Your pelvis isn’t out of alignment.
One thing I truly despise is the unnecessary villainization of perfectly ordinary details about our bodies. Some of the most common examples I run into are:
Flat feet / fallen arches
Twisted or “out of alignment” pelvis
One leg longer than the other
Scoliosis or excessive lumbar lordosis
Poor posture
Let it be known: these are red herrings. Misleading distractions we’ve learned to attach too much meaning to. Are they factors? Sure. Are they the ROOT cause of your pain? Absolutely not.
Think about it: not everyone with one of these “diagnoses” is in pain. So, what are we missing? These labels often come from people who don’t truly understand functional anatomy. They may know static anatomy — the kind you study on a table during an adjustment or surgery — but do they understand what happens when that body is loaded in real life? I’d argue no, based on the fact that they even offer these diagnoses in the first place.
In my evaluations, we don’t just slap a label on something; we listen to the story your symptoms are telling us. Pain isn’t random — it communicates through specific patterns, just like hunger or thirst does. When we ignore these patterns or jump to a diagnosis too quickly, we miss the crucial context of why these so-called “abnormalities” exist in the first place.
Even the ideals behind physical therapy often stem from a racially informed, Eurocentric model that overlooks the global trends of flatter feet or wider hips. But just because something is “atypical” by a narrow standard, does that make it “abnormal”? And should we even be trying to “fix” it?
Take the example of a “rotated pelvis.” Is it really “rotated,” or is that a symptom of another issue? Does “fixing” the rotation even address the underlying problem, or is it just treating the symptom?
Your pelvis doesn’t just rotate itself into dysfunction. So, how did it get there? This is exactly the question I like to ask. Our bodies reflect the forces applied to them — meaning your rotated pelvis didn’t happen in isolation. It came from active load, from the forces placed upon it over time. If that’s true, then it means fixing the “rotated pelvis” requires us to change the load, not just manipulate the pelvis itself.
When we treat the “rotated pelvis” in isolation, we’re missing the point. It’s no more than a distraction, with a Rube Goldberg-esque trickle-down effect. We isolate the local area, convincing ourselves that things really are that simple. But they’re not. I can guarantee that they never are unless we’re also accounting for the global system — the entire body and how it moves in relation to everything else.
This is one reason why I don’t rush to send people for imaging (like MRIs) without due cause. I don’t want someone with mild back pain to get an MRI, only to be told they have a “bulging disc.” That diagnosis might explain some of the symptoms, but it may very well not. Muscular injuries, joint injuries, disc injuries, ligament injuries, nerve injuries, tendon injuries — they all sound different. And while a disc bulge may be present, it’s not always the cause of your pain.
The problem with these misleading diagnoses is that they can lock people into rigid beliefs. They start to think that the only way to reduce their pain is to “correct” the disc bulge, or the scoliosis, or the leg length difference. Maybe they’ll put in arch supports or get treatments aimed at fixing the “alignment.” But that’s not the whole truth. That’s where things go wrong.
Take Simone Biles, for example. She’s one of the greatest athletes of all time, and yet she has remarkably flat feet. Or how about the marathon runner I once treated who had a 20 cm leg length difference — and didn’t feel pain? What’s the common thread? They’re both strong.
Strength is often what keeps these “abnormalities” from becoming problematic. It’s not about fixing the feet or correcting the pelvis; it’s about reinforcing the system to be resilient against the demands you put on it. If you can load the body properly and support the whole system, what may seem like an issue in one part of the body won’t necessarily cause pain or dysfunction.
So, let’s stop focusing on isolated “problems” and start looking at the body as a whole system, with a global approach to loading and movement. That’s where the real solutions lie.
