The #1 Surprising Cause of Pain – From Plantar Fasciitis to Knee, Hip, Low Back Pain & Shoulder Issues

Do you ever wonder WHY pain happens?

When it hits we’re often shocked because it seemed to come out of nowhere. People use terms like “I threw out my back” even if they were doing something as benign as weeding a garden.

Or knee pain might hit suddenly while on a hike, when hiking didn’t hurt at all for decades, and you blame the downhill “pounding” because that’s what everyone thinks is “bad” and you just so happen to be going downhill.

Little do most of us realize that we’ve been doing things our entire life (and one thing in particular) that has been building and building momentum toward injury or pain. Whatever you were doing when pain finally happened was merely the straw that broke the camel’s back. The MAIN CAUSE is almost always something else (unless you’re in an accident or have a traumatic injury).

Watch the video!

It’s a lot easier for me to “show and tell” this particular nugget of wisdom than to write about it…though I’ll be doing that too.

The “one leg” phenomenon:

Not everyone does this to an extreme, but I would venture to guess that 80% of us do. I include myself in that figure, though I am now very aware of it.

I call it “celebrity pose” or “sassy hip” pose 🙂

Why do we lean on one leg?

Most of us choose a leg we feel more comfortable on as children, and as we get older we use that leg any time we’re standing around: at a party, in line at the grocery store, waiting for our morning latte or posing for pictures!

If you have an injury on one leg – say, you sprain your ankle, break your leg or have knee surgery – you may end up on your OTHER leg out of necessity, because you’re taking the pressure off the injured leg. If you keep it up though, you’re likely to have pain or an injury on the leg that has been compensating.

No matter the reason, it can wreak havoc!

Why is this so “bad”?

It may seem like an innocent and harmless habit, but over the last 8 years I have seen it be the primary cause of pain from plantar fasciitis to shoulder issues in a large majority of my clients.

When I talk about primary causes I am ALWAYS looking for the habit or traumatic event that is causing whatever pain shows up in the body. I might talk about a “root cause” in the body, but we HAVE to find the primary cause that is creating the root physical cause if we’re going to eliminate the pain for good AND prevent it from coming back. Otherwise we’re doing nothing but ‘managing’ pain and I hate managing pain! I’m not in the pain management business…I always want to eliminate it for good.

That’s why this is so important to know about.

What happens due to this habit, physically speaking?

When you lean on one leg for DECADES, and – not in all cases, but in many – also use this leg more than the other in situations like climbing stairs (it may be your go-to leg to take the up-step while hiking), or if you have kids it will probably be the hip you hold them on, or if you do heavy lifting you might use that quad to get you out of the bottom of a squat with heavy weight…it’s like this leg becomes your “fighter.” It’s the strong one, the smart one, the dependable one, the one you know you can count on (without even being aware that you’re doing so!); until it gets tired and quits working for you, or causes a serious pelvic imbalance than endangers your central and peripheral nervous systems.

If you’re in the ‘one leg is tighter phase’ (no structural change yet):

Loading that one leg with most of your body weight for years causes the fascia in that leg to shrink, dehydrate and it can and often does stick to itself in balls or knots. This tight fascial system might begin pulling on joints, blood won’t flow as easily throughout that leg and SOMETHING has to give. Your body needs to get your attention to stop this before something catastrophic happens and sidelines you for good.

What ends up getting your attention will be unique to you and whatever other habits you have or sports you play.

If you’re a runner, chances are you’ll end up with plantar fasciitis or knee pain on that side. If you’re a rock climber or CrossFitter, you might end up with a pulled hip flexor or glute pain on that side. If you play soccer (or played soccer in school, even years ago) or you’re a dancer, you may get a pulled hamstring. If you climb mountains or have kids and hold them on that hip, you may end up with hip pain. This list is endless and overlapping, but it should give you an idea of what I’m talking about.

Your gluteus medius on that side may decide to stop firing (it’s tired from you leaning on it for so long!), or your hip flexors (mainly the quad portion) may become so fatigued and over-tight that they inhibit your glutes, or start to pull your pelvis out of alignment. And if that happens…

Structural changes can result (but your brain will try to prevent them):

Photo from How Stuff Works.

As a result of all this one-sided fascial tightening, your brain is alerted to possible danger and may step in to take action since you are unaware. Why? Your brain will do everything in its power to stop a pelvic tilt, shift or rotation because it REQUIRES a healthy central and peripheral nervous system (spine) to communicate with your body properly.

As you can see in the picture, there are some very important nerve channels in the hip and leg, and if any of them are impinged or cut off, it’s very bad news. So your body will FIRST try to stop this from happening. How?

This is my opinion and I haven’t found any scientific evidence to back it up other than my own “citizen science” of working with people in pain since 2008. Here it is: I believe the brain will send a signal to one or more muscles to “contract” neurologically to counteract the imbalance happening from left to right and/or front to back.

