The child's arm is shorter than the other. What to do when a small child has one leg shorter than the other? Measuring the length of the legs

Most often, parents are the first to notice asymmetry: while changing clothes, bathing or playing with the baby, it is noticeable that the baby has unevenly located folds on the legs. Immediately there are suspicions that one leg is shorter.

Such situations are not uncommon. They can indicate both true and false shortening.

Causes of pathology, if one leg is shorter than the other

The diagnosis can only be made if the difference is at least ½ cm. When the bones of one leg are shorter than the other, a true shortening takes place. The reasons for this are hidden in the underdevelopment of bone tissues, that is, with developmental anomalies; as a result of purulent-inflammatory diseases of the hip joint.

Pathology in children up to 8 months of age is eliminated by means of splints, massage, staged plaster casts. Further therapy depends on the diagnosis, but most often it is necessary to perform an operation.

Dysplasia

In this case, there is a false shortening, when the bones are the same in length, but one limb stretches upward.

In children of the first year of life, this most often happens due to:

1. hip dysplasia;
2. partial / complete subluxation, hip dislocation.

The doctor determines the pathology, as they say, "by eye". Difficulties in diagnosis arise in the first 2 months of life. It is easier to identify a unilateral dislocation at the age of 3-4 months.

• Treatment up to 9 months of age involves manual massage to correct the pelvic bones.
• Older children take longer to heal and may need to wear a splint.
• Dysplasia disappears after physiotherapy, massage and exercise therapy.

If it is not treated, the pathology will progress.

1. Parents should not swaddle the baby tightly;
2. Forcibly straighten the limbs;
3. Get on your feet ahead of time;
4. Eliminate vertical loads, as there is a risk of aggravating joint deformity.

hip dislocation

• Congenital pathology is eliminated by gradual reduction and plaster casts or splints.
• The duration of therapy is individual, ranging from several months to a year. The complex of treatment includes manual therapy: selective, acupressure, special exercises.
• The pregnancy calendar allows you to find out how the baby should develop, respectively, the expectant mother can already find out about a congenital disorder on an ultrasound scan and begin treating the baby immediately after his birth.

Manual therapy is resorted to some time after reduction. The chiropractor must strengthen the weakened muscular apparatus, prevent dystrophic changes in the tissues of the joint. After removing the bandage, they strengthen the muscles that were weakened during its operation, and also prepare the joints for the upcoming loads.

Treatment of congenital dislocation is most effective in the first 3 months of life. When the child is much older, you have to do the operation.

Muscle hypertonicity

The causes of false shortening may be hidden in the increased tone of one limb. This is evident after six months of age.

In turn, hypertonicity provokes:

1. increased intracranial pressure;
2. fetal hypoxia;
3. anemia of the brain.

This condition is often observed in babies born during traumatic childbirth and in asphyxia.

Pathology can be suspected when the baby of the first months of life lies in the fetal position, the arms are bent at all joints, pressed to the body, the legs are bent, slightly laid aside, the head is thrown back.

Parents can spread their limbs several times, if there is no resistance, then the tone is normal.

When a child stands on tiptoe with support, tightens his fingers, a consultation with a neurologist is needed. The child needs gymnastics and, possibly, medication.

When the legs are different: normal options

Minor deviations generally do not indicate pathology. There is such a thing as physiological shortening of the lower limb. For example, shortening of the right leg is often observed in children with severe left-handedness and vice versa.

In order for the baby to grow and develop well, he must be physically active. Jumping, running, movements lead to the fact that one limb becomes the leading, jogging, that is, it carries a greater load than the other. Therefore, the push leg is slightly shorter. A stronger limb develops faster. Later this difference will disappear.

One leg is shorter: the reason is heredity

This trait can be passed down from generation to generation. If the parents or close relatives have one, then the child may also have it. You can take measurements yourself, but you can’t take a measuring tape, just lie down on a hard surface. The head should be in the midline of the body, legs together. It is necessary to pay attention to whether the ankles and heels are at the same level.

How to independently determine which leg is shorter than the other

You can detect a violation at home, without having much experience.

Parents may well conduct some tests themselves.

• It is necessary to properly lay the baby before the examination. Optimally - on the surface of the table. The latter must be covered with a diaper or a blanket, but so that the baby does not “drown” in soft bedspreads;
• You have to choose the right time. Children are often difficult to put to bed without interference, because they do not understand at all what they want from them;
• The baby needs to be laid belly down. You can stroke it on the back to relax the muscles. Then it is turned over on its back. You need to pay attention to whether he is comfortable in this position. You need to let him grab your fingers. If the baby actively grabs, tries to pull himself up, moves rhythmically, automatically moves his limbs symmetrically and in full, then the child is healthy. With increased muscle tone, his legs will cross;
• Next, you need to pay attention to the limitations in breeding the limbs: you need to bend your legs at the knees and hips, and then gently spread them apart. In the presence of dysplasia, this will not work;
• Dysplasia can be diagnosed by placing the baby on the stomach. You need to bend his legs, as during crawling. In this position, a pronounced pathology will be noticeable. Parents should pay attention to whether the skin folds on the thighs are symmetrical, whether there is a difference in the length of the limbs. It is worth conducting such a study several times a day;
• If the baby is older than six months, you need to examine his body for asymmetry, and also examine the symmetry of the joints;
• In children older than a year, the symmetry of the muscles of the lower extremities is checked. If one of them is thinner in volume (in the thigh and lower leg), then it is less stressed.

If you have doubts, you must definitely tell your doctor about them, for example, a pediatric surgeon or orthopedist, or a neurologist. Based on the cause of the pathology, treatment will be selected.

Consequences for the baby if one leg is shorter than the other

Many people mistakenly think that different limb lengths will inevitably lead to lameness. It is not always so.

1. In the child's body, if the pathology is not treated, metamorphosis will occur: the existing defect will be compensated by the tilt of the pelvis towards shortening.
2. In the future, such a condition will lead to a curvature of the spinal column, the consequences are no less serious than degenerative changes in the joints.
3. As a result, the spine will bend in the form of the Latin letters "S" or "C", one shoulder will also lean towards the diseased limb.

What to do if the baby has one leg shorter than the other

When the violation is detected in a timely manner, that is, during the period of active growth of the body, then the chances of eliminating the pathology are quite high.

Arthrosis is a chronic pathology of the joints, proceeding according to the degenerative-dystrophic type, due to a number of provoking factors. Osteoarthritis of the elbow joint is diagnosed less frequently than lesions of other large articular joints, due to less stress on this joint. This diagnosis makes up a significant percentage of diagnoses of articular pathologies in older patients.

Reasons for the development of the disease

Osteoarthritis is characterized by a decrease in synovial fluid production, which causes increased friction of the articular surfaces, a decrease in the joint space, and the growth of bone spikes. These processes lead to problems with the mobility of the elbow joint, cause pain and dry crunch during physical activity. Arthrosis affects all articular elements, nearby muscles and tendons, epiphyses of bones.

In case of untimely visit to the doctor, the joint may lose its mobility completely, the pain phenomena grow in intensity, which greatly impairs the patient's quality of life and leads to disability.

Causes and provoking factors for the appearance of arthrosis:

• Elbow injuries: fractures, bruises, dislocations, damage to the meniscus, torn ligaments. Traumatization can occur at a young age and make itself felt many years later, when post-traumatic arthrosis develops.
• Metabolic pathologies that cause malnutrition of the articular tissues.
• Rheumatoid arthritis - with this pathology, the elbow joint is affected among others.
• Low fluid intake in the body, alimentary insufficiency (deficiency of essential substances).

• Chronic processes - tonsillitis, dental caries, gastritis, cholecystitis.
• Infectious inflammation of the elements of the joint, bursitis.
• Changes in muscle and bone tissue associated with age.
• Working conditions, lifestyle, inappropriate loads - while the right elbow suffers more often, as the most loaded, the left less often.
• Heredity.
• Intoxication in case of poisoning.
• Diseases associated with impaired blood clotting.
• Frequent acute respiratory infections.

Osteoarthritis of the elbow is also triggered by hormonal imbalance in menopausal women.

