Hemathrosis is hemorrhage into the joint cavity, which can occur as a result of injury or some pathological disease (for example, a blood disease in which its coagulation is impaired). With a traumatic origin of hemorrhage in the knee joint, the following processes occur: first, there is a rupture of the vessels supplying the joint and the synovium, and then a slow or rapid accumulation of blood.
Causes of hemorrhage into the joint cavity
Most often, such processes occur in the knee area. Hemarthrosis is typical for an intra-articular fracture and for some tears, ligament ruptures, and bruises.
In second place after injury are blood clotting diseases, such as hemophilia and other types of thrombocytopenia, hemorrhagic diathesis.
Symptoms
With hemarthrosis of the knee joint, symptoms occur immediately after its onset and are characterized by an increase in its size, pain and dysfunction. It is also necessary to add that a characteristic complaint in this pathological condition will be a feeling of fullness in the knee area, and if it occurs as a result of injury, the inability to support the affected leg.
With stage 1 of the disease, which is approximately 15 milliliters of blood shed, the joint is slightly increased in size and there is no severe pain in its area. Only manifestations of trauma, if any, come to the fore.
If the patient has grade 2 hemarthrosis of the knee joint, then the above symptoms intensify significantly, and there is also a significant increase in its volume due to the accumulation of up to 100 milliliters of blood in it.
The appearance of such a joint begins to resemble a volumetric ball, due to the fact that its contours are almost completely smoothed out.
At grade 3, hemorrhage into the cavity exceeds more than 100 milliliters of blood. The joint is further increased in size and also completely resembles the shape of a ball. The skin over it becomes bluish in color and sometimes there is an increase in local body temperature.
It should also be noted that if hemarthrosis persists for a long time, an infection may develop and purulent melting may occur. But this happens extremely rarely and is an exception to the rule.
Diagnostics
Diagnosis of this pathology is absolutely not difficult and can be done either with a simple examination by a doctor or with the help of instrumental research methods. Among the latter, it is necessary to highlight ultrasound, with the help of which you can clearly see the hemarthrosis of the right knee joint, and determine the approximate amount of blood in the cavity and the reason for its appearance.
It is also necessary to highlight MRI and CT, with which you can clearly visualize all the structures of the knee and certainly determine the cause of the appearance of bloody fluid.
The most informative method for examining the knee joint is arthroscopy. Using this procedure, you can clearly visualize “under the control of the eye” all the processes occurring there.
Treatment
Treatment of hemarthrosis depends on the nature of its origin. With traumatic genesis of hemarthrosis of the knee joint, treatment also depends on the severity of the disease and the level of medical care. For example, when providing pre-medical or first aid it is necessary to:
- Apply cold to the injury site
- Completely or at least partially immobilize the limb using a splint (elastic bandage)
- Take a pain reliever if necessary
Once in a medical institution, the victim will already undergo a whole range of therapeutic and diagnostic measures and will begin to provide more professional assistance. When treating grade 2 and 3 hemarthrosis, it will be necessary to perform a puncture of the knee joint to remove blood. The latter must be sent to the laboratory to determine its structure and possible infection.
As an example of a puncture, we can provide grade 2-3 hemarthrosis of the left knee joint with a greatly enlarged joint. This entire treatment procedure is performed under local anesthesia using solutions of novocaine or lidocaine. After treating the injection site with antiseptic solutions, puncture is performed with a 20.0 syringe. The puncture is performed with great care, with the simultaneous administration of anesthetics. After effective anesthesia, the collection of spilled blood begins to the “dry syringe”. At the end of the inspection, the medications listed below are injected into the joint.
After performing the puncture, it is mandatory to administer medications into the joint cavity to relieve or prevent inflammatory processes in it. In these cases, NSAIDs (Voltaren), steroid hormones (Hydrocortisone, Diprospan) and substances that improve cartilage regeneration (Chondroitin, Glucosamine) are used.
After performing these procedures in the treatment of hemarthrosis, a prerequisite is the application of a splint to prevent limb mobility. If an intra-articular fracture is diagnosed, then the splint should be worn for at least 4-5 weeks, and for injuries without compromising the integrity of the osteoarticular apparatus, it should be worn for 2-3 weeks.
In parallel with drug injection treatment, it is necessary to use all kinds of physiotherapeutic procedures (magnetic therapy, UHF, electrophoresis with novocaine and anti-inflammatory drugs).
Treatment with folk remedies
For hemarthrosis of the knee joint, treatment with folk remedies can also be used as an additional factor for rapid recovery. The essence of the method is to apply compresses with plants such as dandelion, burdock and Jerusalem artichoke leaves.
These treatment compresses can be easily made at home by crushing the indicated herbs and tincture them in 70% alcohol for a month. After this, gauze soaked in this liquid is applied to the sore joint (for about 20-30 minutes, 3 times a day).
Video on the topic
Why does the hip joint hurt: reasons, what to do, how to treat
The hip joint is rightfully considered the largest. It is also the busiest in the human body. It is located in the area of the joint of the hip bone, as well as the pelvis. Thanks to its unique structure, the limb moves freely in different directions. This joint allows for upright posture. Pain in the hip joint impairs its functionality, causing a person severe discomfort when walking and even sitting. In this case, the limb sometimes even goes numb.
General classification of causes
Diagnosing dysfunction of the hip joint is fraught with some difficulties, since anything can provoke painful sensations: injury, skeletal disease, concomitant pathology of internal organs. In this case, the damaged area will ache, the sensations will become burning.
This problem is most common among people over 50 years of age. Moreover, women are much more susceptible to problems with this joint or hip than men.
Hip pain is often caused by the following factors:
- Traumatic: fracture of the femoral neck, direct bruise to the joint area, severe dislocation of the right or left hip, myositis ossificans, which developed as a result of traumatic damage to the joint, fractures of the pelvic bones, epiphysiolysis of the femoral head.
- Lesions of the connective tissue of the hip joint: Reiter's disease, arthritis, and only rheumatoid arthritis, ankylosing spondylitis.
- Diseases of the joint, accompanied by degenerative processes in tissues: coxarthrosis.
- Osteochondropathies: osteochondritis dissecans, Legg-Calvé-Perthes pathology.
- Problems of skeletal development: epiphyseal varus deformity developing in adolescents.
- Processes of inflammation of soft tissues in the joints: bursitis, transient synovitis, articular coxitis, provoked by the tuberculosis bacillus.
Radiating pain in the hip area develops as a result of the following lesions: symphysitis, radicular syndrome, pathological processes within the sacroiliac joint, enthesopathy. In general, a damaged left or right hip joint causes significant discomfort and pain. It needs to be treated when the slightest symptoms appear.
Detailed characteristics of traumatic causes
If the hip joint hurts, the cause of the development of this pathological condition may be:
- Congenital dislocation of the hip, resulting from unsuccessful childbirth or during intrauterine development. Damage can be quickly diagnosed in newborns. The child has uneven gluteal folds and shortening of one leg. Nerve pinching also often occurs. For a newborn, this disease is quite complex and dangerous, since the consequences of the injury can last a lifetime.
- Traumatic hip dislocation. It is characterized by sharp pain, a person cannot make any movement, and there is no talk of sitting or standing. Swelling and hematoma appear above the joint. During a hip dislocation (running, sports training) only worsens the condition and provokes the progression of changes and pathological processes in the hip joint. This type of injury requires immediate treatment.
- Fracture of the femoral neck. This diagnosis is often made to women over 60 years of age. The cause of such damage to the hip joint is a banal fall or a targeted blow to the hip joint area. At the moment of fracture, a very sharp pain is felt, which intensifies with movement. Unpleasant sensations begin to radiate to the inner thigh. At the site of injury, swelling and bruising appear over the hip joint area. The damaged left or right leg becomes shorter, and the person develops lameness, the joint begins to click. In addition, the injury causes the nerve to become pinched, causing the hip to become numb.
- Pertrochanteric fracture of the femur. The pain in this case is moderate to severe. The symptoms in the hip worsen with movement. Here, a pinched nerve is also quite possible. In such a situation, the pain shoots through, and the limbs may go numb.
- Contusion of the hip joint. Here the pain is of moderate intensity, but it can become severe during active movement of the person. At rest, symptoms disappear. This cause of pain in the thigh or hip joint is very common, especially in people prone to falls. The patient experiences lameness, which quickly passes.
Traumatic damage to the hip joint can be considered the main and common cause of unpleasant pain. Serious fractures or dislocations of the femur or pelvis often require surgery. If a person has a pinched nerve and the patient begins to experience numbness in a limb, contact a doctor should be done immediately.
Systemic diseases as a cause of pain
Pain in the hip joint when walking or in other positions can be caused by systemic connective tissue lesions. Treatment of such diseases must be carried out constantly, since they are considered practically incurable. Moreover, therapy should be comprehensive and provide an impact, first of all, on the cause of the development of unpleasant sensations.
So, the following pathologies can provoke pain in the left or right hip joint:
- Ankylosing spondylitis. Here the pain is dull in nature. For a sick man or woman, the pain becomes worse at night. Localization of the pain syndrome is the sacrum or pelvis. At the same time, he is capable of passing to the knee, thigh, groin, and shooting. Movement in this case, especially walking, is difficult, and the patient feels stiff. The pain in the hip can be quite severe. An inflammatory process develops inside the right or left joint.
- Reiter's syndrome. This disease is a lesion of the joints, genitourinary organs, as well as inflammation of the conjunctiva. The disease is autoimmune and appears as a result of an intestinal infection. The pathological process inside the joint begins several weeks or months after the onset of the disease. It is characterized by acute pain in the hip or joint, and a change in temperature. Severe swelling appears in the pelvic area on the left and right. In most cases, the disease leads to symmetrical damage to the joints.