Your OPPOSITE quadratus lumborum (QL, or low back muscle), a glute muscle (usually medius) or TFL (tensor fasciae latae) might be recruited in an attempt to keep your pelvis stable and your spine in a neutral position. But these are small muscles compared to the quads, IT Band and adductors, and over time will be helpless against the habit of leaning on that one leg. THIS is when low back pain happens (all varieties) – something has to happen that STOPS you in your tracks so you might finally pay attention!

I’ve worked on people bent in half who can’t stand up because the back pain is so bad. And in every single case of low back pain to ever walk into my office, the BACK (spine and surrounding muscles) was NOT the problem. They are simply what is trying to get your attention. In SOME cases where the pain and pelvic imbalance has been present for years, you might end up with disc or spine damage, and in that case I would say that SOME of the problem is now in the spine itself. The #1 thing your spine needs to stay healthy is BLOOD. Blood nourishes the bones and discs. So if this is you, then the more you can open up your ENTIRE fascial system, the better.

In ALL cases of low back pain that I have worked on (hundreds) it was an IMBALANCE in the leg fascia that was the physical root cause. The PRIMARY cause was something habitual and/or sport related, creating the physical root cause. And MOST of these people lean on one leg. (Not all, but most).

How this affects shoulders:

This is simple. Stand in front of a mirror and shift one of your hips higher, lower, left or right. Or…simply do the one leg stance! What happens to your shoulders? There will be an immediate and obvious shift in your shoulders following a pelvic shift. Just scroll up and look at that picture of me again. My left shoulder is obviously lower than my right because I’m leaning heavily on my left leg.

I’m not going to go in depth on these patterns right now, but I at least wanted to let you in on just how much this ONE habit can wreak havoc on a body. If you have a stubborn shoulder issue that upper body methods have not relieved, it could certainly be coming from your hips being out of alignment. And almost always, the hips are out of alignment because of a fascial imbalance left to right and/or front to back.


This may be easier said than done. But if you can catch yourself and go to both legs you will begin to address this issue and your body will respond in kind: your pain may diminish or eventually disappear JUST by doing this one thing!

If you want to accelerate your results:

Release all the areas of fascial tightness/adhesions in the leg you lean on. I wouldn’t automatically assume everything in that leg is tighter though, so be sure to check BOTH LEGS and whichever one is more tender/tight or hurts more with compression, do that side only or more than the other.

I have techniques for every major muscle group in the lower body on this blog and the YouTube channel. A quick search will give you what you need, but a GREAT place to start is with your quad fascia.


If I could pick only ONE area for you to tackle with a foam roller and release technique, it would be your quads and hip flexors. So check out this post and see what you find left to right.

Is this ALWAYS the cause of pain?

Absolutely not. I want to make sure to state that.

What do YOU think? Could something *this* simple be at the root of so many pain issues from head to toe? Comment below and share your thoughts!

If you liked this post please “like” and share it!

  • Joseph Donahue says:

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  • Kevin Morgan says:

    Me again, Elisha.

    As I inserted a link to your video in my newsletter, a few minutes ago, I thought to send you my equivalent video, made ages ago. Kev aka FitOldDog


  • Kevin Morgan says:

    Hi Elisha, excellent article, presenting the same message I’ve been preaching to plantar fasciitis sufferers and others, ever since learning the incredible value of Feldenkrais.

    If you’re interested in leveraging each other’s work, just let me know. There are millions out there who could benefit, if they would only listen. I’m learning marketing, but it’s not my real strength. Deep down, I’m a researcher, really.

    I deal with plantar fasciitis as a sideline (http://athletewithstent.com/plantar-fasciitis-case-reports-cost-estimates/). My real interest is in helping people overcome major health challenges associated with aging. Best if they prepare, but most people look outside for solutions, when the real issue is inside.

    My story is contained in this short video, made for Cook Medical. https://youtu.be/zHDzIzQmnFQ

    Let me know if you would like to work together, to leverage each others strengths.

    Your call, and either way, keep up the great work.

    Kind regards,


  • Claudia says:

    You described me perfectly I sit too long, I had a tilted hip that caused several acute attacks/spasm similar to sciatica pain. I had fascia release massage that helped a lot and after few chiropractic adjustment my hips seem stable but they are too forward, always been that way I think. I’ve been suffering for about 10 years now. My shoulder also is giving me problem and after what you explained now everything that is wrong and tight in my body makes sense. Plantar fasciitis is the last symptom I just recently got, next will be what…my head will fell off?
    I need to find a solution to this and try not to sit for so long.

    • Hi Claudia – there’s ALWAYS a solution! Sounds like there is a lot going on for you. I hate hearing about people in pain for years. If you’d like my help with any of this, I do offer Skype sessions: https://mobilitymastery.com/skype-sessions/

      Otherwise, you can use the resources on this blog to help yourself. Mostly I would encourage you not to give up on your body! It’s trying to get your attention. Pain is a cry for help, and I believe there’s always a way to help.

  • Johanna says:

    Yep, totally with you on this. In my mind it is body mechanics, when you “unbalance” one bit, something else needs to go as well, otherwise we would not stay upright. I see this all the time in my practice as well.

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