Determining Size of Heel Lift Adjustment

 

There is no formula for determining the size of heel lift adjustment...it is not a function of leg length discrepancy...it is more a matter of what adjustment the body will accept. Typically it is between 3mm and 5mm in the initial transition phase of commencing heel lift treatment. Following initial transition, once pelvic distortion and strain has been reduced, it is possible to trial taller heel lift adjustment to further improve outcomes.

 

Initially, two vastly different cases can have the same adjusting heel lift. ​ There is no expectation the body's asymmetry caused by a structural leg length discrepancy will realign into perfect symmetry from the treatment of Short Right Leg Syndrome. Bones and joints have been permanently changed from decades under the influence of gravity as we go about our lives. The pelvis is tilted and mild scoliosis of the spine has distorted the shape of the vertebrae. When placing an adjusting heel lift under the short leg, we are only trying to incrementally back off stress and strain on the soft tissue sufficiently to release tightness and allow energetic Qi flow to resume. To go further over compensates, causing pain and injury.

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I do not measure structural leg length to the accuracy of a tenth of a millimetre or even a millimetre for that matter. It is not necessary to precisely what the leg length discrepancy is in order to determine the magnitude of the adjustment. Examining for the Signature Traits and Cardinal Signs indicates a discrepancy exists. A comparative assessment of the limbs verifies the bones of one leg are longer than the other. We are able to estimate whether it is low, medium or high range case...5mm, 10mm or 15mm and greater. Considered in conjunction with the symptomatic nature of the condition, guides fitting of the heel lift. Can the subject feel the thinner heel lift pushing their hip up? If so, go with that one before progressing to anything thicker. It comes down to trial and error to determine how the subject's body responds to adjustment.

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Should uncomfortable niggles or low back pain occur, heel lift thickness should be reduced. If the unwanted symptoms persist, it should be removed altogether. This will generally be apparent soon after commencing use (hours/days). A negative outcome is uncommon.

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Longer term monitoring is necessary. In addition to an adjusting heel lift, rehab exercises may be prescribed. Where the adjusting heel lift is too thin, the body may not respond despite the exercise. I am not really sure if this is the true nature or they are just not really doing their rehab exercises. In any event, a 3mm heel lift may have little effect in some cases. After two to four weeks with no improvement, progressing to a larger 5mm heel lift can see major change occur in one week. Apart from reduced discomfort and pain, and increased mobility, a key indicator is the First Cardinal sign of anterior rotation of the left hip begins to normalise.

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Once the initial phase of heel lift treatment has played out and the pelvic posture has begun to normalise, with distortion and strain reduced, it may be possible to increase heel lift thickness and achieve a better outcome. My experience is limited largely to my own case but there are a few regular clients whose treatment we are now reviewing. Unfortunately, the bulk of clients once resolving their immediate symptomatic effects do not revisit to monitor progress.

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At the two and a half year mark from commencing my own heel lift treatment, I suffered a knee injury preventing full extension of the left knee for several weeks. In effect, giving a virtual heel lift of increased size. The outcome was remarkable. I am hobbling about needing a cane to help me walk and my schedule gets fully booked for the week. It's like, OMG...how am I going to manage this!?!? The limited knee extension on the left side further reducing distortion and strain through the pelvis, enhancing energetic Qi flow through the fourteen acupuncture meridians and organ channels. My vitality elevated to a level I had not experienced in many years. I managed the increased workload with ease. Once the knee recovered, I began the process of trialling an increased heel lift size.

 

My structural leg length discrepancy is 21mm (+/-2mm). Initial heel lift treatment was restricted to 5mm. Early attempts to use a larger adjustment than this failed. Now trialling a 7mm heel lift there was no noticeable change. Throwing caution to the wind, I increased the size to 10mm. I felt like a pirate on a peg leg for a couple weeks. Hip alignment has improved. Choke points to the Bladder meridian at right hip and Biceps Femoris insertion to the Fibula has improved. That is, tightness and pain at the choke points has lessened. Restriction to ROM at the right knee has lessened slightly. Kidney function and vitality has improved.