overcoming lateral pelvic tilt

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digitalnorbs
Posts: 441
Joined: Mon Jul 31, 2006 6:49 pm

by digitalnorbs

Hi guys, so for a while, I think I been battling lateral pelvic tilt, I drop my hip and that effects my left leg, which never seems to track correctly, Im really good at hiding it, and people might not see it, but I know that Im not tracking right. so, can some one share their story if they had that issue, and if they fixed it. In my case, I can even feel like my pelvis is turning to the right ever so slightly when sitting at my desk, so bummed

I guess core work a must

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tinozee
Posts: 764
Joined: Wed Jun 01, 2011 7:53 am

by tinozee

Yup, dynamic and static stretching, core work, self massage, rinse repeat forever. There are lots of programs that may or may not suit you depending on your issue/alignment.

I read Tommy D's book and was surprised at the range of issues it covers. I thought it was a really good book and the exercises are good as well. Just need to copy them to paper/clipboard. I have done several similar courses with different PTs and have learned what works for me and the condition of my hips, pelvis, vertebrae, discs and muscles. I also think it's crucial to get a MRI or two to be certain of that's going on.

Good news - you CAN fix the issues if you are dilligent. I am now way more flexible than before my first disc bulge. I have a 15cm drop and no problems. My favorite fact to remember is that Biking is not the problem, it's the lack of core and flexibility maintenance. My issues started before I ever rode a road bike seriously. Mine were from power lifting in my early 30s - squats, deadlifts, not enough stretching or supplemental single leg exercises..

If I did not stretch, I would be super tight and bulging my l4/l5 over and over again. Our sport tends to strengthen and tighten things so much that it's absolutely crucial to manage that tightness BEFORE it causes an injury. It can be like a steel cable pulling on a joint at a weird angle - bound to cause injury.

The crappy thing about this reality is the time it takes. For me to do it properly on a riding day = 20 min dynamic stretch, 3hrs ride, 1 hour+ self massage and static stretching. I know some pros who have at least twice that much in a day. It takes a lot of time and work to stay tuned up.

Good luck! I will post a few programs when I dig them up. Get a foam roller!

digitalnorbs
Posts: 441
Joined: Mon Jul 31, 2006 6:49 pm

by digitalnorbs

thank you so much, looking forward to it

mentok
Posts: 577
Joined: Sun Jan 01, 2012 9:58 am

by mentok

This is a particularly pertinent topic to me - i had a microdiscetomy in February at L5/S1 to remove pressure from my S1 nerve root which was causing severe sciatica down my left side. It's been almost 5 months now and I HAD been doing really well until earlier this week when the left side of my pelvis slipped forward dramatically and left me a cripple for a day or so until i could get in to see my physio to correct it. It was a relatively simple adjustment and everything is back where it should be - pain is gone, co-ordination and strength is back, it's like night and day. although i fear it will happen again, it's such a simple fix that i'm not too worried about it at this stage.

my issues stem from really poor hip mobility (prior to seeing my current physio i had 90° of hip flexion at best) and very poor core strength (my PC wouldn't really turn on, my piriformis had trouble turning off). my management post-surgery has been static stretching, pinning (acupuncture - i seem to respond really well to it), time on the bike (not too much but not too little - about 8hrs a week is sustainable) and walking. I'm not sure what brought on this weeks episode, but we've had a lot of rain in the past 2 weeks so my riding volume and walking time have both been down.

interested to hear more experiences from others.

digitalnorbs
Posts: 441
Joined: Mon Jul 31, 2006 6:49 pm

by digitalnorbs

Do you guys think I should go see a chiropractor first, went to a physician few months back and he didn't see anything, besides the fact that my core was weak per him?


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gb103
Posts: 71
Joined: Sun Jun 12, 2011 8:07 pm

by gb103

Hi guys, not sure where you are all based, but i live in the UK and this is my experience. I have an anterior rotation of the left hip, thus making my left leg longer. Beacause of this i suffer from chronic pain at my right SI joint, hip with referred pain in the inner thigh and heel. I also had a lateral pelvic tilt.
I have had this problem for several years due to misdiagnosis and treating the symptoms rather than the cause, ie. chiropractic adjustment/physio/custom orthotics.

Only yesterday did i see a biomechanic coach Martin Haines who runs courses for physio/coaches etc in biomechanic screening through his company Inteligent Training Systems. Basically my piriformis has gone into spasm, which acts like an air bag to minimise any more damage, thus has completely locked my hip in the wrong position. Their is also a similar muscle like the piriformis in the shoulder which is in spasm. Theses two muscles are neurochemically connected hence when one is in spasm generally so is the other.

