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Case Notes - Short Right Leg Syndrome, Simon Crittenden

I knew I had a slightly short right leg prior to a catastrophic low back injury four years ago...looking at the saddle of my race bike you could see it...carbon fibre and titanium bent down, pushed down on the right side. Little did I know what it might do to my lumbro-sacral region. Two months off work, three years of rehab exercises before the symptoms cleared until two months ago, relapse with minor disk bulge >>> rehab like mad and a course of Thymosine Beta 4 >>> all good but the niggles are still there. I have prescribed them for others and now experiment with a heel lift under the right foot for myself. Every case is different and I have written extensively about my observations of Short Right Leg Syndrome. Within two days of commencing the trial on 28 Januart 2021, good but unexpected results. Pictured are two and three layer prototypes constructed of 1.5mm fibre reinforced rubber sheet sourced from local hardware shop. The larger one for my open sandals. The others to go under the insole of runners or workboots.

History:

Left knee unstable due to multiple injuries... patella fractured age 20yrs, medial meniscus tear age 25yrs, patello-femoral syndrome age 45yrs, partial dislocations at head of fibula 3x during 50's. Age 60yrs forced to retire from athletic cycle training due to instability at head of fibula and ongoing deterioration of weight bearing ability. Walking up hill OK...downhill, impossible to bear weight and forced to walk stiff/straight leg. Standing stationary for any extended time (minutes) caused knee pain at head of fibula and limp that would then need to be walked out.

Recent x-ray reveals close to bone on bone spacing at medial meniscus of both knees. Full thickness at lateral meniscus. No sign of arthritis reported.

 

Fitting:

Two layer (3mm) lift completely un-noticeable when first inserted. Three layer (4.5mm) could just detect slight elevation/kick up right hip. I go with the latter. Later will get someone with a good eye to assess hip heights at the ASIS to determine if further height increase warranted. While I do not have a high degree of anterior rotation at the left hip due to daily rehab exercises for the low back injury, there is some which is expected to normalise/back-off with the influence of the right heel lift. This changes functional left leg length (making it slightly longer), hence, the possibility for needing to increase the thickness of the right heel lift as the structure changes and adapts.

Fitting a heel lift for SRLS is more trial and error than a rigorous science. Every body's structure and it's condition is unique. Wearing a heel lift for the first time can cause discomfort as weight shifts from the long to short leg...common for slight aches and pains to occur in the leg using the heel lift due to increased load on that leg. It may take a few days for the leg to get used to it. Some with lower back issues may experience sharp pain. If so, stop using it immediately and consider fitting a thinner one instead.

In my case I started with a 3mm height under right foot and literally could not feel it. Increasing the height to 4.5mm could just feel a slight kick or elevation at the right hip. I continued with this height with very good results. After two weeks progressed to 6mm trying for better result and because the left hip was still elevated over the right. By the end of the day which included several hours yard work and a leasurely stroll with the dog in the forest, I was getting the very niggles about my sacrum that inspired me to use the heel lift in the first place. Healy Resonance Chakra assessment the next morning registered low readings across the three lower Chakras whereas previously with the 4.5mm lift high readings consistently obtained. I have reverted back to the lower 4.5mm heel lift again.

I will give it more time before considering a changed height adjustment to my leg length to accommodate functional postural changes that occur. Young subject's bodies change rapidly in matter of weeks and older cases can take many months.

 

Observations:

Since insertion of 4.5mm heel lift in right shoe on 28 Jan 21 for treatment of SRLS, within two days left knee has begun bearing weight and ability both up and down stairs improved. Pain reaction from standing stationary reduced. The reason for trialing the heel lift was to prevent further injury to lumbar spine. Improved knee function of this nature was not expected.

At day seven, have not found it necessary to do constant rehab sessions to avoid lumbar symptoms for the last three days. 

Also in the therapy mix for the last few months has been daily use of a Healy frequency assessment and treatment device. Interestingly, running the Chakra assessment in Resonance mode, the lower Root and Sacral Chakras always registered poor numbers compared to the higher level Chakras in the body. After a week of using the right heel lift, these Chakras are now consistently registering high numbers.

34 days since inserting heel lift in shoe...note ROM through neck and spine when turning to look to the rear when driving in reverse increased. An act that has been increasingly difficult since I don't know when and put down to "Age" has become easy to do again. In fact, thinking about it while driving the ute...rear vision looking over the shoulder is better now than when I first bought it 19yrs ago.

Interestingly, over the last five years I have been examined and treated by two GP's, one Osteopath, one Chiropractor, two Remedial Massage Therapists, two Traditional Chinese Medical practitioners and one Reiki Master for low back and lower limb dysfunction. Not one has assessed me for leg length differences.

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