Keywords and Concepts of Short Right Leg Syndrome

 

Leg length discrepancy; structurally short right leg; Two Signature Traits - elevated left hip and elevated right shoulder; evolutionary adaptation that gave mother and child greater chance of survival in prehistoric times; Three Cardinal Signs - anterior rotation left hip, rigid right hip, and mild scoliosis;

 

Biomechanical Effects Lower Limbs

 

Left Lower Limb Mechanism; right leaning pelvic tilt frontal plane; uncomfortable standing; anterior rotation left hip sagittal plane; unconscious anatomic adjustment functionally shortening longer left leg to reduce pelvic tilt; SIJ tightly bound; spanish windlass effect; left sij dysfunction, pain, injury, instability.

 

Right Lower Limb Mechanism; structurally short right leg; pendulum effect on gait; hesitant right footfall; holding patterns >>> rigidity about right hip and tight adductor magnus; right leaning pelvic tilt; right lumbar convexity >>> mild disk bulging, tight and sensitive right QL.

 

Biomechanical Effects Spine

 

Right leaning pelvic tilt, mild scoliosis; lumbar spine geometrically misaligned; right lumbar convexity; wedge shape disk spacing; encouraging right sided lumbar disk bulge; rarely catastrophic; low back pain; low range cases either left or right thoracic convexity; higher range cases more convincingly encouraged into right thoracic convexity; right thoracic convexity most common overall; side of convexity revealed by bulging rib cage (versus flattened on side of concavity)...more readily palpated then seen; spinal erectors in thoracic more developed and tighter on side of concavity plus frequent musculo-skeletal dysfunction in upper thoracic quadrant on the side of convexity.

 

Energetic Effects

 

Postural distortion through the pelvis straining soft tissue blocks energetic Qi flow; central Du and Ren meridian flow inhibited; lower energetic chakra centres inhibited; kidney, bladder, stomach, spleen, liver and gall bladder organ channels/acupuncture meridians to lower limbs inhibited/blocked; magnitude of energetic effects outweighs biomechanical effects by large margin.

 

First Order Energetic Effects >>> mobility; proximal block having a distal effect; subtle thickening and tightening connective tissue initiated by left or right sided biomechanical mechanisms at hip and lumbro-sacral region; subtle tightening and thickening of connective tissue backline of lower limb; under influence of loading and other factors can escalate to acute meridian pain, plantar fasciitis, compartment syndrome, piriformis syndrome, achilles, calf and hamstring tightness, pain, dysfunction and injury. Similar energetic block, thickening and tightening of connective tissue above the waist reducing spinal mobility, particularly in transverse plane. These effects better evidenced by rapid change of tone and increased ROM on removal of block.

 

Second Order Energetic Effects >>> internal health; impacting digestive, reproductive and kidney function; Second Order Energetic Effects beyond my scope of practice; observed as coincidental beneficial side effects when treating symptoms from First Order Energetic Effects.

 

Pelvic Block and associated symptoms of First And Second Order Energetic Effects can defy all treatment until the pelvic posture is resolved/normalised and energetic Qi flow is promoted; acute long term cases may require supplementary rehab and TCM treatment in addition to mechanical heel lift adjustment. Compounded by lumbro-sacral and pelvic injury.

 

Management and Treatment

 

Maintaining high degree of flexibility through pelvis preventative; normalise hip posture to relieve acute symptoms; rehabilitation; strengthen abs, activate glutes, stretch hip flexors (left), mobilise hip and stretch adductor magnus and QL's (right); where hip rotation is normalised >>> pelvic tilt increases; relieving lower limb symptoms but aggravating upper body symptoms; in the presence of acute symptoms it is almost always like we have to consider heel lift treatment.

 

Heel lift treatment; determining exact leg length discrepancy unnecessary; heel lift adjustment not a function of leg length discrepancy; no formula for determining adjustment amount; adjustment amount is a question of how much adjustment will the body accept; trial and error approach; no expectation to realign structure into perfect symmetry; object is to reduce postural misalignment sufficiently to enable energetic Qi flow to resume; in the presence of 10mm, 15mm, 20mm or length discrepancy, typically between 3mm and 5mm heel lift suffices initially; in the longer term reassessment and consideration to increase adjustment amount once distortion and strain through the pelvis has been reduced.