Leg length discrepancy

Very enlightening Nick! You mention it's important to stretch the hip muscles early enough. How much time do you think a person has to restore length in those muscles before it's too late?

My PT stretches my quads and hamstrings 3 x a week, but I would like to know what exercises actually stretch the hip muscles, as in that image. Lunges? Or straight leg lowering to the floor, while the other leg is fixed on a 2" platform? That's one exercise they have me do to the non-op leg, which they said was slightly shorter.
 
Melissa - I totally understand your fears! I was quite upset about my LLD right after surgery. I noticed the same thing as you Melissa and asked my first PT about it. He said he noticed it right away but said I should not worry about it as most of the time the legs even out over time. My LLD was bad, almost an inch. I could also see the difference in the mirror - one hip was higher than the other. I did notice it started getting better after about 3 weeks. Noticeable difference after 4 weeks with increased outpatient PT. She used Nick's method but also said the only way to truly measure LLD was with an x-ray. She measured me at less than 1/4 inch and that was a while ago. I still see a little difference, but I am not as worried as I was.
 
Very enlightening Nick! You mention it's important to stretch the hip muscles early enough. How much time do you think a person has to restore length in those muscles before it's too late?

My PT stretches my quads and hamstrings 3 x a week, but I would like to know what exercises actually stretch the hip muscles, as in that image. Lunges? Or straight leg lowering to the floor, while the other leg is fixed on a 2" platform? That's one exercise they have me do to the non-op leg, which they said was slightly shorter.

Hi Hop,

I don't know how much time, but it will be weeks/months, not days. I'm rushed today, so will post some exercises specifically good for THR patients later. But I do want to stress that I am NOT a doctor and anyone thinking of doing a new exercise should check with their physio/doctor.

Basically the Gluteal maximus extends the leg backward, the gluteal medius and minimus abduct the leg, as does the tensor fasciae latae (which connects/assists with the iliotibial band). To strengthen these muscles, extend or abduct as appropriate. To lengthen, do the opposite (but beware the dreaded 90 degree rule :). More later.

Enjoy it all,
Nick
 
I just like to lend my support and confirmation on Nick's posts. Couldn't add or correct a thing.
 
My PT stretches my quads and hamstrings 3 x a week, but I would like to know what exercises actually stretch the hip muscles, as in that image. Lunges? Or straight leg lowering to the floor, while the other leg is fixed on a 2" platform? That's one exercise they have me do to the non-op leg, which they said was slightly shorter.

Hi Hop,

I've put together a series of stretches for those hip muscles, and sent them to Jo and Jamie. I don't feel comfortable to post too much in the way of exercises without their prior approval. Let's see what they decide.

:)

Nick
 
Hi Jo -question for you. I had my 6 week check-up today. Here is a copy of my x-ray taken today. I still feel like my pelvis is tilted (after years of favoring my good side) and am concerned with leg length discrepancy. However, my boyfriend drew up these lines -The red lines show the tilting of the pelvis. The purple lines are exactly the same length, from a point of reference on the femur to a point of reference on the hip bone, they intersect at almost exactly the same point, which I think should be a good indication of equal leg length, at least as far as what would be determined by the length of the implant stem. Is this accurate at all? Obviously you can't accurately measure the length from just looking at a closeup of the hip but I think that if the position of the femur was significantly altered by the placement of the implant then you would be able to tell by that measurement?

My OS told me not to be fixated with the limping at all right now, that I'm still healing and it takes some time.

p.s. We had to use an image for blocking since it wasn't blocked in the X-ray...LOL!

melissaleglengthxray.jpg
 
Melissa, God love you.....you have such a great sense of humor!!!
 
That image actually can't show anything about LLD, Melissa, because it doesn't have any distant points to measure to. The points being used are not fixed points as we are not symmetrical. The lesser two trochanters (bumps on the inner side of the femur) are rarely identical.

To make a more accurate assessment, we'd need an xray that included at least the knees and probably the ankles as well right up to several more of the vertebrae. I can't see the right iliac crest at all. Sorry.

But I liked your 'modesty' patch!
 
Nearly spit up my morning coffee all over my keyboard when I realised what the critter in your x-ray was!

Thanks for the morning giggle, Melissa. And good luck figuring it all out. If its of any value, I'm at 4 1/2 months now and I have just recently gotten to the point that I don't think about my stride anymore, everything has finally settled down.
 
Nearly spit up my morning coffee all over my keyboard when I realised what the critter in your x-ray was!

Thanks for the morning giggle, Melissa. And good luck figuring it all out. If its of any value, I'm at 4 1/2 months now and I have just recently gotten to the point that I don't think about my stride anymore, everything has finally settled down.

Me, too. That is hilarious, Melissa!

Though, I wouldn't be offended had you posted the unaltered image :-D LOL!
 
Hi Melissa, Great image--and sense of humor. More seriously, just be assured that your gait and feeling of unevenness is bound to improve, even months from now. Heel toe heel toe--I still remind myself occasionally on my morning walks.

When are you returning to work? You must be a short timer by now.

Laurie
 
Hey Melissa! I bet by the time you're 6 months out, all this thinking will be a thing of the past! I'm hardly wrong.....just ask my hubby!!! (Yeah, right! LOL!!!). :)
 
I have to say, I did not want to post this picture! I have to give my boyfriend credit for this. He thought it would be silly! Glad to give everyone a morning laugh :)

Laurie -I return to work on 5/11/09. Almost. I'm enjoying this nice weather and don't want to be back in an office! In a few months I'm going to look into teaching pilates again -can't wait.
 
I wish I lived closer to you, M. I'd love to take a class with you! But then you would probably be yelling because we would be laughing too much and not getting too much of a workout in! :)
 
I've had plenty of laughers! Many of the movements easily lead to laughter (rolling like a ball, open leg rocker, swimming, etc); however, within a couple of weeks, usually everyone is under control :)
 
I bet!!!! My daughter in law just started Pilates after giving birth to my grand daughter on Election Day! She loves it! :). I don't know how much laughing"s going on in her class though! THAT part would be a MUST for me though!!! :)
 
Wow! Your BF made you a skeletal striptease superstar-----watch out Demi Moore J/K.
I forgot to ask to see a copy of my "after" x-ray......next visit I will though.

I only used my cane once in the past week. so I am getting better, still limping but improving. When I sit too long the limp gets worse. In another month we should both be walking straight again!

Hop
 
My $'s on both of you,,,,,Melissa & Hop!!! You'll see!!!!! :)
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011

Members online

Forum statistics

Threads
65,167
Messages
1,596,864
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom