Stretching for Functional Leg Length Discrepancy

[ursian1]

For a few years I was under the impression that I had a 17mm structural LLD. I recently saw a physiatrist who says that it is both structural and functional. He recommended stretching the QL, hip flexor, and gluteal muscles. I have noticed that when I give my QL a good stretch my pelvis becomes completely level (when lying down). This effect only lasts a short period of time before the QL becomes tight again. The physiatrist said that if I continue the stretches for 1-2 months the problem should go away, but i'm unsure if this is anything beyond a temporary fix. I want to fix this issue permanently. I talked to a chiropractic doctor I found through pubmed and he eluded to the fact that I have some "other" issue that's causing my QL to be tight and then he just stopped responding to emails...Does anyone know how I can get rid of this functional component? Will stretching fix this?

[Mark Rippetoe]

Have you addressed the structural component with a shim? Is it possible that a shim might alleviate the "tightness" in your "QL" ?

[ursian1]

Yes, I initially addressed the problem with a 17mm shim on the outsole of my Nike Romaleos. However I believe the structural discrepancy to be much less than I previously thought. I am now using an 8mm shim. I have a new plan that I am going to start today. I'm hoping that if I stretch the QL out directly before my squat and deadlift sets, I will 100% symmetrical and I will be able to solve any muscular imbalances that could be causing the tight QL. Would that be a correct assumption?

[Mark Rippetoe]

I don't know. Can't see from here.

[ursian1]

Anything I can share that would help you identify the problem? What would be the factors that can cause a hypertonic QL?

[Mark Rippetoe]

You'll have to ask the geniuses that diagnosed the "hypertonic QL" about the cause. That's kind of an interesting question, isn't it? Does the QL have its own innervation? Why the QL and not the piriformis, the gemelli, or the obturator?

[ursian1]

Well from my understanding they are saying that the QL is the main culprit and the piriformis, hip flexors, and glutes are involved to a lesser extent. Outside of some sort of surgery the only thing I think I can do to fix the problem would be to stretch and strengthen my muscles. The physiatrist only told me to stretch the muscles on the side with the functional discrepancy, but now I am wondering if I should be strengthening the contralateral muscles. I have noticed the QL contralateral to the hypertonic QL is much weaker.

Also, I just tried stretching directly before squatting and deadlifting and noticed that after I do a heavy set at 80% of 1RM, when I lie down and look, it seems like my hip is hiked up again. I tried the same thing with 50% 1RM and it seems like my hips are staying level at lower weights. Maybe I need to play around with the weights till I find the heaviest weight I can use without reinstating the hip hike and maybe that could induce some kind of permanent correction by fixing muscle imbalances...

Still, I would appreciate some more thoughts on this. Is there anything I should be looking for? I am trying to understand what is going on but most of this is too complex and over my head.

[Mark Rippetoe]

Outside of some sort of surgery the only thing I think I can do to fix the problem would be to stretch and strengthen my muscles. The physiatrist only told me to stretch the muscles on the side with the functional discrepancy, but now I am wondering if I should be strengthening the contralateral muscles. I have noticed the QL contralateral to the hypertonic QL is much weaker.

If only there were a way to both stretch and strengthen all the muscles at the same time. Maybe even doing so in their normal anatomically-determined function within the musculoskeletal system.

[ursian1]

If only there were a way to both stretch and strengthen all the muscles at the same time. Maybe even doing so in their normal anatomically-determined function within the musculoskeletal system.

I am trying to understand what you mean by this. I know that squatting and deadlifting both stretch and strengthen muscles. Are you implying that that is all I should be doing? I don't understand how that is going to make the problem go away though. I have been squatting and deadlifting for years already and the problem hasn't gone away.

[Steve Hill]

Oooo!

Oooo!

I have a leg length discrepancy AND low back pain!!!!!

Can I have a hypertonic QL too?

It sounds très cool.

Is there a t-shirt?