Elena Malysheva will tell you more about the syndrome in this video:
- Rheumatoid arthritis. This problem is characterized by damage to connective tissue. This type of disease is never accompanied by the appearance of pus. It is this disease that is considered a prerequisite for coxarthrosis of the hip joints. Gradual progression is noted. Initially, it is characterized by the following symptoms: edema and swelling (on the left or right). Discomfort is felt when walking, pain shoots through. Inside the joint, due to the process of inflammation, the temperature (local and general) rises. Further progression contributes to the appearance of stiffness in any movements. There is pain in the hip joint while lying on the side at night. Usually the presented pathology manifests itself simultaneously on the right and left. Due to the destruction of the joint, the patient’s nerves may be pinched, causing the limbs to go numb. Treatment here must be immediate.
More details
Systemic pathologies can cause pain of different types to a person: sharp, extremely acute, nagging. It is not always possible to cope with severe discomfort on your own, even during a period of rest. Therefore, only a doctor should prescribe the correct treatment. This is especially true in situations where a newborn child falls ill. Ineffective treatment can ruin his entire life in the future.
Pain caused by degenerative changes
Sufficiently sharp, burning or nagging joint pain can cause the following diseases:
- Epiphyseal varus deformity, common in adolescents. With it, the sensations have a dull, pulling character. They are capable of giving to the inside of the knee. Running and other sports training provoke an increase in the intensity of the pain syndrome. The pain may shoot from time to time, and the joint may click.
- Coxarthrosis. The presented pathology occupies one of the leading positions among all lesions of the hip joint. It is diagnosed in both men and women. It will take a long time to treat, and the therapy is quite complicated. The disease is characterized by the development of degenerative and destructive processes in the joint. The symptoms of the pathology are as follows: first, the patient begins to ache in the joint after running, a long walk, or climbing stairs. Moreover, at rest the discomfort goes away. Here movements are not yet limited. At the second stage of development, the following signs appear: pain begins to radiate to the groin, as well as to the thigh. Daily exercise increases the intensity of the sensations, but they go away at rest. Prolonged walking provokes the appearance of lameness, the joint begins to click. The work of muscles and tendons is disrupted, their tone decreases. At the last stage of the disease, the patient experiences pain even at night, and it is quite severe. Lameness becomes pronounced. The muscles lose their volume and atrophy - the person becomes immobile. Treatment can stop or slow down the destruction of the joint.
These pathologies can lead to permanent lameness, and this already means a limitation of work activity and a lack of full-fledged sports training. Even getting out of bed in the morning can be very difficult.
Inflammatory and infectious causes of pain
In addition to direct damage to the bones of the joint, inflammation of the muscles, tendons, and joint capsule can cause discomfort. Infectious diseases can also provoke pain:
- Purulent arthritis. Signs of this pathology are: increased general temperature, redness of the skin in the joint area, severe swelling, sharp or acute pain. Any exercise (running and even walking) or even simply getting out of bed becomes impossible. The pain begins to shoot through. Treatment here cannot be delayed, as the patient develops sepsis.
- Necrosis of the femoral head (aseptic). It is mainly observed in fairly young men. The disease appears due to deterioration of blood circulation in this area. The result of the development of necrosis is the death of tissue cells. The pathology has the following signs: a sharp pain that suddenly appears, which can radiate to the groin, a burning sensation in the affected area. The pain can be so severe that a person is unable to lean on the affected leg and has difficulty getting out of bed. In most cases, the patient requires an injection of an analgesic to relieve pain in the joint. After a few days, the symptoms disappear. If the pathology continues to progress, then the person will experience changes in the muscles and tendons - they will atrophy. The person develops gait disturbance and lameness.
- Tuberculous arthritis. A feature of the pathology is that it predominantly develops in young children who have weakened immunity. The pathology progresses slowly. The little patient gets tired quickly and runs very little. The thigh muscles gradually atrophy. The joint begins to click, the leg becomes shorter. Over time, the affected joint begins to become very painful. Sometimes the pain is sharp, and sometimes it is nagging or burning. Further, suppuration appears inside the joint, and the symptoms intensify.
- Bursitis is an inflammatory lesion of the joint capsule. The main sign of pathology is pain that will spread down the leg. The sensations are acute, and when standing up or walking, the discomfort is very strong. At rest, the injured limb will ache or feel a burning sensation.
Infectious pathologies cause a variety of types of pain inside the hip joint: burning, pulling or dull sensations. Often the discomfort is felt so strongly that a person is unable to sleep at night. Naturally, all these pathologies need to be treated urgently.
Features of pathology diagnosis
To accurately determine the causes and factors provoking pain in the hip joint, the patient needs careful attention from doctors and correct diagnosis. The following procedures are used for this:
- Ultrasound examination of the hip joint.
- X-ray of the thigh area, and it should be done in two projections.
- Laboratory blood tests: general and biochemical. They will determine the presence of rheumatoid factor, increased leukocyte levels and changes in erythrocyte sedimentation rate.
- External examination of the joint with palpation, as well as recording the patient’s complaints.
After the examination, an accurate diagnosis is established and comprehensive treatment is prescribed.
How should the pathology be treated?
If you periodically feel pain in the hip joint, it must be treated. Therapy depends on what caused it. So, treatment of the joint occurs depending on the pathology.
Congenital dislocation
If the dislocation is congenital, the child is given special orthopedic products on the joint: stirrups, spacers, or a Freik pillow is recommended. All these means support the legs of a newborn baby in the correct physiological position. The child will have to stay in them for at least six months. If traditional treatment is not effective, then the baby is prescribed surgical intervention. That is, a newborn child’s head of the femur is surgically reduced, and other defects are also corrected. After the orthopedic devices are removed, your baby can be given a gentle massage to strengthen the muscles.
Traumatic dislocation
If there is a traumatic dislocation, the doctor will have to use medications that help eliminate muscle tone to set it back. After this, the patient needs to be kept at rest. Numbness in a limb indicates a pinched nerve. This will require a mandatory examination by a neurologist.
Femoral neck fracture
Treatment of a femoral neck fracture is carried out by a traumatologist. With such damage, surgery is indicated for the patient. Conservative treatment methods are sometimes ineffective. But if the operation cannot be performed, then the patient is recommended to apply a plaster bandage to the left (right) leg, from the lower back to the heel. In women or men over 60 years of age, such damage to the hip bone rarely heals, and the recovery process takes months. Among the consequences of this disease, one can highlight the insufficient functionality of the respiratory and cardiovascular systems, because the patient is not able to lead an active life and move normally. Even sitting becomes a problem for him. A fracture of the joint may be accompanied by a burning sensation in the soft tissues. As for surgery, in this case the treatment uses fixation of the head and body of the bone with pins or screws, as well as endoprosthetics.
Bechterew's syndrome
Treatment of ankylosing spondylitis is complex. It helps reduce the intensity of symptoms caused by inflammation. Therapy includes medications (anti-inflammatory drugs, hormonal drugs, immunosuppressants), physiotherapeutic procedures, therapeutic exercises (muscle stretching is useful). Massaging the affected joint on the left or right is considered equally useful. All medications, as well as therapeutic exercises, are selected strictly by a traumatologist, orthopedist or surgeon. To strengthen your pelvic muscles, you need to go swimming. In particularly difficult cases, the patient is indicated for joint replacement on the left or right.
Reiter's disease
To treat Reiter's pathology, you will need antibiotics, as well as anti-inflammatory drugs, glucocorticosteroids, drugs to suppress the function of the immune system, and local ointments. Treatment will take a long time - at least 4 months. It should be noted that the presented pathology can recur in half of the cases. During treatment, it is necessary to maintain muscle tone with physical exercise - regular stretching.
Rheumatoid arthritis
Rheumatoid arthritis, which can cause severe pain even at rest, cannot be completely eliminated. But you need to try to improve the quality of life of a sick man or woman. For this purpose, drug treatment is used with cytostatics, hormonal agents, non-steroidal anti-inflammatory drugs, as well as antirheumatic drugs. As for surgical intervention, it is used only in the last stages, when walking and sitting are practically impossible. Fixation or arthroplasty of the joint is recommended. Physical exercise, especially stretching, and topical ointments are also helpful.
You can also learn about the endoprosthetics procedure in this video:
Coxarthrosis
Treatment of coxarthrosis is aimed at eliminating the cause of the development of symptoms and signs. Pathology in the first stages of development is treated using conservative methods. The patient is prescribed NSAIDs (Diclofenac, Ibuprofen), chondroprotectors (Arthra, Dona), as well as medications to improve blood circulation. Painkillers and warming ointments are used for treatment. Additionally, the patient is prescribed light therapeutic exercises. Naturally, the joint often needs to be numbed. In case of severe discomfort, injections are used.
The last stage of coxarthrosis is no longer amenable to conservative therapy. Any load on the joint worsens a person’s well-being. Getting out of bed without assistance is impossible. The patient has to receive painkilling injections. In this case, the disease can only be treated surgically. Generally, joint replacement is required, however, it is contraindicated for very elderly people. Therefore, only auxiliary operations are performed on such patients. After surgical treatment, the patient requires a recovery course: light stretching, very simple exercises under the supervision of a doctor. The load should be minimal.
Proper therapy will help to somewhat slow down the progression of the disease, as well as eliminate unpleasant signs.
Features of the treatment of infectious and inflammatory pathologies
It all depends on the type of disease:
- Purulent arthritis. First, the patient needs to numb the affected hip joint. For this, an analgesic injection directly into the joint can be used. The infection must be fought with antibacterial agents and antibiotics. Moreover, several groups of drugs are used simultaneously. Only a doctor can prescribe them. Additionally, ulcers are removed. The sore leg should be completely at rest, that is, the patient is given a plaster cast or splint.
- Treatment of aseptic necrosis of the femoral head involves restoring blood flow and rapid resorption of areas that have become necrotic. The limb should be numbed with NSAIDs. Vitamin complexes and drugs to reduce blood viscosity are also used. If the hip continues to ache, then you should additionally apply a massage and anesthetic ointment. This disease can also be treated with physiotherapeutic procedures and therapeutic exercises. In difficult cases, minimally invasive surgical techniques or joint replacement are used.
- Since bursitis causes severe pain in the hip joint, it must be numbed. For this, an analgesic and anti-inflammatory drug is used, and it is administered through an intramuscular injection. Steroids are also used to quickly relieve severe discomfort. Since the thigh and hip joint can constantly ache, she should be given rest.
