Leg length discrepancy: not always implicate a shorter leg!
Numerous articles and comments have been written on leg length discrepancy (LLD). How to measure it, how to test it, how to treat it.
I have often been consulted by patients who, according to their physician or therapist, should have a leg length discrepancy. Which was not seen before or even ignored. The majority had no medical history of broken legs or complicated fractures. Testing them both laying and standing I measured indeed this LLD.
Seeing back many of them the before measured length not only seemed to be changed, but also the leg itself! At that time we made so-called podograms on which you could see the pressure of the feet. Today this registration is all ict.
These length changes were so frequent that there must be a pattern. As manual therapist and posturologist I am used to think 3 D (threedimensional).
In many cases I then noticed a pelvis rotation around the longitudinal body axis. I asked the laying patient to bend both knees, resting the feet, leaving the knees free to move. Almost always one or both knees moved to one side. A lumbar support under the loins towards the pelvis was rotating, made, nine out of ten times, makes the LLD disappear. In my experience this was not a ‘real’ LLD but a ‘physiological’. Many professionals, for instance hairdressers, stand their whole working life most on one leg. The muscles of the foot/leg/hip at that side contract and a ‘created LLD’ is born! Do not start to treat this as a shorter leg by means of heel orthotics because the pelvis will rotate even more!! the pelvis has to be corrected by a contra-rotation.