Chiropractic concepts of the short leg: a critical review

There have been relatively few subject areas within the chiropractic profession which have led to such widespread misunderstanding, confusion and controversy. This paper will attempt to examine the research surrounding the development of our current state of understanding concerning the many factors affecting the short leg. Traditionally, research surrounding the short leg has moved in several discreet directions. The first has been toward determining a reliable radiographic method used for measuring structural short legs. Many papers have been published here; included would be the work of Heufelder, Farinet, Giles, Nylander, Manganiello, Marstander, Wettstein, Schilgen and many others. Most tend to center upon use of new instrumentation or use of precise radiographic methods, usually involving femoral head views in some form or other. Another direction the research has taken is into an examination of how the presence of short leg affects biomechanics in both stance and ambulation. Further, investigation here have also centered upon how short leg may alter spinal growth and growth of other bones. I would include here the work of Giles, Pokorna, Moseley, Shapiro, Freiburghaus and Friberg. Other areas of research include diagnosis, therapy and correction. I leave for last a discussion on reliability studies. A major tenant of some chiropractic therapies involves the use of measurement of "functional" short leg. Though procedures for making such measurement are in the public domain, there is no proof within the literature that such exists. There have been done reliability studies attempting to show repeatability of measurement. Results have been mixed at best. I would note here the work of De Boer, Venn and Wakefield, Nichols and others. In all, this is an area under rapid and fairly extensive examination, with a wealth of previous papers available for perusal.