- Tuberculous arthritis is treated primarily conservatively. The baby needs to limit his mobility with a tight bandage. If a child develops an abscess in the soft tissues, it should be removed surgically.
Burning sensation, numbness of the limb, pain in the hip joint, radiating to the leg - these are unpleasant sensations that indicate the possible presence of serious problems.
Osteopathic doctor Evgeniy Lim tells how to treat painful sensations:
Traditional treatment for pain in the hip joints
If a person has burning pain or problems with tendons, but it is not advisable for him to take pills, then folk remedies can be used. They cannot be called a panacea, but they help in complex treatment. Naturally, you should consult a doctor before use.
Treatment of joints Read more >>
The following folk recipes will be useful:
- Clay compress (blue, white). This folk remedy helps relieve swelling and pain. It is better to alternate clay. The clay should be applied overnight and wrapped in a warm cloth.
- Cabbage compresses. They will also need honey. It is smeared on a cabbage leaf and applied to the place where burning or acute pain is felt. Next, the compress is covered with a plastic bag and insulated with woolen cloth. The course of treatment is 1 month. In between compresses, you can do a light massage on the affected hip joint: rubbing, stroking.
- Homemade ointment from interior fat and white foot root (250 g). The fat must be melted, add the root chopped in a meat grinder and put on low heat. Boil the mixture for 7 minutes. After the ointment has cooled, apply it to the affected hip joint at night. In this case, the joint must be insulated. This folk remedy relieves swelling and other unpleasant symptoms well.
- A peculiar folk remedy made from garlic, celery and lemon, which relieves severe pain in the tendons. For preparation you will need 2 lemons, 300 gr. celery root, as well as 130 gr. garlic All ingredients are thoroughly ground in a meat grinder and placed in a container with a tight lid. Next, the entire mixture is poured with boiling water and mixed. Now you need to cover the product tightly, wrap it with a blanket and leave it overnight. The medicine should be taken one teaspoon before meals for several months.
These remedies cannot eliminate a pinched nerve of the hip joint. Numbness of a limb should alert you and force you to consult a neurologist. Any lesion of the hip joint that causes pain must be identified and treated in a timely manner. Light gymnastics and stretching exercises will help prevent the development of dysfunction of the hip joint.
Elena Malysheva and her experts talk more about the disease in this video:
What injections and why are given to the joints?
Today, joint diseases have become a sign of our century. Elderly people and young people are increasingly complaining of unbearable pain in the joints of the legs, arms or spine.
The best time for an active lifestyle is considered to be between 30 and 40 years of age; when this level is reached, a person suddenly loses the ability to move normally and turns into a ball of pain.
What's going on?
Our joints wear out, the reason for this is age, weight, active sports, and the habit of women walking in heels for a long time.
Wear and tear of joints over time leads to bone friction, destruction of shock-absorbing cartilage, misalignment or imbalance of joint ligaments, and the appearance of bone spines. The end result is constant and excruciating pain.
Regular pain provokes sleep disturbances, weakens the nervous system, and leads to surges in blood pressure. Insidious diseases most often affect working joints:
- lumbar and cervical spine;
- knee and hip joints;
- interphalangeal joints.
Fortunately, modern medicine has provided the possibility of a non-surgical method of treating osteoarthritis, arthrosis and arthritis. Today, a technique is recognized all over the world as effective, the essence of which is the introduction of medicinal solutions into the joint. These medications can be prepared on the basis of corticosteroid hormones, hyaluronic acid and other components.
Healthy joints contain sufficient amounts of synovial fluid. Over the years and under the influence of unfavorable factors, it dries out and performs its protective function worse and worse. Today, medicine has found ways to intervene in the development of pathological processes; now it is possible to slow down or completely stop the process of destruction of joints.
Intra-articular injections are prescribed in cases where conventional painkillers and NSAIDs are no longer sufficient.
The most common injection drugs are:
Corticosteroid hormones
Most often, drugs containing corticosteroid hormones are administered intra-articularly: Kenalog, Celeston, Diprospan, Flosterone, Hydrocortisone.
Corticosteroids have gained popularity due to their rapid and effective suppression of pain and inflammation during synovitis (swelling and swelling of the joint). There is one problem here - corticosteroids cannot prevent or cure arthrosis. Hormones do not strengthen bone tissue, do not improve the condition of cartilage, or restore normal blood circulation. They can only reduce the inflammatory response to damage in the joint. Therefore, it is necessary to use intra-articular injections containing hormonal drugs in complex therapy.
The patient was diagnosed with stage II gonarthrosis with fluid accumulation and edema. This situation makes it difficult to carry out the necessary medical procedures. In order to eliminate synovitis, the doctor injects a hormonal drug into the joint. Only after the swelling is relieved does he begin active treatment measures.
If intra-articular administration of hormones is really necessary, you must follow some rules:
1. It is not advisable to inject into one joint more often than once every 2 weeks.
2. The first injection brings more relief. If the first injection of the drug is ineffective, it is necessary to change the drug or more accurately designate the injection site.
Hyaluronic acid
Hyaluronic acid is a lubricant that compensates for the sliding of damaged cartilage. In other words, it is an analogue of a lubricating fluid that helps prolong the functioning of the joint, as well as the surrounding tissues, in the most natural way (without hormones and without surgery).
Treatment with these drugs is expensive, but effective. The product does not have a harmful effect on cartilage. For treatment, it is enough to carry out 3-5 injections of hyaluronic acid into the affected joint. The interval between procedures should be 7-15 days. The course is conducted once a year:
- for stage II arthrosis, treatment is carried out for 2-3 years;
- for stage I gonarthrosis - for 2 years;
- for stage III arthrosis - for 3-4 years.
Chondroprotectors
These are drugs that heal joints. They are used in case of impaired nutrition of the joint (osteochondrosis, arthrosis, metabolic disorders) or in case of injury. Full treatment with chondroprotectors can be started only after the inflammation has subsided.
With the introduction of chondroprotectors into the joint, they have a faster effect than taking medications orally. The result can be noticeable after the first injection. The course of treatment includes from 1 to 5 intra-articular injections, followed by a transition to taking drugs orally.
In addition, in right-handed people, the right hand is stronger and longer than the left, and the nail bed of the thumb on it is longer and wider than on the left. The left leg of 60% of earthlings is 1-1.5 cm longer than the right. And in about 66% of people, the left outer ear is larger than the right one, but the chin most often slopes to the right. The nose of right-handers deviates to the right, and of left-handers - to the left; the curl of hair on the head of right-handers is twisted clockwise, and of left-handers - in the opposite direction.
Even the right half of the Praash’s face is more expressive than the left!
But asymmetry concerns not only external organs. We have a right-sided liver and lungs that are unequal in weight (the right one is larger than the left). Our heart, like our stomach, lies on the left. The intestinal loops are even more asymmetrical. Our aortic arch is bent from right to left, large veins lie predominantly to the right of the midline, and there are more lymph nodes on the right.
The majority of people on the globe are right-handed, a minority, about 11%, are left-handed. In the former, control is exercised predominantly by the left hemisphere of the brain. But this does not appear immediately after birth, but from about six months or even later, after the child begins to sit up. Most newborns, regardless of gender, lie with their heads turned to the right (65%); only 15% reliably prefer left-handed orientation. By the age of eighteen months, the “leading” and “auxiliary” hands are already distinguished.
It should be noted that our immediate and distant ancestors were already right-handed. The famous anthropologist L. Leakey discovered an ancient burial in the Elmentein caves in Kenya, in which male skeletons lay on the right side, and female skeletons on the left. The study of the folklore of the Eastern Slavs and archaeological finds have shown that in paired burials the woman was placed to the left of the man. True, left-hand prints predominated in the rock paintings. But this, according to scientists, is connected with the mystical interpretation of left- and right-sidedness: the left side was associated with the feminine, and the right with the masculine.
The peoples of antiquity were right-handed - the Greeks, Persians, Egyptians, who lived over five thousand years ago. The greater development of their right hands is evidenced by various drawings, bas-reliefs and even entire statues found in tombs, temples, and palaces. An analysis of more than 120 thousand works of art made over 15 thousand years of human history showed that 93% of masters created them with their right hand.
You can also distinguish the “dominant” eye (sixty percent coincides with the dominant hand), ear, and limbs. Even in terms of the distribution of electrical potentials, the surfaces of body parts are unequal. American scientists have determined that the head, right arm and right half of the chest have a positive charge, while the left arm and the same half of the chest, stomach and leg have a negative charge. There have been reports in favor of better sensitivity of the left half of the body in the processes of touch and pain perception. Moreover, asymmetry is manifested even in the chemical composition of sweat. Based on the difference in pepsin content, they are already trying to determine the side of the lesion in the blood vessels of one of the cerebral hemispheres.
Thus, we are asymmetric not only at the level of individual organs, but also systems.
Several interesting hypotheses have been proposed to explain this phenomenon. Here we will consider only some of the most interesting of them.
So, in his right hand the warrior held a sword, and his left, more passive, only covered his heart with a shield. The theory was then supplemented by anatomical information about the commonality of a number of nerves of the left arm and the heart. The ancient people had the same thing, so it is possible that they were used to sparing her.
The second theory explains the asymmetry based on the fact that the mother usually holds the child on the left - closer to the heart. One of the researchers even calculated that this situation is recorded in 80 percent of paintings with a similar plot. And the experiments carried out suggested that this habit is formed in the mother in the first seven days after birth and that not the least role for the baby is played not even by the position, but by the frequency of the sound of his mother’s heartbeats, to which he gets used to while still in the uterine state.
According to the "anatomical" theory. right-handedness depends on the asymmetry of organs: heavy liver on the right, heart on the left; The unequal blood supply to the upper extremities also plays a role. It is assumed that the asymmetry of the body is associated with the rotation of the Earth. And as proof, an example is given of different heights of river banks.
