So for xmas my family gave me an adjustment from a chiropractor. Basically I found out that my right hip is rotated forward, effectively shortening my right leg by about half an inch. This explains why I can never seem to dial in my seat for both my left and right legs to be pain free. To correct the problem, the chiropractor put me on pelvic blocks for about 10 minutes and now both legs have the same length.
Obviously the problem is bound to return (most likely as soon as I go for a run), and I was wondering if anyone has tried any remedies outside of going to the chiropractor. She offered to order me a pair of the blocks to use on my own and right now that seems to be the route I’ll be taking.
Core strength, core strength, core strength. Expecially in the hip areas.
Do a lot of 4-way hip exercises–tie a stretch cord between your ankle and a table leg, and while standing (not holding on to anything), keep your knee straight and pull the cord in all 4 directions: Start from a standing position and pull the cord to the front 8-10 times using your hip flexors; then rotate 90 degrees and pull across the other leg using your adductors; then rotate, etc. Then switch legs and do it again.
You are able to manage the situation with additional certainty if you can label leg length difference as (1) functional (due to spasm and/or rotation at the sacral illiac joint), (2) anatomical (actual boney length differences of the femur or tibia) or (3) a combination of the two. X-Ray of both femurs and both tibia allows you to measure bone length. If you have anatomical differences, you may place a lift in one shoe, shim one pedal, move cleat position on one shoe, etc. A short leg on the bike can create significant problems for you as the short leg reaches for the pedal. Your pelvis rocks as you reach and your taint can get rubbed raw and low back may get pretty sore. You’ll often have chronic saddle sores on the short leg side due to rocking/chaffing.
Kevin, you are are not disputing that the chiropractor is able to make a leg length discrepancy assessment as well, correct? The way she explained it to me was that my right hip was rotated forward (top of hip pushed forward, bottom of hip pushed back) which was creating the length difference. After the pelvic blocks the length was the same. I really want to be careful implementing a shim or lift if I’m only going to be reinforcing a problem I should in fact be correcting.
Brian, thanks for the exercises. I was thinking that poor flexibility was a culprit and was considering enrolling in some yoga classes, but I suppose some hip strengthening wouldn’t hurt.
as the proud owner of a chronically rotated right hip, that got so bad, it helped herniate a disc in my back, i would STRONGLY suggest you learn about the joys of stretching your hip flexor on your rotated side. has done wonders for me, but i had to learn about if after getting surgery on the disc.
I specifically didn’t comment on your doctor’s assessment. That would be easy, but unfair. I don’t know what she did. I am a chiropractor of 25 years // and I have an anatomical short left leg (14mm). I know what I need to do to properly differentially diagnose anatomical short leg vs functional short leg. One is actual boney length difference from side to side (femur vs femur // tibia vs tibia). Functional or ‘apparent’ short leg can be due to muscle spasm, guarding, scoliosis and a host of other things. Sounds like you’ll need to dig a little deeper to see how your doc came to her conclusion and then decide whether that is enough for you.
<< The way she explained it to me was that my right hip was rotated forward (top of hip pushed forward, bottom of hip pushed back) which was creating the length difference. >>
For clarification – that diagnosis is common and may be exactly what you have/had. The treatment is also mainstream (one of several). Sometimes, we can say with a reasonable medical certainty that the pelvis (SI joint) is the culprit; maybe even without radiographs. An x-ray of the pelvis that shows asymmetrical illiac crests and an asymmetrical pelvic brim is one way to help pin down functional short leg due to rotational variables. However, even if you do have functional reasons for short leg, that does not rule out anatomical boney leg length differences. In my view, chronic rotation problems (as sto alluded to) can sometimes be traced to an overlying problem of anatomical discrepancy. That would be my case. Like sto, these problems, over decades, likely contributed to my herniated disc.
It depends. What is the purpose of the orthotic? If you have sh*t for feet, like me, you might use orthotics effectively. If you also have an anatomical short leg you could build a heel lift into one orthotic. I generally go about half the difference. My lift is 7mm.
