Lower limb shortening

LOWER LIMB SHORTENING

There is no other such important goal in orthopaedics than to define the lower limbs lengths difference. Upon this difference the whole success of feet and spine correction is based. As the probability theory and statistics inform us, each and every individual possesses some kind of the body asymmetry. If there is difference in lower limbs lengths, the GCG (General Centre of Gravity) for the body shifts always to the shorter limb, on which the larger extend of deformation is diagnosed, as well as varicoses symptoms, knee pain and so on. Thus deformations are the consequences of GCG displacement and the result of overloading for various groups of skeletal  muscles.

The difficulty to find the shortening has reason: while standing on the floor, the skeleton structures of the feet, spine, joints compensate the existent difference. This adds its own “functional” part in the general amount of shortening, which part can’t be defined visually. After elimination of functional part (by means of standing on hydrosystem) and elimination of valgus or varus heel positions –  only then it is possible to correctly find the anatomic shortening in standing position (on the hydrosystem diaphragms). In standing position the pressure under each foot levels, body is in upright vertical emplacement, all joints are compensated. The shortening dimension may be found preliminary by using feet imprints. More precise eventual dimensions could be found while patient is standing on the podo-correctors, that compensate the functional constituents.

Asymmetry in the posture is fixating and conserved by the formed stable muscles tone. And this tone all by itself is not able to any change inside such system. That’s why it is necessary to have knowledge and appropriate skills to relax the muscle and to position the skeleton in neutral emplacement. It is a big mistake to assume that physical activity and sport activity may eliminate the deformation. In reality, for the start it is imperative to relax the muscles, to remove functional deformations, to compensate the anatomic difference in lower limbs lengths and only then to begin increasing the muscles tone. Without such sequence of actions and operations it is impossible to handle the feet and spine deformations and normalize the human organism functioning.

Possibility to bring to alignment and overlapping the whole body GCG and CG for bearing support feet triangle may be considered as one of the principal objectives when the feet arches correction and spine deformations correction are the goals. Through many years of seeking relief from spinal pains, this man (left photo) was introduced to most unthinkable diagnoses. But nobody informed him that he possesses the big difference in lower limbs lengths. Same case of legs lengths difference demonstrates this child (right photo). Hardly the trained sportsman could be able to keep the spine in such position, as the pain immediately reminds about itself.

Nonetheless important is know-how for compensation of lower limbs length difference when the origin of this difference is the joints replacement (knee and/or hip joints). While the patient (refer to the illustrations and compare) is just standing on the floor, there is impression that the right limb is shorter, but hydrosystem defines the left limb as shorter limb. These facts confirm and justify that it is imperative to perform compensation of legs lengths difference in standing position using hydrostatic method, but definitely not while sitting or laying down. If this difference is not taken into account in orthotics, therefore correction of the feet arches would not be attained. This type of orthotics will not align body GCG and CG of bearing support feet triangle, i.e. will not affix the skeleton on its base support points. It is biomechanics specialists, orthopaedics technicians, prosthetic appliance technicians who master and manage this technical problem.

Contemporary methods of creating the so called “negative” plaster-made foot imprints are not able to solve these problems, they are not directed on compensation of forces in the skeletal-muscular feet apparatus and whole skeleton apparatus. Besides, these methods do not position the human body skeleton into neutral emplacement.

Any feet deformation represents shortening, but notice – we call it functional shortening. The most substantial leg shortening appears under “valgus” effect – turning of the heel bone, or when hyper-pronation of subtalar joint takes place (inner foot arch is completely flattened on the base).

The technologies (namely, process of hydrostatic correction for locomotor system) that we practically apply in our Centre, exclude all mistakes immanent to orthopaedics, and therefore create the effective and controllable correction process.