Recently, the point of view has been discussed that a left-handed child may be one of the surviving members of a monozygotic pair of twins, in whose brain structure the principle of “mirror image” is preserved. However, none of these assumptions ever gained traction. Therefore, the problem of asymmetry still awaits its researchers.
Why does a person have one leg shorter and the other longer?
Everything should be normal, but if there are abnormalities in the growth of the legs, then this indicates hip dysplasia, which is usually treated before the child is one year old. In adults, it seems that it is no longer amenable to treatment, since the bones have already become stronger.
here in the picture you can immediately see that there is dysplasia, both bones on both sides have come out of the hip joint. My daughter had dysplasia, we wore spacers for 5 months, now everything is fine, all the bones are in their places.. Thank God..
One leg is shorter than the other in an adult: how to determine and what to do?
When one leg is shorter than the other, doctors call this phenomenon short leg syndrome. The consequences of such a pathology can be very serious if you do not pay attention to it. In this case, a violation is said only when the difference in length is more than ½ cm. The most common cause of such an anomaly is pelvic distortion.
Many studies have been conducted in this area, and the latest ones have confirmed that even a difference of 3-4 mm provokes curvature of the spinal column, disruption of the pelvis and abnormal growth. If treatment is not started in time, the pathology will progress, disrupting the functions of the spine with all the ensuing consequences.
Causes and consequences if one leg is shorter than the other in an adult
This syndrome leads to uneven load on the intervertebral discs.
In the future, this will provoke twisting of the pelvis, scoliosis, rotation of the 5th lumbar vertebra, blocking the joint of the sacroiliac zone on the side opposite to the shortened limb.
- The main reasons are displacement or distortion of the pelvis from its natural position, resulting in dysfunctional changes in the spine. This means that the axis of load distribution during movement will change, and accordingly, pain will arise in the back, neck, and lower back;
- Such metamorphoses lead to disruption of biomechanics, disc herniations, degenerative changes in the vertebrae, osteochondrosis, scoliosis, radiculitis, and spinal canal stenosis occur. A misalignment of the pelvis provokes pain in the neck, radiating to the shoulders and arms, resulting in problems with the upper extremities;
- Osteochondrosis is a disease characterized by dysfunction of the vertebrae, ligaments, joints, and intervertebral discs. Pathology develops under the influence of a number of factors and over a long period. The risk increases with a history of spinal injuries, poor posture, and hypothermia;
- Lumbago is a syndrome of vertebrogenic etiology. It is characterized by changes in the lumbar area: pain, deformation of this part of the spine, excessive muscle tension. People call lumbago a lumbago because of shooting pains that do not allow straightening and the patient is forced to remain in a bent position.
The difference between leg length can be moderate to severe. In the latter case, the functionality of the body is significantly impaired. With moderate deviations, unsteadiness when walking and periodic falls are observed. One hip is always higher than the other. Almost always this phenomenon is accompanied by pain, which can be localized in the hip, groin, sacroiliac joints, shoulder, neck, lower back, or radiate to the leg.
With prolonged pelvic distortion, the body itself will begin to correct biomechanics and asymmetry. This will lead to adaptation of tendons, ligaments and muscles. Therefore, therapy may take quite a long time. In addition, pelvic displacement is very difficult to correct, because a pathological stereotype of movements is formed. The longer the pathology is present, the more difficult it is to get rid of it.
Diagnosis of different leg lengths
Typically, identifying an anomaly is not difficult. For example, you can pay attention to the length of the trouser leg when a person is standing: when one is longer than the other, or the heel steps on one of them when walking, then there is a high probability of having a disease. If such a condition is detected in children, it is necessary to urgently consult a doctor, since in the future the posture will be disturbed and a pain syndrome will arise, which, as we have already noted, can spread to other parts of the body.
Your doctor may notice changes during a standard physical examination. If necessary, the condition of the hip joints and spine is diagnosed, and an MRI or CT scan may be prescribed.
What to do if an adult has one leg significantly shorter than the other
Quite often, treatment provides only temporary results because it is symptomatic. Standard orthopedic therapy is not able to relieve tension in the iliopsoas muscles. The pelvis will remain skewed, the joint will remain blocked, and the leg will remain short.
The only way out of the situation is manual therapy and similar techniques. Specialists in this field act purposefully, gently, in doses, and make efforts to relax tense muscles.
In addition, it is necessary to perform various exercises, constantly be physically active, maintain good shape, and walk with a straight back. Well-developed muscles will support the bones of the skeleton. Muscle imbalances can be corrected by regularly tensing all muscle groups during exercise. Swimming, horseback riding, and training on special simulators are recommended as part of treatment and for prevention purposes.
Consequences of shortening one leg
People over 50 years of age are at risk. This is due to the natural aging of the body, the destruction of bone tissue, as well as an unhealthy lifestyle and increased stress on the musculoskeletal system. Therefore, older people often experience deformation of intervertebral discs.
As a result of the shortening of one limb and the skew of the pelvis, severe wear of the intervertebral discs occurs, poor posture worsens, and an imbalance of the right and left parts of the body occurs. In particular, the lumbar (quadratus) muscle suffers from pathological changes. The pain syndrome also affects the clavicular, pectoral, and scalene muscles. This, in turn, leads to compression of the intervertebral nerves. Poor posture in a person is accompanied by a limping, galloping or uneven gait, and deformed feet.
Seeing a Doctor When One Leg Is Shorter than the Other
Adults should pay attention to pain, especially in the spine and feet, and control their gait. How much length needs to be compensated is determined by a traumatologist or orthopedist. Shortening can be relative or absolute. To determine its type, an x-ray of the pelvis and spine is required. The diagnostic procedure is done in a standing position. The image will allow the doctor to determine the difference between the length of the lower limbs and analyze the height of the heads of the pelvic joint.
With absolute shortening, full compensation is required, and with relative shortening, partial compensation, up to ½ or 1/3 of the length.
Treatment when one leg is shorter than the other
First of all, you will need orthopedic insoles, which are called compensatory insoles. They are selected individually and produced relatively quickly.
Such products perform the following functions:
- will help stabilize the position of the spinal column and feet;
- slow down the progression of scoliosis and flat feet;
- will unload areas of the spine that are subject to excessive stress and allow them to recover.
If there is a significant difference in leg length, not only compensatory insoles are used, but also instep supports. This will correct your posture and relieve stress on your spine and feet.
As a rule, a person gets used to arch supports and insoles over a certain period of time. Minor discomfort is observed for about a week. But after this the condition improves, the products are practically not felt.
At the same time, leg fatigue occurs much later, walking is much more comfortable, and there is practically no discomfort in the back and legs. Insoles and arch supports will relieve pain in the lower back, reduce the load on the knee joint, and increase ankle stability.
Different leg lengths
leg lengths, types of shortening and method of correcting anatomical shortening of the lower limb.
Differences in leg length are a widespread phenomenon.
With a difference of 1-2 cm, a person simply does not notice this aspect. With a more significant difference (more than cm), the problem of pelvic distortion appears and difficulties arise when walking.
When the pelvis is tilted, the spine becomes at an angle to the horizontal line. To prevent the body from “falling over” with the straight spine to the side, the body bends it, creating secondary compensatory scoliosis in order to shift the center of the body as close as possible to the center line of the body. A difference of up to 1.3 cm curves the spine in the shape of the letter “C”, more than 1.3 cm in the shape of the letter “S”.
Leg length measurement
Shortening of one of the lower extremities can be detected during examination and measurement of leg length.
To measure leg length, natural bony protrusions are used, which are clearly visible to the eye and easily determined by palpation.
Identification bone protrusions for measuring the length of the lower limbs are
A - superior anterior iliac spine,
B - greater trochanter of the femur,
C - apex of the patella,
D - head of the fibula,
E - lateral malleolus,
F - joint space of the knee joint,
G - medial malleolus.
Measuring leg length when comparing symmetrical points is carried out by determining the standing height of the ankles, the upper poles of the kneecaps, the femoral trochanters, the upper anterior and posterior iliac spines (with displacement of the pelvic wings) (4).
When examining a patient in a lying position, the length of the thigh is determined by comparing the height of the knees with the hip and knee joints bent (5), the length of the lower leg - by the same technique, with the only difference being that the patient’s feet rest against the surface of the table on which he lies (6 ).
It is valuable to determine the length of the legs with the hip joints bent at a right angle and the knees bent; the shortening of the leg becomes clearly visible when comparing the height of the heels (7).
This technique makes it possible to determine not only the shortening of one of the legs, but also the strength of the abutment of the femoral head in the acetabulum.
With subluxation in the hip joint, giving the patient’s legs this position strains the hip flexors (biceps, semitendinosus and semimembranosus muscles), and the head, lacking a strong support, is displaced by muscle traction. In this way, it is possible to detect a slight (less than 1 cm) shortening.
When studying leg length using the comparison method, you should check whether the pelvis is positioned correctly.
Types of shortening
True (anatomical) shortening of the lower limb.
Normally, the anatomical length of the lower limb is the sum of the length of the thigh and the length of the lower leg. True (anatomical) shortening is revealed by segment-by-segment comparative measurement of the bone.
Relative (dislocation) shortening of the lower limb.
It is noted when the articular ends are displaced and the relationship between the articular surfaces is disrupted. In a comparative segment-by-segment measurement, no difference in the length of the corresponding bones is detected. An example of relative shortening: hip dislocation, in which, despite the same anatomical length of the lower limbs, shortening of the limb on the side of the dislocation is determined.
Apparent (projective) shortening of the limb.
Total (clinical or functional) shortening of the limb.
Surgical leg lengthening
Surgical leg lengthening is performed using an external fixation device. The method of leg lengthening is called compression-distraction osteosynthesis according to the Ilizarov method. It is based on a law discovered and formulated by orthopedic surgeon Ilizarov: the tension that occurs when bones and surrounding soft tissues are stretched has a stimulating effect on the processes of regeneration and growth of bone tissue.
