leg length discrepancy test
Patient Position
- Patient should be in the supine position with their legs extended and their feet hanging just off the end of the table in a relaxed position.
Directions
True Leg Length Measurement
- Using a tape measure, measure from the anterior superior illiac spine (ASIS) to the center of the medial malleolus and record the length in centimeters.
- This measurement should be performed bilaterally.
Functional Leg Length Measurement
- Using a tape measure, measure from the center of the umbilicus (more commonly known as the naval or the belly button) to the center of the medial malleolus and record the results in centimeters.
- This measurement should be performed bilaterally.
Expected Results
- The measurements found on each measurement (true leg length & functional leg length) should be equal bilaterally.
Positive Signs
- Measurements of either test (true leg length & functional leg length) are not found to be equal.
Implications
True Leg Length Measurement
- A positive sign indicates a leg length discrepancy is present in the patient.
- If no discrepancy was found in the tibial leg length test this would indicate that the length discrepancy is likely in the femur bone.
Functional Leg Length Measurement
- A positive sign would either indicate a leg length discrepancy or a misalignment of the patient's pelvic bone.
- If their is no positive sign noted on the true leg length measurement it would indicate a misaligned pelvis.
- Patient should be in the supine position with their legs extended and their feet hanging just off the end of the table in a relaxed position.
Directions
True Leg Length Measurement
- Using a tape measure, measure from the anterior superior illiac spine (ASIS) to the center of the medial malleolus and record the length in centimeters.
- This measurement should be performed bilaterally.
Functional Leg Length Measurement
- Using a tape measure, measure from the center of the umbilicus (more commonly known as the naval or the belly button) to the center of the medial malleolus and record the results in centimeters.
- This measurement should be performed bilaterally.
Expected Results
- The measurements found on each measurement (true leg length & functional leg length) should be equal bilaterally.
Positive Signs
- Measurements of either test (true leg length & functional leg length) are not found to be equal.
Implications
True Leg Length Measurement
- A positive sign indicates a leg length discrepancy is present in the patient.
- If no discrepancy was found in the tibial leg length test this would indicate that the length discrepancy is likely in the femur bone.
Functional Leg Length Measurement
- A positive sign would either indicate a leg length discrepancy or a misalignment of the patient's pelvic bone.
- If their is no positive sign noted on the true leg length measurement it would indicate a misaligned pelvis.
Treatment Options
- A true leg length discrepancy can be treated conservatively or surgically.
- Conservatively, this condition can be treated by using a heel lift in the shoe of the leg that has a shorter measurement. This treatment method has boundaries and it's effectiveness will depend on the margin of the discrepancy that is found. An individual using this treatment will likely need regular osteopathic manipulative treatment from a certified physician due to the effect this condition has on the hips.
- Surgically, this condition can be treated by either retarding the growth of the longer limb (in young patients who are still growing) or lengthening the femur of the shorter leg (in adult patients).
- Femoral length discrepancies of 2.5 cm or less can usually be effectively treated with orthotic heel lifts and regular osteopathic manipulative treatments.
- Discrepancies that present larger than 2.5 cm may require surgical intervention and that decision should be made by a team of orthopedic surgeons that specialize in this area of surgery.
- Functional leg length discrepancies are always treated conservatively using a combination of prescription rehabilitation exercise and osteopathic manipulative treatment.
Rehabilitation Direction
- The rehabilitation program for an individual with a functional leg length discrepancy should include a core stabilization program with a heavy focus on keeping the pelvis in the neutral position throughout the entirety of all prescribed exercises.
- A true leg length discrepancy can be treated conservatively or surgically.
- Conservatively, this condition can be treated by using a heel lift in the shoe of the leg that has a shorter measurement. This treatment method has boundaries and it's effectiveness will depend on the margin of the discrepancy that is found. An individual using this treatment will likely need regular osteopathic manipulative treatment from a certified physician due to the effect this condition has on the hips.
- Surgically, this condition can be treated by either retarding the growth of the longer limb (in young patients who are still growing) or lengthening the femur of the shorter leg (in adult patients).
- Femoral length discrepancies of 2.5 cm or less can usually be effectively treated with orthotic heel lifts and regular osteopathic manipulative treatments.
- Discrepancies that present larger than 2.5 cm may require surgical intervention and that decision should be made by a team of orthopedic surgeons that specialize in this area of surgery.
- Functional leg length discrepancies are always treated conservatively using a combination of prescription rehabilitation exercise and osteopathic manipulative treatment.
Rehabilitation Direction
- The rehabilitation program for an individual with a functional leg length discrepancy should include a core stabilization program with a heavy focus on keeping the pelvis in the neutral position throughout the entirety of all prescribed exercises.
The core muscles of the body are all muscles that are located in the abdominal or pelvic region of the body. The core muscles are the foundation of total body strength and in order to avoid injuries associated with athletic activities it is important to have a strong core before attempting to build strength in all other areas of the body.
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