Back to Post
| Display Name | Post: Back/Hip/Leg Pain for 9 Months, Hip/Leg Discrepancy Too - Please Help. | |
|---|---|---|
|
JCA Haven't posted much Posts 8 |
11-28-09 12:30 AM - Post#591911
Hi, I am 35. Have never really been a weight trainer, although I have been working my core to death for the last 5 months. And I will continue to keep strong for life after going through this fiasco. For about 9 months, I have had daily and constant (if not on an anti-inflammatory or pain medicine) pain in my *right* lower back, hip and leg. I have gone through the motions (PT, Chiro, X-Rays, MRIs, steroid injections, etc.). I have been diagnosed with sciatica or other nerve pain. I think that is just a symptom of another cause. X-Ray shows lumbar levoscoliosis MRI shows mild bulge at L4/L5 and facet disease at L5/S1. I am 99% convinced that neither the bulge nor the facet disease the primary cause of my pain. Pick 100 people off the street and 60 of them will have worse degeneration than me with no pain. I found this forum via a search I did for high hip information where I found the following blog post: http://www.davedraper.com/blog/2008/09/10/what- is-an-elevated-hip/ I have an elevated left hip. No doubt. Guaranteed. That blog post helped me be convinced even more because my spine bends towards my right side too. However, I have also been x-ray measured as having my right leg *shorter* than my left leg by about 1 cm. So with elevated left hip, you would guess I would have a functionally short left leg, but I also I have a structurally short right leg. It becomes frustrating as to where to begin. It is a 50/50 split between the doctors I have seen whether I should wear a 1/2 cm heel lift in my right shoe. For example, one PT says I should wear the lift; osteopath says I don't need it. I don't know whether I should do wear it or not. It is also not 100% guaranteed as to whether I have an anatomically short right leg either. X-Ray showed 1 cm shortness, podiatrist thinks I am short. Another PT and osteopath do not think so. Even the radiologist examining the x-ray said he can't be 100% certain; although he is probably more correct than any one else, I suppose. I was thinking of having a standing x-ray done by a chiro -- the one I had was supine. Can someone help me as to where to begin so I can get my body back in alignment and eliminate this pain? I saw some of the stretches and exercises in the blog post, but I am not familiar with much of the terminology and how to do some of the foam roller exercises, etc. Pretending I am starting from scratch might be the best approach for me. One thing I do know is that my right glute is noticeably weaker than my left glute -- I compared doing single leg bridges. Also a doctor noticed it when I doing an exam on me as well. Also, I can send you pictures showing my elevated high hip, x-ray photos of my back or leg length, etc. if you feel that would be helpful in coming up with a proper treatment program for me. Thank you very much! |
|
|
ccrow old hand Posts 10055 |
11-28-09 11:44 AM - Post#591956
So with elevated left hip, you would guess I would have a functionally short left leg, but I also I have a structurally short right leg. It becomes frustrating as to where to begin. No, it is just what you'd expect. Think about it: short right leg right hip lower left hip higher (elevated) Whether the leg is really short - it can be deceiving on either a standing or lying x-ray. If there is some equivocation about the necessity of the heel lift, maybe it makes sense to hold off. The whole picture is going to change if you can do some effective corrective work. Unless you spend a lot of time walking or standing on very level surfaces, it might not be a big deal for you. It might not be a great idea to work the daylights out of the core until you have a better handle on what's going on, and you're satisfied you have the area functioning as well as possible.
|
|
|
cajinjohn Old time trainer Posts 12495 
|
11-28-09 03:27 PM - Post#591982
By core work I'm guessing you mean waist work. I have known several who screwed up thier backs by doing ab work. For a while do what the old time lifters did by hanging on a pullup bar. While you are hanging on the bar start doing pullups. Get a kettle bell and start doing swings with it. Start at these few things and lets see what happens.