In order for the bone to lengthen, it must be cut (osteotomy). If it is necessary to lengthen the femur, the femur is dissected; the tibia and fibula are dissected. The bone edges formed after dissection are connected with a gap of 1 mm and fixed using knitting needles or rods. The needles are secured in rings or half-rings of the Ilizarov apparatus. By adjusting the apparatus, the bones are stretched 1 mm per day to the required size. This stretching of the bones is called distraction. The process of leg lengthening using the Ilizarov apparatus can be very painful. In case of severe pain, analgesics are prescribed. Pain and discomfort usually decrease significantly over time.
- - measuring tape;
- - large mirror.
Body type and face
For any type of figure and face, the following rules apply:
Emphasize the waist - this will make any figure much more attractive,
Rule of opposites: for a “triangular” figure, choose clothes “inverted triangle” and so on.
The same rule applies to the type of face - for example, for a round face you need to choose a V-shaped neckline of the dress.
Attention is focused on the beautiful parts of the figure and vice versa - it is distracted from the less “successful” ones; sets of the same tone will visually increase the height and length of the legs.
The most important thing in creating a stylish image is its individuality and uniqueness.
Today there are many ways to determine your color type by season. For an unprepared person, such gradations often cause confusion. There is a simpler and more accessible way to determine the color type according to 2 main criteria: contrast - cold or warm skin tone. Accordingly, bright colors of clothing and expressive patterns are suitable for a brighter, contrasting appearance, and more monochromatic, pastel colors are suitable for a dull appearance.
You should not try to look younger or older than your age - this will not benefit the creation of your unique image. For each age you can choose your own “zest”.
Etiquette rules should be taken into account. You need to dress taking into account the time of day, season, dress code rules, as well as the events taking place around you. A party outfit is unlikely to be appropriate in the office.
How to tell if one leg is shorter than the other
Leg length difference (LLD) may not be noticeable throughout life; however, if left untreated, it can lead to injury while running. In some cases, differences in leg length occur as a result of injuries or improper formation in childhood. Muscle problems can also cause temporary differences, but this is easily corrected by intense physical activity and special muscle strengthening exercises. Learn to determine the cause and type of difference in leg length, and if you notice such a problem, consult a doctor for advice.
Steps Edit
Method 1 of 2:
Identify muscle differences in leg length Edit
Scoliosis, or is modern man's legs the same length?
Scoliosis (from the Greek scolios - curve) - lateral curvature of the spine - is the most common deformity of the human skeleton. This disease is a kind of “cross” of orthopedics, which humanity stubbornly drags through its entire centuries-old history. For centuries, people have had mixed feelings about people with scoliosis. For example, in ancient Sparta, children with spinal curvatures were thrown off a cliff into the open sea, considering them a “mistake” of nature, unworthy of procreation. With the development of civilization, the attitude towards this category of patients softened somewhat, but people tolerated “hunchbacks” next to them only as jesters, who were the subject of constant ridicule. The first mentions of attempts to treat scoliotic spinal deformities date back to the heyday of ancient Greek culture.
The incidence of lateral curvatures of the spinal column is truly impressive. So, Sollmann A.H. and Breitenbach H., when studying a random sample of thousands of radiographs of the spine performed in a direct projection, found that scoliosis was absent in only 28 observations. In other words, in the human population, the incidence of lateral curvature of the spine is 97%.
What is the reason for this prevalence of scoliosis? It is known that for any object of living nature, asymmetry of structure is the norm. It is impossible to find two completely identical leaves in the crown of one tree; any mammal, be it a cat, a dog, an elephant or a hippopotamus, has all four legs of different lengths, and these facts do not raise any doubts in any of us until we hear that we ourselves are the same asymmetrical subjects of living nature .
According to a very widespread misconception, a person’s external structure is a mirror-symmetrical right-left object of nature. However, upon closer examination, it turns out that the axial symmetry of the human body is largely arbitrary: the left half of the face is not similar to the right, the right hand is not similar to the left, the left leg is not similar to the right, etc. If the asymmetry of the face gives each of us individual uniqueness and charm, the dissimilarity of the hands, as a rule, does not cause any trouble, then the asymmetry in the belt of the lower extremities in conditions of upright walking becomes of great importance. Leg length inequality, contrary to popular belief, is a widespread phenomenon. The vast majority of the planet's inhabitants can easily verify this; they just have to carefully examine their own image in the mirror and pay attention to their clothes and shoes. Representatives of many professions far from medicine are faced with different lengths of the lower extremities, without, as a rule, attaching any significance to it. First of all, these are cutters and tailors who make clothes or adjust ready-made industrial designs “to fit.”
A person who gets lost in an unfamiliar area and moves forward describes a circle, returning to the starting point, and this has nothing to do with left-handedness and right-handedness, as was previously believed. It's just that the long leg step is longer than the short leg step. Therefore, the movement that appears to be walking forward is actually a movement in a circle. Moreover, the greater the difference in the length of the limbs, the smaller the circle of radius the person will describe, returning to the starting point. All this is a manifestation of different lengths of the lower limbs. The first physician to draw attention to the widespread prevalence of lower limb length inequality was the German doctor Eva Braun. An important observation made in 1926 later received its creative development. Rush W.A. and Steiner H.A. When X-ray measuring the length of the legs of 1000 military personnel demobilized from the army, they found the same length of the legs only in 23% of cases, while in the remaining 77% of those examined, asymmetry in the length of the legs was observed. These data indicate that the prevalence of scoliotic deformities is comparable to the incidence of different leg lengths.
How is inequality in the length of the lower limbs related to the development of scoliosis? Different leg lengths cause the pelvis to tilt toward the short leg and cause the body to lose balance, which requires compensation to maintain the body in an upright position. Thus, we come to a static law formulated by Biedermann F., Edinger A. and Illi F., the so-called SBT rule: with an oblique position of the pelvis, a certain degree of scoliosis and rotation should always be expected. In the lumbar spine, scoliosis and rotation towards the lowered half of the pelvis are physiological. Thus, we can draw a very important conclusion: scoliosis or scoliosis is, first of all, an adequate physiological compensatory reaction of the spinal column to the oblique position of the pelvis, caused by the presence of different leg lengths.
The vestibular apparatus (VIII pair of cranial nerves), which has a very complex structure, is responsible for maintaining the balance of the human body in space. The vestibular nuclear complex has extensive connections with many of the most important structures of the brain and spinal cord, due to which it is the coordinator of muscle tone. In other words, the vestibular apparatus controls all human muscles. Schematically, the mechanism of scoliosis formation can be considered using a biomechanical human model. When the pelvis deviates towards the short leg, a loss of static-dynamic balance of the body occurs. This is perceived by the vestibular apparatus, which entails an immediate redistribution of muscle tone - an increase on the side of the long leg and a decrease on the side of the short leg. This is how C-type scoliosis is formed. With large amounts of shortening, the muscles on one side are no longer able to maintain the balance of the body, since each muscle has a limit of contractility. In these cases, the tone of the muscles on both sides changes - the required force is divided into two components with the involvement of the muscles of the opposite side of the body. This is how S-shaped scoliosis is formed. The names of the types of scoliosis are given due to the fact that the configuration of the curved spine resembles the letters “C” and “S” of the Latin alphabet.
Here it should be especially emphasized that the described process has an unconditioned reflex (innate) nature and is not subject to human will. At the same time, the vertical position of the human body in space is mainly an achievement of social evolution and represents, just like human speech and the ability to work, a conditioned (developed) reflex, i.e. is learning. Remember, Vysotsky: “...walking on their hind legs every day is the sad fate of people.” Figuratively speaking, from generation to generation, parents teach their children to “walk on their hind legs.” This reflex is easily and quickly lost. As soon as a person observes strict bed rest for several days, he needs to learn to walk again.
It is well known that there is a common and completely fair opinion that scoliosis is a disease of a growing organism. Let's try to understand the causes and mechanisms of progression of lateral curvatures of the spine in children and adolescents. I would like to emphasize that the presence of different leg lengths in newborns and children in the first year of life, contrary to popular opinion formed due to imperfect anthropometric studies, is a very widespread phenomenon. Suffice it to recall the asymmetry of the gluteal folds, diagnosed by neonatologists, pediatric neurologists and orthopedists in almost every second child. However, this asymmetry is interpreted in any way - as a symptom of congenital hip dysplasia, congenital hip dislocation, but not as the presence of different leg lengths in the child. It is known that the main stimulus for the replacement of soft cartilaginous tissue with elastic bone tissue is motor activity. This process begins in utero with the first movement of the fetus (18–20 weeks of intrauterine development) and ends at the end of the formation of the musculoskeletal system (24–26 years). From the moment of formation of upright posture, which is mainly a conditioned reflex socially conditioned process, the human spine receives an axial load. So, a child who has an osteochondral skeleton by the age of one year fundamentally changes his motor pattern in such a way that the spine and girdle of the lower extremities receive maximum load due to upright posture and the need to maintain body balance in an upright position. Already by this age, a minimum inequality in the length of the lower extremities can be formed, due to the following factors: genetic (hereditary structural features of the musculoskeletal system), features of the functioning of the musculoskeletal system in the prenatal period and the newborn period, features of the formation of the central nervous system of the newborn, or a combination of these factors. Under conditions of upright walking, the presence of even a slight difference in the length of the lower limbs leads to the development of the following process:
– a leg that has a greater functional length bears a greater load, the leg does more work, receives more nutrition due to increased blood flow and grows faster;
– a leg that has a shorter functional length, accordingly, has less load, the leg does less work, receives less nutrition due to less intense blood supply than the opposite limb and, as a result, grows more slowly;
– the result of this process, occurring in opposite directions, is an increase in the relative difference in the length of the lower limbs with age, which, according to the SBT rule, entails a compensatory lateral curvature of the spine;
– this is, in short, the mechanism of scoliosis progression. For a more detailed acquaintance with the described mechanism, I can recommend to inquisitive readers the work of the famous Ukrainian scientist, Doctor of Medical Sciences, Professor Anton Timofeevich Brusko, who discovered the law of the influence of functional loads on the formation of bone tissue. I would like to draw special attention to the fact that the degree of scoliotic deformation is determined by the magnitude of the relative inequality in length
legs The absolute magnitude of this inequality increases very quickly during periods of intense growth. Consequently, these periods are the most dangerous for the progression of scoliosis. This is why scoliosis is called a growing disease. Lateral curvatures of the spine, according to the SBT rule, are always combined with rotation, i.e. rotation around a vertical axis. The regularities of this process are described by the rule formulated by R. Lovett. It turns out that the direction of rotation is directly related to the physiological curvatures of the spinal column in the sagittal (lateral) plane and the anatomical features of the structure of various parts of the spine. Based on the direction of rotation, Lovett-positive and Lovett-negative scoliosis are distinguished. In order to simplify the understanding of this rather complex process, which requires a large amount of special knowledge and spatial imagination, some authors compare the process of spinal rotation with spiral twisting.
