Leg Length Discrepancy and Short Right Leg Syndrome
in the context of Remedial Therapy
Catalogue of Energetic/Qi Blocks Sighted in Practice
In practice as a Remedial Therapist employing a fusion of Eastern philosophy and Western science, the following energetic/Qi blocks impacting both mobility and internal health are encountered. First told about the underlying concept 40yrs ago. First sighted/recognised/successfuly treated 20yrs ago. Presented in chronological order in which they were observed. This is not a comprehensive list but it does cover the biggies from the perspective of a physical therapist...
a. Proximal block at shoulder and chest/torso due to soft tissue holding patterns deep to the bone having a distal effect on the limb generating thickening and tightening through forearm flexors/extensors resulting in Medial and/or Lateral Epicondylitis/Repetitive Strain Injury and Carpal Tunnel symptoms. The strain from repetitive work, emotional stress, diet and weather conditions impacting internal health and insufficient rehabilitative exercise and movement contributes. Full ROM and flexibility at the shoulder and torso is preventative…playing on the monkey is bars therapeutic. I would not normally see swimmers with these conditions. The Remedial treatment I administer targeting shoulder and torso typically resolves these issues in one to three treatment sessions.
b. Left Sided Mechanism of SRLS - Proximal block at the Sacro-Illiac Joint due to postural strain caused by chronic rotation of the hip in the Sagittal plane. Generating a thickening and tightening down the backline of the left lower limb from Gluteal musculature to the Plantar Fascia. Under loading and strain this can escalate to acute pain, dysfunction and injury at any point along the line which can be rapidly resolved by rectifying the postural anomaly at the hip.
Note: This energetic effect was observed long before I was aware SRLS was the primary underlying cause for the left sided hip rotation…as a result, treatment was not always totally effective. Without insertion of a heel lift under the short leg, the hip would continue to default to the anteriorly rotated position. This was a mystery to me until the genetically dominant trait of a short right leg was brought to my attention.
c. Emotional impact on the Heart. The Heart is about joy and happiness. Sadness, blocks heart energy/Qi flow through the left side of the chest, shoulder, neck and left side of the head/cranium. I am not necessarily talking about pathological depression, simply the ups and downs of the daily human condition has this effect. Of course, a traumatised individual will be exhibiting heightened symptoms. Virtually everyone I place my hands on is affected to some degree by this condition. It is a part of the story of all left shoulder issues. The left shoulder being more difficult to release than the right shoulder despite not being the dominant, more heavily used arm. Initially causing thickening and tightening in Pec Maj, Pec Min, and the Scalenes on the left side and, in time, moving up the chain to the Cranium. The amplitude of the Cranial Rhythm on the left side is often a quarter or a half of that on the right.
d. In TCM philosophy, each organ is related to and can affect a particular body tissue...the lungs are associated with the skin, kidneys...bone and major joints like knees and shoulders, for stomach it is muscles, and the Liver has a direct effect on tendons. In response to Liver fire a gristle like quality and tightness develops through the tendons, down to the bone. Musculature when palpated has a steel cable like quality. It can escalate to acute long term pain non-responsive to massage, stretching and joint manipulation. Responsive topically to Gua Sha (minutes), TCM internal health herbal remedy (weeks) and dietary change to detox liver/digestion (months). Most noticeable in the upperback and shoulders.
e. Right Sided Mechanism of SRLS - Proximal block at the Sacro-Illiac Joint due to dysfunction from Lumbro-Sacral injury and rigidity through the Pelvis due to gait and scoliosis strains caused by a short right leg. Generating a thickening and tightening down the backline of the right lower limb from Gluteal musculature to the Plantar Fascia. Having a similar effect to that described above by the Left Sided Mechanism. Note this right sided condition is less common than the Left Sided Mechanism yet it is more concerning as integrity of the spine may be compromised.
f. Pelvic block caused by structural leg length difference having a distal effect on mobility and health of lower limbs through a deadening of the vitality/life forces in the limb generally leading to poor wound healing, skin infection, reduced joint mobility, increased joint pain and meridian pain. An overall thickening and tightening of the tissue of the limb frequently interpreted as inflammation…and there will be a component of this manifesting as fluid retention in feet and ankles…it’s a kidney thing… but, in fact, it is also attributed to the effect of reduced energetic flow on connective tissue. These are acute stage cases are not sighted frequently in my practice. I am guessing that should I visit retirement homes I would see much more of it.
In my limited experience I have seen four cases of this effect on the right leg and one where both legs were equally affected. This latter case has both a high range leg length discrepancy (~20mm) and suffered two catastrophic lumbar disk injuries which required surgery. We will never know if heel lift treatment realigning lumbar vertebrae would have obviated the need for surgery…his medical practitioners did not assess for leg length discrepancy…he had not been told he has a short right leg.
g. Pelvic and Lumbro-Sacral block from soft tissue strain blocking energetic flow through the spine upwards through the Thoracic and Cervical vertebrae restricting mobility particularly in the Transverse plane.
h. Pelvic and Lumbro-Sacral block having a negative effect on internal digestive and reproductive organs impacting metabolism and vitality. Many cases treated for leg length discrepancy with a small adjusting heel lift under their short leg report a coincidental beneficial side effect of improved digestion in the following weeks or months.
i. Tightness and rigidity in the right QL’s and hip from the Second Cardinal Sign of SRLS strangling the Bladder Meridian. In the short term, acute stages causing meridian pain in the right lower limb through hamstring, calf and lateral aspect of the heel. This tracks along the path of the Bladder Meridian in the right leg. Consequent effect on the Biceps Femoris tendon insertion behind the knee is a focal point. causing pain, restricted flexion and inflammation of the joint. This can lead to Baker's Cyst behind the knee. In the longer term, sub-acute and acute stages energetically weakens the right kidney. The concern here being the impact on health and vitality, reducing strength and endurance, ultimately reducing life expectancy left untreated. There are a raft of symptoms a TCM practitioner considers indicating energetic imbalance/deficiency present in the kidneys long before kidney disease will be evident by blood testing by a Medical Doctor.
Due to the fact heel lift treatment has not and will not ever totally correct postural asymmetry from the leg length discrepancy and pelvic tilt, it is likely ongoing treatment for releasing rigidity at the right hip will be necessary as SRLS gait issues from the short leg are entirely eliminated. This physical contribution to kidney health is overlooked by TCM practitioners whose acupuncture and internal herbal treatments are beneficial but not totally effective because they do not address the underlying Pelvic Block from structural leg length discrepancy. See Notes: Case 4, Part 10 and 12.
Left sided Bladder meridian blockage at the hip similar to the right sided presentation described is possible...particularly in the rare instance of a short left leg. However, I have not sighted a case.
j. Energetic Qi flow blockage in central Du and Ren meridians contributing to enlarged prostate impinging the urethra experienced by men typically from their 50's and 60's. Thickening and tightening through the connective tissue of the gland occurs due to effect from the Pelvic Block. Treatment for Short Right Leg Syndrome reinstated full urine flow in my case. See Notes: Case 4, Part 11.