Personal Observations

The following observations are based on Ricardo's personal clinical experience as a physical therapist for 27 years and as a Microcurrent Point Stimulation instructor (using MPS therapy to relax muscles and relieve pain).

Several years ago, while working in a pediatric hospital, I had several patients, all male teenagers, who had lumbar laminectomies to correct injuries sustained from playing football or soccer. They also all had a leg length discrepancy. This got me thinking. Could this LLD be a factor in their injury? 

 

Over the next few years I evaluated every patient I treated for leg length discrepancy. In 2007, when I was working as a physical therapist in an outpatient clinic for a year, I found that 80% of my patients with musculoskeletal pain had a leg length discrepancy. In the pediatric hospital, when training patients with crutches prior to a foot surgery for non-traumatic foot pain, I discovered all the patients had a leg length discrepancy. For me, it was clear that this difference in leg length weakens and produces unbalance of the musculoskeletal system so an injury was more likely to occur.

Many of my adult patients with back or extremity pain have a history of playing competitive sports. More than 50% of these patients quit their sport because of repetitive injuries. Those patients also state that after they stopped playing the sport, the pain disappeared for years, but returned when they reached their thirties or forties. 

 

All of those patients had a leg length discrepancy.

Another interesting find was that headaches were directly correlated to patients with a leg length discrepancy. Patients with a history of headaches since childhood had a leg length discrepancy.

As a father of 3 children who play sports for many years, I've gathered histories and facts regarding sports injuries. When I was traveling to different cities with my son who played competitive soccer, I was often asked to help when a child was injured. The most interesting finding was that every child that complained of repetitive injuries, such as pain in the spine, knees or feet, without a trauma showed a leg length discrepancy. 

 

My daughter's gymnastic coach told me that some of the girls doing levels 4, 5, or 6, would sometimes lean slightly after they tumbled and landed on their feet. He also stated that when those girls flipped backwards, starting in the position where the coach's hands hold the feet of the girls, he had felt them push asymmetrically. Of course, 100% of those girls had a leg length discrepancy.

Though all of these patients had a variety of problems and symptoms, the root of the problem was always a discrepancy in leg length. As physical therapists, we treat the consequences of the problem, i.e. muscle pain and tenderness, weakness in some musculature and/or contractures in other. We do muscle energy techniques, mobilization of the joints, and exercises to strengthen and improve posture. We apply many physical therapy agents from TENS units, short wave, ultrasound and electrical stimulation. DC's and DO's believe that everything comes from misalignment of the spine and the main treatment is manipulation of the spinal joints. MD surgeons perform surgery to fix all kinds of problems from lumbar laminectomy for a disrupted disc to navicular transposition for foot pain. 

 

None of the above treatments address the root cause of the problem: the leg length discrepancy.