Featuring Debra Treloar, BSR, FCAMPT - Treloar Physiotherapy, Vancouver BC
Leg length discrepancies are a situation where people have different lengths in legs, or apparent different lengths in legs. There's two different types - apparent and true leg length discrepancies. So, an apparent leg length discrepancy is where you might have a muscle imbalance that's causing the leg length discrepancy, or possibly joint restrictions, or joint hypermobility that will cause it. With a true leg length difference, there will be actual difference in the length of the bones in the pelvis, in the thigh, or possibly in the lower leg. You can pick that up through an x ray, and they actually measure the bones on the X ray, on the radiograph. They'll take a measurement tool and measure those, and then that's the only way that you can really tell that you have a true leg lengths difference.
Various times in people's lives, as kids grow, you'll often see a bit of a leg length difference. We don't really know if that predisposes them to having a leg length for the rest of their life. Often, I think the body will respond to that, and growth will be slightly different to catch up, and the pelvis stays level eventually with them.
As an adult, you're looking at with the apparent leg length discrepancies, you can do a lot of things to start to change them. We can do some muscle balancing techniques, we can use joint mobilizations. We can look for stability where there's hypermobility, and in treating some of these conditions, then we start to get a level pelvis and what was apparently a leg length difference is no longer a leg length difference.
Physiotherapists have clinical tests that they can use to determine whether or not you have an apparent leg length difference or a true leg length difference. The big thing that we look for in that is that lots of the activities of daily living that we do are very repetitive. So, for a lot of people, they sit in their job, they come home, they sit to watch TV, they sit to read. So, they do a lot of sitting during the day, and that starts to get muscle imbalances. Hip flexors, for example, become short because you're always at 90 degrees in the hip, so you go to stand up, and you actually can't get length in the hip flexors in order to stand up over top of your feet. That's just one example, but that happens throughout the body, just from the things that you do repetitively.
We have certain muscles that tend to get tight and tend to get weak, so we look for those patterns. So we might give you some exercises to do at home to try to balance that as well as in the clinic. We have treatment techniques that can help with that as well might mobilize joints in order to balance and level the pelvis, but we're working to try to look for that symmetry. And no body is completely symmetrical. So we're looking for efficiency, really, and getting the right muscles working.
If you think you have a leg length difference, consult a physiotherapist to do an assessment for you if you're concerned further about it and think that you have a true leg length difference, see your GP.
Presenter: Debra Treloar, Physiotherapist, Vancouver, BC
Local Practitioners: Physiotherapist