My feet are in good shape (wide w/ high arch) but I have continually had an issue with my right hip (behind the top of the femur). I’ve been to a local chiro guy who always says that hip is misaligned. He set me straight (he says) last week but it’s still a problem. He believes the solution is orthotics and he’s now in the orthotic business (as of last year). He may be right on and very competent but I’m pretty sure I’m his only runner client. I made an appointment with podiatrist Dr. David Hannaford who apparently is THE guy (podiatrist to many Olympians, ultramarthoners, adventure racers, and other endurance athletes). I just don’t know if I’m heading in the right direction with this. Wish you were up here. If I still don’t have a solution by March I’ll make an appointment with you when I’m in town for O’side.
I do lots of core work, stretching, roller, tennis ball and I just started using bands all for that freaking right hip. Each time I get a breakthrough I’ll get a 2 month reprieve and then it hits again. Pain starts at mile 2 and I can actually push behind the femur and run pain free for another mile. This continues with greater frequency as I run until it kinda just goes numb and I run through it. Probably not a good thing.
I know I sit too much at work but I gotta make a living.
I’ve struggled with IT band and hip burisitis for a year and a half. In that time I’ve had various treatments, PT, chiropractor, cortisone shots, you name it. I finally found a massage therapist whose assessment was that my hips were out of alignment. He gave me some very simple things to do and amazingly my hip pain is nearly gone and I’ve just started running again after a year off. The main stretch is this: lay on your back pull one knee to you chest, grasp your hands around your knee and do a push/pull move. Push out with your knee and pull in with your hands, hold for a 5 count then release your leg out straight. I swear this simple manuever has helped me in a very short time.
Ummmmm. first of all, if you really think you have a problem you need to see a DOCTOR (as opposed to a chiropractor). Im sure you could find a specialist that is familiar with your specific problem.
Your man may be right. I can’ tell. Often there is an array of things going on. That’s why it can be so darn hard to clear everything up and we suffer frequent recurrence. Think about what other structures may be part in parcel to your problem that are in that area (an area that usually has some soft tissue component involved) that might be treated with ART, deep massage or strengthened with specific rehab. The vastus lateralis inserts way up in there. Tensor Fascia Latae could be a player. The major muscle of the posterior hip are the gluteals, piriformis, gamelli, obturators and quadratus femoris. They work together and in similar directions. However, they should be treated in isolation and individually. Interestingly, these muscles change function based on how much the hip is flexed. When you leg is straight they are “external” rotators of the hip. When your hip is flexed past 90 degrees they are internal hip rotators and do some abduction. These muscles are all deep in your butt, behind your “hip” or femur. The fact that you can reach back and dig into the area for relief is a sign they may be involved. Have a look at an anatomy book and see if these muscles are in the area of your symptoms. Hard for me to tell by your description. These guys can also influence the sciatic nerve that exits down the leg near there. They are also frequently irritated in patients with LBP and they do a lot of compensatory motion in those cases (disc, facet pain, etc).
as the proud owner of a chronically rotated right hip, that got so bad, it helped herniate a disc in my back, i would STRONGLY suggest you learn about the joys of stretching your hip flexor on your rotated side. has done wonders for me, but i had to learn about if after getting surgery on the disc.
and don’t sit. the root of all evil, I tell you.
Another strong vote for frequent stretching and strength work from someone who suffers from hip issues. Keep in mind that there are many different hip flexor muscles, including some that are difficult to reach with standard stretches. The older I get, the more yoga-like work that I do.
Sitting in an office all day is about the worst thing that I can do for my hip alignment. I now have stand-up desks at home and in the office. (Google anderlyn desk if you’re interested.)
yes, after my disc herniation round one, i was able to get an “electronic work surface” (yes, welcome to corporate lingo). basically it is an electronic desk that i can raise or lower from standing, sitting or kneeling all with a touch of a button.
i sit for a little then raise it and work standing for a few hours.
sure beats laying on the floor on my stomach on a yoga mat propped up on pillows to type.
KP. Sorry to be of no help, but HP procured and installed my electric desk in my cube, so I did not do this personally. I just crawled around underneath it and can not find any manufacturer information on it.
KP, is this the sort of thing that might happen over time with, say, misaligned shoe cleats or running on canted surfaces?
I’ve been experiencing hip pain and subsequent sorts of compensation issues over the last year or so. I can’t seem to find a good alignment for my cycling cleats, especially on the right…and this is after a few years of running on significantly canted roads around Quantico, VA.
I’ve got an appointment w/phys therapy tomorrow for hip pain issues…maybe they can check for this type of situation?