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Leg Length Discrepancy

Leg Length Discrepancy: Myth or reality?



One of the most frequently cited causes of biomechanical dysfunction is leg length discrepancy (LLD). This is a condition found in more than 33.3% of the population worldwide.

This alleged problem is widely discussed in medical literature and it is re assuring to know that the attitude of the medical profession towards the “shorter leg” has evolved over the years.

After neglecting this diagnosis for years, doctors started to prescribe heel wedges for every case of tilted pelvis, and routinely, their diagnosis rested on the observation of the posterosuperior iliac spine. Although the immediate results were good, in the long term, they were disappointing.

Realizing that something was amiss, orthopedic surgeons will tell you that there is no need to correct a “shorter leg” under 1.5 to 2cm. To think that dentists work on a precision of microns…One would hope, that precision in regards to LLD, is a must!

 

Leg Length Discrepancy Measurement
Disharmonic feet

The first thing to know is that all classical measures are false: pubis to malleoli, greater trochanter to malleoli or iliac crest to malleoli. An articulacy constrain, such as a slight valgus of one foot and a varus on the other foot, will cause one side of the pelvis to rotate forward relative to the opposite side.

To assume that a difference in leg length means that there is an actual difference in the length of the bones (femur and/or tibia) is most of the time a mistake. Most often what we are seeing is an apparent, or functional LLD. This is usually the result of disharmonic feet.

 

Leg Length Discrepancy and X-Rays
The orthogonal projection in X-Rays does not take into consideration the rotary pivot and the heights of the femurs. A simple articulary constraint (asymmetrical feet) can cause an X-Ray to show a difference of several millimeters. Unless you know for certain that the length of one of your legs is different than the other, you should be skeptical of shoe lifts as the first line of treatment for injuries.

 

What should be used?
The most accurate and reliable technique of measure is frontal teleradiography of a subject in the standing position.
The angle between the feet should be of 30 degrees. The angle of the radiography tube should be of 15 degrees. And the patient should not be pressed against the plate.
To be accurate, it should be performed at a distance of 4 meters away from the body by measuring the diaphysis of each bone.
If any doubts remain with respect to possible rotations. The measurements should be from the base of the greater trochanter to the inter-condylicus incisures. Unfortunately, it is rarely done this way.

 

What are the causes of Leg Length Discrepancy ?
Leaving aside genetic and traumatic factors, the two legs should grow symmetrically. To believe that the two legs could grow at different rates would suggest that there is two different types of growth hormones. In fact, asymmetries observed in growth period are linked to postural disequilibrium described in Delpeche’s law: “ Any increased pressure on a limb will slow the growth of that limb” the opposite is also true, “any decrease in pressure will stimulate growth”.

Leg Length Discrepancy and children
In children, most cases of short leg are linked to excessive pressure on the lower limbs caused by a postural disequilibrium. It is important to be aware of your child’s posture habits, as they could be creating an imbalance that will cause them grief in the future. The first thing to do is to reprogram the postural system. By inducing permanent equilibrium, asymmetrical pressure will be reduced. When in doubt, refer to a Posturologist near you.

 

Symptoms of leg length discrepancy:
1) Meniscus ruptures
2) Herniated disk DDD
3) Lower back pain
4) Coxarthrosis (exposure of the femoral head)
7) Hip pain, always on the side of the short leg.

The Posturepro Team
Changing Lives

 


 

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Convergence Insufficiency – Often Misdiagnosed as ADD/ADHD

Convergence Insufficiency – Often Misdiagnosed as ADD/ADHD

For success in school, children must be able to coordinate their eye movements as a team. They must be able to follow a line of print without losing their place. They must be able to maintain clear focus as they read or make quick focusing changes when looking up to the board and back to their desks. And they must be able to interpret and accurately process what they are seeing.

Unfortunately, about 20% of school-aged children struggle to read. Some of these children suffer from learning disabilities or dyslexia, the inability of the brain’s verbal language to accurately decode the connection between the word’s written symbol. However, a large portion of children struggling to read are not dyslexic at all; their processing skills are fine. It’s their vision that is interfering with their ability to read.

If children have inadequate visual skills in any of these areas, they can experience great difficulty in school, especially in reading. Children who lack good basic visual skills often struggle in school unnecessarily. Their “hidden” vision problem is keeping them from performing at grade level. Convergence insufficiency can cause difficulty with reading, which may make parents or teachers suspect that the child has a learning disability, instead of an eye disorder (oculomotor muscles).

How to detect an oculomotor asymmetry in your child

1- Extend your arm and look at your index finger.

2-Then, slowly bring it forward for your eyes to focus inward ( what we sometimes call cross-eyed).

3-You should be able to maintain focus to the root of your nose with both eyes.

If you see two fingers, it means that you are not able to stay focused on that same point. One of the eyeballs might be weak and moving out.

This can be a dysfunction of an eye “muscle”.

It is essential that a systematic screening program should be set up in schools and that training for GPs and pediatricians should be reinforced. As for ophthalmologists, they should make themselves familiar with these concepts so as to collaborate more closely with posturologists.
If you want to improve you child’s focus or brain function; have them do eye exercises!

 

For more information please contact us at 877.315.8489
or at education (at) posturepro (dot) net

 

The Posturepro Team

Changing Lives

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Eye ex.

Eye Convergence | How to use the magnet and do the eye exercises with a client

Why are eye exercises important

If you want to look at someone’s brain and the function of the brain; look at their eyes!  The eyes are a direct conduit into the brain.  The eyes are formed from brain tissue.  To have good “eye function” will actually improve good “brain function”.The eye is not only an element of vision, it is also (with the foot) one of the most important receptors of the postural system. This has been confirmed by all of the neuroscientific work done in this field.

How to perform the eye exercises

The eye exercises, performed with your very own index (of the dominant side), serve to re-educate symmetrical movements and create a synergy between the right and left eye. They are a fundamental part of the process as the magnet only sets the stage for the re-education to take place, via the eye exercises. Start the eye exercise at 30cm away from the root of the nose, move up in a clockwise direction (no higher than the forehead and no lower than the level of the eyes). The exercise should be done 1-2 times a day for 90 seconds, before 5pm.

These eye muscles are treated with a magnet and eye exercises. The magnet is to be worn over a muscle called Rectus Lateralis. This muscle is located on the outer part of the eye and, when tight, does not allow the eye to converge (move inwards). It is the main culprit in a lack of convergence. The magnet actually calms the muscle down to allow better convergence and to equalize overall muscle tension.

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