Leg Length Discrepancy and Short Right Leg Syndrome
in the context of Remedial Therapy
Common Presentations of Short Right Leg Syndrome
The following diagrams represent the vast majority of presentations of SRLS in my clinical practice.
Common to each are:
Structurally Short Right Leg
Ankles aligned in Supine
Right leaning Pelvic Tilt
Anterior Rotation of the Left Hip and Right Hip Level
Tightly bound Left SIJ
Rigidity at Right Hip
Mild Scoliosis
Of course, exception cases not depicted are sighted. While bilateral presentation of prominent Left and Right Lower Limb Mechanisms are not common, a mix of Left and Right sub-acute symptoms are sighted. Another variation not depicted here are where injury at shoulder and neck opposite to the side of convexity present overwhelming symptomatic effects. The same will be occasionally sighted at the Lumbar spine where in lieu of prominent tenderness and tightness at the Right QL's, it will be a Left sided Lumbar presentation. Hip rotation exceptions include both hips being level leading to greater right leaning pelvic tilt and greater symptomatic effects from the Short Right Leg. Where the Lower Limb Mechanism has escalated to acute levels, Ankle alignment in supine will not be level and will be superior on the symptomatic side. This is not common.
Most common or classic presentation of SRLS
Structurally Short Right Leg
Ankles aligned in Supine
Right leaning Pelvic Tilt
Anterior Rotation of the Left Hip and Right Hip Level
Tightly bound Left SIJ
Rigidity at Right Hip
Mild Scoliosis with Right Convexity through the Thoracic
Prominent Left Lower Limb Mechanism
Right QL's Tender and Tight
Mild Scoliosis with Right Convexity through Lumbar and Thoracic Spine
Right Vertebral Extensors in Middle and Lower Thoracic more heavily developed and tight.
Tightness and dysfunction through Upper Right Quadrant of back through anchoring musculature of the Right Scapula, Levature Scapula and the Upper Trapezius into the Right Occipitals.
Elevated Right Shoulder
Second Presentation
Structurally Short Right Leg
Ankles aligned in Supine
Right leaning Pelvic Tilt
Anterior Rotation of the Left Hip and Right Hip Level
Tightly bound Left SIJ
Rigidity at Right Hip
Mild Scoliosis with Right Convexity through the Thoracic
Prominent Right Lower Limb Mechanism
Right QL's Tender and Tight
Mild Scoliosis with Right Convexity through Lumbar and Thoracic Spine
Right Vertebral Extensors in Middle and Lower Thoracic more heavily developed and tight.
Tightness and dysfunction through Upper Right Quadrant of back and anchoring musculature of the Right Scapula, Levatur Scapula and the Upper Trapezius into the Right Occipitals.
Elevated Right Shoulder
Third Presentation
Structurally Short Right Leg
Ankles aligned in Supine
Right leaning Pelvic Tilt
Anterior Rotation of the Left Hip and Right Hip Level
Tightly bound Left SIJ
Rigidity at Right Hip
Mild Scoliosis with Left Convexity through the Thoracic
Prominent Left Lower Limb Mechanism
Right QL's Tender and Tight
Mild Scoliosis with Right Convexity through Lumbar and Left Convexity through Thoracic Spine
Left Vertebral Extensors in Middle and Lower Thoracic more heavily developed and tight.
Tightness and dysfunction through Upper Left Quadrant of back through anchoring musculature of the Left Scapula, Levatur Scapula and the Upper Trapezius into the neck.
Elevated Left Shoulder
Fourth Presentation
Structurally Short Right Leg
Ankles aligned in Supine
Right leaning Pelvic Tilt
Anterior Rotation of the Left Hip and Right Hip Level
Tightly bound Left SIJ
Rigidity at Right Hip
Mild Scoliosis with Left Convexity through the Thoracic
Prominent Right Lower Limb Mechanism
Right QL's Tender and Tight
Mild Scoliosis with Right Convexity through Lumbar and Left Convexity through Thoracic Spine
Left Vertebral Extensors in Middle and Lower Thoracic more heavily developed and tight.
Tightness and dysfunction through Upper Left Quadrant of back through anchoring musculature of the Left Scapula, Levatur Scapula and the Upper Trapezius into the Left Occipitals.
Elevated Left Shoulder
Fifth Presentation
This is an actual case depicting the absence of the First Cardinal Sign of SRLS of anterior rotation of the left hip. It is a high range case with approximately a 20mm structural leg length discrepancy. While not common, these cases are sighted often enough that it must not be assumed leg lengths are equal where hips are evenly aligned. Full leg length assessment should be completed because in the majority of such cases it does reveal a leg length discrepancy is present.
Anterior rotation of the left hip is an unconscious anatomical adjustment functionally pulling up the longer leg, reducing pelvic tilt, making us feel more comfortable and protecting the spine to some degree. In its absence, a greater right leaning pelvic tilt and greater symptomatic effects are observed.
The Right Lower Limb Mechanism is very prominant, constant low back pain and strong thickening and tightening through the backline of the right lower limb generating Plantar Fasciitis in the right foot. Working up the spine and into the upper right quadrant of the back, energetic blockage through torso and shoulder was contributing to thickening and tightening through the forearm flexors sufficient to generate Carpal Tunnel symptoms in the right hand.
