Top 100 Biomechanical Guidelines #26: Know Gait Findings for Short Leg Syndrome

When evaluating gait and looking for signs of a possible leg length discrepancy, look for these findings:

1. Asymmetry Rules
2. Leg Dominance
3. Uneven Pronation
4. Unequal Arm Swing

In the short video above, look again for these signs. Liz has the following gait changes:

• Head Tilt to the left
• Shoulder Drop to the left
• Dominance to the left (marked left shift in body mass)
• Right arm held out to the side (an attempt at balancing weight)
• Increase arm swing on the left matching the increased pronation on the right side (the right lower extremity matches the left upper extremity

These gait findings do not actually tell us what side is the longer side, in fact they are contradictory if we just use generalizations. Generalization #1 tells us that 80% of the time adults are dominant to their longer side. Generalization #2 tells us that increased pronation is on the longer side. Since, these contradict each other, we must measure, but the exam hopefully would have screamed at us to check for short leg syndrome.