Although I've seen people talk about the importance of the hips (and I've been one of them) I thought I'd pass along a recent experience. This definitely seems to be one of those situations where the pain is far away from the root cause problem.
Those of you that have been around here for a while have heard of my various foot issues. I've been working on them for years - literally. The main problem was Plantar Fasciitis. It was horrible. I actually got over that quite a while ago. But I've had a lingering pain in my left heel - basically right where you heel strike when you walk: Right on the transition from vertical to horizontal surface as well as the transition from posterior side to lateral side. About 18 months ago it was so bad I had a stress reaction there and wore a boot for 3 weeks to calm it down.
I saw a PT (different from the one I normally see but in the same clinic) and she found a significant leg length difference. She had a procedure she did to even it out (pelvis adjustment). But we had trouble keeping things in the right place. We thought we had it taken care of so I stopped going. The pain seemed to consistently be there. I figured I just had to live with it. I went on like this for the last 6-8 months.
A couple of weeks ago I began to wonder if things were significantly off again. So I go back to her. She has me do a bunch of walking and then says "Had I been to my hip class before I last saw you?" "Nope."
PT: "Walk toward that mirror and tell me what you see."
Me: "When my left foot is planted and I"m bringing my right leg forward my left shoulder drops."
PT: "Your left hip is messed up. It's not giving you the motion you need. You're dropping your shoulder so you can swing your body around, since your hip won't easily let you do it."
She measures the internal rotation of the legs and finds the left is about 1/2 the range of motion than the right. She does some manual massaging/loosening of the posterior hip capsule and then gives me exercises to encourage that to stay loose between visits.
Well I'll be darned:
* The IR is staying where it should be.
* The heel pain, on average, is starting to decrease.
With the bad internal rotation of the hip the pelvis was tilting and making the left leg longer - and likely encouraging me to heel strike harder on that side.
With all the sitting many of us do all day the hips can really get screwed up. And having them work well is critical to all sorts of things below the hips.
"Kick off your high heel sneakers, it's party time."