Neurologist M.M. Sperling from Novosibirsk on his video channel talks about the most serious problem - arthrosis of the joints:

Clinical picture

The symptoms accompanying arthrosis of the elbow joint are divided into four main groups:

1. Pain. It is noted in motion, at the moment of flexion and extension of the arm, when turning the limb and walking. At the first stages of the development of pathology, pain symptoms are not particularly pronounced, they appear only with additional load. The progression of the degree of arthrosis is expressed in almost constant pain, and at rest. The pain may radiate to the neck and be felt with pressure on the elbow area.
2. Crunch. The sound of a dry crunch is due to the friction of the bone surfaces of the joint. As the process of arthrosis worsens, the crunch becomes more audible, with the addition of pain. Sometimes a crunch is confused with clicking in the joint when performing any movement with the elbow, but clicks are normal and are not signs of illness.
3. Limited movement of the elbow. It becomes difficult for the patient to move his hand, turn it. It is caused by a violation of the motor amplitude, the growth of osteophytes, a reduction in the size of the joint space, muscle spasms. With elbow arthrosis, Thompson's symptom is noted: the patient cannot hold the hand in the fist in the back position, and he quickly spreads his fingers. Another typical symptom of elbow arthrosis is Wetl's symptom, which is characterized by the inability to freely bend and unbend the limb at the level of the lower jaw.
4. Elbow joint deformity. Due to the erratic growth of osteophytes, inflammation, which increases the volume of joint fluid, the joint swells, outwardly this manifests itself as tubercles on the surface of the elbow, redness of the skin.

The severity of the clinic depends on the severity of the disease. Osteoarthritis of the elbow joint develops in the stages described below:

1 degree

Unexpressed pain in the joint during physical effort, outwardly arthrosis does not manifest itself in any way. The doctor may note a slight decrease in muscle tone and some difficulty in moving the arm back, the processes of flexion and extension in the elbow area. With such symptoms, additional instrumental studies are already required. X-ray shows a slight narrowing of the space between the articular surfaces. Arthrosis at this stage must be differentiated from carpal tunnel syndrome and cervical osteochondrosis.

2 degree

There are noticeable pains, so patients are already turning to doctors for help and starting to be treated. Pain and discomfort are felt even at rest, they are joined by a dry crunch during movements in the joint. The patient is practically unable to bend the arm at the elbow or take it back. There is a slight atrophy of the muscles, it becomes difficult for the patient to do simple household things, which greatly affects the quality of life.

The picture shows multiple osteophytes, articular tissues are deformed. External changes are not yet observed or swelling of the skin in the elbow area is noted, as a rule - during periods of exacerbation.

3 degree

The pains accompany the patient almost constantly, including at night, becoming aching and intense. The range of motion is severely limited. In the absence of appropriate treatment, some patients fix the limb so that pain symptoms decrease.

More

The radiograph shows the destroyed cartilage, the absence of the joint space, many overgrown osteophytes. Changes in the shape of the articular joint are also noticeable externally - in addition to the edematous elbow joint, one arm becomes shorter than the other, the muscles are atrophied. The patient can no longer perform the usual household activities. At this stage, full recovery is almost impossible.

In this video, for you, passive gymnastics for the elbow joints, which can also be used for arthrosis:

Deforming arthrosis of the elbow joint

About 50% of the identified arthrosis are deforming arthrosis. Patients complain of the presence of pain in the joint, with increasing intensity as the pathology develops. The radiograph shows signs of joint deformity in the following stages of development:

• Osteophytes are localized in the area of ​​the distal epiphysis of the humerus, although their significant increase is not observed in this segment throughout the course of the disease, in contrast to the joint area, where the growth of bone spikes can complicate hand movements already at the onset of the disease. The depression of osteophytes into the cubital fossa and their localization in the region of the coronoid process of the humerus do not allow patients to extend the arm.
• Bone growths are distributed evenly around the elbow joint, movements in the elbow are still observed. Dysfunction comes on gradually. Osteophytes may affect the head of the radius.
• Sclerosis of adjacent bone lobes joins the overgrown osteophytes.

The periphery of the humerus is mainly deformed, osteophytes mostly grow near the articular cavity. Painful symptoms and a severe limitation of motor amplitude in deforming arthrosis are indications for surgery.

Diagnosis and treatment of elbow arthrosis

The diagnosis is made on the basis of anamnesis, x-ray picture, laboratory tests. If necessary, arthroscopy and MRI may be additionally prescribed.

Treatment of arthrosis of the elbow joint in the undeveloped stages is carried out by conservative methods. The goal of treatment is to eliminate pain symptoms and limited movement. Treatment of arthrosis is complex and long-term, including several methods at once. For the duration of treatment, the arm is immobilized with a special bandage.

Principles of treatment of arthrosis:

• Performing physical exercises to restore the mobility of the diseased joint;
• Exclusion of loads on the joint;
• Medical treatment to relieve inflammation and pain.

If conservative treatment fails, surgery is indicated. Also, patients can treat arthrosis with traditional medicine at home to alleviate the condition.

Medical therapy

The drugs for the treatment of elbow arthrosis include the following:

1. NSAIDs.
2. Ointments containing medicinal substances.
3. Chondroprotectors.

Non-steroidal anti-inflammatory drugs for the treatment of joints, relieving inflammation and pain. They can be prescribed in the form of injections intramuscularly and into the joint capsule, tablets and locally acting ointments. The most commonly used injections are diclofenac, indomethacin and their analogues - voltaren, orthofen, ibuprofen. In the acute period of the disease, it is advisable to inject NSAIDs, after a few days switching to tablet forms, as inflammation subsides. It should be borne in mind that too long a course of treatment with NSAIDs can adversely affect the gastric mucosa.

• Containing salicylates and relieving inflammation. Works well for bruises. These are salicylic ointment, solcokerasal, hemosol.
• Containing capsaicin and due to this, they warm up the diseased area, which stimulates blood supply, improves tissue trophism and relieves pain. These ointments include nikoflex, nizer, nise, kutenza, espol.
• Containing biologically active substances, based on bee or snake venom, with a combined effect - they relieve swelling and pain, warm and reduce the likelihood of tissue necrosis. Known representatives of the group: apizatron, viprosal, ungapiven.

Chondroprotectors

Chondroprotectors for joints - substances that contribute to the restoration of cartilage tissue of the joint. They are prescribed in the form of injections into the joint capsule and in the form of ointments. Of the drugs, it is most often recommended to treat joint diseases with glucosamine sulfate, chondroxide, ostenil and structum. Chondroprotectors are used for a long time, the course of treatment is usually at least six months.

Arthrosis treatment More >>

Physiotherapeutic methods of treatment are used during the period of subsiding of acute phenomena and during rehabilitation after treatment. Of the methods used, the following are effective:

• Paraffin therapy, which warms the soft tissues in the joint area and thereby stimulates blood flow;
• Electrophoresis with drugs, for their penetration into the joint capsule;
• Laser - reduces the growth of osteophytes and destroys existing ones, due to which the joint regains mobility;
• Mud compresses prescribed to eliminate atrophic changes in tissues;
• Acupuncture - the impact of needles on certain points projected onto the body, which reduces pain, reduces inflammation of the elbow, returns muscle tone;

• Massage - at the stage of rehabilitation, manual techniques have a beneficial effect on the state of the joint and surrounding muscles, restoring limb mobility and relieving pain;
• Therapeutic gymnastics is a special set of exercise therapy exercises, which is compiled by a specialist, exercises are also performed under the supervision of an instructor, they can be done both at home and in the clinic.

Additional treatments for arthrosis

To reduce pain and swelling, you can apply the recipe of alternative treatment, these are ointments, compresses, baths and tinctures:

• Propolis ointment: mix 50 grams of vegetable oil and propolis, dissolve in a water bath. Rub the resulting product into the elbow at night, after closing it with a piece of polyethylene and wrapping it with a towel.
• Compress from birch leaves: pour dry or fresh leaves with boiling water and leave to infuse for 2-3 hours, then drain the water. Apply the leaves to the sore joint, wrap with gauze and a warm cloth.
• Bath of needles: boil spruce, pine needles in water for 10 minutes, cool slightly, lower the sore arm into the bath so that the elbow is covered with water.
• Infusion of herbs: for the treatment of arthrosis, you can make infusions of elecampane and cinquefoil.

Folk remedies for the treatment of arthrosis should complement the main course. In addition to the medical complex, annual sanatorium treatment is recommended for patients with arthrosis of the elbow joint.

Gymnastics for the treatment of pain in the elbow and elbow joints from Dr. Evdokimenko:

The physiology of newborns is significantly different from that of adults. The ligamentous-muscular apparatus of infants develops during the first year. Increased bone flexibility and clicking of the articular ligaments are common in toddlers. Often, inexperienced parents know little about this, so after the first case, they immediately turn to specialists with questions.

The development of joints in infants

Small children after birth are little adapted to life outside the womb. The systems of internal organs and the musculoskeletal system in an infant function poorly.

The dynamics of development of the whole organism is not always proportional. Babies gain weight, which interferes with the strengthening of bone tissue. After six months, the kids begin to actively move, gradually lose weight. Most children by this time learn to sit, some of them are already beginning to crawl. Fat goes away, muscles and tendons appear, bones become strong and strong. By the end of the first year of life, the child will be able to confidently stand on his feet. The development of the articular and ligamentous apparatus is a long process that lasts for several years.