There are two more types of scoliotic deformities of the spine - functional and fixed. As the name implies, functional is a type of scoliotic deformity that is completely reversible with timely and adequate treatment. Over time, in the absence of proper treatment, the disease progresses with the development of organic fixation of spinal deformity. Organic fixation of scoliotic deformities is carried out due to the formation of lateral wedge-shaped deformities of the vertebral bodies and the formation of a costal hump. Wedge-shaped deformities of the vertebral bodies are, in fact, pathological compression fractures of the latter in places of maximum asymmetric axial loads arising from lateral curvatures of the spine.
The mechanism of formation of the costal hump is as follows. On the concave half of the chest, the ribs are brought together, which prevents their normal growth. Due to such rapprochement, the new bone tissue formed by the growth zones cannot uniformly increase the length of the rib, and is forced to form an additional curvature on the costal arch - the costal hump. The first visible sign of the beginning of the formation of a rib hump is the appearance of the so-called pterygoid blade - the distance of one of the blades from the chest, pushed away by the resulting additional curvature of the rib. There is another little-known, but, unfortunately, quite dangerous manifestation of the organic fixation of scoliosis - the formation of a reduced hemipelvis. Above the leg, which has a shorter length, the corresponding half of the pelvis lags behind in growth. This deformation leads to the persistence of scoliosis both in a standing and sitting position. In addition, a reduced hemipelvis is important for the developing female body in terms of creating serious obstetric problems during vaginal delivery.
It is known that the spinal column is the axis of the human body, serving as a kind of support for the internal organs. In a situation of deviation of the body axis, disturbances in the relationships of internal organs occur, which inevitably leads to disruption of their normal functioning.
For example, it is known that people with scoliotic spinal deformities are prone to chronic lung diseases due to limited volume of respiratory movements of the diaphragm, which leads to retention of microparticles and pathogens in the bronchopulmonary system. But the most dangerous complication of scoliosis is the destruction of the spinal column and, above all, its intervertebral discs with the formation of hernias of the latter. This is the most common chronic human disease and the third, according to statistics, the most expensive after pathology of the cardiovascular system and cancer. The United States annually spends more than 19 billion dollars on the treatment of this category of patients. In Sweden, more than 13 thousand people of working age become disabled every year due to this pathology.
What is a herniated disc? To answer this question, you must first consider how the intervertebral disc is structured. The disc consists of two main parts - the nucleus pulposus, located in the center of the disc, and the fibrous ring surrounding it on all sides. The nucleus pulposus consists of specific proteins that can bind large amounts of water. Water, as is known, is an absolutely incompressible liquid. Such a water-protein conglomerate, which is an elastic-elastic ball, is able to withstand very heavy loads. The annulus fibrosus consists of concentric fibrous fibers that perform the task of holding the nucleus in the center of the intervertebral disc. The size of the intervertebral discs, as well as the vertebral bodies, increases in the direction from the cervical to the lumbar region in accordance with the increase in the load on each underlying vertebral motor segment. Normally, the center of mass of each segment of the human body should be in the center of the intervertebral disc, i.e. on the nucleus pulposus, which acts as a segmental shock absorber. For this purpose, the so-called physiological curves of the spine are used - alternating cervical lordosis (anterior bending), thoracic kyphosis (posterior bending) and lumbar lordosis resting on the sacrum. Figuratively speaking, the spinal column, like a virtuoso tightrope walker, tries to maintain the balance of the body by comparing the centers of gravity of each body segment with the nuclei pulposus of the corresponding intervertebral discs. However, this can only be achieved if the sacrum, which is both the bone that closes the pelvic ring and a part of the spinal column, is perpendicular to the plane of support. With different lengths of the supporting limbs, the pelvis tilts towards the short leg and the sacrum, which represents the “foundation” for the upper parts of the spinal column, together with the pelvis is set at an angle to the plane of support. For the spine, a peculiar “Leaning Tower of Pisa” situation arises. What happens to the intervertebral discs? In the lumbar, the most loaded part of the spinal column, the following situation develops:
– the center of mass shifts to the side of the leg that has a greater functional length, and physiological lumbar lordosis leads to the fact that the posterior outer parts of the fibrous ring fall under the maximum axial load, the task of which is not to counteract these loads, but to hold the nucleus pulposus in the center of the disc;
– over time, degenerative changes develop in these overloaded sections, fibrous fibers swell and collapse, and for a long time this process occurs painlessly, due to the absence of nerve endings in the disc;
– cracks appear in the fibrous ring, into which the nucleus pulposus penetrates, and the disc begins to extend beyond its bed;
– this process is accompanied by painful attacks, or so-called lumbago, due to the pressure of the hernia on the tissue surrounding the disc;
– when the size of the hernial protrusion becomes such that it presses the spinal cord;
g root, then the pain spreads along the innervation of this root - in the leg all the way to the toes.
Most often, two lower lumbar intervertebral discs undergo herniation. In the figurative expression of Arthur Dzyak, “... all available data speaks in favor of the fact that degeneration of the nuclei pulposus of the intervertebral discs of the lumbar spine belongs to the group of diseases that represent a certain kind of “payback” for the vertical position of the body in modern man, which he acquired in process of evolution."
I would like to especially emphasize that, in accordance with new scientific data obtained in recent years, the main reason for the development of scoliosis and the formation of herniated intervertebral discs is asymmetry of the body structure in the form of different leg lengths. Consequently, the main diagnostic method for these diseases is to measure the magnitude of this difference - instrumental anthropometry, and the main method of treatment is orthosis (the production of special orthopedic products that eliminate existing asymmetry) and, which have already become routine, manual therapy and traction of the spinal column. Moreover, high-precision anthropometric diagnosis is the main condition, a kind of starting point for further successful treatment. The absence in complex treatment of adequate orthopedic correction of existing asymmetries of the body structure, as the main cause of the disease, leads to the fact that the process is steadily progressing, and we still have the “fortune” to observe hunchbacks and people moving through life with canes, on crutches and in wheelchairs.
So that you, dear readers, do not join the ranks of those who suffer, allow me, at the end of the story about the troubles that asymmetries in the structure of our body bring us, to give a number of tips on how to protect yourself from this trouble. First of all, pay attention to your children, because by influencing a growing organism, you can achieve the maximum positive effect. Undress the child and examine him from the back in a standing position. Starting position: legs fully straightened at the knee and hip joints, feet together, big toes at the same level. Pay attention to the coincidence of paired folds of skin and bone landmarks, such as: popliteal folds, gluteal folds, waist triangles (formed between the waist and freely hanging arms), the lower angles of the shoulder blades, shoulders. Normally, conventional lines connecting the listed landmarks of the left and right halves of the body in pairs should be parallel to each other and to the plane of support (the floor). If you find a discrepancy between any paired landmarks, you must immediately seek qualified medical help. The same basic self-examination can be recommended for adults while standing in front of a large mirror. In this case, the following should be used as paired bone landmarks: knees, tops of the pelvis, waist triangles, shoulders.
Clothing and shoes can provide additional information about existing asymmetries and curvatures of the spine. The need for relative correction of the lengths of the left and right trouser legs or the hem of a skirt indicates progressive asymmetry. Pay attention to the degree of relative wear of the soles and heels in a pair of shoes - shoes wear out more on the side of the leg that is longer, because it bears a heavy load.
Two legs of different sizes
Everyone has probably noticed when buying shoes that one foot is larger than the other. Some people have their right foot a size or half a size larger, while others have their left foot. Why is this happening?
The fact is that the human body is asymmetrical, that is, the right side of our body is different from the left side. It is not difficult to verify this. If you look at your reflection in the mirror more closely, you can see that the right side of our face is more developed than the left. The cheek on the right side protrudes a little more. The outlines of our mouth, ear and eye are clearer on the right side than on the left. The same can be said about our entire body. Our legs vary in strength and dexterity. The inside of the body is also asymmetrical. The liver is on the right side and the heart is on the left side. Therefore, the entire human skeleton is developed unevenly. And this affects the actions we perform and our gait.
That is why in those moments when we are unable to see, for example, during a snow or sandstorm, we will move in circles. By the way, the same applies to animals. Their body structure is also asymmetrical. By the way, if someone is going to drive a car blindfolded, then renting a car on the website http://www.avtomaxi.ru/ is the only way out, because soon the driver will start driving only in circles.
Does the same apply to left-handers and right-handers? There's something interesting here. 96 percent of people are right-handed, the reason for this is different symmetry of the brain, not the body. The left side of the brain controls the right side of the body, and the right side of the brain controls the left side.
Different leg lengths
Different leg lengths.
Leg length difference is a fairly common condition. Most often it begins to appear in children during growth. It is not uncommon for this condition to be associated with other disorders or diseases of the body.
Facts about different leg lengths:
- Normally, a healthy person may experience a difference in the length of the lower limbs of up to 0.5 cm. Out of 1000 people, this can occur in 40-50%.
- The first sign of gait disturbance (lameness) begins to appear when the leg is shortened on one side by more than 2 centimeters. With 3 or more lameness becomes noticeable from the outside.
- People with a pronounced difference in leg length and lameness get tired faster, since the biomechanics of both legs are disrupted and the person expends more energy.
Types of shortening.
- True or anatomical shortening or lengthening. It is determined by anatomical changes in the length of the limb, i.e. the longest bone itself (femur or tibia).
