Rough DRAFT Only...do not pay too much heed...only just started this article and incomplete.
Treatment for Short Right Leg Syndrome
I do describe several physical tests examining comparative leg length that identify the longer and shorter structural legs and give some indication whether it is a low or high range discrepancy. The accuracy of determining actual leg length by tape measure is low and I do not attempt to do this. It is not necessary to do so for treatment purposes. Sub-acute cases may be managed with exercise and physical therapy. Where there are acute symptoms, it is almost always necessary to place an adjusting shim beneath the heel of the shorter leg. There is much more to say about this.
The thickness of an adjusting shim is not a function of leg length difference. It is more a matter of what amount of adjustment is the body willing to accept. While I am guided by a number of factors in choosing the adjusting thickness, it is typically between 3-5mm. There is no expectation of being able to realign the client to perfect symmetry. This is not going to happen and attempting to do so in a mature adult will injure them.
The object is to make a minor adjustment to back off soft tissue tightness in the joints and encourage the left hip position to normalise to some degree...sufficient to release tightness in the SIJ and ease loading and stress in the lumbar vertebrae so that energy/Qi flow can resume. Improvement low in the spine is rapid. Enduring change occurs. Acute Lumbar and lower limb symptoms can take days, weeks or months to resolve. Progression up the spine to the Thoracic and Cervical regions can take months.
One client in his 70's reported ongoing improvement to gait, balance, function and vitality for two years from commencing heel lift treatment. Over a twenty year period he had successively suffered several left leg issues. Initially Piriformis Syndrome and Sciatic pain which resolved to only begin experiencing Plantar Fasciitis. Much therapy received for both conditions kept them at bay but inordinate tightness in the backline of the limb persisted. Then in the space of two years a 3rd degree tear of the left Hamstring occurred and on recovery from that full rupture of the left Achilles. Seeking massage treatment after surgery, I had to tell him we would not be able to clear tightness from his left leg as requested. He had a large leg length discrepancy and left hip in very high range anterior rotation. This was cause for his litany of left leg issues. Being a retired engineer he got it and inserted a heel lift under the right as leg recommended. Muscle tone in his left leg rapidly returned to normal. Gait, balance, function and vitality continued to improve over a two year period. Where he had stopped climbing ladders at age 60 due to poor balance, he now walks about on the cambered tiled roof of his house with leaf blower in hand cleaning the gutters.
Recovery can be accelerated with rehab exercise. More acute cases may require additional phases of treatment to address effects from the Second Cardinal Sign and SIJ injury. Massage and other physical therapies plus TCM herbal and acupuncture treatment can be helpful. However, without addressing the leg length discrepancy, many undergo vast amounts of therapy over long periods of time and never achieve more than limited temporary relief for their condition.