Causes of crunching in the joints

During exercise, you can hear the baby's arm or leg clicking. Mothers begin to wonder why the child's joints crackle.

The main reason is the physiological feature of infants. The skeletons of a newborn and an adult are significantly different. Immature joints and bones act as a defense mechanism. In the event of an accidental fall or injury, flexible tissues are less susceptible to damage.

Lack of joint lubrication can also cause cracking. The rapid growth of children is not always good. The child is actively growing, the bones are stretched, the joints are enlarged. The skeleton becomes larger, but the body does not have time to adapt to it, and continues to secrete joint lubrication in the same volumes, but they are not enough.

Severe bruises and injuries can provoke deformation of the joints, which causes a crunch. In case of such situations, you need to take an x-ray and consult a doctor.

Problem Diagnosis

The clicking of immature cartilage is more natural and is not a cause for concern. In rare cases, the cause is a disease such as dysplasia. This is a congenital disease in which the head of the femoral joint is not fully connected to the articular cavity. The patient's bones develop slowly, without proper treatment, the skeleton is formed incorrectly, which can lead to a child's disability.

Signs of dysplasia:

• Explicit asymmetry of the folds in the baby's legs.
• Clicking when moving the legs to the sides.
• One limb is shorter than the other.

This disease is hereditary, often transmitted from mother to daughter. Girls get sick four times more often.

Arthritis, arthrosis, rheumatism can also cause crunch in children. They can be triggered by metabolic disorders, sometimes they are complications of past infectious diseases.

Survey plan

Experienced specialists are able to recognize dysplasia within a few days after birth. The presence of external signs in children is not enough to make a final diagnosis. Examination of the child should be done by a specialized doctor: a surgeon or an orthopedist. Ultrasound examination will help in clarifying the medical conclusion. Radiography is applicable only for children older than 8 months.

Dysplasia is a serious disease that requires good complex treatment and special care. If violations are found, you must follow all the instructions of the doctor, do physical exercises, massage, warm baths, physiotherapy procedures.

Prevention

The baby's body develops at a rapid pace. Full growth of bones, strengthening of muscles and ligaments is impossible without nutrition, saturated with all the necessary vitamins and minerals. The daily diet should include the daily norm of all useful substances, for this you need to eat:

• dairy;
• dried fruits;
• eggs;
• cereals;
• sea ​​fish;
• beef liver;
• fruit.

It is clear that it is impossible to feed the baby with the listed useful products, so the mother should make sure that the baby can get everything he needs with milk.

Physical exercise for babies will help strengthen the bones and muscular system. You can do exercises from 3-4 months. Most of the complexes of physical exercises are aimed at stretching the ligaments, strengthening the muscles, and developing the vestibular apparatus.

If a child has cracked joints, this is not a cause for concern. Up to a year this is quite common. Children grow, their musculoskeletal system develops until about 18 years of age. Limbs click in infants, usually due to the natural features of the skeleton or from a lack of vitamins.

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- this is a decrease in the length of both limbs or a reduction in one leg relative to the other, in which the proportions of the human body are violated. A slight shortening of 1-2 cm is widespread and has no clinical significance. This phenomenon is observed in 90% of people, is imperceptible to the patient himself and is detected only during research.

Shortening of the limbs by more than 3-5 cm gives a person serious inconvenience when walking, as it causes a noticeable distortion of the pelvis. This defect, especially one-sided, leads to various diseases of the spine and joints.

Types and causes

The reasons for the slight shortening of the limbs (1-2 cm), which occurs in most people, experts believe

• incorrect muscle stereotypes that affect the formation of the human body during its growth;
• posture disorders;
• dominance of one of the hemispheres of the brain.

Shortening of one or two limbs by more than 2 cm is considered pathological.. There are the following types:

1. Bilateral limb shortening:
   • symmetrical. It is manifested by a mismatch in the proportions of the limbs and torso. Occurs with achondroplasia (underdevelopment of long bones, leading to dwarfism) and other hereditary diseases.
   • Asymmetrical. Anomalies in the development of the upper and lower extremities lead to such shortening.
2. Unilateral shortening causes various diseases. The following types are distinguished:
   • true (anatomical),
   • relative (dislocation),
   • apparent (projective),
   • total (functional or clinical).

Anatomical (true) shortening

With such a defect, the total length of the leg and thigh of one limb is less than the other. Occurs with organic bone lesions due to congenital deformity or certain diseases. There are the following reasons:

• osteomyelitis, poliomyelitis;
• fracture of the leg or thigh;
• unilateral flat feet, most often with pronation (eversion of the foot inward or outward);
• postoperative, neurogenic or post-traumatic (improperly healed fractures) retraction in knee flexion;
• congenital dysplasia (underdevelopment) of the hip joint;
• congenital dysmorphism of the tibia and femur, accompanied by impaired bone growth.

Relative (dislocation) shortening

With such a defect, the relationship between the segments of the limb is violated. This is due to the displacement of the articular ends of the bone due to congenital dislocations or intra-articular fractures.

Relative shortening is characterized by the fact that one limb seems shorter than the other, but when measured, it turns out that the thighs and lower legs of the two legs are of the same length. An example of relative shortening is hip dislocation, in which there is no difference between the anatomical lengths of the two limbs, but the defect is determined on the side of the dislocation.

Apparent (projective) shortening

It occurs due to forced flexion due to a fixed pathological installation in the spinal column or in the joints. Reasons for this bending:

• Post-traumatic contacture (stiffness), which appears most often due to the development of ankylosis. This disease is characterized by immobility of the joint, which occurs due to the formation of cartilaginous, bone or fibrous fusion of the articular ends of the articulating bones as a result of the destruction of the joint during injuries and wounds.
• Joint diseases (arthrosis, arthritis, swelling of the articular ends of the bone, etc.).

With projective shortening, as with relative shortening, the lengths of the legs seem to be different, but measurements show that they are the same. An example of such a defect can be a lumbar spine with a pelvic tilt.

Total (functional or clinical) shortening

It is characterized by the fact that the patient has several types of limb shortening. For example, flexion stiffness of the knee joint (apparent shortening) can be combined with a decrease in the length of the femur after an ill-union fracture of the femur (true shortening).

Functional shortening can be eliminated. Most often it occurs due to imbalance at the level of the lumbar muscles and pelvis. The etiology of this defect:

• Iliosacral causes: unilateral flexion (flexion) of the sacrum on the opposite (contralateral) side of the shortening, as well as posterior torsion (twisting) of the sacrum on the side of the shortening and anterior torsion on the contralateral side.
• Lumbar causes: spasm of the square muscle on the side of shortening or lumbar bulge on the opposite side.
• Sacroiliac causes: postero-superior displacement of the pubic bone on the contralateral side, posterior rotation (rotation) of the ilium on the side of shortening and anterior - on the opposite side.
• Muscular causes: retraction (contraction) of the quadriceps femoris or ischio-tibial muscles.

Symptoms

They can be moderate or pronounced. The following signs of limb shortening are distinguished:

1. Unsteadiness when walking, accompanied by frequent falls. The symptom manifests itself in patients with a slight shortening of the limbs.
2. Lameness. It appears and is clearly visible when the limb is shortened by more than 5 cm. With a less pronounced difference, this symptom may not be, because the body compensates for it by curvature of the spine and tilt of the pelvis.
3. The difference is in the level of location of the greater trochanters, popliteal fossae, anterior and posterior superior iliac bones, and superior poles of the patella.
4. Pain localized depending on the damaged area:
   • in the groin, thigh, sacroiliac joints;
   • in the lower back with irradiation to the leg;
   • in the neck and shoulder area;
   • in the knee or ankle.

Diagnostics

1. Inspection

When examining a patient, a difference in the lengths of the limbs is almost always revealed, which is not always noticeable due to the compensatory curvature of the spine. Therefore, measurements are made of the relative length of the legs (from the anterior superior iliac spine to the medial malleolus) and absolute (from the greater trochanter to the medial malleolus).

Visually, shortening of the limb can be determined by the following features: different levels of position of the patella and popliteal fossae, trochanters of the thigh bones, anterior and posterior superior iliac spines, and iliac crests. The detected changes are evaluated taking into account the position of the levels of the shoulder blades, shoulders and ribs, revealing scoliosis.

The diagnosis of "anatomic shortening" is made on the basis of the clinic, the height of the iliac crests, radiography and data obtained by measuring the legs. Functional shortening is determined using various tests:

• test of four parallel lines;
• leg length test lying on the back (shortening caused by iliosacral causes);
• flexion tests sitting and standing (positive - with pathology in the sacrum, a positive test standing and a negative sitting - with iliac causes);
• leg length test lying on the stomach (sacral-iliac causes).