The solution is daily massage for the piriformis and shoulder to release the spasm and two hip excercises at 20% strength for 20 seconds (5 reps, 5 x a day). The problem with doing core strength exercises straight away is that the body is not ready. Firstly, you need to eradicate any muscle spasms to provide the building blocks for normal movement. Secondly, you need to stabalise the pelvis through isolated stability excercises and only then can you carry out functional strength exercises directed for your sport. If your exercise programme is not in the correct sequence you are merely training the body to compensate for their biomechanical dysfunction, rather than training correct movement patterns. The screening/diagnosis is not clinical but mechanical.

This whole process can take between 12-18 wks with re-screening every 3 wks to assess and issue new exercises. Obviously every situation is different and this is a very simplified explanation of my symptoms and treatment. Hopefully in the next month or two i can provide a positive update. I second getting a lumbar/pelvis MRI to ensure their is no nerve compression etc. In some situation if you do have a lateral pelvic tilt (ie leaning to one side) you may initially need chiropratic treatment to get you straight, followed by a programme of treatment.

I an no way connected to Martin Haines or Intelligent Training Systems and this whole biomechanic treatment is new to me. I hope it will help me and others alomg the way. Some interesting links/video below:

http://www.thebodymech.com/biocoaching.html

http://www.youtube.com/watch?v=SaffhYuFoKw

http://www.itsmovesuk.com/site/




http://www.itsmovesuk.com/site/

pixeleater
Posts: 2
Joined: Thu Jul 04, 2013 12:22 am

by pixeleater

You need to determine the cause of your pelvic tilt before you embark on any kind of therapy/prevention routine. If your tilt is a result of muscle imbalances etc. Then a good chiropractor, massage therapist, and physical trainer will be able to help you mitigate the issue pretty effectively. However, if your leg is structurally (physically) shorter, you will need to adapt your equipment to successfully address the issue. Many chiropractors/physical therapist will jump to the conclusion that your dealing with a imbalance issue and put you on a therapy routine that will yield short term temporary relief, but will require constant attention and a lot of money. This happened to me for years until I found a chiropractor who would listen and verify what kind of issue I was dealing with. Once it was determined that my right leg was .5" (12mm) shorter then the left, I was able to deal with the issue permanently with a spacer under my right cleat and special chainrings that address the leverage imbalance caused by shimming out your cleat. I now sit straight on the saddle and produce better power without pain or discomfort during or after rides.

I'd encourage you to find a chiropractor who specializes in athletes (preferably bike riders/triathletes) and have him/her verify what is causing your pelvic tilt. I find that chiropractors who have graduated from the Palmer program to be the best. If it turns out you have a short leg, then High Sierra Cycle Center can help you with the drive train mods and fit issues:

http://www.hscycle.com/

Hope this helps!

Cleaner
Posts: 213
Joined: Wed Oct 28, 2009 7:13 pm

by Cleaner

Finding the root cause is the first and most important step to resolution. I suffered a functionally short leg for many years due to muscle imbalance, this was corrected by a massage therapist who specializes in trigger point therapy. Chiropractic adjustments would bring very temporary relief of the discomfort. The Chiropractor did assess the cause of the imbalance as muscle spasm but adjustments never got the spasms to subside. The revelation was when I could tell that I was positioned on the bike "differently" after only a one hour session of trigger point therapy. I rode the morning after and could tell immediately that I was sitting on the bike in a different (more balanced left/right) manner.

The two most effective treatments I have experienced in correcting soft tissue issues have been trigger point therapy and Graston manipulation to break up adhesions. Both of these techniques have yielded immediate and lasting correction of muscle/skeletal issues in my case.

700c
Posts: 1
Joined: Wed Jul 17, 2013 10:39 pm

by 700c

Hi,

Could you explain the type of piriformis massage you practise on a daily basis please?

gb103 wrote:Hi guys, not sure where you are all based, but i live in the UK and this is my experience. I have an anterior rotation of the left hip, thus making my left leg longer. Beacause of this i suffer from chronic pain at my right SI joint, hip with referred pain in the inner thigh and heel. I also had a lateral pelvic tilt.
I have had this problem for several years due to misdiagnosis and treating the symptoms rather than the cause, ie. chiropractic adjustment/physio/custom orthotics.

Only yesterday did i see a biomechanic coach Martin Haines who runs courses for physio/coaches etc in biomechanic screening through his company Inteligent Training Systems. Basically my piriformis has gone into spasm, which acts like an air bag to minimise any more damage, thus has completely locked my hip in the wrong position. Their is also a similar muscle like the piriformis in the shoulder which is in spasm. Theses two muscles are neurochemically connected hence when one is in spasm generally so is the other.