|
|
|
JCA Haven't posted much Posts 8 |
11-28-09 05:07 PM - Post#591993
Thanks for the replies. ccrow, let's assume that both of my legs are of equal length. If you have an elevated left hip, wouldn't the left leg be functionally shorter because it would be raised up higher than the left hip? cajinjohn, when I said core exercises, it is about all about strengthening the muscles to support your back, including the abs and glutes. So not just crunches, but things like bridging, squats, bow and arrow, etc. I have attached 2 images. One standing X-Ray of my back that I took in March at the chiro. And another lying (supine) leg length X-Ray that I took just a couple of weeks ago. You can tell by the X-Ray, my left hip (which is to your right as you look at it since this is from the perspective of looking into my stomach) is higher than my left. You can see that I have a scoliosis too -- according to Dave's elevated hip blog , if you have an elevated left hip, the spine should bend towards the other hip. And in this case it does (unless I am misunderstanding the definition of bend.). The pelvis looks pretty even across, but I am not sure if my pelvis is uneven from the perspective of back to front though. As far as my leg length, the radiologist said that my left leg is 1 cm bigger than my right leg (0.5 cm at the femur and 0.5 cm at the tibia), but this X-Ray is not the best in my opinion. You cannot see the whole pelvis and notice the angle to which the left femur (again on the right side as you look at it since it is a frontal view) is coming into the knee. It is coming in at a greater angle to the knee than the right femur. Both femurs meet at the knee nearly at the same location on each side. So it is quite possible that my left femur is even bigger than the 0.5 cm than originally thought due to that angle discrepancy. Also lately my right hip pain seems a bit more prominent and my right glute feels like there is a pulled muscle or something with sometimes pulsating pain. Not exactly sure how to describe it. Like I said, quite confusing and frustrating. Most all of the pain is on my right side. Thanks. |
|
|
ccrow old hand Posts 10055 |
11-28-09 05:53 PM - Post#591994
Did something happen to your right ankle? It looks like you supinate on both sides, but the right more than the left; don't know if that could be cause or effect of the tilt of the hips. Sometimes it's best to work from the ground up. Did the podiatrist you mentioned say anything about that, or talk about orthotics?
|
|
|
ccrow old hand Posts 10055 |
11-28-09 05:57 PM - Post#591995
(BTW, when I said from the ground up, I wasn't saying get the heel lift, I was suggesting maybe fix straighten out the ankles and see if that changes the picture.)
|
|
|
ccrow old hand Posts 10055 |
11-28-09 05:59 PM - Post#591996
BTW, can't the MRI determine the length of the bones best, since it is three dimensional?
|
|
|
JCA Haven't posted much Posts 8 |
11-28-09 06:18 PM - Post#591997
Did something happen to your right ankle? It looks like you supinate on both sides, but the right more than the left;  The x-ray technician told me to turn my feet inward as much as possible. So my ankles were like that on purpose as much as possible. That said, I do not have a "normal" walk. I noticed on my last pair of shoes, that the sole of my left shoe was *very* worn towards the top and outside. The sole of my right shoe was not as worn. The wear though was towards the top of the shoe as well. Re: the MRI, I have only had an MRI of my back. No one has referred me to an MRI of my legs. |
|
|
Laree (Rhymes with Marie) Posts 26002 
|
11-29-09 09:55 AM - Post#592046
That said, I do not have a "normal" walk. I noticed on my last pair of shoes, that the sole of my left shoe was *very* worn towards the top and outside. The sole of my right shoe was not as worn. The wear though was towards the top of the shoe as well. Something's wrong with this picture. Your spinal tilt and hip elevation are on the right, but your shoe wear is on the left? That seems odd. |
|
|
DanMartin Shomer Shabbos Posts 20705 
|
11-29-09 10:18 AM - Post#592049
Working your core to death how? Were the exercises specific to your situation or were they random/general in nature?
|
|
|
JCA Haven't posted much Posts 8 |
11-29-09 10:20 AM - Post#592050
Something's wrong with this picture. Your spinal tilt and hip elevation are on the right, but your shoe wear is on the left? That seems odd. Laree, my hip elevation is on the *left*, not the right. Remember, the X-Ray is a *frontal* view, looking through my stomach. So my left hip is on the right side of the X-Ray. My spine is bending towards my right hip, though. Do you agree with that? (Remembering that my right hip is on the left side of the X-Ray, where the "R" is on the picture). Regarding the shoe wear on the left, I have two unsubstantiated theories. 1. My right leg is *not* anatomically shorter than my left, thus my left leg is functionally shorter because my left hip is elevated -- therefore when I walk, I walk on my tip toes of my left foot. 2. My right leg is anatomically shorter than my left, thus I my left foot is always hitting the ground first, putting more wear on the shoes. I have attached a picture of the shoes. |
|
|
Laree (Rhymes with Marie) Posts 26002
|
11-29-09 01:56 PM - Post#592076
I'm in the middle of something else and my head's not right for thinking this through at the moment. Bad guessing is worse than no guessing at all, right? :~) Meanwhile, what are we working with here -- what age range? What job, that is, how do you spend the bulk of your day? What I would be doing for certain if I were you is foam rolling, especially the glutes (all around -- including the sides and around to the front of the hips, in various positions including with the rolling leg bent)and QL and upper legs (front, inside and outside and back). If you do this well, it's fairly time-consuming and definitely gives you something to do for awhile. It also may go a long way in terms of fixes. You'll also want to stretch the calves, strengthen the front of the shin area and begin working on your feet, starting with rolling them over a tennis ball. Would you like for us to try to find you a local person to help cut this trial and error process short? If yes, where do you live? |
|
|
JCA Haven't posted much Posts 8 |
11-29-09 04:11 PM - Post#592086
Meanwhile, what are we working with here -- what age range? What job, that is, how do you spend the bulk of your day? Laree, thanks for the reply. I am mid-30s with a desk job. However, ever since this problem has surfaced, I have been sitting a lot less every day. Either standing up and walking around or lying down mostly. I just started working with a naturopath who is also a certified personal trainer and conditioning coach. I am hoping that he works out for me when we start my rehab. I was hoping to bring this blog post article: http://www.davedraper.com/blog/2008/09/10/what- is-an-elevated-hip/ to him because I thought that was directly applicable to my situation. Do you think after all I have posted here including my symptoms, x-rays, shoe photos that I am a perfect candidate for the exercise program recommended in that blog post? In fact, in one of the links in the blog post, you Laree posted the program for elevated hip. My only problem is that I didn't understand how to perform some of the corrective exercises.