For children, these reasons are so varied that it simply makes no sense to list them all. Since the difference in length begins to form during the period of growth, it is easier to say that any pathological process in the bone can cause both a decrease in the rate of bone growth and its acceleration. This is especially pronounced if the pathological process directly affects or is located next to the growth zone responsible for bone growth in length.
In an adult, a change in the length of a limb can only be due to injury or surgery leading to a change in the length of the bone.
The first thing that catches your eye is that a person with legs of different lengths has a pronounced lameness. In addition, people with a pronounced difference in leg length experience:
- increased fatigue
- pain in the joints of the lower extremities (ankle, knee, hip)
- pelvic distortion
- compensatory scoliotic deformity of the spine
- back pain
- equinus deformity of the foot on the shortening side
The final diagnosis is made by a specialist, an orthopedist. During a clinical examination, the doctor makes segmental and general comparative measurements of the length of the limbs using a centimeter tape. This method has a fairly large error, as it requires careful positioning of the patient. More accurate data is provided by the method of placing standard blocks under the shortened limb. Blocks of 0.25, 0.5 and 1 cm are laid until the pelvis is completely leveled. Their sum gives an idea of the shortening a person has.
Any clinical examination must be complemented by a diagnostic procedure. To determine different leg lengths, this is a topogram of the lower limbs. Modern equipment allows you to take x-rays from the hip to ankle joints while standing. Then, using special software, the length of the bones is calculated. If all the rules are followed, this method allows you to compare the length of the limbs down to millimeters.
There are 2 main directions: conservative and operational.
I would like to immediately make a reservation that different leg lengths cannot be cured conservatively. The conservative method was created to mechanically compensate for the existing difference. This is especially true for a growing organism. Children in the process of formation are more prone to the appearance of various types of deformations, which over time acquire a stable form. Then, with these deformations, they enter adulthood and over time begin to “reap the benefits” of these deformations. Disc herniations, deforming arthrosis, pain of varying localization and intensity, this is an incomplete list of problems that these people may encounter. Therefore, a conservative method must be present, but it is important to understand its capabilities.
Conservative methods of compensating for different leg lengths include:
- orthopedic insoles
- heel pads
- special orthopedic shoes
However, it has been proven that conservative methods are effective with a difference of no more than 4 cm (optimally 2-3 cm). Therefore, shortenings of 4 or more centimeters are indications for surgical treatment.
- Shortening of a longer limb.
- Lengthening a shorter limb in an external fixator.
- Blocking growth zones.
Here, surgical methods for treating different lengths of the lower extremities are discussed in detail.
People with one leg shorter than the other are actually not that uncommon. Have you often seen an adult walking with a hopping gait? What about the child who doesn’t want to play with his friends because he has a “funny” limp? Orthopedic instep supports for different leg lengths will help with this seemingly insoluble problem.
Children with different leg lengths are at risk
According to numerous studies, those children whose height of the longitudinal arch of the foot is asymmetrical are combined with scoliosis of various types in 15-20%. Girls are more susceptible to these conditions - they suffer from poor posture and flat feet more often than boys. This is explained by the more sedentary lifestyle of girls.
The most dangerous lifestyle for scoliosis is from 10 to 14 years of age - adolescence. At this time, the child’s skeleton is not yet formed, but the load on it increases. The child often sits bent over at his desk during lessons, and then at home when preparing homework. It is at this age that a boy or girl of 7-9 years old develops scoliosis - statistics have registered up to 30% of such children.
Children aged 10 to 1 4 years suffer from the initial stages of scoliosis in 40% of cases, and in older adults this figure is also very high - it is almost 35%. The sooner doctors diagnose scoliosis in a child, the sooner it can be treated. And there is still a good chance of correcting spinal curvature and associated foot deformities.
And one more point: the earlier scoliosis is detected in a child, the sooner you can work with a shortened leg, compensating for this deficiency with the help of orthopedic shoes. Parents should know: the sooner scoliosis is detected in children between the ages of 8 and 10, the sooner deviations in posture and arch of the foot can be eliminated, because the course of scoliosis, according to statistics, worsens significantly in the next 2-4 years, up to 12 years.
The fact that posture worsens at this age can be explained simply: at this time the child is growing rapidly, and this growth does not occur evenly, like nets. The progression of this dangerous disease and foot deformities usually slows down and sometimes ends by age 14.
Adults with different leg lengths are at risk
The largest group of adults who especially suffer from scoliosis and associated foot deformities are people over 50 years of age. At this time, bone tissue ages and breaks down, especially with an unhealthy lifestyle associated with smoking and poor nutrition, as well as increased stress on the musculoskeletal system. Therefore, people over 50 often experience a change in the length of the intervertebral disc - it becomes deformed.
The pelvic bones become distorted due to the fact that one limb (leg) becomes shorter than the other. Therefore, the disc between the vertebrae wears out and does not serve well, which aggravates poor posture and leads to an imbalance between the left and right sides of the body. The lower back muscle, called the quadratus muscle, is especially affected; it is located in the lower back). This chain also includes the pectoral, clavicular, and scalene muscles, so the intervertebral nerves are compressed, many parts of the body hurt, in particular the spine, and the person continues to hunch over even more. Poor posture in people over 50 is accompanied by an uneven, skipping or limping gait, and deformed feet.
Consequences of different leg lengths
In a child (especially a small one), the height of the longitudinal arches of the foot can be asymmetrical, which ultimately leads to scoliosis of the spine. Scoliosis is a curvature of the spine in one direction. Unlike the usual violation of children's posture (the child stands incorrectly or sits hunched over, his muscle tone is impaired), scoliosis destroys the structure of muscles, bones, ligaments and cartilage, which have not yet been fully formed in the child. Therefore, scoliosis leads to improper distribution of load and incorrect distribution of support points, and the child develops foot deformity, in particular, flat feet.
Scoliosis can be dysplastic (a metabolic disorder in the spinal tissues, such as twisting) and static. All this together causes a jumping gait due to the different lengths of the child's legs. As for adults, their different leg lengths can lead to gross violations of the skeletal structure. As a result, muscles, ligaments, and cartilage develop incorrectly, spinal discs fall out, and a herniated disc occurs. Therefore, people with such abnormalities often have back or stomach pain. These pains are long-lasting and painful.
When should you go to the doctor?
It is very difficult to understand whether a child’s legs are different or the same length. Therefore, at the slightest suspicion of poor posture in a child, you should definitely visit an orthopedist or traumatologist for consultation and treatment. Very often, physical therapy and dancing, as well as swimming, can help with the initial signs of scoliosis and foot deformities. In order not to miss the initial, subtle signs of deformities of the spine and foot, you need to see a doctor once a year for a preventive examination.
As for adults, they need to monitor their pain sensations. Especially in the area of the spine and feet. And also control your gait. If friends tell you or you yourself feel that your gait has become uneven, skipping or limping, consult a doctor for examination and treatment.
The extent to which the missing leg length needs to be compensated is determined by an orthopedist or traumatologist. Shortening of the legs (don't be alarmed, this is a medical term) can be absolute or relative. To determine the type of shortening, you need to take an x-ray of the pelvic area, as well as the spinal column. This is done in a standing position. From this x-ray, the doctor will accurately indicate the difference between the length of one leg and the other by analyzing the height of the heads of the pelvic joints. This will make it possible to determine the difference in leg length.
If the shortening of the leg is absolute, full compensation is required, and if it is relative, incomplete compensation of the leg length is required, up to one third or one second for adults and up to half the length for children.
How to help a person with different leg lengths?
First of all, order orthopedic insoles. Such insoles are also called compensatory insoles. They are selected individually, they are manufactured within 20 minutes, the patient does not even have time to leave the clinic, and the insoles will already be ready. You can pick them up right away. What can you achieve with orthotics?
- Stabilize the position of the spine and feet
- Scoliosis and flat feet stop developing further
- Those areas of the spine that were heavily loaded are now unloaded and can calmly recover
- If the shortening of the legs is too great, not only orthopedic insoles are used, but also instep supports. They make it possible to improve posture and relieve stress on the spine and feet.
It should be taken into account that a person may not get used to insoles and arch supports right away. Minor discomfort may be felt within 4-5 days of wearing the insoles. Then the person feels incredible relief: the insoles are almost not felt, but fatigue in the legs develops much more slowly, walking is much more comfortable, and there is practically no pain in the legs. Stability in the ankle increases, the load on the knees becomes lighter, and the lower back hurts much less.
If discomfort in the feet and spine does not go away within a week, it means that the orthopedic insoles were selected and modeled incorrectly. A repeat visit to the orthopedist and other insoles are needed.
A condition in which one leg is shorter than the other is called short leg syndrome. Different leg lengths are a common occurrence in both adults and children. According to the International Classification of Diseases, 10th revision (ICD-10), defects that shorten the lower limb are classified as class Q 72. Even if the length of one lower limb is only 4–5 mm longer than the other, this can still lead to various disorders of the musculoskeletal system.
The difference in leg length, which is about 5 centimeters, is visible externally. A person suffering from this disorder has impaired gait and lameness. If one leg is shorter than the other by up to 5 cm, it is practically invisible in appearance due to the tilt of the pelvis and curvature of the spine. In addition to postural disturbances and changes in gait, the patient is also bothered by pain in the joints and spine. A problem that does not receive proper treatment can eventually lead to diseases such as arthrosis, bursitis, etc.
There are several types of shortening of the lower extremities: anatomical (due to a decrease in bone length), relative (dislocation, decreased joint mobility), combined. Various growth disorders, in which growth is delayed or accelerated, can affect the length of both limbs.
The reasons that provoke the occurrence of such a phenomenon as different leg lengths include the following:
- Congenital shortened leg due to intrauterine developmental disorder of the fetus (according to ICD-10 Q65-Q79). In this case, pathologies such as clubfoot, hip dislocation, and hemophilic hemarthrosis develop. Dislocations and deformations of the hip in a child are possible, which may lead to adverse consequences in the future (ICD-10 Q65).
