Diagnosing Leg Length Discrepancy

by ThePB4RGuys · February 26, 2015

At some point, you may have been to a doctors office and been told the words, “you might have a difference in the length of your legs”. What that means is that the physician has detected an imbalance in your body that may be biomechanical (that is, muscles pulling) or it may be structural (phyically, the bones of the lower leg may be shorter on one side or the other). It may also mean a drop in one of your arches as well. Here, we see a short video on leg length analysis.

Leg Length Discrepancy: Proceeding With Treatment

In our Clinical Pearl Series, MedBridge instructors share their expertise through research reviews, case studies, and op-ed articles. Dr. Laurie Hartman, DO, PhD writes:“In my experience, when working with patients with Leg Length Discrepancy, one of the first questions I run into is whether or not treatment is needed. If the patient is not experiencing pain, then treatment is unadvisable as it could actually lead to problems. However, if the patient is experiencing pain in the foot, knee, hip, or lower back, then I would absolutely recommend treatment.Often times, it is necessary to help the patient see how their Leg Length Discrepancy is affecting them. Without realizing it, the patient will stand with more pressure on their shorter leg with the knee on their longer side partially flexed. This stance places more weight on the shorter side and the spine will adopt a tendency to bend toward the shorter leg. This can manifest itself as a number of ailments, such as:

Tightening of the muscles behind the longer leg knee
Tightening of the hip muscles on the shorter side, which could lead to arthrosis if not corrected
Bending of the lower spine and in some cases the lumbar towards the shorter leg
The foot on the shorter side becoming flatter and larger
Problems standing

Most of these problems are due to the patient’s posture. The issues can start out small, but given a minor trauma, the symptoms can intensify greatly and become more difficult to treat.

A good course of action is to ask the patient to bring in photos of themselves standing. In most of the photos, they will see the way they stand with the weight put on their shorter leg. I have found that this is a powerful way of showing the patient the importance of treatment. Then, I explain that without correction, they may begin experiencing painful symptoms like those listed above. I will often incorporate the patient’s partner in the treatment, as they can help keep an eye on their posture when I am not around. It is recommended that they stand with their legs wider apart to make sure that they are not putting all their weight on the shorter leg.

I recommend seeing the patient every two months for a few sessions to make sure that they are correcting their posture. If no improvements are made, it may lead to a recurrence of symptoms.

The spine is actually very easy to manipulate from the shorter side; it is the other side that requires more pressure. Use of a table makes manipulating the longer side much easier.”

Watch a clip of Dr. Hartman as he explains Leg Length Discrepancy and demonstrates a brief test for spinal irregularities

Original Article posted at Medbridge.com

Diagnosing Leg Length Discrepancy

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