2. Measuring the length of the legs

The size of the shortening of the limb is determined by placing boards of different thicknesses under the foot until the pelvis is in a normal position: the midline of the body should be perpendicular to the horizontal line that connects the anterior upper pelvic spines. After that, the total shortening is determined by measuring the height of the boards placed under the foot with a centimeter tape.

3. Conducting tests

• Test of four parallel lines. 4 lines are drawn through the points:
  • iliac crests;
  • posterior superior iliac bones;
  • greater trochanters of the thigh bones;
  • ischial tubercles.

If the lines are oblique and parallel to each other, then anatomical shortening is diagnosed. Drawing at least one line that is not parallel to the others indicates a functional shortening.

• Test lying on the back and stomach

The doctor covers the patient's ankles with his hands and probes the medial ankles with his thumbs, assessing their rotation and relative position. After that, the patient sits down. With limited mobility in the sacroiliac joint of one of the legs, the injured limb in the prone position will be shorter than the healthy one or have the same length with it, and longer in the sitting position.

With the patient in a sitting position, the doctor measures the distance between the levels of placement of the ankles. A difference of up to 2 cm is not a pathology. The same measurements are made in the position of the patient lying on his stomach with straightened legs. If one of the ankles is closer to the body, then there is a sacroiliac pathology on this side, and with the same level of ankles, there is no shortening.

• Standing Flexion Test

The patient stands with straightened legs. The doctor is behind him and places his thumbs under the postero-superior iliac spines on both sides.

If, when the patient leans forward, one of the sides goes up and forward, then the sacroiliac joint and the sacrum are blocked,

and there is pathology.

• Sitting Flexion Test

Patient position: sitting, feet on the floor, legs bent at the knees at an angle of 90 degrees and moved apart so that the patient's shoulders enter between them when leaning forward. The doctor stands behind and places his hands in the same way as in the previous test.

If the patient can lean forward and the posterior-superior spines do not change their ratio, then the dysfunction is in the lower extremities. If it is impossible to tilt, the place of pain should be determined.

The pain may be localized in the lower extremities, pelvis or spine. A combination of painful zones is also possible, in which the doctor watches the movement of the posterior-superior iliac spines when bending forward. When their ratio changes, damage is diagnosed from the side that goes up and forward, and if the ratio does not change (negative test) or is less pronounced than with the standing test, then the damage is located at the level of the pubic joint, iliac bones or lower extremities to the talus. With a positive sitting test, the damage is at the level of the sacrum.

4. Additional research

The list depends on the alleged cause of limb shortening and its location. The following diagnostic methods are used:

• Radiography. Perform with tumor processes, old fractures, infections. Depending on the location, a picture of the thigh or lower leg is taken. With arthrosis, they are sent for x-rays of the hip or knee joint.
• Arthroscopy. The method is relevant for arthrosis of the knee joint.
• MRI. Do with suspicion of soft tissue damage.
• Consultations of specialists (infectionist, oncologist, venereologist, phthisiatrician, rheumatologist) according to indications.

Treatment

With a slight shortening of the limb, it can be compensated with the help of individual orthopedic insoles or shoes. On the side of the shorter leg, an insole with a heel pad of a certain height is used. The use of such orthopedic devices is not recommended for functional shortening of the leg, since the heel pad will fix the incorrect position of the pelvic bones and will be harmful.

In case of anatomic shortening, insoles with a heel pad are made after osteopathic correction of the pelvic ring. They keep the pelvis in a physiologically correct position and prevent pathological reversal. In this case, the heel pad must be made to the nearest millimeter.

If a large difference between the lengths of the limbs is revealed, leg lengthening is shown using the Ilizarov apparatus, which stretches the thigh by 5-6 cm, and the lower leg by 8-10 cm. able to move, as it experiences severe pain.

Installing and wearing the Ilizarov apparatus

Compression-distraction osteosynthesis is based on the law: the tension that occurs when bones and soft tissues are stretched stimulates the processes of growth and regeneration of bone tissue. Limb sprain is a long process lasting 6-12 months. During this time, bone elongation and ossification of the regeneration zone occur.

During the operation, a dissection of the bone is performed, which must be increased. The bone edges are connected with a gap of 1 mm and fixed with rods or spokes fixed in half rings or rings of the Ilizarov apparatus. Then the bones are lengthened to the required value by 1 mm per day by adjusting the apparatus. The stretch zone is gradually overgrown with bone tissue.

The bone lengthening process can be painful and may require pain medication. Over time, adaptation occurs, and discomfort decreases.

Wearing the device is quite easy to carry, as it retains sufficient mobility, but during treatment, the patient can only move a limited distance with the help of crutches. The installation of the Ilizarov apparatus on the thigh significantly limits self-care and movement, therefore it is more difficult to tolerate. In addition, the process of operating the femur itself is dangerous due to the development of various complications (infection, bleeding), which is associated with a more complex arrangement of nerves and joints and a large volume of soft tissues in the thigh compared to the lower leg.

During treatment, patients should perform exercises to maintain joint mobility and prevent muscle atrophy (metered walking). After removing the apparatus, restorative therapy is indicated: massage, physiotherapy, exercise therapy, etc.

Effects

Discomfort when walking and standing, caused by shortening of the limb, violates the normal anatomical relationships between body parts and leads to various diseases of the musculoskeletal system. The trunk and legs are twisted and displaced, the alignment of the joints is disturbed. To ensure the vertical position of the body, compensatory deformations are formed. The load on the longer limb increases, the pelvis warps.

First of all, the spine suffers, compensating for the defect in the legs. When the pelvis tilts, it becomes at an angle to the horizontal line, but with a straight spine, the body begins to "fall" to the side. To prevent this from happening, the body bends it, trying to shift the center of the body as close as possible to its center line.

With unilateral shortening up to 1.3 cm, the spine forms a C-shaped bend, more than 1.3 cm - an S-shaped one. Over time, a violation of posture is fixed, and secondary compensatory scoliosis develops, in which the muscles are in a state of constant increased tension. This leads to pain in the joints, back, muscles, heaviness in the legs and feet after walking. Blood and lymph circulation worsens.

With a long-term pathology, deforming arthritis of the hip (coxarthrosis) or knee (gonarthrosis) joint develops, osteochondrosis (dystrophic disorders in the articular cartilage), and flat feet are aggravated. After the onset of these diseases, it is difficult for the patient to move due to intense pain, and he becomes disabled.

- this is a decrease in the length of one limb relative to the other, or a decrease in the length of both limbs, in which the proportions of the human body are violated. A slight shortening (1-2 cm) is widespread and has no clinical significance. A significant shortening of the lower extremities, especially one-sided, is manifested by violations of support and walking, can provoke a number of diseases of the joints and spine. The diagnosis is made after special measurements. Correction with insoles and orthopedic shoes is possible; in case of severe shortenings, the limb is lengthened using the Ilizarov apparatus.

ICD-10

M21.7 Q71 Q72 Q73

General information

Limb shortening is a widespread phenomenon. A slight difference in the length of the lower limbs is detected in 90% of people. Among the reasons are the dominance of one of the hemispheres of the brain, posture disorders and incorrect muscle stereotypes that affect the formation of the body during the period of growth of the child. The difference in leg length up to 1-2 cm is imperceptible even to the patient himself and is found only during special studies. Shortening of one limb by more than 3-5 cm causes a noticeable distortion of the pelvis and makes it difficult for a person to walk.

The reasons

Shortening of the limbs can be unilateral and bilateral. Symmetrical bilateral shortening is detected in achondroplasia and some other genetically determined diseases and is manifested by a mismatch in the proportions of the trunk and limbs. Asymmetric bilateral shortening is observed with anomalies in the development of the upper and lower extremities. The cause of unilateral shortening can be a traumatic injury, tumor, infectious process, or malformation.

Classification

Diagnostics

To clarify the severity and nature of the shortening, the absolute and relative length of the limb and the length of each segment are measured using visible bone protrusions (ankles, the upper pole of the patella, the joint space of the knee joint, the greater trochanter and the superior anterior iliac spine) as reference points. Measurements are carried out with fully extended legs, with alternate flexion of the hip and knee joints and with simultaneous flexion of the large joints of the limb. To identify relative and apparent shortening, special tests are used.

The list of additional studies depends on the location and the alleged cause of the shortening. For old fractures, tumor processes and infections,

The Ilizarov apparatus allows lengthening the lower leg by 8-10 cm, and the thigh by 5-6 cm. It should be borne in mind that the increase in the length of the segment is carried out gradually and can last up to six months or more. Installing the device on the shin is relatively easy to tolerate by patients, since it allows them to maintain sufficient mobility, slightly interferes with movements in the joints of the limb, etc. Installing the device on the thigh is more difficult to tolerate, since it significantly limits movement and self-care. During the entire period of treatment, patients perform special exercises aimed at preventing muscle atrophy and maintaining joint mobility. Functional results are good.

