1. Is your balance worse on one side? Could alignment be the problem?
This is the first article in a series about body alignment.
Background: I went from enjoying an active lifestyle to being unable to take a quick, short walk without significant pain and discomfort.
I wrote this series in the hopes the information might help other people avoid this fate or overcome similar problems. Don’t mistake this for professional advice – I’m in no way a qualified professional when it comes to bodies and injuries.
The culprit in my body’s misalignment is a left leg half an inch shorter than the right. Even if your legs are the same length, you might still be suffering from alignment problems and be able to benefit from what I’ve learned.
- Is your balance worse on one side? Could alignment be the problem? [YOU ARE HERE] This article describes the progressive deterioration I experienced over the course of, well, decades actually, but it seemed to accelerate in the last few years. My right leg mysteriously twisted inward and I lost my balance on that side. Figuring out what was happening to me was a long, frustrating and expensive process.
- If your body’s alignment is a problem, how will you know? In this article I tackle several topics, like does alignment even matter? The biggest message I hope you take from that article is that when we take a reductionist view of our injuries and pain points we miss the chance to make real and positive changes to our bodies.
- Surprising Signs of Misalignment: Assess Yourself This article describes ways you might begin to get a sense of your own alignment.
- Exercising for Alignment In this article I describe how I exercise to improve my alignment. Remember, I am not a strength trainer. I’m not even pretending to be one on the internet. I’ve done many, many exercises and programs to try to improve my chronic problems, prescribed by professionals. Nothing has been as effective as what I do now.
- 12 Random Tips, Insights and Admonitions About Alignment This is just a mash up of a bunch of things I’ve learned or have helped me during this process.
As cross-country skiers and people who enjoy active lifestyles, we’ve all heard the message that alignment is important. Good alignment:
- Helps prevent injury.
- Helps us move more efficiently.
- Is important to our overall health.
I bet you accept these claims, almost without question. I certainly did. But that didn’t prevent me from developing injuries and issues because of alignment problems. I knew alignment was important. Beyond that, I knew very little.
- I didn’t have a clear enough understanding of what alignment meant.
- I couldn’t sense my own misalignment.
- I lacked practical tools and knowledge for correcting my alignment.
Most disturbingly, I had no idea that the cascade of physical problems I was experiencing were, at their root, problems of alignment. Not only that, of the more than one dozen professionals I consulted over 10+ years, only one made the connection.
This has been a tough and frustrating journey. I can’t enjoy the same activities I used to, including nordic skiing, and misalignment has left me with joint pain that may be irreversible.
Perhaps sharing my experience will save someone else from a similar fate.
This is a photo I took last winter from the top of a gradual downhill. I’d stand on one ski and glide down the hill, using my poles lightly for balance.
I made the 2 straight tracks with my left ski, on 2 separate runs. The 2 tracks that veer off were made by my right ski.
Standing on one ski while you glide downhill is a balance drill, but I was using it as a controlled experiment. I was trying to understand why I lost my balance on my right side. I used to be comfortable on that ski – now it skittered and floated on the snow, even when I stood with my full weight on it.
I repeated the experiment over and over, at least 50 times that day and many times on other days. My left ski always tracked straight and my right ski always veered.
I experimented with endless variations such as changing the direction my head and shoulders faced or repositioning my spine and pelvis. I did my best to exactly reproduce what I did on my “good” left side with my right “bad” side, all the way down to how I distributed my weight on the bottom of my foot.
No matter what I tried, the right ski inexplicably turned away. I was so frustrated and discouraged that I was in tears. It was one of my many low moments in the last few years of skiing.
Losing My Balance
I started to notice my loss of balance on my right side 3-4 years ago and it was most obvious when skate skiing. Previously, my right side was better for balance, but now it was giving me a lot of trouble.
Not only did my balance worsen, strange things were happening in my right lower leg and foot. It felt twisted, like there was a line of torsion that started behind my right knee, wrapped around my lower leg and travelled across my foot to my big toe. If you can visualize a wet towel being wrung out, that’s what my leg felt like.
It’s a difficult sensation to put in to words. I call it my “bad leg” and, when it ramps up, I say my leg is in “panic mode”.
Why I lost my balance, but not the real reason.
Standing at the top of the hill for another run, I tried a new variation of my “Gliding Downhill on One Ski” experiment. This time I leaned back, driving my weight through my heel. That was the first thing to make a difference. The ski tracked a little straighter. After that, I tried over exaggerating my weight distribution in other directions.
Finally, I drove my weight through my big toe joint. My right ski tracked perfectly straight. I went for a short skate ski, driving my weight through my right big toe joint every time the ski landed. For the first time in years, I had perfect balance on my right ski and I felt “connected” to the ground.
Instead of feeling happy, I just wanted to cry more. Driving my weight through that big toe joint made the twisted feeling in my leg a hundred times worse.
Why I lost my balance, the real reason.
Fast forward to today and I’m confident my “bad”, twisted leg and balance problems are the result of postural misalignment owing to different length legs, a.k.a. a leg length discrepancy (LLD). Clearly, disorganized muscular activity and loss of balance are neural problems but misalignment is the root cause of my issues.
By alignment, I’m not only talking about my static posture — how I sit and stand — more importantly, I’m talking about my alignment during movement and the overall structure and balance of my musculoskeletal system.
My right leg is approximately 1 cm longer than my left leg. I say approximately because even though it was measured by x-ray, there is no error-proof way to measure LLDs.
The figure to the right illustrates a common way the body “adapts” to a LLD. My body didn’t adapt exactly as described in this article, but it’s a good approximation.
See how the longer leg twists inward (the skeleton’s left leg)? That accounts for the sensation of torsion in my longer right leg.
The pronation threatens the joints in my knee, ankle and foot, which is why my brain tries to keep my weight off that leg (loss of balance). It’s also why there’s inappropriate muscular activity in that leg; my brain is trying to stabilize the vulnerable joints.
I know LLDs are quite common but I don’t want to get sidetracked by the specifics of my experience or LLDs. I’d rather use my experience to talk about alignment more broadly because that’s a topic that is relevant to everyone, whether they have a structural asymmetry or not.
Losing my balance was the best bad thing to happen to me.
I hardly skied last year and can’t even hike like I used to. Endurance activities just strengthen and reinforce poor movement patterns and muscle imbalances. I have to put those activities on hold until I straighten my leg and sort out my alignment. It’s not even clear whether my joints will recover to the point where I’ll be able to enjoy my previous level of activity.
So how is this a good thing?
Every injury and setback is an opportunity to learn more about your body and improve yourself in some way. This experience is no different. I’m further refining my body awareness and systematically improving my movement patterns and strength throughout my body. The experience has completely upended my approach to fitness and to rehabilitating injuries.
Strength and endurance are the foundation of your fitness, but your alignment, posture and movement patterns are even more fundamentally important. They dictate everything about your biomechanics, all the way down to your balance. The effects can be insidious, hard to detect and take decades to unfold. They’re also difficult to undo.
We’re all asymmetrical and misaligned to some degree. My misalignment reached a tipping point. In a way, being so far out makes it easier to sense and understand alignment. Maybe it’s confirmation bias, but I now see how the root cause of decades of injuries and pain was simply alignment.
I’m planning a series of articles about alignment to publish over the next few months. It’s the foundation of good ski technique, but more importantly it’s the foundation of a fun and active lifestyle.
I’m not a physiotherapist. My expertise comes from experience, deep study and critical thinking. There’s plenty I still don’t know, but I can offer you practical advice about things like how to recognize signs of misalignment, ways to monitor your alignment and exercise strategies for improving your alignment.
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