06 | Short Leg Syndrome

Front 1

proprioception

Back 1

unconscious perception of movement and spacial orientation from stimuli within the body.

knowing where you are in space

Front 2

two organs important to proprioception

Back 2

eyes

ears/vestibular apparatus

Front 3

result of proprioception-

Back 3

eyes level with horizon

Front 4

lateral posture line goes through -

Back 4

external auditory meatus

tip of acromion

center of body of 3rd lumbar vertebrae

center of knee

anterior to lateral malleolus

Front 5

potential sources of short leg include:

Back 5

ankles

knees

hips

pelvis

lumbar spine

Front 6

ankle is important because

Back 6

weight of the entire upper body rests here.

if not in alignment, there will be serious problems upstream.

Front 7

talus

Back 7

ankle bone. joint bone that carries the weight.

stabilizes dorsiflexion and plantarflexion

Front 8

flat feet mean that some has feet that are

Back 8

overprotonated

externally rotated

Front 9

this type of trauma typically goes unrecognized...

Back 9

Hip trauma

Front 10

key things to look for in hip trauma

Back 10

legg calve perthes

avascular necrosis

painless limp

slipped capital femoral epipysis

painful limp

Front 11

important hip joints to short leg -

Back 11

SI Joints (2)

Pubic symphysis

Front 12

patient constantly externally rotating right leg. what is the problem?

Back 12

shortened leg length

Front 13

would an anterior or posterior innominate make the leg shorter?

Back 13

posterior***

Front 14

if the innominate is rotated anteriorly on the right, the iliac crest on that side would be

Back 14

higher

Front 15

adductors attach -

Back 15

pubic ramus to femur

Front 16

hip flexors attach -

Back 16

iliac fossa and lumbar spine to lesser trochanter of femur

Front 17

hamstrings attach

Back 17

ischial tuberosity to tibia, fibula, or both

Front 18

superior innominate shear results in...

Back 18

short leg on the same side

pelvic diaphragm strain

urogenital diaphragm strain

Front 19

systems impacted by short leg

Back 19

GI

Reproductive

Respiratory

Cardiac

Genitourinary

Front 20

gait is most efficient when...

Back 20

center of gravity moves the least

Front 21

center of gravity is at about -

Back 21

S2

Front 22

knee on the long side of short leg syndrome individual -

Back 22

earlier osteoarthritis

Front 23

hip on side with long leg of short leg syndrome -

Back 23

joint pain and osteoarthritis

Front 24

patient will favor ______ side which is an example of _____ gait.

Back 24

painful side

antalgic

Front 25

because all neurological aspects are compensating, people with short leg have an increased risk for ______.

Back 25

radiculopathy

Front 26

effects of an unlevel sacral base -

Back 26

compensatory curves of the spine to keep eyes level with the horizon and maintain sense of place and position.

Front 27

early postural compensatory changes include -

Back 27

C shape curve

convex on short leg side

shoulder more superior

Front 28

late postural compensatory changes include-

Back 28

distributes force over several lateral curves giving you an S shaped curve

shoulder more inferior

Front 29

posture associated with short leg -

pelvis shifts...

innominate on long side...

innominate on short side...

tendency for...

Back 29

rotates towards short side

anterior

posterior

overpronation on long side.

Front 30

pelvic transverse plane changes due to ...

Back 30

tight hamstrings on one thigh and tight rectus femoris on the opposite side

Front 31

pelvic coronal plane changes due to ...

Back 31

tight abductor on one side and adductor on the other.

Front 32

gold standard for measuring leg length issues -

Back 32

standing radiograph

Front 33

this test is preferentially used for pediatrics

Back 33

scanogram

Front 34

Radiographic lines for evaluating the sacral base ..

Back 34

iliac crest

sacral base

femoral heads

Front 35

goal of treatment of short leg is to -

Back 35

level pelvis

Front 36

for short leg, we typically start with ________ to treat

Back 36

lift in shoe

Front 37

Heilig Formula

Back 37

L = [SBU]/ [D+C]

L=lift

SBU = sacral base unleveling

D = duration

C = compensation

Front 38

for normal patients, begin with this lift and increase at this rate.

Back 38

1/8th inch

1/16th inch per week or 1/8 inch per two weeks

Front 39

for fragile patients, begin with this lift and increase by this much

Back 39

1/16th

1/16th

Front 40

for patients with sudden loss of length length, use this treatment

Back 40

lift full amount to start and recheck once in place.

Front 41

consider lift therapy ONLY AFTER

Back 41

every joint is without restriction

balanced muscles

clear radiograph

no indication for lift therapy