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Pelvic tilt - leg length difference
Pelvic tilt ?
A difference of length of legs often is thaught to be responsible for back problems ; in reality however this link is mostly not valid.
If we find an oblique position of the pelvis, we could neutralize it by putting boards under the shorter leg. If this would abolish the pain on standing, then a raised heel is recommended. A difference in leg length of less than 1 cm is considered irrelevant.
There a five factors to decide whether there is a real difference in leg length or not :
compare, bilaterally, the position of the posterior superior iliac spine
Compare, bilaterally, the caudal aspect of the gluteal muscles
Compare, bilaterally, the hight of the iliac crests
Compare, bilaterally, the position of the anterior superior iliac spine
Measure and compare bilaterally the distance between the SAIS and the medial malleolus.
Only when all five elements agree are we convinced that a true leg length discrepancy or pelvic tilt presents. This does not necessarily indicate the cause of the patient's symptoms, however.
(See Part I, p186) |
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