Leg Length Discrepancy

Medical Q&A [Moderated]
1

Hello Guys,

I have been experiencing a hip pain on and off for some years now.
I have been doing strength training for about 3-4 years now and have been having issues with my squat all along this time.
Im 35 years old, 1.8 m height and about 85 kg.

Initially the problem was that when I started to reach about 100 kg the hip pain will start.
The pain is basically like a tendon or ligament that hurts at the bottom of the squat.
I can manually cause the pain when this tendon/ligament is inflamed when I flex the leg and rotate it so that my feet points to the other knee.
The pain feels internally like in the middle of the joint between my quads and my hip.

On my training what usually occurred is that when I had the pain, I will go off doing squats for about 1 month.
Then I will start from very low weight, up until the point of around 100kg where the hip pain will start again.

I got reviewed by a physiatrist which diagnosed me with a leg length discrepancy.

I have about 1.6 cm difference between one leg and the other.
He recommended me to use 1 cm shim (I think it is called) inside my shoe.
He recommended me only 1 cm because he said that usually 0.5 cm should be a normal difference.

Now after using this shim while squatting, I have been able to get to 125kg, but the pain returned at that point.
I was feeling the squat very heavy and I think I was driven a bit lower than usual, and then the pain restarted.

Lately some months ago what I have been doing is that whenever the pain arises I just took anti-inflamatories for a couple of days
and then once the pain fades, I will start training again adding weight a bit quicker this time.

I was thinking about using a shim added to the bottom of the shoe instead of internal, but do not know if that will make a difference.

Also would it make a difference if my training shim is for 1.6 cm? would that make it better?

I have read some articles of some guys that put one foot a bit in front of the other, but that seems that not very exact.

Im a bit frustrated with this pain that won’t allow me to progress on my squat.
Would like to hear recommendations if possible on how to diagnose or improve.

If I should do the external shim or if I should try some other options.

Thanks in advance.

2

How was this LLD diagnosed? I am not convinced it is the cause of your pain.

3

The LLD was diagnosed by a physiatrist.

I went to a StartingStrength seminar on late 2016.
There I commented about this problem with Rip in specific, and he commented me very briefly that he had not a real idea what may be causing the issue, but that I should get checked to discard a hernia.

After that I got the appointment with this physiatrist, I commented about the potential hernia and the issue that I have been having with squats. The doctor was not very related to strength training.
In any case he reviewed and pretty much discarded the hernia but found the LLD.

The LLD was diagnosed via 2 ways.
First a measurement with a metric tape.

Then to confirm it he sent me some X-Rays.
After seeing the X-Rays he confirmed me that I had a LLD of 1.6 cm.

He commented me “Lets fix this first, and then if the issue continue we will revalidate”.

The truth is that I have been assuming that the issue is still the LLD, but now you got me thinking if it may be another thing.

I was reading another post in the forum about “athletic pubalgia”, which sounds relatively similar to my symptoms.
Of course, have no idea if that might be it.

Any additional comment or thought is welcome.

Thanks a lot.

4

Yeah - I just have a hard time attributing a clinically diagnosed LLD (which has known reliability/accuracy issues) that has presumably been present for your entire life, starting to cause discomfort all of a sudden in your 30s. I suppose it’s possible, I just wouldn’t jump to that diagnosis right off the bat just because I happened to find a LLD on exam, you know?

5

I’d guess the number of people who attribute problems to LLDs vastly exceeds the number who actually have problems due to LLDs.

6

I would agree with that.

7

Hello Austin,

is not exactly like that.
Is not like I had issues before 30 or after 30.

The only issue I had with LLD was when I walked for long period of times, I can only attribute it to LLD, because after using the shim it got significantly better.

Now regarding the groin pain at the bottom of the squat, I think this physiatrist was not sure what it was, and then thought something like, “it might be this, lets fix it and see if its that”.

Although it might not be that.

Any additional clue of what might be?

Do not know if its very common or not to experience groin pain in squat or if there are some common causes that I might ignore.