I really hope you can give me some direction as I have struggle with pain for a number of years now and it is keeping me from doing work and play. Here is my history:
I have had a low right shoulder for as long as I can remember but have only really had pain for the last 4 years, I am now 39. My first visit was to an orthopedic surgeon who gave me 3 injections of cortizone and prescribed 2 different physical therapists over a years time. I had no relief. I tried a recommended chiropractor but no relief. I finally got substantial relief from a neuro muscular massage threrapist. He got my muscles out of spasm and the pain subsided. He then also noticed that I was way out of alignment(hips going one way, spine going other way with low shoulder, neck going the other way and head then leaning the opposite way, a big zig zag all the way up.) By trial and error with foot lifts he found that when 10mm lifts were put under foot my left foot everything straightened out. This was good for about 9 mos. I had different pains as muscles adusted but all worked out except for a sharp hamstring pain that we could not get to subside. I then looked for help from my gp and he sent me to a new chiropractor, he determined that the hamstring was overworked because of the lift. He believes that my short leg is functional and with excericise and manipulation it will correct. After some time my hamstring subsided but now my shoulder dropped again and I am once again getting shoulder and neck pain. I don't know where to go next. Any advice would be greatly appreciated. I am from New Jersey and if you know of anyone in the New Jersey or New York City area I would be willing to travel to see them.
George, Thank you for your patience with my answering this email due to my vacation. It sounds like the typical adult pattern of long right leg with dropped right shoulder. The short left leg would cause the head to lean to the left. The body deals with this by creating a scoliosis. The upper 1/2 of the spine brings the head back over the center thus dropping the shoulder of the side of the long leg. This seems plausible for you since the lift under your left foot did get rid of your shoulder pain. So, at initial glance, sounds like we need to get you back into your lift.
Let's discuss why you got the hamstring pain that did not allow you to continue wearing the lift. I apologize for not asking you if the hamstring pain was on the right or left side or both. I am assumming it was on the side of the left lift. If not, let me know. When you use lifts to correct for a short leg, you can create some instability by lifting the foot out of the shoe (especially if only heel lifts were used for the lifts, or it the lifts were on very soft material). The hamstrings in this case work harder to stabilize the leg and can become painful. As you use lifts you may also straighten the knee some putting a stretch on the hamstrings (more stretch than what they are used to experiencing). If you add already tight hamstrings (like me), that extra stretch can be painful. The sciatic nerve off the back is can get painful as it runs through the hamstrings, and is often misdiagnosed as hamstring strain. The same treatment for sciatica (as it is called) is totally different than hamstring strain. The sciatic nerve could get irritated for multiple reasons, including using a lift inappropriately (say on the wrong side).
So, as this is pieced together, and you can hopefully see it is detective work, you should be able to find a solution. As I have mentioned in my posts, when there is differing opinions on what side is short, and whether it is trully functional or structural or combination, I would get the Standing AP Pelvic Xray barefoot. You stand with the knees straight and feet in normal position. If one arch is alot flatter than the other, and you wear orthotics to correct that, you would want to wear shoes and orthotics. But, if your feet are fairly symmetrical, barefoot is perfect. That one xray will answer once and for all if you have a short leg, then treatment is not so much guess work. There is radiation with xrays, so docs try to avoid this xray unless forced into it. I think you should have the xray. Ask your GP to order for you.
Every profession has biases. Podiatrists are biased certain ways. Chiropractors think most short legs are functional. Orthopedists generally feel that under 13 mm short legs do not cause much problems. GPs generally think lifts are a big pain to deal with so they don't even want to get started on short leg treatment. This is why the chronic pain syndromes caused by short legs can go on forever.
I am hoping when you read this that you were just using heel lifts under the left side, and once you change to full length lifts (as described in various posts), your shoulder pain will again disappear and your hamstrings will remain calm. That is actually what I would do if you were sitting in my office right now. If that did not help, I would get the xrays (although I would also do the standing LLD exam that my blog even has videos on).
So, in summary (with questions):
- Has anyone done the standing LLD measurements outlined by my blog?
- Was your hamstring pain on the left or right?
- Were your lifts in the heel only or were they full length (at least going to the toes)?
- Did the doctor who was the most helpful feel that the shoulder pain was coming from your neck?
- Did they try to differentiate the hamstring pain from possible sciatica?
- I would recommend one of the following podiatrists in no particular order. They are all outstanding sports medicine podiatrists, but you will have to call there offices and see if they deal with short leg syndrome. They are Karen Langone, DPM (Southampton, NY), David Davidson, DPM (Amherst, NY), and John McNerney, DPM (Westwood, NJ). They may have a great physiatrist or osteopath in their area that deals with this issue that they co-treat patients with. They may also recommend a great doc in your area that they are more familiar with. Please ask them to read this post so that they understand what we are trying to accomplish. Please feel free to send a comment to this post of answers to my questions and other thoughts, or progress report when something happens ---like no pain!!! Hope this helps, and thank you for your patience. Rich Blake