"A functional leg length discrepancy is often diagnosed when there is some form of sacroiliac joint dysfunction": http://www.nielasher.com/blogs/video-blog/testing-for-leg-length-discrepancy
Defined as a condition is which there is a discrepancy in the length of paired limbs.
Occurs in 40-70% of population.
Structural – fixed osseous shortness in one or more segments
Functional – due altered mechanics eg asymmetrical foot pronation/supination or unilateral soft tissue contracture in the spine and/or pelvis pelvic or hip rotations, contractures or obliquity
Additional classification – had since childhood or develops in later life (development in later life tends to be more debilitating.
Mild cases can be easily hidden by walking with slight bend in knee or tilting the pelvis.
Uneven shoe wear
Galeazzi’s sign – patient lies supine with knees flexed and feet on table – if knees are at different heights LLD
Head may tilt towards longer side; shoulder usually lower on shorter side; pelvis higher on long side; arm swing may be greater on short side; step length longer on long side; flexed knee on longer side
May depend on signs and symptoms
Measurement – some inaccuracy with all measurements of LLD
Some authors argue forcefully that less than 20mm should be ignored found that a discrepancy of 5-9mm was more common in those with low back pain.
>1cm is a guideline for many
Gait is inefficient
? predisposition to osteoarthritis in hip of longer leg
Many authors have found associations with low back pain while others have not .
Heel lift ( may cause an anterior pelvic tilt secondary problems)
Manual therapy of hip, sacroiliac joint and pelvis
If severe in a child – epiphyseodesis procedures to arrest growth of longer leg or leg lengthening procedures for short leg