How Do Posture Imbalances Impact Uneven Hips or Leg Length? [Video]

How Do Posture Imbalance Impact Uneven Hips or Leg Length Discrepancy? Video Summary:

In this discussion, we explore how postural imbalances contribute to issues like uneven hips and leg length discrepancies, which are common concerns among our clients at Activ8 Posture. Many people are told they have a leg length discrepancy, but in most cases, it’s not an anatomical issue—they weren’t born with one leg shorter than the other. Instead, it’s often a functional leg length discrepancy caused by muscle imbalances and postural misalignments.

For example, if one hip is elevated due to tightness in muscles like the quadratus lumborum (QL) or inner thigh muscles, it can pull one leg up, making it appear shorter. This imbalance can lead to a range of symptoms, from lower back pain to hip, knee, and foot issues. Our team highlights the importance of addressing these imbalances through a holistic approach that looks at the entire body, not just the symptomatic area.

The conversation also touches on the complexities of multi-planar deviations, where imbalances in one area, like the hip, can affect the alignment and function of other body parts, including the spine, shoulders, and feet. By focusing on correcting these imbalances and reminding the body of its proper movement patterns, we help clients achieve lasting relief from pain and discomfort.

If you’ve been told you have uneven hips or a leg length discrepancy, this video will provide valuable insights into how posture alignment therapy can address the root causes and help you restore balance and function to your body.

How Do Posture Imbalance Impact Uneven Hips or Leg Length Discrepancy? Video Transcript:

Hey guys, we are going to answer a question we got in today. And the question was, how do postural imbalances contribute to issues like uneven hips or leg length discrepancies?

In Boston, it's one of the most common things that clientele who we see have been told. When we're asking people what they've been told about their symptoms or who they've seen for other practitioners and

I know, Carrie Ann and Miranda, you have clients say this all the time. It's like, well, I've been told that one of my legs is shorter than the other. 

It is a very common thing, you know, for people to be told, because that uneven hip does play a big part. For sure, it is true that you can have anatomical leg length discrepancies, which means that you were born with one leg shorter than the other, or, you know, seeing few people with car accidents too, or other traumas of the hip where, you know, there is a leg length discrepancy because of, you know, procedures that they've had to have done for that. But most commonly it's a functional leg length discrepancy, which means that a hip elevation is leading to one leg being pulled up more than the other, which then appears that it is shorter.

Yeah. I mean, it could be as simple as there is one muscle that isn't firing on one side and the other side starts working harder or compensating. And then like, a lot of times we see the quadratus lumborum really tighten up on one side and pull the hip up, right? Which is like a side oblique muscle. That is so common. And people think like they've had pants tailored to different lengths and they just really, they have to stretch out their back and then get whatever isn't firing on the other side going and then boom, you have even hips. So I would say that's probably the biggest one.

Yeah, I think the, yeah, the QL, like oblique muscles at the side and like side of your lower back for sure. I think the inner thigh muscle group or adductor muscle group is another common one that we'll see. So typically if a hip is elevated, we'll see on the same side that the upper leg is angled inward because those adductor muscles are tight. They're compensating for other muscle groups that are their purpose is to align the leg, not activating as much as they need to. So yeah, just muscle imbalance for sure. 

Yeah, and we kind of see like, you said, Carrie Ann about like why that happens. It's a offloader, mechanically too. If one hip is elevated, it's typically the body's way of being able to shift more weight or more load on one side and offload another side. So, it gives us a good clue as to potentially where the root cause issue is when we're assessing people's biomechanics and not so much where the symptom is.

Yeah, totally. And I think it's a good point. And so, you know, true leg length discrepancy versus apparent, you know, it's similar, I would say down down the line of what we see with scoliosis, a lot of people coming in and is it like true scoliosis? Or is it functional scoliosis? A lot of times that comes from uneven hips, right? So you see the asymmetry in the QL, the asymmetry in the psoas, iliacus muscles, and then of course, because of the elevation at the hip and pelvis, then you have adductor abductor offset also or imbalance there as well, where one side is sort of stretched long and the other side is short. 

A lot of times people don't come to us for uneven hips right away, even if they've been told that they're usually coming in with pain. So some of the symptoms associated to uneven hips, lower back pain is an easy one, SI joint issues, hip issues, whether it's chronic and long-term, could be arthritic, could be for more acetabular impingement, could be just bursitis or something along those lines, muscle strains, and then knee issues, foot issues. So all these different things people are coming in with that may be symptoms that they're coming in with. 

And I'd say to add to mechanisms, sometimes the rare birth defects, I think that's a rarer thing. And then it's, was there a childhood accident where the epiphyseal plates or growth plates were affected that may have impaired growth on one side? And even in those cases, like I remember having a client a while back now, he came in and said he had an accident, I think when he was 14 or something, it was near the growth plate and whatnot. And so he had a half inch lift, orthotic on one side. 

And so we're going through and it's not just a hip elevation doesn't happen in a vacuum. Right? So, you know, there's valgus stress more on one side, there's tibial torsion, you know, on one side to, and then, you know, the shoulders are uneven, the spine's uneven, everything's uneven. So we're kind of going through and, and as we do looking at a whole body approach rather than just, you know, one part and we get to foot circles because his, one of his feet has collapsed also more than the other. So it's like, well, that is a height difference that's going to be affecting. That side's also more valgus. So the knocking of that knee is also collapsing that side, making it shorter. So it's like all these things going on. And so this is his right leg. 

