Hip internal rotation is one of the most commonly restricted movement patterns — and one of the most important. It influences how well you squat, lunge, walk, and transfer load through a single leg. It also has a direct relationship with pelvic floor function, meaning that when rotation is limited, the effects are felt well beyond just the hip joint.

The hip shift, also referred to as the iliacus pullback, is an effective tools and step for restoring it.

What Is a Hip Shift?

Your hip is a ball-and-socket joint. The head of the femur (your thigh bone) sits inside the acetabulum, the cup-shaped socket in your pelvis. For most people, particularly those who spend a lot of time sitting or who have been through pregnancy, the femoral head tends to sit compressed and slightly forward in that socket. Over time, this limits how freely the joint can move.

A hip shift is a deliberate repositioning of the femur within the socket. Rather than allowing it to sit compressed forward, you encourage it to glide back and down, creating more space inside the joint itself.

The iliacus is a muscle that runs along the inside of your pelvis and attaches directly onto the femur. When it becomes overworked or shortened, which is common in pregnancy and the postpartum period, it can pull the femoral head forward in the socket, compress the hip joint, and create a ripple effect of tension up into the lower back and down into the knee. A hip shift gives that muscle room to release, and gives the joint room to move.

Why Does Hip Internal Rotation Matter?

Hip internal rotation — the ability to rotate your thigh bone inward within the socket — is one of the most commonly restricted movements during pregnancy that then lingers into postpartum. Yet it plays a significant role in how well you squat, lunge, walk, and load through a single leg.

When internal rotation is limited, your body finds workarounds. You might notice your knee caving inward during a squat, your lower back taking on more load than it should, or asymmetry in how your hips feel side to side. Over time, those compensations add up.

Hip internal rotation is also directly connected to pelvic floor function. The muscles of the pelvic floor don’t work in isolation and they respond to the position and movement of the hip. When the hip joint is compressed and rotation is restricted, the pelvic floor often reflects that tension. Restoring better hip IR doesn’t just improve movement; it can positively influence how the pelvic floor is able to lengthen, load and recover.

What Changes During Pregnancy?

Pregnancy brings significant changes to the pelvis and the surrounding tissue and many of them directly affect hip mobility.

As the uterus grows, the pelvis shifts into a more anteriorly tilted position. This means the front of the pelvis tips forward and down, while the back rises. For the hip joint, this changes the angle at which the femoral head sits in the socket — often reducing the available range for internal rotation and loading the iliacus further as it works to manage that new position.

Relaxin, the hormone responsible for increasing ligament laxity during pregnancy, also plays a small role. While it allows the pelvis to expand in preparation for birth, it can reduce the passive stability that the joint normally relies on. The muscles around the hip, including the iliacus, often compensate by working harder to provide the stability that the ligaments are no longer contributing as effectively.

The result is a hip joint that feels tighter, more compressed, and less able to move freely through its full range, particularly into internal rotation.

How the Hip Shift Helps

By encouraging the femoral head to move back and down within the socket, the hip shift creates space at the posterior aspect of the hip,  the very area where internal rotation originates. It allows the iliacus to decompress rather than continually pull the femur forward. And when combined with breath work, it brings the diaphragm and pelvic floor into the picture, helping the entire system (not just the hip) find more ease.

This is why hip shifts are used across so many different positions and contexts. They’re not a single exercise so much as a principle you can apply to your movement: create space first, then build from there.

The six variations below show you exactly how to do that.

1. Side Lying

The side lying hip shift is the most accessible entry point for this work. In this position, gravity assists the femoral head in dropping away from the acetabulum, encouraging natural decompression of the joint without any active effort to create it. Because the demand is low, it’s an ideal starting point if you’re new to hip shift work, early postpartum, or working through significant hip tightness. It also makes it easier to focus on breath — using the inhale to expand into the back of the ribcage while allowing the hip to settle further into the shift.

2. Quadruped Off a Yoga Block

Placing a yoga block under one knee in a quadruped position creates a subtle elevation on one side of the pelvis, encouraging the iliacus on that side to lengthen. The result is a gentle decompression of the hip joint without requiring a large range of motion or significant load. This makes it a useful progression from side lying, you’re introducing a little more positional demand while still working within a supported, low threshold environment. It’s particularly useful in pregnancy, where getting into and out of positions needs to remain manageable.

3. Supported with Back Leg on a Wall

This variation uses a hinge-style— think hip airplane with the back foot supported against the wall. The wall grounds the back leg and gives you a stable base to hinge forward from, allowing the pelvis to tip and the hip to shift into decompression without the position collapsing. The support means you can really commit to the shift rather than managing balance at the same time. It’s a meaningful step up from the more passive variations, beginning to load the hip shift pattern in a way that translates to single-leg movement. This was a game changer for me and SI joint pain during both my pregnancies!

4. 90/90 Hip Shift

Lying on your back with hips and knees at 90 degrees against the wall, a foam roller squeezed between the knees adds an important layer to this position. The adductor activity required to hold the roller helps organise the pelvis and creates a more stable base from which the hip shift can occur. This variation is particularly well suited to layering in breath and pelvic floor work. The position naturally supports diaphragmatic breathing, and the combination of adductor engagement and hip decompression gives the pelvic floor an opportunity to respond and lengthen appropriately. Although a supine, supported position this can actually be one of the more challenging variations to do correctly.

5. Inverted Breathing with a Hip Shift

Breath changes everything in this work. Adding an inverted breathing with a hip shift can be a small but effective adjustment. The inhale creates an internal expansion that helps offload the joint from the inside, while the exhale provides an opportunity to gently organise pressure through the system.

6. Lateral Hip Shift

This is where the work becomes functional. A lateral hip shift where you move the pelvis sideways over one leg while keeping the ribcage relatively neutral, is a pattern that shows up constantly in everyday movement: walking, stepping up, transitioning through a lunge, loading through a single leg. Training it consciously helps transfer the joint space and mobility you’ve been building in the earlier variations into the way you actually move. It’s also a useful tool for identifying asymmetry — most people will notice quickly that one side feels notably different from the other, which in itself is valuable information.

Final Thoughts

The hip shift is not a fix all, but it is a fundamental. If hip internal rotation has felt restricted. Whether you’re pregnant, postpartum, or neither, these variations give you a way to create space in the joint before asking it to load and perform. Start with the positions that feel most accessible, layer in breath where you can, and notice how the more functional variations begin to feel different as a result.

If you’re looking for programming that builds on foundations like this — through pregnancy, postpartum, and beyond — the Lift with Emily App brings it all together in one place. You can try it free for 7 days.