Pelvic Tilt vs Leg Length Discrepancy - WTF is wrong with me?

I'm not sure how it fits into your financial situation, but I'd suggest you talk to a good chiropractor. He/she might be able to get you at least partly straightened out.

You said that the lift in your left shoe seemed to help and felt better, but you dismissed it as "not a good fix". Why not?

You've probably read all sorts of stuff, but here is one article:

http://www.chiroweb.com/mpacms/dc/article.php?id=15329

Did the PT find a functional leg length discrepancy or an anatomical leg length discrepancy.  There's a difference, and it will determine treatment.

Hi... I have had (and still do have) the same problem.  Basically, I have a herniated disc in L4-5 that was diagnosed from a CT scan.  I also have a tilted pelvis that also freezes up @ the Sacroiliac joint.  Both these conditions have led to a leg length discrepancy.

I know that you are maxed out with health care funds.  The key is a proper diagnosis.  I have been to many, many PT's and chiro's and they all have said different things.  I am @ the point where I have found people in my health care team that I really trust and they have really helped me.  Currently, I only see my chiro for "tweeks".  My chiro does adjustments, soft tissue work and gives me exercises.

A heel lift is only a band-aid solution unless you truly have a longer leg!  It could be that your pelvis is titted and that is it.  If this is the case, you are right about stretching.  What you need to add in is stabilizing as well.

What works best for me is exercise, rolling, specific exercises, stabilization and watching my weight.  Also, I just started these exercises (again) : http://www.youtube.com/user/ZealousVitality#p/a/f/0/aRzx01L0Pdw

They have helped me out.  I hope this helps.  Basically, if you have a proper diagnosis that you trust.... you may be able to do most of the rehab on your own.

Good luck.

Hi wurkit_girl!

I know you posted this many years ago, but I am dealing with EXACTLY the same thing right now. I would love to know if you found a fix.

Thank you!

Me Too

A pelvic tilt forward and down will cause your leg to be lifted, making it appear to be shorter. This is a bit long and confusing, so please bear with me while I explain. I've been treating endurance athletes since 1989, and I've seen this situation hundreds of times. Fortunately I know that you can self-treat each of the muscles causing this problem, and I will explain the treatment for the keystone muscle (Rectus Femoris) at the end of this message.

There is a muscle called the Psoas that originates on the front side of your lumbar vertebrae (behind your intestines) that starts this whole situation. The psoas muscle comes down the anterior lumbar vertebrae, passes along the inside of your pelvis, and it inserts into the inside/top of your thigh bone. When the psoas contracts you go from standing to sitting (pedaling your bike while in the aerodynamic position causes your psoas to go to its shortest possible length). The next muscle is called Iliacus. Your iliacus originates along the entire inside curve of your pelvis and inserts into the exact same place as your psoas. When this muscle contracts you lift your leg to take a step or sit down (ditto about cycling). When these muscles are held contracted for an extended period of time, a phenomenon called muscle memory causes them to shorten to the contracted length. This is happening whether you are sitting in your car, at your desk, or cycling for hours.

When the muscle shortens due to muscle memory and you go to stand up straight, the shorter muscle won't let you stand up without putting a strain on your lumbar and pelvis. As a result the two muscles are rotated forward and down. This puts a strain on the front side of your lumbar vertebrae, putting pressure on your disks and the nerves that come out of your vertebrae. As your pelvis rotates downward, another muscle called Rectus Femoris (one of your quadriceps muscles) is forced to shorten in order for it to straighten your leg as you stand up. The reason it needs to shorten is because your rectus femoris muscle originates on the tip of your pelvis and inserts into your shinbone, below your kneecap. However, its origination point moved DOWN during the rotation and now it's too long to do the job. The body ties a big knot (spasm) in the center of the muscle, which works when you go to stand up, but when you try to bend your knee the muscle is too short. The shortness of the rectus femoris muscle is now holding your pelvis tilt forward and down. It is also pulling up on your kneecap and could cause you to either have stiffness or pain in your knee when you try to bend it.

As this is happening, all of the muscles that originate on your sacrum and your pelvis, and insert into the top of your thigh bone, are being twisted. This causes them to also shorten, pulling up on your thigh bone. It causes your leg to appear shorter, but it’s only because the muscles are pulling up on your thigh bone.

Even though this isn’t your issue, I’ll continue explaining what happens in the back of your body. As your pelvis is going down in the front it is moving your pubic bone backward causing your adductors (inner thigh) to overstretch, causing pain either at your groin or your inner knee. Your hamstrings are being overstretched because their origination point is moving up, causing pain at either the top of your leg or the back of your knee. Plus your hamstrings feel so tight that you think you need to stretch them, but they are already overstretched and stretching could cause the muscle fibers to get micro-tears. And your pelvis is also pressing up on your sciatic nerve, causing terrible pain from your hip to your foot.

A muscle in your hip (Tensor Fascia Lata) is being torqued, which puts a strain on your iliotibial band (ITB), causing hip and otter knee pain. And a muscle of your low back on the top of your pelvis (Quadratus Lumborum) shortens or it can’t do the job of picking up your hip when you take a step.

There’s a lot more, but you get the point, to just say that your pelvis is tilted is ignoring a lot of problems that occur because of the tilt. And most practitioners ignore the impact of the psoas, iliacus, and rectus femoris as the cause of the pelvis tilt, so it doesn’t go away with chiropractic adjustments or even deep massage.

To treat your rectus femoris, take the heel of your hand, or a 12” length of 1” PVC pipe, and slide (don’t roll) down toward the outside of your quadriceps. The muscle is located between the front of your thigh and the very outside of your thigh. If you go to my Instagram page (@JulstroMethod) you’ll see self-treatments for your quadriceps and hips. It’s easier for you to go there and see the pictures than for me to explain how to do it here. I wrote a book titled “The Pain-Free Athlete” that teaches you how to treat each of the muscles, but doing this treatment is the most important one to rotate your pelvis back where it belongs.

Wishing you well,
Julie Donnelly

YOU are your own Best Therapist! Visit www.FlexibleAthlete.com and www.JulstroMethod.com to find logical solutions to chronic pain and sports injuries.