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Tuesday, November 16, 2010

Top 100 Biomechanical Guidelines #22: Evaluate Leg Length Differences with Standing Palpation or Standing AP Pelvic Xrays

You can see from the standing AP Pelvic Xrays that left side is higher (side marked with the label upright). The patients are told to stand with feet in a normal position, knees straight, and back as straight as possible. Dare the xray to capture anything but perfect posture. From this one xray, you can see hip heights, pelvic heights/asymmetries, and sacral base unleveling (base of the spine). Here the right leg at the hip heights is shorter, the sacral base leans to the right, and the top of the pelvic is lower on the right. With this pattern, I feel confident to begin lift therapy on the right side. Since corrective orthotic devices are being used, and since one side pronates more than the other, I feel comfortable taking these xrays with shoes and orthotic devices in place.

Some key points to bring out at this point are:
  1. Tape measurements have so many built-in errors that they are not considered credible.
  2. Chiropractors have a totally different reference point (non weight bearing) and 95% of the time feel that the opposite side is short. So, if you use standing based measurements/xrays and feel that the right is short, chiropractors will feel that the left is short. There reference point  is not the ground.
  3. You could try the Magazine test demonstrated in the video below.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.