Possible Leg Length Discrepancy

Hi Martin

I am working with an athlete and have just done the normalise tests with him.

His left leg is 5 to 7 mm longer than his right. Downing’s test was fine so in my eyes suggests that he has actually got one leg longer than the other. Gillett’s test was positive (there did seem to be a little movement on both sides but not great).

In his upper body there was high tone on right erector spinae in the thoracic spine, high tone on left upper traps, mild left scapula winging when standing and rotated to the right (right shoulder back, left shoulder forward) sway back posture.

What is the best way ahead? If he does have a leg length discrepancy, do we pop an insert in the shoe of the shorter leg? This would obviously mean dramatically altering his training for a long period for his body to adjust. Do we leave it? The athlete is 18 years old and is currently on 30 miles a week. He has been up to 40 miles a week last cross country season. He and his coach are looking to up the mileage to 50 for this cross country season. He has no history of any injury. I think this may change though when the mileage goes up. He is in the top 40 in England for 1500 metres in the under 20 age range. A very dedicated athlete.
I would welcome any comments you can make on this.

Hi ‘Coach’

He may indeed have a genuine leg length discrepancy if Downing's is negative. However if Gillett's is positive (and I notice on the screening form that the 4-sign is positive on the left side too) it is possible that his pelvis is still rotated, remember Downing's is just one way of establishing if the pelvis is functioning correctly. So I'd do the anti-spasm exercises and the exercises that work the other areas that biomechanically load the pelvis (all the other tests that are positive in the Normalise screening) and then re-measure.

When the pelvic (and other tests) come back negative, then see how the leg length discrepancy measures. If it's still longer then a heal raise may be appropriate depending upon the exact discrepancy. If that was the case I'd send him to an Orthotist or Podiatrist (or even a musculo-skeletal therapist who was experienced in this type of thing) for the prescription. If however the leg length has been reduced by the biomechanical work then we know it was from the pelvis and he may well not need a raise.

Generally though, there would need to be quite a good argument and significant discrepancy before we should consider heel raises for anyone.

I hope that helps.

Martin

I’ll let you all know how this athlete gets on with that advice and see how he improves over time.