Individuals with leg length asymmetry often adapt at the pelvis via posterior or anterior innominate rotation. This is a very common adaptation. But, does the actual adaptation itself change pelvic height? i.e. does a posterior innominate adaptation lower the ipsilateral acetabulum, and does an anterior innominate adaptation raise the ipsilateral acetabulum?
Clinically it appears to. Don Tigny's leg length test moving from supine lying to long sitting can show an alteration in leg length between the two positions and this strongly suggests usually an anteriorly rotated innominate, which when corrected then corrects the leg length, suggesting it is an apparent leg length ie from the pelvis rather than a true leg length difference where the difference in leg length doesn't appear to change. Clearly these are clinical findings and have not been validated by s proper biomechanical study using accurate, reliable and valid measurements using either imaging or eg a Vicon type system to monitor and measure the changes. That would be one to do if one has access to the right equipment and is motivated to do it. Hence so far it remains a clinical test but if used judiciously and in the correct context, with the right clinical reasoning can lead to interventions that improves a patients biomechanics and also their symptoms and signs. Hope this helps
Hi Paul, Thank you for taking the time to reply. Like me you are doing a PhD late into your career. I just started mine at Keele Uni. You have an interesting subject matter there around the pelvis and lower back pain. Mine too is in this area. I'm looking at pelvic adaptation to LLD. I developed a digital pelvic inclinometer to quantify pelvic position. just started my literature review. Getting some fascinating findings. Have you found many articles around pelvic adaptation. I believe that most LBP are mechanical and as a result of pelvic obliquity and pelvic torsion in coexistence. Where are you based?
Hi Clifton,
Good to meet you, hope everything is going well with your studies. I am based near Windsor and work in Surrey clinically adn studying at Imperial. We are just at the beginning stages here having done some literature searching adn strting to get going on the ethics application so early stage. However the study is something clinically I have been working on for a long time through both clinical work and also in my teaching, I was a senior lecturer for ~ 10 years. Regarding pelvic involvement in low back pain, yes biomechanically I think it can be involved more than just the 12% recorded in the literature as a source of pain and adjustments can make a big difference and help a lot. Good luck with your studies hope it all goes well. Just keep going !
SIJ manipulation improved pelvic asymmetry and dysfunction.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613156/
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