Leg Length Discrepancies Cause the Majority of Overuse Injuries
By CEO Robert Forster, PT
There is a sports medicine idiom that states: for every day you workout with pain, it takes two days of rest and rehab to get better. Unless you fall down and break something, most of the injures you are likely to suffer from workouts are “over-use” injuries related to the repetitive stress of cyclic activities. However, if both legs are subject to the same training load, whether it be from running, cycling, elliptical workouts, stair master, etc., then why are so many injuries suffered in one leg and not the other?
In my experience, the vast majority of lower extremity overuse injuries are one sided, and pelvic alignment issues that create a leg length discrepancy are the cause of them. When the pelvis, which is two separate bones, is not aligned properly, the result is that one leg is slightly longer than the other is. The human body will attempt accommodate the longer leg by collapsing the arch on that side (excessive pronation), and holding up the arch on the short leg (supination). Each of these events changes the mechanical stress patterns on the various anatomical structures of the lower extremities that cannot be sustained, and soon you are injured.
With overuse injures such as Achilles tendon pain, illio-tibial band syndrome (lateral knee pain), plantar fasciitis (heel pain), patella tendonitis (pain in front of the knee), or hamstring injuries in the back of the thigh, when the pain first appears it represents a breakdown in tissue repair that has been brewing for weeks, if not months.
Every workout creates some tissue damage that stimulates the body’s repair process. This process results in the creation of scar tissue designed to shore up that area of the body. If you outpace your body’s ability to heal itself, the damaged tissue continues to breakdown and the failed scarring of the damaged structure becomes a problem in its own right. While local treatment is indicated to reduce inflammation and eliminate excess scar tissue (rest alone does not fix overuse injuries), the mechanical cause of the injury must be addressed by realigning the pelvic asymmetry that caused the leg length discrepancy in the first place to avoid re-injury.
If you have pain in one spot or another, during or after workouts, twice in a seven-day period, consider yourself injured and begin taking the steps toward recovery. Reduce your workout time, eliminate high intensity workouts like hills and intervals, and give your body a chance to heal. Increase your stretching efforts, apply ice three times per day for 20 minutes with ice cubes and water in a bag (gel packs do not work). Do not “work through” the pain, it only prolongs the injury and increases the time it will take to get back to your pain free workouts.
If pain persists in spite of the self-help measures described above, please contact us for a Free Physical Therapy injury assessment either at Westminster or at Forster Physical Therapy.
You can be seen Saturday after your run for treatment at our PT clinic in Santa Monica. Call 320-804-5228
You no longer need a doctor’s referral to see a Physical Therapist.
If scheduling an evaluation is not possible you can read all about overuse injuries and how to determine if you have a leg length discrepancy as well as self help rehab strategies to get you back to your workouts, in my new book,
Healthy Running Step by Step.
COMPREHENSIVE Structural Analysis by a Physical Therapist
A complete head to toe structural examination is performed to evaluate your strength, flexibility, postural alignment, pronation, and supination foot function, leg length discrepancies and muscular imbalances. We use goniometers to measure joint range of motion, manual muscle testing to determine strength deficiencies, and orthopedic testing to identify functional joint stability. In the process we render a picture of your current state of structural preparedness.This exam is the starting point for all PHASE IV Periodized Strength/Flexibility/Injury Prevention Programs designed to meet your goals for life and sport!Book an Appointment