PELVIC TILT

TRENDELEMBERG

A Trendelenburg gait occurs when the pelvis drops on the side of the swinging leg, signaling that the hip abductors (Gluteus Medius and Minimus) on the stance leg are not strong enough to maintain a level pelvis. Instead of a stable, level stride, this "pelvic drop" causes the rest of your kinetic chain, specifically your knees and lower back, to compensate for the lack of lateral stability.

Generally, a trendelemberg gait decreases running efficiency from excessive force lost in the lateral movement rather than forward progression. In addition to decreased efficiency, the medial knee joint will undergo increased stress and the IT band will experience increased strain.

COMMON CAUSES OF A TRENDELEMBERG GAIT PATTERN:

• Poor lumbopelvic control from core weakness

• Weakness of the hip abductors (gluteus medius and minimus)

EXERCISES

In general, you want to work on core, gluteus medius, and medial quadricep strength to address weakness and the areas undergoing increase strain.

Standing Hip Hikes

• Start standing on a step/yoga block/ledge with one foot hanging off the side

• Lift and lower your hip of the leg that is hanging by pulling your hip up to "crunch" your hip up to your ribcage and then lower back down

• Imagine you have a pole through your leg and you are lifting straight up and down the “pole”

Side Stepping

• Start with the band around your ankles and in a small squat position 

• Take 20 steps to the right and then 20 steps to the left 

• Focus on leading with your heel. Do not let your toes turn out; this will activate the hip flexor instead of the lateral hip stabilizers (glute med and glute min) which are the target muscles of this exercise

• Stay in the small squat position the whole time. Imagine you have a pencil on your forehead and “draw” a straight line as you are stepping, rather than an up-and-down line

Single Leg RDL (Romanian Dead Lift)

• Standing on one leg, hinge forward until your body is parallel to the ground and then stand back up

• Keep your non-standing leg inline with the rest of your body; imagine your upper body and non-standing leg are a board

• Don’t let the hip of your non-standing leg rotate up; keep your hips level while you hinge forward 

COMPENSATED TRENDELEMBERG

With a compensated trendelemberg gait pattern, the runner’s trunk leans towards the side of the weight-bearing leg. The runner is actively shifting their center of mass over the weight-bearing hip joint to reduce the demand on the hip abductors.

Generally, a compensated trendelemberg gait pattern can lead to IT band syndrome, due to increased lateral tension placed on the structure and low back pain due to excessive lateral flexion of the lumbar spine with every step.

COMMON CAUSES OF A COMPENSATED TRENDELEMBERG GAIT PATTERN:

• Hip abductor (gluteus medius and/or minimus) weakness —> causes instability of the pelvis and the runner will lean their torso over the weak hip to mechanically decrease the leverage that the hip muscles have to work against

• Adductor (groin muscles) tightness —> can pull the pelvis into a medial tilt and the runner will then lean the trunk to counteract the pull and maintain balance

EXERCISES

In general, you want to work on gluteus medius and minimus strength, stretching of the groin muscles and low back muscles to address weakness and the areas undergoing increase strain.

Side Stepping

• Start with the band around your ankles and in a small squat position 

• Take 20 steps to the right and then 20 steps to the left 

• Focus on leading with your heel. Do not let your toes turn out; this will activate the hip flexor instead of the lateral hip stabilizers (glute med and glute min) which are the target muscles of this exercise

• Stay in the small squat position the whole time. Imagine you have a pencil on your forehead and “draw” a straight line as you are stepping, rather than an up-and-down line

Child’s Pose with Side Stretch

• Sit back into child’s pose; stretching your hands forward and bringing your hips towards your heels. 

• Bring both hands to the right and hold for 30 seconds to feel and left-side-body stretch and then switch sides.