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LEG LENGTH
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LEG LENGTH - April 21, 2005 6:12:00 PM
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AllAboutMovement
Posts: 17
Joined: April 20, 2005
From: Boca Raton, Fl
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I'm very interested in hearing different thought processes when dealing with a leg length discrepancy. i.e- tests, palpation techniques, xrays, etc.?
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David Westerman, NSCA-CSCS,FES, LMT
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Re: LEG LENGTH - April 22, 2005 2:37:00 AM
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dosrinc
Posts: 335
Joined: December 9, 2004
From: Bonita Springs
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I would suggest finding a certified manual physical therapist in your patients area and making the appropriate referral. Good Luck!
Rick
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Re: LEG LENGTH - April 22, 2005 3:15:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
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David-
You can find a PT in you local area by using the American Physical Therapy Association's free service "Find A PT".
Go to [URL=http://www.apta.org/consumer/findapt]www.apta.org/consumer/findapt[/URL]
In general leg length discrepancies are mostly benign and have very little to do with any symptomatology that patients may develop. It is a useful thing to check in some patients with some problems, but be careful not to over-emphasize it's importance.
Use the service, or you can also post on the NSCA's web forums, myself and other PTs post there as well.
Good luck.
Jason.
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: LEG LENGTH - April 22, 2005 8:51:00 AM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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Just my two cents,
I usually encounter functional leg-length discrepancies much more often than true structural ones. I just address the underlying muscle imbalances, do some muscle energy if indicated, and strength the core. That seems to do the trick.
Sarah
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Re: LEG LENGTH - April 26, 2005 11:57:00 AM
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certMDT
Posts: 154
Joined: April 5, 2004
From: Durham, NC
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There was an extensive article on this topic in JOSPT about two years ago. I can't find the reference at the moment, but I remember it being a very thorough article.
Charlie
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Charles Sheets PT OCS Dip MDT
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Re: LEG LENGTH - April 26, 2005 3:14:00 PM
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jma
Posts: 2414
Joined: August 24, 2000
From: NY
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Hello,
I think this was the article in question. Here is the info on it:
"JOSPT May 2003 Vol.33 No.5
Limb Length Inequality: Clinical Implications for Assessment and Intervention
Rebecca J. Brady, PT, Physical Therapist, HealthCare Partners Medical Group, Torrance, CA
John B. Dean, PT, ATC, Athletic Trainer, Physical Therapist, University of Southern California, Los Angeles, CA
T. Marc Skinner, PT, ATC, Physical Therapist, Athletic Trainer, Meadowview Regional Medical Center, Maysville, KY
Michael T. Gross, PT, PhD, Professor, Division of Physical Therapy, Program in Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
The purpose of this paper is to review relevant literature concerning limb length inequalities in adults and to make recommendations for assessment and intervention based on the literature and our own clinical experience. Literature searches were conducted in the MEDLINE, PubMed, and CINAHL databases. Limb length inequality and common classification criteria are defined and etiological factors are presented. Common methods of detecting limb length inequality include direct (tape measure methods), indirect (pelvic leveling), and radiological techniques. Interventions include shoe inserts or external shoe lift therapy for mild cases. Surgery may be appropriate in severe cases. Little agreement exists regarding the prevalence of limb length inequality, the degree of limb length inequality that is considered clinically significant, and the reliability and validity of assessment methods. Based on correlational studies, the relationship between limb length inequality and orthopaedic pathologies is questionable. Stronger support for the link between low back pain (LBP) and limb length inequality is provided by intervention studies. Methods involving palpation of pelvic landmarks with block correction have the most support for clinical assessment of limb length inequality. Standing radiographs are suggested when clinical assessment methods are unsatisfactory. Clinicians should exercise caution when undertaking intervention strategies for limb length inequality of less than 5 mm when limb length inequality has been identified with clinical techniques. Recommendations are provided regarding intervention strategies.
J Orthop Sports Phys Ther. 2003;33(5):221-234."
JMA
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