The solution is daily massage for the piriformis and shoulder to release the spasm and two hip excercises at 20% strength for 20 seconds (5 reps, 5 x a day). The problem with doing core strength exercises straight away is that the body is not ready. Firstly, you need to eradicate any muscle spasms to provide the building blocks for normal movement. Secondly, you need to stabalise the pelvis through isolated stability excercises and only then can you carry out functional strength exercises directed for your sport. If your exercise programme is not in the correct sequence you are merely training the body to compensate for their biomechanical dysfunction, rather than training correct movement patterns. The screening/diagnosis is not clinical but mechanical.

This whole process can take between 12-18 wks with re-screening every 3 wks to assess and issue new exercises. Obviously every situation is different and this is a very simplified explanation of my symptoms and treatment. Hopefully in the next month or two i can provide a positive update. I second getting a lumbar/pelvis MRI to ensure their is no nerve compression etc. In some situation if you do have a lateral pelvic tilt (ie leaning to one side) you may initially need chiropratic treatment to get you straight, followed by a programme of treatment.

I an no way connected to Martin Haines or Intelligent Training Systems and this whole biomechanic treatment is new to me. I hope it will help me and others alomg the way. Some interesting links/video below:

http://www.thebodymech.com/biocoaching.html" onclick="window.open(this.href);return false;

http://www.youtube.com/watch?v=SaffhYuFoKw" onclick="window.open(this.href);return false;

http://www.itsmovesuk.com/site/" onclick="window.open(this.href);return false;




http://www.itsmovesuk.com/site/" onclick="window.open(this.href);return false;

gb103
Posts: 71
Joined: Sun Jun 12, 2011 8:07 pm

by gb103

[quote="700c"]Hi,

Could you explain the type of piriformis massage you practise on a daily basis please?

Hi 700c, i lay on my side with my legs together and knees bent. You need a volunteer who then massages around the glute/hip/lower back my pushing down using their elbow. Generally massage every evening for 5 mins or so each side of the body. If you piriformis is in spasm you will know as the massage is painful, be careful for signs of tissue bruising. If this happens have a day or two off.

Hope this helps.

mattyb95
Posts: 128
Joined: Fri Aug 10, 2012 11:54 am

by mattyb95

gb103 wrote:
Hi 700c, i lay on my side with my legs together and knees bent. You need a volunteer who then massages around the glute/hip/lower back my pushing down using their elbow. Generally massage every evening for 5 mins or so each side of the body. If you piriformis is in spasm you will know as the massage is painful, be careful for signs of tissue bruising. If this happens have a day or two off.

Hope this helps.


Could you do something similar by lying on a tennis ball to work in to the muscles?

gb103
Posts: 71
Joined: Sun Jun 12, 2011 8:07 pm

by gb103

mattyb95 wrote:
gb103 wrote:
Hi 700c, i lay on my side with my legs together and knees bent. You need a volunteer who then massages around the glute/hip/lower back my pushing down using their elbow. Generally massage every evening for 5 mins or so each side of the body. If you piriformis is in spasm you will know as the massage is painful, be careful for signs of tissue bruising. If this happens have a day or two off.

Hope this helps.


Could you do something similar by lying on a tennis ball to work in to the muscles?



Yes that would work. A hockey ball or even a golf ball maybe better. However, i don't think you can beat having someone else manipulate the muscles with their elbow and body weight etc.

digitalnorbs
Posts: 441
Joined: Mon Jul 31, 2006 6:49 pm

by digitalnorbs

so as Im getting older, my body is failing me, now when riding when i get out of the saddle, my right side goes straight up and down while the left can go out and come over the pedal from outside, i at this point dont know which leg is the issus, time to go see someone again since the previous visits didnt really net much besides being told that my core use some love. anyone with similar single side issues, please advice, hope this makes any sense

toride
Posts: 153
Joined: Fri Sep 02, 2011 6:19 pm
Location: Lincolnshire

by toride

Not sure about this problem digitalnorbs, mind you I don't really understand.. has the right side usually gone ''straight up and down'' ?

by Weenie


Visit starbike.com Online Retailer for HighEnd cycling components
Great Prices ✓    Broad Selection ✓    Worldwide Delivery ✓

www.starbike.com



mentok
Posts: 577
Joined: Sun Jan 01, 2012 9:58 am

by mentok

@norbs: do you run any sort of leg alignment adjustment do-hickeys? i recently went through some trial and experimentation with various orthotics, wedges, shims, etc and have landed on a set up which has mad a massive difference to leg stability and with that, an apparent (small) increase in power and endurance. could some reading in this area help you?

in my case, my arches were collapsing under load, allowing my knees to fall medially and changing the alignment of my hips. by supporting them and adding some wedges, the whole system stays much more rigid...

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