Many parents notice that their child has one shoulder higher than the other. This condition sometimes also occurs in adults. It always indicates a lateral curvature of the spine. Some believe that there is nothing wrong with that, what difference does it make at what level the shoulders are.

But in fact, such a curvature is a serious pathology and, without treatment, can lead to dangerous health consequences.

The mechanism of the appearance of pathology

When one shoulder is lower, the other is higher, it is always associated with a curvature of the spine. Such a pathology in medicine is called "scoliosis". According to statistics, it occurs most often in children from 7 to 15 years. After all, it is at this time that there is a huge load on the spine that has not yet formed. The child is forced to sit at the table for a long time. His muscles can't support his spine and get tired. Because of this, the child involuntarily bends his back, lowering 1 shoulder. The flexibility of the bones and the weakness of the ligaments support the curvature, so it remains even when moving.

Such a pathology in adults rarely occurs, and even less often they go to the clinic with it. After all, it is difficult to independently control the symmetry of the shoulder girdle, and this condition usually does not cause discomfort. Deformation is detected in an adult with the appearance of back pain, numbness of the legs or arms, lameness, dizziness and other consequences. At the same time, it is almost impossible to correct the situation, it is only possible to stop the progression of the deformity.

The reasons

Most often, parents turn to the doctor with a question why the child has one shoulder higher than the other. Only in rare cases, with congenital anomalies of the skeleton, it is possible to detect asymmetry of the shoulder girdle immediately after birth. Usually, at the same time, other pathologies are observed in the baby, for example, torticollis or deformities of the limbs. This condition also develops with cerebral palsy or rickets. But most often the curvature of the spine is acquired, and occurs due to an improper lifestyle.

If such a curvature in an adult was not a consequence of untreated scoliosis in childhood or weakness of the back muscles, then the reasons for it may be more serious:

• osteochondrosis;
• herniated discs;
• spinal stenosis;
• osteoporosis or osteomalacia;
• osteomyelitis;
• consequences of spinal surgery.

When sitting at a table for a long time, the child involuntarily raises one shoulder to compensate for the increased load on the spine.

How it manifests itself

Scoliosis in the initial stages is very difficult to recognize. It usually does not cause any back pain or discomfort at first. But the progression of deformation gradually leads to serious consequences. Therefore, it is very important for parents to pay attention in time to such a sign as asymmetry of the shoulders. In addition, you can notice that the child has one arm shorter than the other, the pelvis is tilted, which is why the hip joints are not in the same line. Asymmetrical arrangement of the shoulder blades, as well as protrusion of the ribs, can also be symptoms of scoliosis. Best of all, such signs are noticeable if you ask the child to lean forward with his hands down. In this case, it will be clearly seen that the spine is curved, and one arm is longer than the other.

Children usually do not show any other symptoms, except for increased fatigue. But with such a deformation in adults, back pain, weakness in the muscles of the legs, numbness or tingling of the fingers can be observed. May develop a change in gait, difficulty in movement.

Most often, the asymmetry of the shoulders is a manifestation of the lateral curvature of the spine.

What are the consequences

Sometimes only on this basis it is possible to detect the curvature of the spine at the initial stage. It is very important not to ignore different shoulder heights, as the pathology will gradually progress. Scoliosis is not dangerous only at grades 1 and 2, then it can be cured, especially in a child. But after the ossification of the skeleton, it will be almost impossible to correct the deformation. And the work of all organs, the blood supply to the brain and the proper functioning of the musculoskeletal system depend on the health of the spine.

The most harmless consequence of such a deformation is headaches and dizziness. They signal squeezing of blood vessels due to the curvature of the spinal canal. In addition, the nerves that control the functioning of the limbs can also be affected.

Sometimes there are problems with the hip joint, knees. With a curvature of the spine in the thoracic region, and this is the reason that one shoulder becomes higher than the other, the work of the heart, digestive system or respiratory organs may be disrupted.

Treatment

Most often, conservative therapy to correct spinal deformity is used in children. Methods of treatment are selected individually depending on the degree of curvature, the age of the patient. Usually this is physiotherapy exercises, massage, physiotherapy and wearing corsets. Only in severe cases, when the spine is tilted more than 40 degrees, surgical correction is indicated. But according to statistics, such treatment is required only in 1 case out of 1000. For the rest, constant control over posture and muscle strengthening is sufficient. In the early stages of the curvature, wearing reclinators or other orthopedic devices to control the position of the shoulders is effective.

It is very important to diagnose the presence of deformity in time and start treatment.

The same methods are prescribed for deformation of the shoulder girdle in adults. Only their effectiveness will be much lower. True, it is much easier for an adult to control the position of the shoulders and the correct posture. But due to the fact that at this age the curvature most often develops against the background of other pathologies, specific treatment is also prescribed, for example, drugs against osteoporosis. Treatment of spinal deformities in adults can take not a year or two, as in childhood, but much more.

And with scoliosis in children, the entire responsibility for the result of treatment lies with the parents. Therefore, it is very important to know what to do at home in addition to the procedures prescribed by the doctor.

• First of all, it is important what the child sleeps on. Up to 15 years, and especially with a curvature of the spine, it is recommended to purchase a hard or semi-rigid orthopedic mattress. It will help slow the progression of the deformity.
• For school books you need to buy a backpack. After all, wearing a bag on one shoulder is often the reason that it becomes lower than the other.
• To do homework, you need to purchase a table that matches the height of the child, and a chair with orthopedic properties.
• It is important to constantly control your posture, especially during the lessons. It is at this time that the child most often lowers or raises one shoulder to compensate for the work of tired muscles.
• Regularly you need to perform special exercises prescribed by your doctor.
• Nutrition should be complete, balanced, fully meet the needs of a growing organism in nutrients.
• You should not look for yourself how to correct the deformity, use folk methods or visit chiropractors. Only a specialist after examination and determination of the cause of the pathology can prescribe treatment.

Massage is effective for strengthening the back muscles that support the spine in the correct position.

Physiotherapy

Since most often the cause of the curvature is weakness of the muscular-ligamentous apparatus, then the pathology is treated with special exercises. In addition to them, swimming, skiing, outdoor games are useful. And every day you need to do gymnastics. Therapeutic exercises can be included in the morning exercises or performed in the afternoon. When exercising, you should avoid strong stretching of the back muscles and increased stress on the spine. Each exercise is performed 5-7 times. When working only one side of the body, be sure to repeat it on the other side.

So, the sequence of execution is as follows:

• Stand straight, feet shoulder-width apart, arms down. Perform tilts to the side, while one hand slides down the leg, the other up into the armpit.
• In the same starting position, raise one hand up. Perform jerks with your hands back. Change the position of the hands.
• Get on all fours. Raise your right arm and left leg at the same time, stretching your body.
• In the same starting position, with a sliding motion, move your hands forward, bending in your back, then bring your hands closer to your knees.
• Lying on your stomach, spread your arms to the sides. At the same time, lift your upper body and bend back.
• Do the same by picking up a gymnastic stick and stretching your arms forward.
• Lying on your back, raise your arms above your head. Perform exercises "bike" and "scissors".

When one shoulder is higher than the other, it may just be a bad posture that is corrected by muscle control and strengthening. But sometimes this condition is a symptom of scoliosis. It is necessary to treat the pathology as early as possible, then complications can be avoided and the health of the musculoskeletal system can be maintained.

Why can one shoulder be higher than the other and how to fix it?

Scoliosis is a curvature of the spinal column in relation to the vertical axis of the body, with one shoulder higher than the other. In most cases, the disease manifests itself in childhood. If the pathology progresses slowly, the signs are expressed in adulthood (with an increase in physical activity). To develop an optimal treatment regimen for scoliosis, it is necessary to take into account the provoking factors, the degree and speed of development of pathological changes in the structure of the spine.

This pathology manifests itself in various ways. Deformation of the spine due to development:

1. 1. Acquired - manifests itself at the age of 6-15 years during the period of intensive growth of bones and the formation of the skeleton. In girls, the disease is more common, but the reasons for its development have not been studied.
2. 2. Congenital - develops with abnormal development of the fetus in the womb. Often scoliosis occurs due to violations in the formation of the hips and spine, fusion of the ribs. Sometimes in the process of intrauterine development, an extra vertebra is formed in a child.

Violations in the structure of the spine by type of curvature:

• c-shaped scoliosis - the spine curves to the left or right side in the form of the letter c;
• z-shaped curvature of the spine - curvature of one or 2 sections of the spinal column in opposite directions;
• S-shaped deformity of the spinal column - a curvature in 3 places, affecting the cervical, thoracic and lumbar vertebrae.

