Hip rotation… a problem?

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  • Hip rotation… a problem?
  • mrblobby
    Member

    Been told I have a leg length discrepancy (about 2cm) caused by hip rotation apparently. I don’t think it’s ever caused me any problems, and the chap who was doing a quick assessment was surprised I’d never had any back pain or similar problems. I do get very occasional muscle spasms in my back that last a few days, could be related i guess. Anyway he recommended seeing a chiropractor as a preventative measure. I think this guy knows what he’s on about.

    So what’s the scoop with hip rotation? Would i always have had it? Will it become a problem? What’s the best way to get it sorted (chiropractor, osteopath, physio, GP, core work, etc.)? What’s your experience?

    mrblobby
    Member

    Bump for the all knowing evening crowd… Thanks.

    mulv1976
    Member

    Why were you having an assessment in the first place?

    Premier Icon flap_jack
    Subscriber

    Physio. They’re the real thing.

    Premier Icon theotherjonv
    Subscriber

    ‘I’ve never had any back pain or similar problems’

    ‘I do get occasional muscle spasms that last a few days’

    Eh? Sounds like you do get back problems.

    I’d go physio first, and see what they say.

    mrblobby
    Member

    I may try a consulatlon with a few different ones, not convinced about any of them TBH. If it was actually causing discomfort then I’d just go see the GP but I’d feel a bit silly going for this!

    Anyone got any real experience of this sort of thing?

    Edit: theotherjonv… ha, yes I did think that when I typed it. I’d not really consider it back pain though, it’s not like it’s consistent. I think the spasms actually have more to do with picking up and carrying blobby jr!

    Premier Icon njee20
    Subscriber

    Miss Njee20 and BIL have been seeing an osteopath to undo the damage a chiropractor did!

    mrblobby
    Member

    So osteopath and chiropractor not the same thing then? Hmm better go do some research…

    mulv1976
    Member

    In what way is your hip rotated? Internal (foot points inwards/straight up when lying on back) or external (points outwards). Could mean different muscles/movements are being affected. Any history of groin pain or low back stiffness particularly after repeated hip flexion ie riding or running? Did they say it was a functional leg length difference or possibly structural?

    STW is probably one of the worst places for advice – too many “experts” and it always descends into a physio vs chiro vs osteo vs NHS argument which doesn’t help anyone.

    Go and see someone in “real life” who is decent ie recommended. Doesn’t matter if physio, chiropractor or osteo – if they are any good, they will do a full assessment and pick up issues all along the kinetic chain that could cause future problems.

    Premier Icon flap_jack
    Subscriber

    Doesn’t matter if physio, chiropractor or osteo

    IMO it does matter.

    Chiro = pseudo science.
    Osteo similar but less damaging.
    Physio 5 years degree + work in NHS hospitals.

    mulv1976
    Member

    Chiro = pseudo science.
    Osteo similar but less damaging.
    Physio 5 years degree + work in NHS hospitals.

    FYI Chiro = 4 year degree including 12 month clinical placement + 1 year mentored post graduate training before becoming fully qualified chiropractor. That’s UK, not sure about US.

    Premier Icon sheck
    Subscriber

    Have had similar diagnoses myself over the past 10 years following regular, but not chronic pain in my right hip. Osteopaths tend to tell me I have a leg length discrepancy, chiropractors and physios tend to blame it on hip rotation or pelvic imbalance. Some practitioners have been able to manipulate my soas muscle (not pleasant) to make it appear that my legs are the same length. I genuinely don’t know who to believe. My “investigations” have included GP referring me for MRI scans, which led to arthroscopic treatment of hip (which involves general anaesthesia and hip dislocation)and yielded zero positive benefits! I have decided that regular stretching and living with it is probably the best course of action. If you’re not in any pain, I’d be wary of messing with it

    mrblobby
    Member

    Blimey sheck! Sounds like quite an ordeal.

    mulv1976, thanks for the response. I’ve no idea what way it’s rotated (though left foot is more outward pointing when lying on my back) or if it’s functional or structural. I’ve no pain or stiffness during or after running/riding (would be happy to do nothing though now worried that if I do that then it’ll become a big problem later.) I’ve been recommended a physio and an osteopath so may go speak to both.

    coracle
    Member

    FYI Chiro = 4 year degree including 12 month clinical placement + 1 year mentored post graduate training before becoming fully qualified chiropractor. That’s UK, not sure about US.

    Sounds like a chiropractor to me.

    Chiropractors are a blot on the manual therapy landscape in my opinion. They are trained in sales techniques like telling perfectly normal people they have leg length differences. Google sceptic James Randi talking about the unreliable diagnosis of leg length discrepancy.

