Daily Mobility Exercises by Dr. Kelly Starrett › Forums › General › Leg Length Discrepancy and Chronic Pain

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    • 11/14/2014 at 3:51 am #71186
      AvatarMurat Karakas
      Participant

      Hi Everyone,

      I’m writing to get some insight about some chronic pain and complicated dysfunctions that I’ve been dealing with for about seven years now. I’m a 21 year old college athlete and I’m currently unable to compete due to the numerous issues I’m having. Any input or resources would be greatly appreciated and I do apologize for the complexity of the problem. 
      Background:
      About seven years ago I clearly remember “tweaking” my right glute during a baseball game. I hadn’t warmed up well before the game and as a catcher I had to quickly shift laterally to block a ball and when that happened I had some sharp pain in what I was told was my right glute medius. It was kind of tender to walk on and my hip felt a little weak but I was able to play through it and never really had to address it. Later on that season I started to develop ipsilateral low back pain and lateral hip pain. It has never fully gone away since then and my problems have only traveled up stream and down stream. 

      Current:
      I’m dedicating all of my time and effort to solving these issues by watching mwod videos, reading, meeting with my pt, and practicing some self mobilization so I can get back to gaining strength and moving forward. I‘ve been told that I have a functional leg length discrepancy by a couple of therapists. I’m still struggling with similar hip and low back pain but also cervical, thoracic, rib, and shoulder pain/dysfunction all on my right side. My pelvis is laterally tipped with my right side appearing higher while my right leg appears to be longer. My right hip has an anterior tip and my left hip has a posterior tip which I believe is causing some of the torsion and pain in my low back. My right shoulder has a bit of a dip and I’ve been told my spine slightly curves to the right. My obliques, QL, and psoas on my right side are obviously tight and I’ve spent countless hours trying to restore the tissue but I feel like I’m fighting an uphill battle with my nervous system.I have slight muscle tone asymmetries as well. My right arm is smaller than my left, the right side of my “abs” are smaller than the left, and my right neck flexors are larger than my left. These are only a few of the many muscular imbalances I’m beginning to uncover.

      Tests:
      – Right Hip/Glute Ultrasound: “Impingement” (Spring 2011)
      – Right Elbow Ultrasound: “Impingement” (Spring 2011)
      – Cervical, Thoracic, and Lumbopelvic x-rays: normal with slight compression at C7/T1 and L5/S1 (Fall 2014)
      – Right Hip MRI Arthrogram: Normal  (Fall 2014)
      – Leg Length Radiograph (Fall 2014): LLD but determined to be “functional”

      I really just want to get to the bottom of this mess and start training hard again so if you have any ideas, resources, or any questions please comment and I will respond.Thank you for your help.

      Austin 
       
    • 11/14/2014 at 3:52 pm #75471
      AvatarAnonymous
      Guest

      Austin–
      Do you have a current evaluation of what is going on?
      7 years ago something happened was it ever resolved?
      Have you identified the root cause of the pain?
      You can go after symptoms, but they won’t fully resolve until the cause of the issue is resolved.
      Are you seeing improvements with what you are addressing?
      Do you have anything in your shoe to even out the discrepancy?
      When something is out of line in the base of the system everything is thrown off up stream and forces your body to make compensations you may or may not be aware you are making.
      Has anyone looked at resetting your pelvis?

    • 11/14/2014 at 9:17 pm #75472
      AvatarMurat Karakas
      Participant

      Kaitlin,


      I just started doing physical therapy again about two weeks ago. Prior to this, I was seeing a chiropractor/manual therapist about once a week while playing football. He suggested that I had a true leg length discrepancy and gave me a heel lift that I wore diligently for about two months with no results. I’ve really been given no real diagnosis or answers as to why I’m having these problems. I understand the upstream and downstream effects but I’m having trouble beating the pain spasm cycle. I’ve had my pelvis reset numerous times but it seems like I just go right back to my crappy default position without any real change. Thank you for your help.
    • 11/15/2014 at 9:18 am #75473
      AvatarAnonymous
      Guest

      When you wore the heel lift were you also working on mobility?
      If not I would look at doing that. You may need an adjustment to align your hips.
      here are a few to start with
      The QL Is NOT a Bone…Even in THE Matt Chan
      Jill Miller Smashes Your Guts! (and psoas, and tacked down viscera, and matted down abdominals…) Part 2
      Psoas Flossing and Biker Hips | Episode 301
      Episode 290 Haiku Contest And Landing Position Part 2
      Episode 129: The Twin Bowstrings, the Psoas and Scalenes
      Episode 75: Your Inside Psoas Bits, World Record?
      Episode 26: Hips and Seppuku: Psoas and Hip Soft Tissue Mob
      Yes, the positioning may revert back to the old positioning. Its like learning anything new constant reminders are key. Getting the areas around it more supple will help feed slack to the system and help in holding the changed positioning. Keep chipping away at it.
      Episode 128: The Pelvic Fault and Back Pain
      email me [email protected] and we can look at some additional resources

    • 11/16/2014 at 3:59 pm #75479
      AvatarSukho Gomes
      Participant

      Austin,

      As an add-on to Kaitlin’s great advice, have a look at how you sit in a chair and whilst driving a car (over time). As an Osteopath I see a lot of what reverts an unbalanced pelvis to be habitual in our sitting posture. For example, take note of how your posterior superior iliac spines (PSIS – or bony posterior hip bits) fit into the back of a chair – are they both contacting the back of the chair? Are they still both contacting after 5 mins? This can be common if you drive an automatic car as the accelerator leg goes towards the pedal and the left gets lazy.

      If there is a change over time it should give you a better idea of the shortened tissues vs the long weak one. Good luck!

      Scott

    • 11/16/2014 at 8:34 pm #75481
      AvatarMurat Karakas
      Participant

      Kaitlin, 

      When I was wearing the lift I was doing some mobility work, yes. I think the lift is unnecessary. I believe that I just need to fully commit to feeding slack to some of the systems and continue to focus on my posture and technique constantly. Thank you for the links and insight.
      Scott,
      I’ve been progressively becoming more aware of my position errors. What seems comfortable or normal for me is usually a poor position that is facilitating my problems. So I totally agree with what you’re saying and I appreciate your help. 
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