Journal of Chiropractic Medicine
Volume 8, Issue 3 , Pages 107-118 , September 2009

The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature

  • Robert Cooperstein, MA, DC

      Affiliations

    • Professor, Director of Technique, Director of Research, Palmer Center for Chiropractic Research, Palmer Chiropractic College, San Jose, CA 95134
    • Corresponding Author InformationCorresponding author. Tel.: +1 408 944 6009; fax: +1 408 944 6118.
  • ,
  • Makani Lew, DC

      Affiliations

    • Instructor, Palmer Center for Chiropractic Research, San Jose, CA

Received 8 April 2009 ,Revised 10 June 2009 ,Accepted 11 June 2009.

References 

  1. Cooperstein R. Sacro-occipital technique use of padded wedges for diagnosis and treatment. In:  Chaitow L editors. Positional release. 3 ed. New York: Churchill-Livingstone; 2008;p. 179–198
  2. Cooperstein R. Padded wedges for lumbopelvic mechanical analysis. J Am Chiropr Assoc. 2000;37(10):24–26
  3. Long A, Donelson R, Fung T. Does it matter which exercise? A randomized control trial of exercise for low back pain. Spine. 2004;29(23):2593–2602
  4. Mannello DM. Leg length inequality. J Manipulative Physiol Ther. 1992;15(9):576–590
  5. Friberg O. Leg length inequality and low back pain. Clin Biomech. 1987;2:211–219
  6. Baylis WJ, Rzonca EC. Functional and structural limb length discrepancies: evaluation and treatment. Clin Podiatr Med Surg. 1988;5(3):509–520
  7. Danbert RJ. Clinical assessment and treatment of leg length inequalities. J Manipulative Physiol Ther. 1988;11(4):290–295
  8. Irvin RE. The origin and relief of common pain. J Back Musculoskeletal Rehabil. 1998;11(2):89–130
  9. Triano JJ. Objective electromyographic evidence for use and effects of lift therapy. J Manipulative Physiol Ther. 1983;6(1):13–16
  10. Irvin RE. Reduction of lumbar scoliosis by use of a heel lift to level the sacral base. J Am Osteopath Assoc 1991;91(1):34, 37-44.
  11. Knutson GA. Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance. Chiropr Osteopat. 2005;13(1):11
  12. Knutson GA. Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry. Chiropr Osteopat. 2005;13(1):12
  13. Cooperstein R, Lisi A. Pelvic torsion: anatomical considerations, construct validity, and chiropractic examination procedures. Top Clin Chirop. 2000;7(3):38–49
  14. Knutson GA. The functional “short leg”; physiological mechanisms and clinical manifestations. J Vertebral Subluxation Res. 2000;4(1):22–25
  15. Cooperstein R. Relationship of pelvic torsion and anatomical leg length inequality. J Chiropr Educ. 2008;22(1):53
  16. Levangie PK. The association between static pelvic asymmetry and low back pain. Spine. 1999;24(12):1234–1242
  17. Pitkin H, Pheasant H. Sacrarthrogenetic telalgia. II A study of sacral mobility. J Bone Jt Surg. 1936;18(2):365–375
  18. Hildebrandt RW. Chiropractic spinography. 2nd ed. Baltimore: Williams & Wilkins; 1985;
  19. Booth A. "brimful of STARLITE": toward standards for reporting literature searches. J Med Libr Assoc 2006;94(4):421-9, e205.
  20. Drerup B, Hierholzer E. Movement of the human pelvis and displacement of related anatomical landmarks on the body surface. J Biomech. 1987;20(10):971–977
  21. Cummings G, Scholz JP, Barnes K. The effect of imposed leg length difference on pelvic bone symmetry. Spine. 1993;18(3):368–373
  22. Beaudoin L, Zabjek KF, Leroux MA, Coillard C, Rivard CH. Acute systematic and variable postural adaptations induced by an orthopaedic shoe lift in control subjects. Eur Spine J. 1999;8(1):40–45
  23. Young RS, Andrew PD, Cummings GS. Effect of simulating leg length inequality on pelvic torsion and trunk mobility. Gait Posture. 2000;11(3):217–223
  24. Zabjek KF, Leroux MA, Coillard C, Martinez X, Griffet J, Simard G, et al. Acute postural adaptations induced by a shoe lift in idiopathic scoliosis patients. Eur Spine J. 2001;10(2):107–113
  25. Giles LG. Lumbosacral facetal “joint angles” associated with leg length inequality. Rheumatol Rehabil. 1981;20(4):233–238
