Anterior, Left Fixed Pelvic Torsion Pattern, or The RALF Pattern for short.

While there are some variations from person to person, this is the twisted pelvis torsion pattern I have seen again and again and again over the course of thirty years of clinical practice.

Is there a solution?

Yes, definitely. Because a twisted pelvis -- pelvic torsion -- is a functional pattern, it can be corrected.

I have just released the first of a 3 Course Series created to address this, and many other, issues related to musculoskeletal pain.

The three courses -- the Stretching Blueprint, the Postural Blueprint and the Toning Blueprint -- are self-paced online courses that guide individuals through a process that mirrors the guidance I would provide during an extended series of in-person appointments.

The first course in the series -- Stretching Blueprint for Pain Relief and Better Flexibility -- is now available on my new learning platform, Relieving That Pain Online Courses.

The Blueprint Series
for Lasting Pain Relief

COURSE 1 - Stretching blueprint

The Stretching Blueprint for Pain Relief and Better Flexibility: The Complete Guide to Active Isolated Stretching is the flagship and foundational stretching course from my new learning platform, Relieving That Pain Online Courses.

Using the highly effective method of Active Isolated Stretching in combination with an innovative Flexibility Diagnostic, this course guides you in the creation of a highly personalized stretching plan that targets your specific needs: Your Stretching Blueprint.

For many, building a personalized Stretching Blueprint will be all that's required in order to see improvement for a wide range of stubborn and mysterious problems.

And for some individuals the protocols of the Stretching Blueprint can also alleviate postural distortion patterns like pelvic torsion (twisted pelvis).

Because distortion patterns are the result of excessive tightness in certain muscles and fascia, and because the flexibility scoring system of the Stretching Blueprint clearly identifies and effectively resolves inflexibility, this course can resolve some instances of pelvic torsion. It just depends on how entrenched the pattern has become.

learn more

COURSE 2 - postural blueprint

For many, the first course in the series, the Stretching Blueprint, will be sufficient to address a wide range of aches and pains and problems, including some cases of pelvic torsion (twisted pelvis).

But for those with very entrenched postural distortion patterns, the Postural Blueprint will offer detailed guidance.

The Postural Blueprint: A Step By Step Guide for Resolving the Pain and Dysfunction of Postural Distortion, guides individuals in resolving the two primary distortion patterns -- pelvic torsion (aka a twisted pelvis) and hyperflexion (aka forward head posture).

Both of these patterns can result in "unexplained" pain and mysterious symptoms that elude a standard medical diagnosis. The Postural Blueprint provides clear guidance for relieving the pain associated with these patterns.

This course is scheduled for release in mid 2021.

COURSE 3 - toning blueprint

The Toning Blueprint: A Step By Step Guide for Restoring Reciprocal Muscular Balance completes the series and will utilize a range of toning and strengthening methods -- including free weights, resistance bands and yoga -- to restore the reciprocal muscular balance so often lost when chronic muscular tightness and distortion patterns have persisted.

Restoring reciprocal muscular balance is what insures that distortion patterns a twisted pelvis don't recur.

This course is scheduled for release in late 2021.

learn more about the first course in this series...

resolving a twisted pelvis

Relieving That Pain Online Courses is a learning platform dedicated to detailed instruction and actionable tools of self-care for individuals seeking help with pain for which the diagnosis has been vague or inconclusive.

For many, the missed diagnosis is pelvic torsion (aka a twisted pelvis). That's why much of the course work on the new platform is dedicated to resolving this problem.

Drawing on thirty years of clinical practice helping thousands of individuals gain relief for chronic pain, the platform's founder, Stephen O'Dwyer, CNMT, has developed a complete methodology for identifying and resolving mysterious and stubborn pain symptoms.

With the outbreak of the Coronavirus pandemic and the closure of his in-person private practice in March 2020, Stephen turned his full attention to the development of online course work for this new platform.

Relieving That Pain Online Courses offers both FREE and premium courses.

You can take advantage of subscriber-only benefits by registering for a FREE mini course here...

REGISTER FOR free mini course

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Anatomy Images Courtesy of BIODIGITAL

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