There is confusion amongst many therapists between Functional short leg syndrome, which is correctable with stretching and therapy, and a possible underlying structural issue, Anatomic Short Leg.
Both syndromes often lead to postural compensation higher up in the body. Over time, decades with some clients, this process gets camouflaged and embedded.
Care must be taken during the therapeutic de-compensation process to balance the issues of symptoms (aggravation can occur) with symmetry and mobility .
Anatomic Short Leg
This is a controversial topic. Many studies investigating leg length exist, the key implication being a 300% discrepancy between ‘health population’ subjects; and ‘normal subjects’.
Between 20% and 25% of ‘normal subjects’ have an anatomic leg length discrepancy.
Between 65% and 75% of ‘health population’ subjects have one leg anatomically shorter.
As our clients constitute this health population, the implication is that at least two-thirds of our clients will have an anatomic short leg.
If one leg is actually shorter, typically by 4-10mm, no amount of stretching, massage, manipulation, postural and gait awareness or strengthening will make it grow in an adult.
Why this fact, and its implications for health and therapy, is not better known is bizarre. The teaching of ‘abnormal’ (imperfect, un-idealised) anatomy is complex, and therapy texts have not successfully bridged the gap between theory (normative anatomy) and practice (the variations we see with clients daily).
Short Right Leg
A startling and significant clinical finding, first observed and understood by this author in 1987, is that almost every case involves only the right leg being short.
Anatomic short left leg has been noted in some subjects but is rarely observed. This peculiarity is unsupported by currently available information and is the subject on ongoing research.
While not all clients will benefit from a corrective heel lift (or orthotics of different heights), some cases result in permanent significant improvement where the adverse effects of this syndrome are neutralised. Relevant client statements will be added to our Testimonials post over time.
Gordon Zink’s ‘Common Compensatory Effect’ describes postural compensation as a rotating tendency linked to the coriolis effect, the fact that the earth spins and creates rotational forces.
Another factor, gestational posture, was considered as a cause of congenital (but not genetic) postural and tissue-tension distortion. Babies, children and adults have bodies that in real life are unlike the symmetrical, proportioned figures in anatomy or therapy texts.
In 2008 a web search uncovered the fact that Erik Dalton had written on this topic a few years earlier, the only other author investigating short right leg and published as at 2013.
This therapy observation is supported by other descriptions of the human body, such as is found in figurative art and sculpture. Michalangelo’s famous sculpture David displays the classic contraposto stance of many people with short leg syndrome.
Scoliosis Capitus and Short Right Leg
A variable consequence of postural compensation, further up the body, is cranial assymetry, called Scoliosis Capitus by Viola Frymann.
The observation of this author is that most cases of Scoliosis Capitus involve the sphenoid bone displaying a displacement to the right, the same side as the short leg in most cases.
A separate Scoliosis Capitus post is being developed.
This post will develop over time, please visit again later. Future therapy topics will include assessment methods, heel lifts and the timing of therapy.
Implications for anatomy, physical education and public health, plus links to research will also be explored.