DO YOU HAVE A SHORT LEG?

Maybe you have a short leg but perhaps, it just appears that way. Certain patients who have repetitive back pain present with what appears to be a short leg. When the patient is lying flat on their back, we can visually inspect the leg lengths and determine that one leg is shorter than the other. Another way is to inspect the hips when the patient it standing and determine that one hip is higher than the other.

But is  one leg really shorter that the other, that is, anatomically shorter than it’s opposite? The answer to this question is not always straight forward. The definitive answer would come from a proper x-ray study but that avenue is not always a practical solution – it takes money, resources and time.

A PRAGMATIC SOLUTION

This how I usually deal with the issue. Simply stated, a short leg can be either anatomical, a structural leg length discrepancy or A functional leg length discrepancy caused by misalignments of joints, by shortened muscles etc. or it may be caused by a scoliosis (curvature of the spine) which is usually a congenital problem. A functional problem, may be possible to correct by lengthening shortened muscles and realigning joints. When a patient presents with lower back pain or neck pain and after taking a proper history and doing all the biomechanical testing, if a short leg is suspected, I usually recommend 2 to 4 treatments to see if we can correct the problem, if we can, then so much the better. If not, we usually are able to reduce the severity of the problem because, even an anatomically shorter leg will over time exaggerate itself as muscle groups become shorter and as the adaptive response of the whole body continuously responds to the problem it usually making the problem worse over time.

After a course of several treatments, if the remaining difference in leg length is minimal and the patient is symptom free, we leave it at that preferring to adhere to the philosophy, ‘If it ain’t broke, then don’t fix it.’ If the patient’s symptoms resolve and don’t return, I would generally let things be. If they return and this reflexts a longstanding history of repetitive chronic pain, I would recommend orthotics to resolve the problem. In the case of a scoliosis, we would treat osteopathically with the intention of re-aligning the body as much as possible with the goal of mitigating the problem with regular preventive treatments several times per year.

A BRIEF WARNING ABOUT ORTHOTICS

Take note that if your osteopath or other health care professional recommends getting an orthotic, it should be done by a professional. A reputable podiatrist will create two custom made orthotics one for each foot and never use something off the shelf. If for example, your left leg is 6mm shorter than the right leg, then the Podiatrist should correct for 3mm at first and give you a number of weeks to adapt to this change. If symptoms persist then another 1.5mm will be added. This process will go one until symptoms resolve. The final correction may not end up being a full 6mm but something less. A Podiatrist who proceeds in the above manner is working in a professional manner and in your best interests.

Eddy Basch, Osteopath D.O.