Short (Right) Leg Syndrome - Signs and Symptoms, Assessment, Consideration for Treatment with Remedial Massage
Body builder getting regular sports rubdowns asks the question, "What issues or conditions do I have?" On reflection I had noted left hami's & calf were marginally tighter than the right. He concurs but states he only notices it during massage sessions. Otherwise, at all other times there is no discernible difference...except...the left calf measurement is significantly larger than the right. He is right side dominant.
Further examination notes the left hip is anteriorly rotated, no pain on palpation of the left or right SIJ's, and the right hip is level. Apparent leg length indicates right leg is fractionally shorter (1-2mm) than the left leg...if both legs were actually the same length, the expectation would be left leg apparently shorter than the right by 5mm due to anterior hip rotation of this degree. Hence, I suspect the subject's right leg is actually shorter than the left. This is verified by a test isolating hip anomalies from tibia/femur length comparison. Estimated leg length difference is 5-7mm...the right being the short leg.
As the leg length difference is only moderate, postural anterior flop/rotation of the contra-lateral hip to the short leg successfully balances the leg length difference, eliminating potential hip tilt that would otherwise cause low back pain.
However, low grade tightness along the backline of the left leg is occuring due to anterior hip rotation binding the SIJ and blocking energy flow. Resulting fascial thickening has been objectively noted when measuring his anatomical dimensions. At this time, the subject claims no adverse symptoms have been experienced during training sessions.
Advice: Be cognisant of the condition and should training loads elevate, there is potential for left leg backline tightness to be aggravated. Should that transpire, inserting a heel lift in the right shoe to correct hip posture will reduce backline restriction/tightness and reduce risk of injury. Commence with 2-3mm heel lift and monitor response. Progressing to full thickness correction should never be necessary.