The division of scoliosis according to the degree of development of the disease:

1. 1. Scoliosis of the 1st degree - a barely noticeable curvature with a slight stoop, while the right shoulder is slightly higher than the left or vice versa. This type of disease can be detected when examining a patient.
2. 2. Scoliosis of the 2nd degree - characterized by back pain and asymmetry of the shoulder blades. It is the most common form of pathology.
3. 3. Scoliosis of the 3rd degree - unbearable back pain occurs. Perhaps a change in the shape of the body, manifested in the form of protrusion of the ribs.
4. 4. Scoliosis of the 4th degree - a costal hump is formed against the background of a pronounced deformation of the back. This form is characterized by retraction or protrusion of the parts of the costal skeleton.

Types of the disease, divided by age categories:

• infantile deformity of the vertebrae - manifests itself in children under 3 years old;
• juvenile deformity of the vertebrae - diagnosed at the age of 3 to 10 years;
• youthful deformity of the spinal column - found in adolescents under 15 years of age;
• deformity of the spine in adults - is fixed in patients of mature age after the complete formation of the skeleton.

Noticing a stoop in a child, anxious parents resort to self-medication. Scoliosis is a serious disease of the spine. Therefore, unskilled therapeutic intervention can lead to impaired musculoskeletal functions. Incorrect posture can be evidence of various pathologies of the spine. An accurate diagnosis can be made with an x-ray.

The causes of the disease are associated with deviations of the central nervous system and the musculoskeletal system. Spinal deformity can be caused by:

1. 1. Intervertebral hernias.
2. 2. Osteochondrosis.
3. 3. Rickets.
4. 4. Violations of tone and muscle spasms in the back and neck.
5. 5. Congenital curvature of the neck.

When examining the patient's back, you can see the bend of the spinal column, and in a healthy person, the spine forms a straight axis. The main symptom of pathology is pain when walking or staying in a standing position. The longer a person stands, the stronger the pain becomes.

Signs of scoliosis appear when the child begins to walk. There is a stoop, with the left shoulder lower than the right. Signs of illness:

1. 1. If you look at the child from the back, there is a deviation of the head to the left or right along the axis of the spinal column.
2. 2. Asymmetry of the shoulders, while there is an unequal distance between the shoulder and the ear (both on the right and on the left). Due to the uneven line of the shoulders, one arm seems longer.
3. 3. The shoulder blades are at different levels, and one of them protrudes. With a slight inclination, they can stick out in different directions.
4. 4. The spine is bent along a vertical line from the occipital to the sacral region. With the help of a thread and a weight, the curvature can be determined. It is necessary to attach the thread to the central point of the cavity (on the neck), releasing the weight. The thread must pass strictly in the center of the column.
5. 5. In an even stance in a healthy child, the distance between the arm and the hip line is the same on both sides.
6. 6. With a curvature of the spine, the child has an uneven line of the hips horizontally, that is, one thigh is higher than the other. Possible asymmetric displacement of the hip bone.

If one or more signs are found, professional medical attention should be sought.

To confirm or refute the diagnosis of scoliosis, an X-ray machine is used, which allows you to identify other diseases of the musculoskeletal system. When conducting a diagnosis, it is important to determine the degree of curvature:

1. 1. Initial form (1 degree) - up to 10º.
2. 2. Medium form (grade 2) - up to 25º.
3. 3. Moderate form (grade 3) - up to 50º.
4. 4. Severe form (grade 2) - up to 25º.

Treatment options for curvature of the spine include:

Surgical intervention is used in complicated cases of scoliosis. The disease puts pressure on the internal organs, which leads to their deformation. To eliminate the curvature of the spine of the 1st degree, it is necessary to pay attention to the development and strengthening of the muscles. Exercise therapy, swimming and massage contribute to the normalization of muscle tone.

Treatment of scoliosis of the 2nd degree involves not only physical exercises, but also the wearing of a specialized corset. It is created in accordance with the individual parameters of the patient's skeletal structure. First, the corset should be worn for several hours, and then throughout the day.

To cure the disease of the 3rd degree, long-term wearing of a corset is indicated. When the angle of curvature is more than 44º, surgical intervention is applied. Specialists install a corrective system on the spinal column. It allows you to pause and correct curvature.

With 4 degrees of scoliosis, radical methods of treatment are used, the main tasks of which are:

• elimination of the causes of scoliosis;
• maximum correction of curvature of the spine;
• suppression of pain in the back and limbs;
• return of vertebral mobility.

Therapy is prescribed by a qualified specialist, depending on the picture of the disease. In especially severe cases (against the background of the rapid development of pathology), doctors resort to the use of a muscular corset and surgery. The likelihood of recovery increases if psychological support is provided to the child.

Mud and sun baths, hydromassage, baths with sea salts have a positive effect. It is necessary to constantly monitor the child's posture and remind them that the correct posture will make them feel better. Additionally, exercises are performed to correct flat feet and hardening. At the same time, walks in the fresh air and outdoor activities are recommended.

Congenital scoliosis cannot be prevented, but measures should be taken to prevent acquired scoliosis:

One hand is smaller than the other in volume - what to do ?!

After training for a while, you notice that one arm is smaller than the other in volume of the other, especially the biceps. What to do?

You should try to load the right and left hands separately. Thus, you will be able to equalize the strength and volume of the biceps due to the additional load on the lagging arm. Take a closer look at your roommates at the moment when they perform bending of the arms with a barbell while standing.

If the weight of the projectile is large enough, then when lifting the bar begins to warp somewhat. This is because one hand is stronger than the other. Keep in mind that the total amount of weight you can lift by working each arm alone is more than the weight of the bar if you were lifting both arms at the same time.

And this means a greater load on the muscle, a more tangible blood flow to it, and hence greater progress. Your attention is invited to an approximate version of such a workout (see table 1):

Do the same number of repetitions on the left and right hands, and also follow the correct technique for performing the exercises.

If you crookedly press the bar, or crookedly lift dumbbells, then the load on one side will be more than on the other. Therefore, follow a clear technique in all exercises, control the exercise by looking in the mirror, or ask a friend to watch how you do the exercise.

This breaks the technique of the exercise, develops incorrect skills in you and can lead to injury. Moreover, if one side is weaker, then what is the point of taking more weight for it? It turns out that the strong side will not work, and the weak side simply will not pull out too much weight. It is necessary to train correctly, observe the technique and load the muscles equally, then the muscles will gradually even out in size, and will continue to develop evenly.

Exercise regularly, then you can align your muscles

Muscle development takes time, so be patient, train regularly and you will notice that the muscles will begin to develop harmoniously and proportionately.

Why is one leg shorter than the other, causes and treatment

Different leg lengths: causes and treatment

Different leg lengths are a fairly common phenomenon: short leg syndrome occurs in people of any age, gender and social status, and more often in children than in adults. When one limb is only a couple of centimeters shorter than the other, this is not very noticeable, but a drop of more than five centimeters cannot be ignored with all the desire: a person walks, limping, rolling from side to side or leaning on a cane, his shoulders are located at different levels ( due to the difference in height, many develop scoliosis).

On slippery surfaces and in moving public transport, such people find it difficult to maintain balance, as their musculoskeletal system is unbalanced. Obviously, living with such a deviation is not easy. Not every person who has encountered a similar problem knows what to do if one leg is shorter than the other. Fortunately, there are ways to level the difference in leg length - more about them will be discussed below.

Causes of Short Leg Syndrome

You can’t envy a person whose limb is longer than the other: lameness, curvature of the spine, constant pain in the joints and back, a high likelihood of developing arthrosis and bursitis. Not life, but continuous overcoming of difficulties. So what to do if one leg is much shorter in size than the other, how can you protect yourself and loved ones from a similar fate? To answer this question, you must first familiarize yourself with the specifics of the disease, namely with the causes of the pathology and its varieties.

If one leg is shorter than the other by 3, 5 or more cm, then there can be many reasons for this development of the pathology of the lower extremities, but they all belong to one of three factors. Experts identify three factors that affect the length of the lower limbs:

1 Anatomical factor (decrease in bone length).

2 Relative factor (dislocation, joint immobilization).

3 Combined effect (stunting or accelerated growth, due to which the length of both limbs changes at once).

The shortening of one of the limbs, as a rule, leads to:

1 Failure in the process of intrauterine development of the fetus, as a result of which an unborn baby develops a clubfoot or hemophilic hemarthrosis, or a dislocation of the hip occurs.