  26. Krawiec CJ, Denegar CR, Hertel J, Salvaterra GF, Buckley WE. Static innominate asymmetry and leg length discrepancy in asymptomatic collegiate athletes. Man Ther. 2003;8(4):207–213
  27. Petrone MR, Guinn J, Reddin A, Sutlive TG, Flynn TW, Garber MP. The accuracy of the Palpation Meter (PALM) for measuring pelvic crest height difference and leg length discrepancy. J Orthop Sports Phys Ther. 2003;33(6):319–325
  28. Barakatt E, Smidt GL, Dawson JD, Wei SH, Heiss DG. Interinnominate motion and symmetry: comparison between gymnasts and nongymnasts. J Orthop Sports Phys Ther. 1996;23(5):309–319
  29. Grieve GP. The sacro-iliac joint. Physiotherapy. 1976;62(12):384–400
  30. Sabharwal S, Zhao C, McKeon J, Melaghari T, Blacksin M, Wenekor C. Reliability analysis for radiographic measurement of limb length discrepancy: full-length standing anteroposterior radiograph versus scanogram. J Pediatr Orthop. 2007;27(1):46–50
  31. Sturesson B, Selvik G, Uden A. Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis. Spine. 1989;14(2):162–165
  32. Sturesson B, Uden A, Vleeming A. A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test. Spine. 2000;25(3):364–368
  33. Sturesson B, Uden A, Vleeming A. A radiostereometric analysis of the movements of the sacroiliac joints in the reciprocal straddle position. Spine. 2000;25(2):214–217
  34. Goode A, Hegedus EJ, Sizer P, Brismee JM, Linberg A, Cook CE. Three-dimensional movements of the sacroiliac joint: a systematic review of the literature and assessment of clinical utility. J Man Manipulative Ther. 2008;16(1):25–38
  35. Cibulka MT, Delitto A, Koldehoff RM. Changes in innominate tilt after manipulation of the sacroiliac joint in patients with low back pain. An experimental study. Phys Ther. 1988;68(9):1359–1363
  36. Smidt GL, Wei SH, McQuade K, Barakatt E, Sun T, Stanford W. Sacroiliac motion for extreme hip positions. A fresh cadaver study. Spine. 1997;22(18):2073–2082
  37. Smidt GL, McQuade K, Wei SH, Barakatt E. Sacroiliac kinematics for reciprocal straddle positions. Spine. 1995;20(9):1047–1054
  38. Cooperstein R. A tale of two papers: the demise of the Gillet test may be greatly exaggerated. J Am Chiropr Assoc Online. 2009;47:
  39. Sabharwal S, Kumar A. Methods for assessing leg length discrepancy. Clin Orthop Relat Res. 2008;466(12):2910–2922
  40. Rhodes DW, Mansfield ER, Bishop PA, Smith JF. The validity of the prone leg check as an estimate of standing leg length inequality measured by x-ray. J Manipulative Physiol Ther. 1995;18(6):343–346
  41. Hanada E, Kirby RL, Mitchell M, Swuste JM. Measuring leg-length discrepancy by the “iliac crest palpation and book correction” method: reliability and validity. Arch Phys Med Rehabil. 2001;82(7):938–942
  42. Cooperstein R, Gleberzon B. Technique systems in chiropractic. Churchill Livingstone: Edinburgh; 2004;
  43. In:  Fuhr AW,  Green JR,  Colloca CJ,  Keller TS editor. Activator methods chiropractic technique. St. Louis: Mosby; 1997;
  44. Thompson C. Thompson technique reference manual. Elgin, Illinois: Thompson Educational Workshops, Williams Manufacturing; 1984;
  45. Pierce WV, Stillwagon G. Pierce-Stillwagon seminar manual. Pennsylvania: Monongahela; 1976;
  46. DeJarnette MB. Sacro occipital technic: 1983. 1983;Nebraska City, Nebraska: self-published
  47. Dott GA, Hart CL, McKay C. Predictability of sacral base levelness based on iliac crest measurements. J Am Osteopath Assoc. 1994;94(5):383–390
  48. Manheimer J, Lampe G. Clinical transcutaneous electrical nerve stimulation. Philadelphia: F. A. Davis Company; 1984;

 Funding sources and conflicts of interest: The funding for this study is courtesy of the Palmer Center for Chiropractic Research. Neither author is involved in any conflict of interest related to participation in this project.

PII: S1556-3707(09)00064-9

doi: 10.1016/j.jcm.2009.06.001

Journal of Chiropractic Medicine
Volume 8, Issue 3 , Pages 107-118 , September 2009