Question
QUESTION: I was recently told by an orthopedic surgeon and a rheumatologist that it is impossible to change leg length by this method and you cannot move bones at all.  I ask because I had some pelvic adjustments done that have had a very negative effect on me.  I feel the wrong leg was shortened.  He did the leg, pushed the pelvis back, opposite to my high pelvis side and immediately I fell over and felt uneven.

They are claiming it will have just caused a spasm as my leg length could not be altered AT ALL by this method.  But something happened as my other leg now feels like its bending, my knee cracks and seizes and my back is in spasm.  Any advice for me?  Thanks.

ANSWER: I'm not sure what your exact question is. Unfortunately, I can't give you specific treatment recommendations over the Internet. I do, however, have a few thoughts to offer you regarding some of the points you raised.

First, regarding leg length discrepancies (LLD), there some disagreement with regard to the role that LLD plays in musculoskeletal disorders, and the amount of LLD necessary to warrant treatment (1). LLD has been suggested to be associated with a variety of musculoskeletal problems, including altered posture, balance and gait (1,2); and low back pain, hip pain, and sacro-iliac joint pain (1, 3, 4).

Secondly, from your description of your present symptoms, it sounds as though you may be experiencing a muscular response attempting to compensate for the pelvic adjustments you underwent. You may consider seeing another chiropractor or physical therapist, as well as a massage therapist, for additional evaluation and treatment. You may need to work on a number of postural rehabilitation exercises, with which the PT should be able to help you, and the massage therapist should be able to help relax the tight and cramped muscles of your extremities and trunk.

I hope this helps to answer your question.

References:

1. Gurney, Burke. Leg length discrepancy. Gait and Posture 15; (2002), 195-206.
2. Walsh, M, Connolly P, Jenkinson A., O'Brien T. Leg length discrepancy - an experimental study of compensatory changes in three dimensions using gait analysis. Gait and Posture 12; (2000), 156-161.
3. Kiapour A., Abdelgawad A., Goel VK, Souccar A, Terai T, Ebraheim NA. Relationship between limb length discrepancy and load distribution across the sacroiliac joint - a finite element study. (2012) Journal of Orthopedic Research. Apr 9. doi: 10.1002/jor.22119. [Epub ahead of print].
4. Gofton JP. Persistent low back pain and leg length disparity. J Rheumatol. 1985 Aug;12(4):747-50.



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QUESTION: Sorry, I don't think I gave you enough info.  The adjustment I had done was to reduce my right leg by an inch.  This was done in one go, not gradually.  It immediately felt wrong and my back started to bow and my jaw and neck went into "spasm".  I really wanted to know if this was just too much for my body to adapt too.  Other practitioners of manipulations have said it was irresponsible of him to do that.  My body has gone into haywire since and it has disabled/deformed me greatly.  However the medical personnel I see are telling me that chiros etc cant move bones whatever they claim and it is just not possible for my leg length to have changed.  They refuse to believe that moving my pelvis can affect the LLD, no matter how much I tell them I felt like I was leaning the wrong way afterwards and my gait changed overnight.  Do you have an opinion on this?  Can you move bones, can you change leg length like this and was it too severe an adjustment?  Or is it just protective spasm that has caused my body changes and neurological problems like the hospital consultants claim.  I had a slight scoliosis that never bothered me at all, but the osteopath said it would help me in the long run if he treated it.  My back had a slight S curve, that is now a C curve and have lost the natural curves in my spine and neck.  Is it possible he just put me in a whole body permanent body spasm or do you think there is more to it than that?  Thanks again.

Answer
Functional leg length discrepancies may be altered by joint or muscle manipulation. Functional leg length discrepancies are the result of muscle or joint imbalances.

Structural leg length discrepancies are the result of an anatomically shorter limb, which is the result of a genetic defect, and is present at birth. Structural leg length discrepancies may not be altered by manipulation and usually require the use of a prosthetic device or surgery to compensate for the imbalance.

As to whether or not an improper manipulation was performed on you is not something I can answer. By your description of the procedure that was done, I am not familiar with any such treatment, nor is shortening a lower limb length a treatment goal that I would contemplate.

In my previous response I indicated several options for attempting to treat what sounds, by your description, to be a functional leg length discrepancy. This would include evaluation by a musculoskeletal-based chiropractor or physiotherapist, and co-treatment for the muscular problems you are having by a massage therapist.

In general, a potential adverse side-effect of any form of manipulation, particularly if inappropriately applied, may include protective muscle spasms.