And when we go to foot circles, he pulls, he grabs the leg behind and his first foot circle, like pop, there's this loud popping noise that comes from his knee. And he's like, whoa, and didn't hurt or anything. But he's like that, that hasn't happened before. And so his whole like tibial, fibular attachment there had was impaired or was off. And so when he did that, he went back to at the end of the session, we went back to, we used a test to see and he was, and then validated later when he went back to his podiatrist, but he went from a half inch down to a quarter inch.

So yes, he had an accident. Yes, there was a true leg length discrepancy, but the amount of deviation that was from the accident and injury versus how much of that was from all the compensations and the lack of balance that he'd had over the decades now, he was in his 40s at the time. So it's just one of those things that are, yeah, we can have uneven hips from an accident, but it doesn't preclude you from balancing out your body still. Or stopping it from getting worse and causing all these other issues. 

Yeah, it can be multifactorial. It usually always is. Yeah, yeah. Why that hip is elevated. 

It can also be an inflare, like from a tight psoas or TFL, but you kind of hit that with all the different planes. That's another common one, especially in more active people, I would say. I see that. And that one also usually relates to some kind of sacral pain as well.

Yeah, and it's interesting thing too, which you were talking about before with symptoms, like sciatica is a big one that we see, but then also like talk about like the hip in relation to scoliosis, right? So if like that hip is elevating and it's not allowing that spine to sit in that vertical column, then we can see that that uneven hip actually translated into, not only lower back, but upper back, neck, shoulder symptom because of how it deviates the spine and then how everything else up the chain, if you will, gets affected by that.

Yeah, like to your point, like common techniques to correct that we'll see people for before they come in for the postural realignment therapy is like lifts in the shoes or like adjustments like we learned it, you know, and that's called shotgun technique where you're kind of pulling the leg and know that's supposed to level out the hips and usually, you know, just that adjustments, temporary stop gap there. And then the lift is trying to even out the feet, you know, to your client like you're talking about, but that does not mean it truly corrects that root cause of why that hip is elevating. 

Yeah, even going off of, you know, people using lifts due to the hip elevation or having a leg length difference. I've had so many clients where their hips start to even out and all of a sudden they're like, these shoes that I've been wearing for years with the, you know, this lift, it doesn't feel good anymore. And I'm like, because you don't need it anymore now that your hips are in a more functional position. So yeah, it's gonna be uncomfortable now because you're wearing something that was just helping to put a bandaid on what was really going on.

Yeah, yeah. 

Totally. Totally, and most of those are, again, apparent. So I would say over 90% of what we see in the clinics is apparent leg length discrepancy is not true. And so that hip looks elevated and it's kind of silly how sometimes we'll have fun, but it's part of our process. You know, put your hands behind your head and then all of a sudden their pelvis is level, you know, on palpation, we can see it come out. And, you know, I would say also like uneven hips, there are different planes that we need to consider also. 

So, you know, usually we're thinking of hip elevation, where there's also anterior to posterior pelvic tilt disparities where, you know, one side is tipping more anterior because maybe that hip flexor is tighter on that side or the hip flexors are tighter. Or maybe the glute is weaker inhibited on one side versus the other, or maybe, you know, something's contracted on the other side that's creating that disparity. Then there's also rotation that might come into play. That's a form of uneven hips that in all these deviations can lead to where it just seems like things are not balanced, which they're not, that will affect apparent length.

Even if you're walking also, that you might feel like you have to reach further with one leg, or it just doesn't feel like you're hitting the ground with the heel the same on one side versus the other. Those can be clues or one heel is worn out more on your shoes than the other. Those are all things that might show up.

Yeah, if you feel like you're losing your balance, right? For that matter to you, like you just feel unstable, you know, that uneven hips is a big piece. And yeah, to your point, Paul, for sure, like the multi-planal deviation that we'll see in uneven hip that would dictate how we would help people resolve that. So it's not like a one size fix all thing, right? We have to see like all of the planes of motion, cause it can be both, can be like that hip elevation and that pelvic disparity you're talking about too. So, we're gonna customize the, the correction specific to the client in front of us. 

Yeah, and in that example, it was multi-planar. So, you know, the guy that, man, he had, you know, rotation in the femur. So that was changing how the socket was going. He had a change in the pelvic tilt on that side. He had then the lower leg where the knee and the lower leg meet, or, you know, the femur and the lower leg meet at the knee then he had torsion there. So that was changing how that was articulating. And then he had the valgus stress. So that's, you know, in a different plane and then they had the foot collapse. And so he had like all these different areas that were leading up to that.

Yeah, for sure. And you  need to address all of them too, right? Like it's not just address the hips and you know, you're good. It's yeah, like you said, ankle correction with foot circles, then knee, then hip and then shoulders, and you know, help them just square away these individual components and then help them communicate together as a whole. For true…

I think that's a cool thing about what we do too though, because we're reminding the body of proper patterns, proper synergistic patterns of how it can work and how it's supposed to work. And so those pathways, you know, neuromuscular pathways and, you know, synergies and, you know, kinematic chains or kinetic chains in our body, they're all there and we just tend not to use them or we use them in these dysfunctional ways. 

So our job becomes easier when it's just like, oh yeah, we just need to remind this or, you know, it's kind of like, I always think of like a circuit board. If we had to shut all the circuits off all at once to make sure that they're not doing this screwy thing, and then just reset them, like, let's turn them all back on. But now they're all in sync, right? And that's like our brain talking to our body and getting things back in line.