Leg Length Discrepancy and Short Right Leg Syndrome
in the context of Remedial Therapy
Mechanism for Left Lower Limb Symptoms
When one leg is longer than the other, standing both legs evenly planted feels uncomfortable...the higher hip throwing a slight tilt across the pelvis into the base of the spine. Unconsciously we make a postural flop, anteriorly rotating the hip on the side of the longer leg. This is an anatomical adjustment pulling the left leg upwards and we feel better. The hip rotating about the Sacro-Iliac Joint (SIJ) in the Sagittal plane is a cam adjustment for the hip joint at the acetabulum which rotates about the SIJ posteriorly and superiorly on an arc with a radius of approximately 120mm...this has the potential to pull the limb upwards in the order of 20mm at full rotation, adjusting the apparent leg length, levelling the hips to some degree. This is good because it is protecting the spine. It is bad because the rotation is causing undue tightness in the soft tissue of the SIJ. It is rarely sufficient to compensate fully for the leg length difference and sign of mild scoliosis still results.
There is no neurological connection or readily recognised biomechanical link between the SIJ and the Plantar Fascia. Hip posture anomalies and SIJ dysfunction of this nature are disregarded by therapists treating Plantar Fasciitis. However, in Eastern philosophy it is known tightness blocks energy flow causing thickening and tightening through the soft tissue and this is observed in the back line of the lower limb where a hip is held chronically in forward rotation. A subtle thickening and tightening will be evident through the entire backline of the limb. Some cases will be unaffected beyond this, exhibiting no acute symptoms and treatment to normalise hip position is not required; particularly considering the mechanism of hip rotation is protecting the spine. Athletic activity relieves scoliotic symptoms in the upper body but frequently aggravates lower limb symptoms. Should acute symptoms develop, they are typically experienced in one area of the limb only. However, I do have one client affected by this condition who, over a period of years, successively suffered Piriformis Syndrome and Sciatica, Plantar Fasciitis, Achilles rupture and a Hamstring tear on the left side before being assessed with SRLS. Direct treatment provides limited temporary relief until the postural anomaly at the hip is rectified. Once this is done, recovery is swift....usually within a matter of days.
It should be noted that while those cases appearing to be unaffected down the backline of the lower limb by chronic hip rotation, long term strain on the SIJ can lead to instability and injury through the joint later in life.
Some readers will be sceptical of energy concepts and that is OK. This report is based on numerous first hand observations of the condition using basic hip posture and leg length assessment methods and palpation skills of muscle tone through the back line of the limb. Regardless of the underlying reason chosen to support the observed effects, the observations still hold true.
First published 11 May 2020 https://www.facebook.com/MassageWorksDandenongRanges