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  • Dr. Brandon J. Van Seters, DC

Have you ever been told you have a short or long leg?



What is it?


A true anatomical short leg is very rare. It can only be caused by a few things like breaking a bone in your leg exactly at the growth plate or other extraordinarily rare anomalies. In the vast majority of cases it is a 'functional short leg'. Functional short legs are the result of compensatory mechanisms elsewhere in the body most common in the spine and hips.


In the scientific literature having a short leg or one longer than the other is referred to as a 'leg length inequality' or 'leg length discrepancy'. Leg length discrepancy has been strongly associated with back pain, lower extremity pain, osteoarthritis, and degenerative conditions.


Research


* A study in 2005 found that out of 573 subjects in the general public 90% had a 1mm or more leg length discrepancy.


* Another study from 2005 looked at 81 patients about to do a total hip arthroplasty found they had an average of 7.5mm or just over a 1/4 inch leg length discrepancy. What was also interesting was that 84% of them were getting the hip arthroplasty on the LONGER leg.


*A 2010 study of 2964 patients found that knee osteoarthritis was 2x worse in the short leg side.


* A 2017 study found that 70% of knee replacement patients had a leg length discrepancy of greater than 5mm versus only 5% of knee replacement patients that had no leg length discrepancy.


* Another 2017 found a statistically significant correlation between leg length inequality and hip and lumbar spine degeneration.



How do you get a leg length discrepancy?


Accidents or injuries damage the ligaments and tendons that hold the spine in its postural equilibrium. This causes the muscles to reflexively contract in a compensatory attempt to maintain postural equilibrium. This reflexive muscle contraction causes imbalances within the muscles of the spine pulling up on one leg appearing shorter.


What can Gravity Spinal and NUCCA Care do to help?


We check the area of the spine most vulnerable to damage from an accident or injury. This area is known as the upper cervical spine or craniocervical junction at the junction between the head and neck.If there is a misalignment in this area, correcting it through the NUCCA protocol returns the spine back to equilibrium. Leg length is checked at the beginning of every visit to determine if a NUCCA correction is needed.





1. Brady RJ, Dean JB, Skinner TM, et al. Limb length inequality: clinical implications for assessment and intervention. J Orthop Sports Phys Ther. 2003;33:221–234.

2. Gurney B. Leg length discrepancy. Gait Posture. 2002;15:195–206

3. Harvey WF, Yang M, Cooke TD, et al. Association of leg-length inequality with knee osteoarthritis: a cohort study. Ann Intern Med. 2010;152:287–295

4. Knutson GA. Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance. Chiropr Osteopat. 2005;13:11

5. Murray KJ, Molyneux T, Le Grande MR, et al. Association of mildleg length discrepancyand degenerative changes in the hip joint and lumbar spine. J Manipulative Physiol Ther. 2017;40:320–329.

6. O’Toole GC, Makwana NK, Lunn J, et al. The effect of leg length discrepancy on foot loading patterns and contact times. Foot Ankle Int. 2003;24:256–259.

7. ten Brinke A, van der Aa HE, van der Palen J, et al. Is leg length discrepancy associated with the side of radiating pain in patients with a lumbar herniated disc? Spine (Phila Pa 1976). 1999;24:684–686.

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