There is a big difference between fitness trainers and physical therapists.
The education they receive is different and the motivations that bring people to work with them is also different.
What happens when someone hires a personal trainer but needs a physical therapist?
This can be a tricky situation, as often times, personal trainers aren’t educated on what to look out for. Poor postural alignment is the number one cause of injury both in and out of the gym and should be the sole focus of all of your strength training until it is dealt with. While most personal trainers are taught to observe and correct postural imbalances, they are only taught to look for the ones that they themselves have been taught to correct. As a result, most postural issue are not observed, few referrals get made to qualified professionals, and trainers seldom learn through their experiences.
During my tenure as a Personal Trainer in one of the fitness-mill type gyms (where many a great trainer has gotten their start) I often took ten, hour-long sessions each day for up to six days a week. That is a lot of clients, and generally gives the trainer little time to invest what is really needed in each session. There is one benefit to this kind of workload, however, and that is that you are able to see all kinds of people, with all sorts of different postural and health issues. You also learn that everyone has something that limits them physically somewhere. For the meticulously observant, such a situation as this is a gold mine of experience and knowledge that would be difficult to find elsewhere.
In addition to the common ones we were taught to look out for, one of the postural deviations that I kept seeing in my clients was an asymmetry in the size of the erector spinae. These are the muscles that start at the pelvis and run straight up your back, on either side of your spine, and among other things, are mostly responsible for torso extension.
When I saw this, I would naturally go through a series of strength and flexibility tests with that client that were specific to that problem, as I did, I was alarmed at the high rate of occurrences of the following:
* A leg-Length discrepency that was great enough to cause one side of the pelvis to sit higher than the other side from the front view.
* A resulting crooked spine (Functional Scoliosis), which was concave toward the lengthened leg, as was the core musculature. This caused the discrepency in the size of the erector spinae, the side toward the shortener leg being much more developed as a result of a much greater workload.
The greater the Leg Length Discrepancy, the more obvious these symptoms became. In addition to these obviously linked issues, I also saw these people suffered from;
* Disparity in thoracic rotational range of motion and strength
* Uneven loading of the hips, knees and ankles
* Shoulder height asymmetry
* Tight neck
I began to research the link between the two and found that what I had observed was already being studied and that the connection between these postural issues had been confirmed. What I found so unusual, however, was that not a single person that suffered from this ailment was aware of the cause of their scoliosis. Almost every individual I had encountered that had both LLD and resulting scoliosis was aware of the scoliosis but not that it was caused by LLD. Some people even knew they had BOTH but were unaware they were linked.
These issues, especially left uncorrected, are treated with powerful pain killers, spine braces, invasive surgery, and corrective exercises that address only the symptom and not the cause.
Leg Length Discrepancy can happen from one leg actually being longer than the other, it can also occur from one hip being out of alignment. Another less common cause is environmental, from standing or waling on an uneven surface.
If you think you suffer from LLD and functional scoliosis that will inevitably result from it, it is very important that you work with a professional to discover the cause of the LLD before addressing it. If you have one leg longer than another, a foot orthotic may be a simple answer to what you thought was many seperate problems.
In my experience, the severity of any postural deviation combined with the factor of time will determine the likelihood of injury.
Poor alignment in your hips and pelvis will, without exception cause more problems further up the kinetic chain. Solving these issues while you can and preventing new ones from arising is one of the most important things you can do to stay young even as you get old.