I think I finally narrowed down my on going ITBS and leg issues to a leg length discrepancy. If I stand straight up and lock both of my knees out I can tell one leg is most definitely longer than the other. My chiropractor was the first one to notice this when I was having lower back issues. My question is how does one measure the difference, I am looking at having orthotics made for my running and cycling shoes and as for my other shoes will most likely use a heel lift. Has any of you gone through this same process.
The Ortho Doc x-rayed the pelvis then measured the drop from one hip crest to the other. I’m 1" shorter on the right. Getting hit by a car has a tendency to mess up alot of things.
For a number of years I ran with a 1/4" heal pad in the running shoe and 1/4" of spacer between the cleat and the cycling shoe. After about 5-6 years I’ve removed both and have had NO problems since. I first removed the running pad and used just the cycling shim for about 1-2 years, then took that off also.
You have to distinguish between an anatomical short leg or a functional one.
An anatomical short leg is when the leg bones are actually shorter. You could be born this way or this may have happened after certain types of leg fractuures. Spiral fractures of the tibia often make the bone shorter after it is healed. I once had a case of a spiral fracture making the tibia 3/4" shorter on that side. The patient was suffering from chronic back pain and after fitting him with a custom heel lift the back pain went away.
Functional leg length differences are more common and can be caused by conditions such as pelvic torsion, muscle imbalances, dropped foot arch, etc. These type of leg differences can be sometimes corrected by chiropractic, stretch exercises, etc., but sometimes a heel lift or custom orthotics can be used.
It s very difficult to accurately 100% determine leg discrepancies. An x-ray is most accurate, but that’s a fair amount of radiation. Measuring legs with a tape or assessing pelvic heights are clinical exam methods but are often inaccurate.
For cycling you can have spacers under the cleat or custom orthotics. Runners often benefit from custom running orthotics.
My short leg was the result of a R tibia spiral fracture and amounts to a full inch. I attempted to jump over a car that was about to hit me…but, seeing as I have “white mans desease”, I did not clear the front bumper and was hit in tibia and flipped onto the hood and off the other side. I also smashed the shit out of her windshield with my head!! Maybe thats why I became a triathlete!! : ) I’m NUTS!!!
Yep, been there, done that too. So it’s your longer leg which is giving you the ITBS, I guess? You can measure leg length discrepancies accurately enough without x-rays.
a) Length of tibia: Lie on the floor, face down, knees bent to 90 degrees and have someone measure from the floor up to your footsole. Or sit on a stool with knees at 90 degrees and measure from floor to top of the knee.
b) Femur length: Sit on a stool (90 deg knees) with your back and hips pressed against the wall. Measure from the wall to front of knees on both sides. A little tricky, I admit.
c) Total length: Standing posture and add spacers under your short leg until the hips are horizontal.
Hopefully, the discrepancy in a and b corresponds to the discrepancy you get in c, otherwise try again til it makes sense. The tibia can be corrected with spacers under the cleat or with full length shoe inserts (don’t use just heelcups). Femur discrepancies can be compensated by having one cleat further back than the other. In some cases, combinations of this works best, depending on your hips. When you are finished and out riding, the end result is hopefully two knees that move in a straight line up and down, at an equal distance from the toptube.
But ITB problems are primarily solved by stretching