2 Inflammation provoked by tuberculosis, thrombosis of the veins of the lower extremities, arthritis, elephantiasis.

3 The tumor process can cause a difference in the length of the legs, both in an adult and in a child.

4 Neuropathic factors can cause this pathology.

5 Damage to the growth zones located on the heads of the tibia and femur. Children who find themselves hostage to such a situation have a harder time than adults: the difference in their leg length continues to increase until the growth stage is completed. Adults have already experienced this stage of their lives, and therefore the difference in the length of their limbs as a result turns out to be significantly lower.

When one limb is shorter than the other, the load on the spinal column is unevenly distributed. As a result, a person develops scoliosis and osteochondrosis, twisting of the pelvis occurs, as well as eversion of the fifth lumbar vertebra. Such deviations occur both when a certain part of the leg (thigh or lower leg) is shortened, and the entire limb as a whole.

The difference in the length of the legs in children, the reasons why this happens?

The sooner parents notice that the child has one leg shorter than the other, the less time and effort it will take to eliminate it. Violations of the musculoskeletal system in the fetus can be detected already at an early stage of pregnancy thanks to ultrasound, which is mandatory for all expectant mothers.

There are two types of deviation that can cause shortening of the legs in an unborn child:

1 Symmetrical developmental delay (diameter of the head and abdomen, length of the trunk and thigh are within the normal range, but the size of the fetus is proportionally reduced).

2 Asymmetric developmental delay (non-compliance of certain parts of the baby's body with generally accepted standards).

After the birth of a child, checking the parameters is assigned to the local pediatrician. You can measure the length of the baby's limbs without resorting to the services of a doctor. To do this, lay the baby on his back, bend his legs at the knees so that the angle between the body and thigh, thigh and lower leg is ninety degrees. If one of the knees is higher than the other, then the child's hips are different in length. To determine the size of the shins, you need to lower the baby's legs, still bent at the knees, and press his feet to the surface of the bed. If one of the knees rises above the other, then the size of the legs also does not match and you need to consult a specialist.

In children, the height of the longitudinal arches of the feet often does not match, which is why babies develop scoliosis. The curvature of the spinal column to the right or left side disrupts the structure of muscles, cartilage and ligaments, which is fraught with the development of serious diseases. If there is a suspicion of a deviation, you should immediately consult a doctor: the sooner the pathology is eliminated, the better for the child.

Treatment of short leg syndrome, what to do if one leg is shorter than the other

Modern medical technologies make it possible not only to lengthen short limbs, but also to correct the curvature of the legs that develops against the background of pathology.

There are several methods to achieve the desired result if one leg is longer than the other. A conservative tactic for treating short leg syndrome, which is used if one leg is shorter than the other by no more than two centimeters, involves:

1 Putting orthopedic insoles in shoes to compensate for the difference in the length of the limbs.

2 Visiting a chiropractor to relieve muscle stiffness and pain.

3 Performing exercises aimed at strengthening muscles, joints, ligaments and tendons, preventing curvature of the spinal column.

4 Swimming in the pool and attending water aerobics classes to develop and strengthen the musculoskeletal system.

If one leg is significantly shorter than the other, surgery is performed. Traction in the Ilizarov apparatus is rightfully considered the most effective way to lengthen a limb, which involves cutting the bone with subsequent fixation of the leg in the device. Almost immediately after the operation, the bone fragments begin to grow towards each other (at a rate of one millimeter per day). When the bone is completely healed (and this happens no earlier than six months after the procedure), the device is removed and the patient is sent for rehabilitation.

Traction using the Ilizarov apparatus is also used in aesthetic surgery clinics, which are used by absolutely healthy people who dream of lengthening their limbs. Such a procedure is not cheap, and its result does not always live up to expectations, which, in principle, is understandable. Any intervention in the body does not pass without a trace. It’s good if you come across an experienced surgeon who, as they say, “ate a dog” while stretching his limbs. And if you get a newbie? And then, even a professional with many years of experience is not immune from mistakes. So is it worth lengthening short legs if they do not cause problems? People with short leg syndrome have no other choice, but healthy representatives of homo sapiens have, and yet they take such a desperate step. It is a pity that few think about the possible consequences.

In addition to traction on the Ilizarov apparatus, blocking of the growth zones of a healthy limb is also used. This method is suitable for children: thanks to the intervention of the surgeon, the difference in the length of the lower limbs is leveled over time, and when the growth phase stops, the need for any manipulations to align the legs disappears by itself.

Competent specialists can diagnose such a pathology as asymmetry of the lower extremities even during ultrasound during pregnancy. In this case, the diagnosis and the appointment of a course of treatment will be made immediately after the birth of the baby.

If any developmental pathologies are established by an orthopedist during a routine examination in the first months of a baby’s life, then the doctor must register such a child and prescribe the necessary therapy for him. If there are symptoms that indicate hip dysplasia, when the child reaches the age of three months, he will need to have an x-ray examination and ultrasound. Based on the results of these examinations, a diagnosis will be established and treatment will be prescribed depending on the severity of the pathology.

You can determine the presence of asymmetry in the legs of a child yourself at home. To do this, visually assess the symmetry and depth of skin folds. It is most convenient to do this when the baby is lying on the tummy. Then you should turn the child on his back, straighten his legs, bringing them together and again evaluate the symmetry of the folds on the inner surface of the thigh. The next step is to spread the bent legs of the child to the sides - in a healthy baby, each leg should touch the surface of the changing table. If you can’t spread your legs to the sides, then this may be evidence of both increased muscle tone and hip dysplasia. You should also pay special attention to clicks during this procedure, as they always indicate a problem with the joints.

You can check for dysplasia in another way - to do this, put the child on a hard surface on his back and bend his knees. If the baby's knees are at different levels, then immediately contact an orthopedist to clarify the diagnosis and prescribe an effective treatment for the problem.

Checking muscle hypertonicity at home is also quite simple. The child must be laid on his back and give him your fingers so that he can grab them tightly. At the same time, a healthy baby begins to move his legs very actively, trying to take a sitting position. If the child constantly crosses his legs, then the likelihood of muscle hypertonicity is very high.

Increased muscle tone may be accompanied by other symptoms, among them:

1 restless sleep;

3 too frequent regurgitation;

4 independent holding of the head from the moment of birth;

5 emphasis on socks in a vertical position;

6 active resistance when trying to spread the legs apart;

7 irritated reaction to extraneous sounds and lights on;

If a child has at least one of these signs, then it should definitely be shown to a specialist. In case of a fracture of the lower extremities, especially if it happened in childhood, it is necessary to constantly monitor the fusion of bones by conducting an X-ray examination.

Another dangerous reason for the asymmetry of the lower extremities is the presence of neoplasms of a different nature. However, the difference in the length of the legs may appear already at a late stage of the disease, much earlier the child may begin to complain of excessive fatigue, pain when resting on the affected limb. Visually, you can also notice that one leg looks a bit thicker than the other. Any of these symptoms or their combination should be the reason for contacting a medical institution.

Mandatory vaccination against tuberculosis has caused a decrease in the number of cases in the younger age category, however, a decrease in the protective forces of the child's body and his close contact with a sick person can lead to illness. Tuberculosis of the bones begins gradually, its first signs are quite blurred and some children do not even pay attention to them. A visit to the doctor is mandatory if the child begins to complain of a breakdown, irritability, drowsiness, muscle aches, absent-mindedness. Visually, you can note the appearance of a stoop, sudden lameness, a change in the volume of one of the limbs.

To confirm the diagnosis, a tuberculin test should be performed, as well as an MRI and radiography of the affected segment.

When is the difference in leg length not a pathology?

A slight difference in the length of the lower limbs is a variant of the norm; quite often, shortening of the right leg is diagnosed in children who prefer to use their left hand. In addition, a healthy child is usually physically active. He spends a lot of time in motion, running, jumping, riding various modes of transport. Over time, one of his legs becomes the leading one, which he prefers to use when pushing off the ground. Such an uneven load leads to a slight shortening of the jogging leg. Over time, the length of the limbs becomes the same.

Complications associated with different lengths of the lower limbs

The pronounced asymmetry of the legs, especially in childhood, can cause a curvature of the spinal column, resulting in scoliosis - a persistent deformation of the spine relative to its axis. In the absence of proper attention, this disease can lead to irreversible complications, for example, chest deformity, pelvic asymmetry, malfunctions of the cardiovascular system, respiratory organs and spinal cord. The uneven distribution of the load also leads to the development of flat feet in the child.

Depending on the mechanism of development of the disease, several varieties of scoliosis are distinguished:

1 Dysplastic - occurs in childhood against the background of metabolic disorders in the tissues of the vertebrae and intervertebral discs.

2 Static - manifested as a result of bone and joint disorders in the legs.

In adulthood, the asymmetry of the lower extremities can cause various pathologies of the musculoskeletal system, which can lead to the appearance of a hernia, prolapse of the vertebrae and other complications. Such patients quite often complain of pain in the abdomen and back.