- Inflammation (tuberculosis, arthritis, elephantiasis, thrombosis of the veins of the lower extremities).
- Neuropathic factors (cerebral palsy, poliomyelitis).
- Tumors.
- Traumatic shortening. It is associated with damage to special growth plates that are located at the ends of the tibia and femur. With such damage, the child experiences slow growth of one or both limbs. In childhood, due to the growth of the child, such shortening develops and worsens, while in adults it remains unchanged.
If one leg is shorter than the other, the load on the spine is distributed unevenly. The spine begins to bend, and osteochondrosis appears. There is a twisting of the pelvis, as well as a rotation of the fifth lumbar vertebra.
With this disorder, shortening of both one section of the lower limb (thigh or lower leg) and all sections simultaneously can be observed. According to ICD-10, longitudinal shortening of the femur is classified as ICD-10Q72.4, longitudinal shortening of the tibia ICD-10 Q72.5, longitudinal shortening of the fibula ICD-10 Q72.6.
Some body asymmetry is normal. But even if a leg is just a few centimeters shorter than the other, this can lead to some problems and diseases.
Children at risk
The earlier a problem is identified, the easier it is to treat. This is especially true in the treatment of children, since the shortening of the leg progresses over time and becomes more and more obvious. Disorders of the musculoskeletal system in the fetus can be detected using ultrasound already in the early stages of pregnancy.
There are symmetrical and asymmetrical delays in fetal development. With a symmetrical violation, the ratio of circumferences and sizes are within normal limits and are harmonious. But the size of the fetus is proportionally reduced. With an asymmetric delay (occurs in later stages), there is a delay in the growth of certain areas. There are certain standards for fetal development at each stage of pregnancy: the circumference of the fetal head, tummy, and fetal length. Data on fetal thigh length are also used to determine gestational age.
If you have any suspicions, you can measure the approximate difference in your child’s legs yourself at home. First you need to determine if there is a difference in thigh length. To do this, lay the child on his back, bend his legs at the knees so that 90° angles are formed at the hip joint and knee joint. If one knee is slightly higher than the other, this may indicate that one hip is larger than the other.
To compare the length of the lower leg, place the child in the same position. Legs are bent at the knees, feet pressed to the floor. Visually draw a line above your knees. If one knee is higher than the other, you should consult a specialist for advice.
In children, the height of the longitudinal arches is often asymmetrical, which can lead to scoliosis. Scoliosis is a curvature of the spine in any direction from the axis. Scoliosis disrupts muscle structure, the structure of muscles, ligaments and cartilage. This is dangerous because the child’s body has not yet fully formed.
Scoliosis and unequal leg lengths are directly related to each other.
Treatment: there is a way out
The fact that one leg is shorter than the other is not a death sentence. Treatment of pathology exists and is quite successfully used in modern medicine. Today, with the help of modern methods, it is even possible to lengthen short legs or correct crooked legs.
There are several methods that can help patients who have one leg shorter than the other. The conservative treatment method is used for patients whose leg is no more than 2 centimeters larger than the other.
If one leg is significantly larger than the other, then surgical treatment is recommended. The most common method is to lengthen the lower limb using the Ilizarov apparatus. The bone is cut in the required area, and then the leg is fixed using a device. The bone tissue will grow towards each other, and over time the two bones will grow together. The bone growth rate is 1 mm per day, i.e., it will take 10 days to lengthen the leg by 1 cm. It takes about six months for a person to fully recover. After removal of the device, another period of rehabilitation is necessary.
This method is also used in aesthetic surgery to lengthen short legs. But without special indications, lengthening short legs is not recommended. In addition to the high cost, pain and duration of the manipulation, in any case, this is an intervention in the body that does not go away without leaving a trace. Before deciding to undergo such an operation, you should seriously think about this issue. Perhaps your short legs are a problem that needs to be treated by a psychologist, not a surgeon.
Another treatment option is to block growth plates. In this case, manipulations are performed with the healthy leg. The method is used in children and is aimed at restraining the growth of one leg so that over time both legs become equal in length.
People with one leg shorter than the other are actually not that uncommon. Have you often seen an adult walking with a hopping gait? What about the child who doesn’t want to play with his friends because he has a “funny” limp? Orthopedic instep supports for different leg lengths will help with this seemingly insoluble problem.
Children with different leg lengths are at risk
According to numerous studies, those children whose height of the longitudinal arch of the foot is asymmetrical are combined with scoliosis of various types in 15-20%. Girls are more susceptible to these conditions - they suffer from poor posture and flat feet more often than boys. This is explained by the more sedentary lifestyle of girls.
The most dangerous lifestyle for scoliosis is from 10 to 14 years of age - adolescence. At this time, the child’s skeleton is not yet formed, but the load on it increases. The child often sits bent over at his desk during lessons, and then at home when preparing homework. It is at this age that a boy or girl of 7-9 years old develops scoliosis - statistics have registered up to 30% of such children.
Children aged 10 to 1 4 years suffer from the initial stages of scoliosis in 40% of cases, and at the age of 15-17 years this figure is also very high - it is almost 35%. The sooner doctors diagnose scoliosis in a child, the sooner it can be treated. And there is still a good chance of correcting spinal curvature and associated foot deformities.
And one more point: the earlier scoliosis is detected in a child, the sooner you can work with a shortened leg, compensating for this deficiency with the help of orthopedic shoes. Parents should know: the sooner scoliosis is detected in children between the ages of 8 and 10, the sooner deviations in posture and arch of the foot can be eliminated, because the course of scoliosis, according to statistics, worsens significantly in the next 2-4 years, up to 12 years.
The fact that posture worsens at this age can be explained simply: at this time the child is growing rapidly, and this growth does not occur evenly, like nets. The progression of this dangerous disease and foot deformities usually slows down and sometimes ends by age 14.
Adults with different leg lengths are at risk
The largest group of adults who especially suffer from scoliosis and associated foot deformities are people over 50 years of age. At this time, bone tissue ages and breaks down, especially with an unhealthy lifestyle associated with smoking and poor nutrition, as well as increased stress on the musculoskeletal system. Therefore, people over 50 often experience a change in the length of the intervertebral disc - it becomes deformed.
The pelvic bones become distorted due to the fact that one limb (leg) becomes shorter than the other. Therefore, the disc between the vertebrae wears out and does not serve well, which aggravates poor posture and leads to an imbalance between the left and right sides of the body. The lower back muscle, called the quadratus muscle, is especially affected; it is located in the lower back). This chain also includes the pectoral, clavicular, and scalene muscles, so the intervertebral nerves are compressed, many parts of the body hurt, in particular the spine, and the person continues to hunch over even more. Poor posture in people over 50 is accompanied by an uneven, skipping or limping gait, and deformed feet.
Consequences of different leg lengths
In a child (especially a small one), the height of the longitudinal arches of the foot can be asymmetrical, which ultimately leads to scoliosis of the spine. Scoliosis is a curvature of the spine in one direction. Unlike the usual violation of children's posture (the child stands incorrectly or sits hunched over, his muscle tone is impaired), scoliosis destroys the structure of muscles, bones, ligaments and cartilage, which have not yet been fully formed in the child. Therefore, scoliosis leads to improper distribution of load and incorrect distribution of support points, and the child develops foot deformity, in particular, flat feet.
Scoliosis can be dysplastic (a metabolic disorder in the spinal tissues, such as twisting) and static. All this together causes a jumping gait due to the different lengths of the child's legs. As for adults, their different leg lengths can lead to gross violations of the skeletal structure. As a result, muscles, ligaments, and cartilage develop incorrectly, spinal discs fall out, and a herniated disc occurs. Therefore, people with such abnormalities often have back or stomach pain. These pains are long-lasting and painful.
When should you go to the doctor?
It is very difficult to understand whether a child’s legs are different or the same length. Therefore, at the slightest suspicion of poor posture in a child, you should definitely visit an orthopedist or traumatologist for consultation and treatment. Very often, physical therapy and dancing, as well as swimming, can help with the initial signs of scoliosis and foot deformities. In order not to miss the initial, subtle signs of deformities of the spine and foot, you need to see a doctor once a year for a preventive examination.
As for adults, they need to monitor their pain sensations. Especially in the area of the spine and feet. And also control your gait. If friends tell you or you yourself feel that your gait has become uneven, skipping or limping, consult a doctor for examination and treatment.
The extent to which the missing leg length needs to be compensated is determined by an orthopedist or traumatologist. Shortening of the legs (don't be alarmed, this is a medical term) can be absolute or relative. To determine the type of shortening, you need to take an x-ray of the pelvic area, as well as the spinal column. This is done in a standing position. From this x-ray, the doctor will accurately indicate the difference between the length of one leg and the other by analyzing the height of the heads of the pelvic joints. This will make it possible to determine the difference in leg length.
If the shortening of the leg is absolute, full compensation is required, and if it is relative, incomplete compensation of the leg length is required, up to one third or one second for adults and up to half the length for children.
How to help a person with different leg lengths?
First of all, order orthopedic insoles. Such insoles are also called compensatory insoles. They are selected individually, they are manufactured within 20 minutes, the patient does not even have time to leave the clinic, and the insoles will already be ready. You can pick them up right away. What can you achieve with orthotics?
- Stabilize the position of the spine and feet
- Scoliosis and flat feet stop developing further
- Those areas of the spine that were heavily loaded are now unloaded and can calmly recover
- If the shortening of the legs is too great, not only orthopedic insoles are used, but also instep supports. They make it possible to improve posture and relieve stress on the spine and feet.
It should be taken into account that a person may not get used to insoles and arch supports right away. Minor discomfort may be felt within 4-5 days of wearing the insoles. Then the person feels incredible relief: the insoles are almost not felt, but fatigue in the legs develops much more slowly, walking is much more comfortable, and there is practically no pain in the legs. Stability in the ankle increases, the load on the knees becomes lighter, and the lower back hurts much less.
If discomfort in the feet and spine does not go away within a week, it means that the orthopedic insoles were selected and modeled incorrectly. A repeat visit to the orthopedist and other insoles are needed.