Mechanism for Right Sided Lower Limb Symptoms Due to Short Right Leg Syndrome
Rough preliminary notes...
Right Sided Lumbar Disk Bulges
From early in my career I have frequently observed tightness & tenderness in the right QL's accompanied by tightness and spasming in the left glutes. It is a common pattern. Eventually I worked out the cause for thickening and tightening down the backline of the left lower limb...being anterior rotation of the hip about the SIJ >>> joint tightness blocking energy flow down the limb...eg, with one exception, every case of Plantar Fasciitis I have sighted is accompanied by anterior hip rotation and the most common unforced football injury is a torn left hamstring. The right QL condition remained a mystery until after a spate of cases brought it front and centre in my attention. Several had medical scans revealing right sided disk bulging. What all these cases had in common was Short Right Leg Syndrome (SRLS). It then struck me the postural anomaly of a dropped right hip causing a right leaning scoliosis will open the lumber vertebrae on the right and the elevated left hip will close the lumbar vertebrae on the left. This accordion like action creates a wedge shape where the vertebral surfaces should be parallel and forces the disk out to the right. I am inclined to think this is a common cause for right sided lumbar disk bulges.
Short Right Leg Syndrome (SRLS) effects on lower limbs are not known and poorly understood by the therapeutic community. Left leg cases due to the postural anomaly of anterior hip rotation at the left hip. Right sided cases due to lumbro-sacral dysfunction caused by disk bulging through lumbar region and disturbed hip rhythm from rigidity at right hip on the right side. Right sided cases are less common and I consider to be more serious as these symptoms indicate the integrity of the spine is being compromised. Right side symptoms may never amount to anything more than low level symptoms but under sustained pressure, loading and an event may result in catastrophic failure.
Less common by a factor of ten, are SRLS cases with right sided Lumbro-Sacral symptoms even though hip posture on the right is good. Left sided cases are more common. This was always a mystery to me until I noted right leaning tilt of the pelvis from SRLS >>> right sided disk bulging through Lx vertebrae (generally mild not causing acute symptoms) causing tightness and pain through right QL's >>> compounded by rigidity at the right acetablum and adductors due to momentary hesitation while seeking to plant each footfall delayed by the "Pendulum Effect" of the shortened leg >>> disrupting hip rhythm of the region generally and, I hypothesise, unduly affects the right SIJ that is forced to compensate and over-mobilise due to the tightness and rigidity described both above and below it. Also too, the Lx dysfunction has an energetic blocking affect on the right SIJ. The right SIJ may ellicit pain on palpation together with thickening and tightening down the backline of the right lower limb from glutes to plantar fascia. I consider the right sided Lumbro-Sacral presentation more serious than left sided cases as the integrity of the spine is compromised. While it may never amount to anything more than tenderness in the right QL's and thickening and tightening down the backline of the lower limb, under sustained pressure and loading may result in catastrophic failure of the lumbar vertebral disks.
First published 5 Sept 20