From the top down, here's a list of some corrective exercises that should bring things around. Scap pushups Horizontal rows Thoracic spine mobility work Then you'll have to separate your lower body work, one leg at a time. The elevated side is tight, and the normal side is weak, so they need different things. On the elevated side: Foam roll then stretch the QL, glute, TFL, IT band and hamstring Tennis ball on piriformis and around QL Massage calf Tennis ball under foot Take your time with the stretching. Each stretch should be several minutes, moving from a light stretch deeper and deeper as you feel a release. On the normal side: Side plank Glute activation Cook hip lift Drop back lunge 1-legged deadlift Finally, extensive foam rolling and tennis ball triggerpoint work is a part of this rehab process -- really search around and find the various muscles of the glute region. Include the outside of the leg, the iliotibial band (IT band), which will hurt... a lot. Don't skimp on this part. Seriously. |
|
|
Laree (Rhymes with Marie) Posts 26002
|
11-30-09 12:13 PM - Post#592198
I just started working with a naturopath who is also a certified personal trainer and conditioning coach. I am hoping that he works out for me when we start my rehab. I was hoping to bring this blog post article: http://www.davedraper.com/blog/2008/09/10/what- is-an-elevated-hip/ to him because I thought that was directly applicable to my situation. Wait up a sec. Are you saying he didn't know about pelvic positions already? If that's the case, you will probably want to consider a different therapist/adviser, at least in the initial stages until you get some relief. Do you have a foam roller and have you started using it yet, like maybe an hour a day over two sessions? This would be my priority in life until I got some pain relief. Add a tennis ball and golf ball to the shopping list if those aren't already on the floor by your feet. |
|
|
JCA Haven't posted much Posts 8 |
11-30-09 01:04 PM - Post#592205
Working your core to death how? Were the exercises specific to your situation or were they random/general in nature? Dan, the core exercises I guess are general in nature. Working both sides evenly. A lot of ab and glute work. Crunches, Bow and Arrow, Bridging, etc. |
|
|
JCA Haven't posted much Posts 8 |
11-30-09 01:11 PM - Post#592206
I just started working with a naturopath who is also a certified personal trainer and conditioning coach. I am hoping that he works out for me when we start my rehab. I was hoping to bring this blog post article: http://www.davedraper.com/blog/2008/09/10/what- is-an-elevated-hip/ to him because I thought that was directly applicable to my situation. Wait up a sec. Are you saying he didn't know about pelvic positions already? If that's the case, you will probably want to consider a different therapist/adviser, at least in the initial stages until you get some relief. Do you have a foam roller and have you started using it yet, like maybe an hour a day over two sessions? This would be my priority in life until I got some pain relief. Add a tennis ball and golf ball to the shopping list if those aren't already on the floor by your feet. Laree, I think he knows something is amiss. During his physical exam he could tell there was something going on, especially with the weakness of my right glute. I do have a foam roller, tennis ball and golf ball. Can you point me to any videos or step-by-step exercises to use with the foam roller? I am assuming I should do the ones that you mentioned in that forum post about elevated hip -- stretching the QL, etc on the elevated hip side. Any pointers to how to do these things would be very much appreciated. Thanks. |
|
|
Laree (Rhymes with Marie) Posts 26002
|
11-30-09 01:26 PM - Post#592208
Laree, I think he knows something is amiss. During his physical exam he could tell there was something going on, especially with the weakness of my right glute. In my opinion, this is not good enough, not by a long shot. Your x-ray shows a substantial shift. It's so obvious the average person would probably notice it just watching you walk down the street. Unless you're downplaying his reaction, I would seriously consider finding a new therapist/coach.
