METRICS THAT MATTER: What Is Contralateral Hip Dip?

When One Hip Does All the Work

Picture this: you’re watching a runner from behind, and on every step, one side of their pelvis drops dramatically. That’s contralateral hip dip—and it’s a major red flag for instability, compensation, or weakness in your kinetic chain.

Contralateral hip dip (also called Trendelenburg sign) refers to the downward drop of the non-stance-side hip when the opposite leg is in contact with the ground. Ideally, your pelvis should stay relatively level. When it dips, something upstream—or downstream—isn’t doing its job.

Why It Matters in Running

Contralateral hip dip can signal:

• Weak hip abductors (especially the glute medius)

• Pelvic instability

• Inefficient or asymmetric force transfer

It’s also a known contributor to running injuries such as:

• Iliotibial Band Syndrome (ITBS)

• Lateral hip pain

• Low back pain

• Knee valgus and runner’s knee

What the Science Says

Clinical studies have consistently linked contralateral pelvic drop with injuries in runners. A 2018 study in the American Journal of Sports Medicine found that runners with larger contralateral pelvic drop—visible as a Trendelenburg sign—were significantly more likely to sustain overuse injuries, including ITB syndrome and patellofemoral pain .

Another study showed that female runners, in particular, may be more prone to this dip due to greater Q-angles and often reduced gluteal strength. Hip strengthening and targeted gait retraining are shown to reduce this compensation pattern significantly.

Couro’s Take

Couro’s analysis identifies even subtle degrees of pelvic drop during your stride, allowing you to catch imbalances before they become injuries. Our system flags hip asymmetries and recommends targeted feedback to help you regain control and improve load distribution.

Pelvic alignment might not be the first thing you think about—but it’s often the root cause of recurring pain and inefficiency.

We'll continue updating this post as more studies refine the clinical and performance implications of pelvic asymmetry.