Pelvic Differences and Running

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Your pelvis plays a role in your running biomechanics. A correctly aligned pelvis can improve your running economy. An incorrect pelvic tilt can raise your risk for overuse injuries, which are common among runners. Overuse injuries happen when you regularly experience small amounts of damage as you run that build up over time. The cumulative effect eventually becomes a problem such as a stress fracture, knee problem or iliotibial band syndrome.

Forward Tilt

A pelvis that is tilted too far forward, known as an anterior tilt, is one common abnormality that happens during running. Overuse injuries associated with an anterior tilt include hamstring strain, low back pain and patellar tendonitis, which causes pain in the tendon that connects your kneecap to your shinbone, and patellofemoral syndrome, in which you have knee pain from running. Patellofemoral syndrome is commonly called runner’s knee. If the angle of your gait is widened, an anterior tilt also may lead to lower leg issues such as shin pain.

Lateral Tilt

Having one side of your pelvis lower than the other, known as a lateral tilt, is another common issue when it comes to abnormal pelvic biomechanics. This can lead to iliotibial, or IT, band syndrome. The iliotibial band is a thick band of tissue that runs from your hips to below your knees. IT band syndrome can cause knee, thigh or hip pain and a snapping sensation where the band passes over the knee. It also can cause low back pain, which is usually felt on one side, groin strains and pain on the outside of your hip.

Biomechanical Issues

Biomechanical abnormalities like hips that are tilted laterally or forward often are caused or worsened by muscular imbalances. They also may be caused by structural issues, like a leg length discrepancy. Doing a one-legged squat on each side, lowering yourself until you have a 90-degree bend in the knee, is one way to check for a biomechanical issue in your hips. If balance on one side is more difficult or one side seems less coordinated, painful or weaker, take a closer look at your pelvic biomechanics, recommend the experts at Rice University in Texas. If you suspect a biomechanical problem with your pelvis, have a gait analysis performed by a health-care provider to pinpoint the issue and its potential cure. Depending on the cause of your issue, you may need to strengthen your abdominals, improve flexibility and strength in your hamstrings and hip flexors. Or, you may need custom-made shoe inserts called orthotics to correct an issue like a leg-length discrepancy.


Gender differences in the pelvic area may be a factor in the injury rate disparity between men and women. Women are almost twice as likely to have running injuries. Women’s hips rotate in and out more during running than men’s hips do. Women also have more activity in the gluteus maximus. These factors may come into play in the higher incidence of runner’s knee and IT band syndrome among women, says Elizabeth S. Chumanov, lead author for a 2008 study published in “Clinical Biomechanics.” However, more study is needed to pinpoint whether these differences are related to the higher injury rates among women.

Hip Utilization

Even if you don’t have a biomechanical problem, you may be underutilizing your pelvis as you run, say “Chi Running” authors Danny Dreyer and Katherine Dreyer. You may not be leveling your pelvis as you run, which is done by engaging your core muscles. Or, you may be holding your pelvis too immobile, which adds strain to your hip joints as you run. Men tend to have the latter issue. It’s usually caused by holding too much tension in the gluteal, quad or lower back muscles. Women tend to run without engaging core muscles to level the pelvis, which causes your pelvis to move side to side as you run. This leads to unsupported movement that increases injury risk to your lower back and hips.