Heuristic exploration of how leg checking procedures may lead to inappropriate sacroiliac clinical interventions

Abstract

Several primary studies have shown that an anatomical short leg predicts anterior rotation of the ipsilateral ilium, whereas anatomical long leg predicts posterior rotation of the ilium on the long leg side. At the same time, in chiropractic and other manual therapy professions, it is widely believed that the leg check finding of a short leg is associated with posterior ilium rotation, and a long leg with anterior ilium rotation. The purpose of this commentary is to explore the consequences of this paradox for the manual therapy professions, insofar as leg checking procedures are commonly used to derive appropriate vectors for chiropractic manipulation/adjustive procedures.

Comparison of Supine and Prone Methods of Leg Length Inequality Assessment

“…Three participants (7.0%) reported prior histories of lower extremity injuries and surgeries. The sample was 37% female, and their mean age was 25.5 years (range: [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42].…”

“…29 Considerations such as these suggest that discrimination of functional from anatomic short legs may have an impact on clinical outcomes. 32 Practitioners who focus on the upper cervical spine are also entrenched in functional leg checking. 33,34 The assumption for this group is that it may be a surrogate measure of the state of atlas alignment, given that upper cervical radiographs cannot be obtained during every office visit.…”