Muscle asymmetry. What to do?

My respects, ladies and gentlemen!

We owe this article to Pavel, Oleg, Valentin and other male readers of the ABC of Bodybuilding project. They asked their question: muscle asymmetry, what to do? - through the feedback form and wanted to get a detailed answer. Well, if you want, then get it!

So, sit down, my dear, let's start broadcasting.

What is muscle asymmetry? An unthinkable theory.

I think that everyone reading these lines has had such a situation in the gym when you do an exercise, for example, alternately lifting a dumbbell for biceps and suddenly you realize that your left hand is no longer furying - it’s not pulling weight, but the right one can still calmly perform 2- 3 repetitions. Familiar, right? Also, I'm sure some of you have experienced muscle disproportions or asymmetries - this is when you look at yourself in the mirror and understand that the left pectoral is larger than the right one or the left biceps is larger than the right one. In training, this is manifested through the emergence of the leading (taking the load) and driven (lagging behind) muscles. As a result of all this, the athlete cannot fully load the muscles, and always one or another muscle group (its mirror counterpart) remains undertrained. In fact, when visually inspecting your body, it turns out that one muscle overtakes its fellow in development.

What to do, ie. how to get out of this situation - to restore balance and in general - what is muscle asymmetry, we will consider further.

For better assimilation of the material, all further narration will be divided into subchapters.

Muscle imbalance is something that most people experience during their training (and not necessarily iron). It implies that the strength (and/or size) of the muscles on one side of the body is not the same/symmetrical on the other side.

Asymmetry can appear:

• in a particular sport (for example, tennis, golf), where one side of the body is involved more than the other;
• when an athlete performs the same type of action over and over again - this is the so-called biomechanical cause of repeated movements in one direction or prolonged postures;
• due to neuromuscular imbalance due to the predisposition of individual muscle groups to be strong or weak;
• in people with limbs of different lengths.

These are some of the possible causes of muscle asymmetry, and the curvature of the spinal column also makes a significant contribution here - the deviation of parameters from the norm. Look at physiological signals corresponding to muscle activity (EMG) and heat maps of the human body of the ideal and standard case.

These scans help doctors identify soft tissue injuries, imbalances in muscle development, and the degree of spinal curvature in patients.

It is worth saying that there are no ideally “even” people, and this is due to the intrauterine development of the fetus. All of us are initially in the position of a little ball in the womb, and already there the degree of “curvature” of our spine begins to be laid. Therefore, if you think that scoliosis (lateral deviation of the spine from the normal straightened position) is purely your feature, then this is not so, almost everyone has it, only its degree is different.

So, we figured it out, now we’ll talk in more detail and scientifically about ...

Muscle asymmetry: what, why and why

Human movement and function require a balance of muscle length and strength between the opposing muscles surrounding the joint. Most joints in our body have two or more separate and opposing sets of muscles acting on it. Muscular balance is an equal amount of opposing forces between muscles, which is necessary to maintain a concentrated (centered) position of the bone in the joint during movement. On the other hand, muscle imbalance occurs when opposing muscles provide different directions of tension due to tightness or weakness.

To make it clear what is at stake, look at the following images.

As for the general asymmetry, it can be different, in particular this:

• front and back - for example, the back lags behind the chest;
• left and right - one arm / leg is larger than the other;
• upper and lower body - a massive top on chicken legs.

Regarding muscle groups, most often asymmetry is observed between:

• lower leg and hands;
• biceps and triceps;
• trapeze and shoulders;
• delta heads (front, middle, back);
• triceps heads (lateral, medial, long);
• forearms and upper arms.

Muscle asymmetry usually occurs in the early stages of training. As soon as you begin to perform the exercise, the brain evaluates which side of the body is easier for it to perform the task. The body then establishes a favorable pattern of movement (memorizes it), as a result of which the increase in strength and volume occurs unevenly - the most frequently used areas increase faster. Over time, the fine line increases, as a result of which the muscle group constantly “pulling out” the load becomes dominant (stronger, more enduring, voluminous). This creates an asymmetry.

How to prevent muscle imbalance? Practical advice.

Bodybuilding is not just about muscle mass - it is, first of all, ideal proportions and symmetry. Of course, a mere mortal does not necessarily become a sculpture with ideal circle shapes, but it would not be bad to acquire some aesthetic physique.

Actually, let's do this.

So, in total there are two types of movements that can be done - bilateral and unilateral. Bilateral - when an athlete uses two limbs (arms, legs) at the same time, for example, lifting a barbell for biceps. Unilateral - when one limb is used, for example, lifting a dumbbell with a hammer grip. Sometimes muscles grow more on one side than the other, and this is due to the dominant side of the body. The host is always trying to override and do all the work. If we talk about arms / legs, then for right-handed people the right one is leading, for left-handers, respectively, the left one.

To strike a balance, i.e. to pull equally different sides (and align the volumes), you must adhere to the following tips:

No. 1. Application of unilateral exercises

Add more unilateral exercises to your current PT - this will isolate one side of the body from the other. Use dumbbells, single block cables, and any equipment that will help focus on the weak side of the body for this purpose. Also, if possible, avoid machines and use free weights more.

Adjust the number of repetitions in the exercise according to your weak side. It is necessary to start the exercise from the lagging part and perform until it (for example, a weak left hand) fails, while the right one can still perform, but the approach must be completed. As a result, the dominant side will be slightly undertrained, allowing the lagging side to progress and pull up.

Number 3. Proper technique and flexibility

The correct form of performing exercises, taking into account the anatomical features, will correct the asymmetry. Pre-warming up the muscles and cool-down/stretching at the end of the workout, focusing on the weak side, will also help in combating muscle imbalances.

No. 4. Strengthening internal muscles and ligaments

Do not forget about the ligaments and internal muscles (deep). Strong superficial muscles with weak ligaments/weak core muscles is like a big building without a solid foundation. Use exercises such as rotation with a dumbbell to strengthen the rotator cuff, tilts to the sides with a barbell on the shoulders, lifting the legs and body from a prone position, plank.

The greater the athlete's muscle mass, the less visually noticeable disproportions and asymmetries, i.e. differences are leveled out. Therefore, try to gain more lean muscle mass.

No. 6. Increasing the strength of the weak side

When performing exercises, try to consciously place a large load on the lagging muscles, as if pulling them up to the dominant ones. So, for example, with asymmetry of the chest, you can perform a bench press with different weights on the sides, more, 3-5%, on the lagging one. For example, your left chest is larger than your right, in which case we throw 50 kg on the left, and 52 kg on the right and press in this mode. You can do the same with dumbbells. Regarding the asymmetry of the biceps, you can do this. While lifting the bar for biceps, move the hand with the smaller biceps muscle closer to the center of the neck, and leave the other in place.

Training program to get rid of muscle asymmetry

The main rule to remember to eliminate muscle imbalance is that, while working out the following muscle groups, it is also necessary to train their antagonists (and not necessarily in the same workout). Here is a list of such muscle groups:

• chest and back;
• press and extensors of the spine;
• biceps and triceps;
• quadriceps and muscles of the back of the thigh;
• calves and tibial muscles.

Make sure your current PT is giving the antagonist muscles an equal share of the training load. So you will bring balance and build a harmoniously developed body.

In addition, understanding the issues of muscle anatomy and their kinesiology (functions and movements) will help you correctly select exercises and integrate them into your training days. As an example, let's take a bench press, which, in addition to the pectoral ones, also affects the front deltas, the triceps are also connected. And so in many other exercises - non-core muscles are indirectly loaded. In this case (during the bench press), the rear deltas fall out. Therefore, on the days of a separate shoulder training, it is necessary to work out the back beams (as under-receiving loads in the main exercises during the week), and not “hollow” the front and middle heads.

Now let's look at specific routines aimed at eliminating muscle imbalances.

PT #1. We remove the asymmetry of the chest.

Fri #2. We remove the asymmetry of the deltas.

Between sets, 1 minute of rest and soon you will be able to observe a picture of the growth of lagging areas.

In general, in order to avoid asymmetry (preventive measures), it is necessary to use a special type of training - a balanced training program. This is a PT that simultaneously focuses on several muscle groups.

She might look like this:

Such a program should be periodically scrolled (twice a week, every 2-3 months), then you definitely will not have any muscle asymmetry.

Well, perhaps, and all that I would like to report on, it remains to sum up and see each other :).

Afterword

Today we discussed the issues of muscle asymmetry. Now you will be as even and proportional as possible, which means you will look more spectacular.

Somehow, I was glad to write for you, until we meet again!

PS. Are you all the same or do you mow a little?

With respect and gratitude, Dmitry Protasov.