One of the most common things that Chiropractors assess are leg length inequalities. The reason why this assessment is so important is because leg length inequalities actually impact the entire body. There are two forms of leg length inequalities:
1. Anatomical leg length inequality
This less common form of leg length inequality is purely due to a structurally shorter leg – where there is an actual difference in bone length. This type normally occurs as a result of a congenital abnormality (being born with it) or due to growing irregularities during adolescence. In saying this, it may also be caused by past physical trauma or surgery.
2. Functional leg length discrepancy
This form of leg length inequality more prominently affects the larger population. It occurs due to compensatory biomechanical changes throughout the spine, in which a lateral pelvic tilt draws up one leg – creating the inequality. The discrepancy between leg lengths can range between 5mm to 30mm.
Unfortunately, many people are unaware about leg length inequalities as it is difficult to assess yourself for these subtle discrepancies. Some common signs and symptoms of a leg length inequalities may include poor posture
, lower back pain
, pain in lower limbs, balance issues, walking with a limp (minor or major), uneven shoulder heights, upper body or a head tilt.
What causes functional leg length inequality?
Quite simply, as with any spinal dysfunction (Chiropractic subluxation), a functional leg length inequality that is associated with a lateral pelvic tilt occurs as a compensatory biomechanical change in response to physical, chemical and/or emotional stresses
. In regards to physical stresses, lateral pelvic tilts may occur due to things such as major or minor trauma, fatigue or poor postural habits.
What are the effects of leg length discrepancy?
The reason leg length inequality is a problem is because of its cascading effects on the entire body. Firstly, a leg length inequality means there is an unlevelled foundation for the rest of the spine and upper body. As a result, there are compensatory distortion patterns that are adopted by our musculoskeletal system.
Skeletally, this involves spinal dysfunctions that cause things such as shoulder and head tilts. Muscularly, this involves muscle imbalances as certain muscles are switched on and are tighter, as others are switched off and weaker. Ligaments throughout the body are also affected – either becoming more taut or lax. It is essential to understand that these distortion patterns also a have significant impact on our nervous system – which is responsible for absolutely everything we feel or control consciously or unconsciously.
Together, this limits our mobility, flexibility and functionality. From more of a mechanical perspective, it causes uneven weight distribution, unhealthy strains on our body, and adds to poor posture. This is a problem because our body has been designed to bear weight evenly. Therefore, over time, uneven weight distribution through our body due to an unresolved leg length inequality (lateral pelvic tilt) increases the rate of wear and tear throughout our body – especially on the side with additional weight. Additionally, the resulting muscle imbalances and ligament changes increase the likelihood of injuries.
A good comparison to highlight the importance of addressing leg length inequality (lateral pelvic tilt) would be thinking about the importance of wheel alignment on your car. Wheel misalignments can cause the tread on your tyres to wear down faster and more unevenly. To add, the wheel misalignment impacts the efficiency of the drive, which means your engine will then need to work harder. On the other hand, maintaining proper wheel alignment extends the longevity of your tyres and to some degree can increase the efficiency of the drive.
Similarly, spinal misalignments – including a leg length inequality – can increase the rate of wear and tear on one side of your body, whereas, addressing your spinal misalignments can ensure an even distribution of weight through your body to extend the longevity of your body and optimise your function.
Keep in mind, that unlike your tyres which can be replaced once completely worn out, a lot of our body parts cannot be replaced as easily, which is why it’s so important to prioritise the maintenance of your musculoskeletal system.
Another great comparison would be recognising the importance of a level foundation for your house. An unlevelled foundation can cause issues throughout your house such as cracks in the walls, creaky floors and doors that get jammed. Fixing any of these issues in isolation would only be a short-term solution as the underlying cause of all the issues has not been addressed. Additionally, in a natural disaster, the house with an unlevelled foundation is more likely to be affected negatively than a house with a stable, level foundation.
Comparably, an unlevelled pelvis associated with a leg length inequality causes issues throughout the body due to the negative impacts on the musculoskeletal
and nervous system
. Without addressing the potential underlying cause, the broad range of symptoms that can be experienced may not be alleviated. In addition, individuals with an unlevelled pelvis associated with a leg length inequality may be more prone to injuries in response to environmental stressors.
How can Chiropractic care help with length inequality?
While medications, massage and other treatments may reduce the symptoms caused by leg length inequalities, they don’t address the underlying cause. If you have a leg length inequality, your Chiropractor may begin by determining whether it is anatomical or functional. If it is anatomical, your Chiropractor may recommend orthotics heel lifts to balance the pelvis or may even decide to co-manage with a podiatrist.
In the more common scenario of a functional leg length inequality, there are a range of modalities your Chiropractor can utilise. Your treatment plan may include specific spinal manipulations to realign your spinal joints, restoring even weight distribution and optimal function of your musculoskeletal and nervous system. Other techniques may also include soft tissue therapy to address more prominent muscle imbalances or rehabilitation exercises and retrain your muscles.
Article written by Dr. Dymal Champaneri (Chiropractor)