    Be very wary of recommendations to have never ending preventative treatment when you have no symptoms.

    mrblobby
    Member

    Thanks. Am quite wary. Where to go to get decent medical advice?!

    coracle
    Member

    To be honest everyone gets a bit of low back pain sometimes and if it settles quickly then don’t worry about it.

    If it persists then find someone who isn’t going to take the piss by charging you hundreds of pounds.

    mulv1976
    Member

    Chiropractors are a blot on the manual therapy landscape in my opinion. They are trained in sales techniques like telling perfectly normal people they have leg length differences. Google sceptic James Randi talking about the unreliable diagnosis of leg length discrepancy.

    Yes I’m a chiropractor. Please do some reading before you spout the usual tosh regarding our education. We are not trained in sales techniques. You can read what we learn here http://courses.glam.ac.uk/courses/16-master-of-chiropractic#about_course

    A “leg length difference” means bugger all – make sure whoever you choose to see gives you a good functional or structural reason behind it, and explains their treatment plan including appropriate exercises.

    mrblobby
    Member

    Thanks mulv1976. I’ve had a few recommendations from folk in the local club so shall follow up some of those and see who seems to have the best plan.

    fourbanger
    Member

    Chiropractic “medicine” isn’t based on actual science though is it?

    coracle
    Member

    The chiropractic profession is based on bad science, disgraceful business tactics, dangerous assessment and treatment techniques, it has no plausible theoretical basis and they are very quick to sue if they get negative press.

    The chirotalk website has some interesting stories from disillusioned chiropractors. It also has some useful deprogramming techniques for people who want to get out.

    Premier Icon cinnamon_girl
    Subscriber

    @ coracle – have you ever personally used a Chiropractor? Or have you been listening to your mates?

    mulv1976
    Member

    The chiropractic profession is based on bad science, disgraceful business tactics, dangerous assessment and treatment techniques, it has no plausible theoretical basis and they are very quick to sue if they get negative press.
    The chirotalk website has some interesting stories from disillusioned chiropractors. It also has some useful deprogramming techniques for people who want to get out.

    I’m sorry mate but this is utter garbage. I’m not hijacking another poor fellas thread to debate and argue about chiropractic (again) – it’s not really fair on the OP.

    I just hope the OP finds someone decent to sort his problem. There are dodgy chiropractors out there – as with GPs, osteos, physios, surgeons etc but to say we use “dangerous assessment and treatment techniques” is just plain wrong.

    Premier Icon cinnamon_girl
    Subscriber

    New user (coracle) with an axe to grind shocker. 😐

    Premier Icon flap_jack
    Subscriber

    I’m with coracle. And I’ve been here since 2001.

    b45her
    Member

    my view on medical treatment is never to trust any private practitioners no matter what discipline they are from, they are there to make money so often drag out long unnecessary treatment plans which often do bugger all or in my case made the problem worse.

    go the GP/NHS route, they got my knee sorted in no time for £0

    coracle
    Member

    @ coracle – have you ever personally used a Chiropractor?

    Yes

    coracle
    Member

    I just hope the OP finds someone decent to sort his problem.

    The OP did not have a problem until a chiropractor invented one in order to rustle up some business for himself. The OP would then be asked to sign up for a course of 25 treatments for a knockdown price of only 300 quid to fix an imaginary problem.

    That is a perfect example of the unethical practices of the profession and I hope the OP can see that this “healthcare professional” is trying to take him for a ride.

    mrblobby
    Member

    For the record, it wasn’t a chiropractor, it was a bike fitting chap on a club demo (though I didn’t want to open the whole bike fit debate again!) He did say he’s never seen such a sizeable discrepancy in anyone he’d fitted and that it may be a good idea to see someone like a chiropractor to have a look at it.

    I actually know very little about chiropractors, I actually thought it was just an American term for osteopath before I did some research!

    coracle
    Member

    Fair enough, I made an assumption there. Apologies to all chiropractors for the disservice.

    I would say that almost everyone is asymmetrical if you look closely enough because we are all one side dominant. Everyone has an elevated shoulder, a slight scoliosis and a tilted pelvis which often leads to one leg appearing longer than the other.

    So does asymmetry need to be corrected if there is no pain? Probably not in most cases.

    Premier Icon cinnamon_girl
    Subscriber

    coracle – what was your experience of using a Chiropractor? Was this from personal recommendation?

    coracle
    Member

    There is some interesting research about asymmetry and pain (Hides et al, 2010, psoas and quadratus lumborum muscle asymmetry among elite Australian football players, British Journal of Sports Medicine).

