The Problem
The client in this case was complaining about an awkward running gait, tight hips, back and an internally rotated right shoulder. He is a very active person that runs and trains often for marathons and iron man races. He does sit often as he does desk work at home running his online business. The constant rotation feeling was very bothersome, he said especially when he ran and sat down.
The Assessment
For any lower body associated issues, I always check hip alignment. The easiest way to assess is by checking the alignment of the legs at the ankles. It is very clear if the ankles are not aligned. From there you can follow the fascial sling system up his body. I immediately check for lateral line tightness (oblique and lats) on the elevated hip side all the way to his rolled forward shoulder.
The Solution
The goal here was to align the hips- get the right hip to drop. Once the hip drops down, the legs will align at the ankle. The big muscles lengthen to achieve this are hamstrings, glutes and lats. More specific work was needed to be done on the psoas and sartorius to release his leg out of internal rotation. Lengthening his later line specifically lat and oblique is also crucial for the hip to relax. Because there was a lot of ground to cover, I mainly used PNF and ART techniques with cups and blades to lengthen the muscles mentioned above. In this session, I was able to address his shoulder rotation, but was able his hip to drop and his leg length to match.
Conclusion
Having one leg shorter than the other can be a complex problem because we are dealing with specific tightness and weakness with multiple muscles. Different length legs will cause an uncomfortable walking/running pattern, a sense of feeling “uneven” and a lot of the times affect the upper body with associated pain. Not to worry, this can be resolved with proper mobility and strengthening. The key is addressing the uneven hips considering the myofascial sling system. What is this? It is the system of muscles that connect the upper and lower body across the torso. You need to identify the tight muscles, mobilize them. The other half of the solution is to strengthen the weak muscles. Strengthening homework was assigned to this client to give him a long term solution to his rotation issue.
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