The study aims to determine whether lumbopelvic manipulation yields superior improvements in pain, pelvic alignment, and functional ability when combined with METs compared to the treatment provided through METs solely.

With anterior innominate dysfunction (AID), the innominate bone rotates anteriorly over the sacrum, which produces pelvic dysfunction affecting the biomechanics of the pelvis, usually causing pelvic asymmetry and problems in regional and musculoskeletal patterns of pain, with the most affected being in the hip and low back. AID can hinder posture, mobility, and activities in daily functional living. Physiotherapy always includes a conservative approach. This study will be a randomized controlled trial with 46 participants. The target sample size was adjusted to 52 participants to accommodate a 10% dropout rate.

Inclusion Criteria:

• • Participants' age range 25_40 years.

  • Females
  • Have subacute (4-12 weeks) pain close to PSIS
  • Have ≥3/4 positive test PSIS height, standing flexion, prone knee flexion, supine to long sitting
  • Two out of four positive tests of pain provocation Distraction, compression, thigh thrust, and sacral thrust test)
  • Patients have moderate pain on the NPRS

Exclusion Criteria:

• Participants with True leg length Differences
• Systemic illnesses, such as ankylosing spondylitis or RA, or pregnancy
• Individuals with anticoagulation or bleeding disorders, acute muscle trauma, infections, lumbar disc herniation, spinal deformities, or a history of spinal surgery or anticoagulation medication
• No history of fracture

Anterior tilt more common in females