    They basically found that professional athletes in kicking sports have massively overdeveloped hip muscles on one side. However this asymmetry is not correlated with increased pain.

    My experience of a chiropractor was that he tried to pull my head off and I didn’t like it much. To be fair osteopaths and physios use manipulation as well and I wouldn’t like it from them either.

    mulv1976
    Member

    So does asymmetry need to be corrected if there is no pain? Probably not in most cases.

    I’m not sure if this is a serious question or not but I can try to answer it if you like…

    The first thing is that pain is the body’s way of telling you that damage is being or has been done – and to do something about it. Whether that’s to rest, exercise or get some help in getting it better.

    When I see patients, it is usually because they are in pain, but I will examine their whole spine/posture for functional or structural asymmetry which may indicate a deep seated issue which could actually be the true reason for the injury they have. Postural syndromes being the most common I see e.g. “I get shoulder, neck pain and headaches” “Ok, let’s check your posture, workstation, muscle imbalances (anterior vs posterior muscle tone, strength etc).”

    There is no point treating a problem like this without addressing the cause. The pain might ease, but I can be 99% certain it will return over time without the right ergonomic, postural, stretching and strengthening advice.

    In the case of “leg length discrepancy” – it doesn’t mean anything unless there’s a functional or structural reason behind it. Some structural examples include previous fracture of the femur/leg, hip arthritis, congenital hip defects. These need to be addressed even if there’s no actually hip or back pain, because in 10 years time when they are having a hip replacement or have severe disc degeneration on that side thanks to imbalance, they will blame you for not putting a heel lift in or correcting it.

    Functional leg length differences are also important – usually due to imbalance or injury to pelvic muscles such as the iliopsoas (which originates from the lower back). Chronic imbalance in this e.g from injury can also contribute to accelerated lumbar disc degeneration through increased tension on that side (some of the muscle fibres actually originate from the outer material of the discs). So addressing it can prevent future issues. They should be reasonably simple to sort out unless it has been going on for a long time, so anyone who says you need 25 treatments is full of shit.

    Unfortunately, this is where a lot of specialist areas (in the nhs for example) fall down. They “chase pain” but don’t look at how the whole body is affected. Sadly, some people think this is quackery. I see it as proper musculoskeletal healthcare.

    A (real) example is that they replace the worn hip joint, but no one has addressed the long term leg length difference on that side before or after surgery. Also no-one has addressed the capsular restrictions or strength of the hip and low back stabilisers. Result = chronic lumbar disc degeneration and eventual prolapse. Once the pain and muscle spasm had been controlled, a simple 1.5″ heel lift solved the problem.

    So yes it is important – in a lot of cases. But not all.

    crikey
    Member

    I suspect that you are actually quite a capable physical therapist, despite me having issues with the above, but the real problem many people have with chiropractic is the mumbo-jumbo.

    The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, but that there is no credible evidence or mechanism for effects on other conditions, and some evidence of severe adverse effects from cervical vertebral manipulation.[12] The ideas of innate intelligence and the chiropractic subluxation are regarded as pseudoscience.[13]
    http://en.wikipedia.org/wiki/Chiropractic

    This, essentially.

    mulv1976
    Member

    No, I’m a very capable chiropractor who uses some physical therapy techniques to compliment my treatments. What some people would call a “mixer” I suppose. I also have issues with some of the theories behind “straight” chiropractic and it’s a very divisive subject in the profession (particularly in the UK). I don’t actually believe manipulation alone is enough to treat conditions, but combined with exercise and other techniques it is extremely powerful. I could give examples but case studies are not seen as evidence…

    BTW OP sorry to hijack (again).

    crikey
    Member

    …and the lack of evidence…
    …and the vertebral subluxation stuff…
    …and the almost diagnostic attempts to discredit medicine…
    …and the suggestion that example and anecdote trumps data…

    Sorry fella, not with a barge pole.

    mulv1976
    Member

    Sorry fella, not with a barge pole.

    Bothered? Sorry fella, not really.

    crikey
    Member

    I would be if the evidence for the treatments I provide was so scarce.

    I would be seriously questioning what I’d been taught, and looking at what I did in as critical and as objective way as I could.

    But, if you’re not bothered.

    mulv1976
    Member

    But, if you’re not bothered.

    Ha ha. No I’m not. I’m past arguing about it. Or justifying my techniques to people on forums.

    I’ve helped thousands of patients get well; I am proud of what I do and I don’t lose a seconds sleep. Get over it.

    coracle
    Member

    http://en.wikipedia.org/wiki/Applied_kinesiology

    Just been reading about applied kinesiology. It is a strange assessment technique that chiropractors are fond of but there is strong evidence that it is unreliable.

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