I do have a foam roller, tennis ball and golf ball. Can you point me to any videos or step-by-step exercises to use with the foam roller? I am assuming I should do the ones that you mentioned in that forum post about elevated hip -- stretching the QL, etc on the elevated hip side. Any pointers to how to do these things would be very much appreciated. There's nothing to it, really. Get on it and roll. If you spend 30 minutes on it each day this week, or better yet, 30 in the morning and 30 in the evening, you'll know as much about foam rolling as anyone. You'll find the spots that make a difference for YOU, and you'll learn which areas you like long, sweeping strokes and which you like shorter movements or even simply resting on the roller (or tennis ball, or golf ball, whatever the implement). There's no substitute for practice on this one; book learning doesn't work. Here's a long thread on foam rolling, and there are a few video clips included in the discussion. |
|
|
Wicked Willie The mouth of the South Posts 16864 
|
12-01-09 10:31 AM - Post#592356
I don't know where to start with you. Your physical problems are very, very similar to mine. I have a "functionally" shorter left leg due to various effects of cerebral palsy. (When measured...the bones are actually the same length.) My pelvis, knee, ankle, back...you name it are all out of "normal" positioning (it may even effect my shoulders.) I have tried a heel lift and a wedge at the side of the left shoe where the wear is the greatest - no permanent positive results. (In fact, orthopods now say that style of "fix" is ineffective.) I have tried increasing the thickness of the left shoe sole by 1/4"...which basically knocked everything out of line, creating a lot of pain while everything stretched, contracted and tried to find a "new" position. I've tried so many things I won't list them here...but I "understand" your pain and frustration. Here's what I would try: First, find a new practicioner...one who is willing to try newer body alignment techniques. Get a gait analysis done, if you can. This can be enlightening and show a lot of effected areas. Over the counter orthotics can provide a good start...though the break in process is painful. (I'm willing to bet your left foot is flat as a pancake.) Stretch your Achilles tendon, hamstrings and hip flexors. ALSO, have your PT show you the various stretches for the periformis muscle deep in your glutes...this quite often is what creates the sciatica. Yours will be a long road of trial and error. Unfortunately, building up a lot of strength and hypertrophy with weight training can be counterproductive, since they will quite often only exaggerate your imbalances. (This is the road I have chosen...I'll suffer the consequences but I ENJOY my strength.) I still suffer pain but I'm too stubborn to start over from square one. I wish I could speak more specifically to your condition but it would only be conjecture. Laree's suggestions are very good...start foam rolling and using trigger point therapy and consider those your starting points. Wicked
|
|
|
DanMartin Shomer Shabbos Posts 20705
|
12-01-09 10:43 AM - Post#592358
Working your core to death how? Were the exercises specific to your situation or were they random/general in nature? Dan, the core exercises I guess are general in nature. Working both sides evenly. A lot of ab and glute work. Crunches, Bow and Arrow, Bridging, etc. My L4/L5 and S1 discs are non-existent. Initially, I did "general" core exercises with no relief or positive effect. When I moved to a specific program, the healing began. I must caution you, what I do now is a result of being patient and understanding that the rehabilitative process is continuous and on going with no let up or end.
|
|
|
Wicked Willie The mouth of the South Posts 16864
|
12-01-09 11:24 AM - Post#592374
[ I must caution you, what I do now is a result of being patient and understanding that the rehabilitative process is continuous and on going with no let up or end. There it is in a nutshell. Wicked
|
|
|
Laree (Rhymes with Marie) Posts 26002
|
12-01-09 11:44 AM - Post#592381
Definitely ditto the guys above: This is a long, slow, frustrating process. But it's better than the two main alternatives, surgery that may not work and no relief at all. Hands-on help will cut the trial-and-error by about 75% probably, but I have a sneaking suspicion the help you're getting now isn't going to do any magic. |
|
|
cajinjohn Old time trainer Posts 12495
|
12-01-09 11:46 AM - Post#592383
You train your abbs with a good eating plan. Anything taken from the ground up to overhead works your abbs. The very best abb work for me is slid dragging. wow
|
|
|
JCA Haven't posted much Posts 8 |
12-01-09 08:57 PM - Post#592500
Thank you everybody for your replies. It is very much appreciated. I am going to start with some foam rolling exercises. I am meeting with a personal trainer too this weekend. I am going to get one more leg measurement done to see if wearing a small lift might also be beneficial in conjunction with my workout plan too. I just want my spine straight again and slow down the progression of my facet arthritis. |
|
|
Laree (Rhymes with Marie) Posts 26002
|
12-09-09 08:11 PM - Post#593841
If you're still around, this is in response to your question... might help you figure some of this out. http://davedraper.com/blog/2009/12/09/the-e levated-hip-and-gait/ |
|
|
What's New |
Weekly Columns |
Weight Training Tips
General Nutrition |
Draper History |
Mag Cover Shots |
Magazine Articles |
Bodybuilding Q&A |
Bomber Talk |
Workout FAQs
Privacy Policy
Top