There are a few possible reasons why your hips are uneven. Uneven hips might be the result of a developmental issue that happened before you were born or a problem with your posture.
Scoliosis
Scoliosis is the most common cause of uneven hips.
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In this condition, the spine has a sideways “S”- or “C”-shaped curve and may be slightly rotated.
Most people experience their first symptoms between the ages of 10 and 15. Although people of any sex can develop scoliosis, girls are more likely to develop the condition and to have a more pronounced curve that requires treatment.
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The curve is more likely to get worse if it’s “S”-shaped, large, or in the middle of the spine. It’ll usually stop progressing once the bones stop growing.
Scoliosis may occur because of an issue with the way the spine develops before birth. It can also be the result of a nerve or muscle problem, such as:
- muscular dystrophy
- cerebral palsy
- polio
- spina bifida
- Marfan syndrome
Scoliosis can run in families.
Functional leg length discrepancy
A functional leg length discrepancy is when one leg looks and feels longer than the other, but it’s the same length when measured. This discrepancy is caused by poor posture, which leads to tension and imbalances in muscle strength.
When poor posture becomes a habit, and you sit or stand in the same position daily for months or years, your muscles compensate. Some muscles become shorter and tighter, while other muscles become weaker. This leads to imbalances that may make one hip appear longer or shorter than the other.
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Another cause of functional leg length discrepancy is staying in one position with one hip higher than the other for a long time. This can happen if you always lean to the same side when sitting or standing.
Structural leg length discrepancy
Structural leg length discrepancy is when one leg measures longer than the other.
Most people’s legs are slightly different lengths, but it’s uncommon for the legs to be so different in length that they make the hips uneven. A difference of only 2 centimeters (cm) can cause problems such as walking difficulties or a limp.
Sometimes the difference in leg length is congenital, which means you’re born with it. The reason for it may not be known.
In other cases, the discrepancy is caused by:
- a short or missing bone in the leg at birth
- a congenital abnormality in which the upper part of the thigh bone has not formed properly or is missing
- a severe infection in a leg bone during infancy or childhood
- a broken leg bone that heals badly during childhood
- an injury to the growth plate of the leg during childhood or adolescence, which is called a Salter-Harris fracture
- Blount’s disease, which affects the growth plates in the knee joint
- conditions that affect growth on one side of the body, such as clubfoot or developmental dysplasia of the hip
- conditions that make the joints swollen and inflamed, such as juvenile rheumatoid arthritis
- conditions that cause tumors to form on the bone, such as hereditary multiple exostoses (HME), neurofibromatosis, and Ollier’s disease
- nervous system disorders such as cerebral palsy or polio
- Legg-Perthes disease, in which loss of blood flow to the ball of the hip joint causes the bone to die
- hyperemia, which is increased blood flow into an area (such as the leg)
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