It’s a matter of asymmetry

The human body is a remarkable thing, I think. Today I learned that my left leg is slightly longer longer than my right leg from Dr. Moriarity at the University Clinic. This small defect has caused a mild pronation to compensate. An article on the issue is found here, from which I quote:

Chronic overuse problems that persist despite appropriate care are the hallmarks of a leg length discrepancy (LLD) in an athlete. While the symptoms associated with LLDs are diverse and, at times, vague and confusing, you should suspect limb length asymmetry when athletes have back or lower extremity complaints. Leg length asymmetries appear to be the third most common cause of running injuries and occur in 60 to 90 percent of the population.

This pronation causes asymmetric muscle construction in both legs, which in turn causes the knees to bend in awkward directions to compensate. Again, from an outside source, I quote:

Contrary to popular belief, the acquired shortage is a pronation problem, first and foremost. The reason is that, while you may look identical on both sides of your body, the left and right don’t work exactly the same. The same goes for pronation. As you develop, the brain picks up on the patterns of two feet, recognizing the slight variation in gait. The body compensates by rotating one of the hip bones (called the ileum). The ileum can rotate either backward and downward (called PI Ileum for posterior inferior) or forward and upward (AS Ileum for anterior-superior). This pulls the leg higher into the hip socket, causing the leg to function short, changing the alignment of the muscles around the hip and spine. Unfortunately, this causes those muscles to work unequally and inefficiently, and ultimately causes pain.

What this means is that the muscles in my legs have caused a misalignment in one of the two primary “joints” inside of the knee - the femoro-patellar joint, which consists of the “kneecap” the, sesamoid bone which sits within the tendon of the anterior thigh muscle, and the patellar groove on the front of the femur through which it slides. Muscles which are “overgrown” in response to the height discrepancy will pull on the patella (kneecap) in such a way that it becomes misaligned with the patellar grove. The end result is knee pain. Conditioning the under developed muscles will push you to rely on them more - thereby attaining symmetry in your movement.

This means that I need to condition the muscles that are underdeveloped by doing exercises which promote a more ‘natural motion’ in the knee. I’ll take a picture of what I mean when I get my camera in the mail (Nikon D80. Thanks for all the money!) Hopefully next week. But the idea is quite simple:

If you stand on one leg, with your hands on your hips and do a squat (on one leg) your knee should naturally fold down right on top of your foot. If it bends in (or out) and your hips twist out (or in) then your not built quite right. In my case, my knee swings well inside and my hips rotate around to correct it. I cannot squat directly over my knee as my muscles do not support my weight. In the end, one should be able to squat to an almost ’sitting position’ with the knee over the foot.

In the end, what all this means, is that I need to do strength training on my legs which include some ridiculous looking exercises, which include standing on one foot for two minutes at a time with the patella, foot and hips all perfectly straight. After that’s nearly effortless, I then do squats, lunges and various other knee bending exercises to sculpt a normal shaped knee. This means that, in the short term, I’m allowed to do short jobs, elliptical, stationary bike and swimming.

And, most importantly, I shouldn’t have any problem running in the Sunburst in two months, though I most likely will not be able to run very well, since this sort of injury takes a while to work out. But I am cleared for short jogs until the pain is mostly gone.

Tags: Sunburst, running, knee, exercise