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short leg - weak turns?

post #1 of 12
Thread Starter 

The Bootfitters forum says 92% of all humans have one leg shorter than the other. Almost all skiers make turns better to one direction than the other. I know which way I turn best but I do not know which leg is shorter. Sounds like a relatively easy fix to add a little spacer under the bindings to resolve the length issue. Only problem is it evidently requires a doctor to diagnose. Anyone know what kind of Doc? Can I get it checked at next physical? Has anyone actually done a study to see how much this issue impacts skiing? Do most high level competitive skiers address this issue?

post #2 of 12
Chiropractor.

You should get an alignment first. I think folks are miss aligned because of not doing things equally, like having a fat wallet and sitting on it all day.
post #3 of 12
Quote:
Originally Posted by steveturner View Post

The Bootfitters forum says 92% of all humans have one leg shorter than the other. Almost all skiers make turns better to one direction than the other. I know which way I turn best but I do not know which leg is shorter. Sounds like a relatively easy fix to add a little spacer under the bindings to resolve the length issue. Only problem is it evidently requires a doctor to diagnose. Anyone know what kind of Doc? Can I get it checked at next physical? Has anyone actually done a study to see how much this issue impacts skiing? Do most high level competitive skiers address this issue?

you might want to come up with a better source for that 92% figure than the bootfitters' forum

post #4 of 12

Here's a quote from a recent article in J Orth. Sports Phys. Ther.: "Little agreement exists regarding the prevalence of limb length inequality, the degree of limb length inequality that is considered clinically significant, and the reliability and validity of assessment methods. Based on correlational studies, the relationship between limb length inequality and orthopaedic pathologies is questionable."

 

And here's an older review, from J. Manip. Phys.Therap. that pretty much says the same thing, and adds that visual or anthropometric measurements are unreliable; you need radiographs or CT scans: "There appears to be a lack of agreement concerning incidence, classification and point of clinical significance...Of the three most commonly utilized evaluation methods, radiographic measures such as the scanograms are recognized as the most reliable procedure for the evaluation of anatomical LLI. Much controversy exists with some of the clinical orthopedic methods and the visual "quick" leg check. Because there is such a vast range in estimates of reliability, few if any definitive conclusions can be made regarding these methods. Given this, it is evident that more research is needed before the use of certain orthopedic and visual checks are considered reliable and valid." 

 

I can personally attest to the unreliability of simply measuring bony landmarks to detect a difference that small, just too many other sources of variation. Even having tight lower back and leg muscles on one side , which can be associated with disk problems, will change leg length more than .5 cm. As will habitual posture, which is also asymmetrical left-right.

 

Put another way, no human being has a perfectly symmetrical skeleton left-right. Most studies look at discrepancies after broken legs, replacements, serious osteoarthritis, or infections that require re-sectioning.

 

That said, leg length diffs of .5 cm to 1 cm are found in roughly 1/3 of the non-pathological population, and are considered within normal variation, meaning that whatever impact they have on gait or stance is washed out by competing variables; impossible to measure reliably and no clinical impact anyway. As a point of comparison, folks who have undergone hip replacement also tend to have differences toward the upper part of this range. Those with congenital vascular syndromes, like Klippel-Trenauncy-Weber, tend to have the greatest overgrowth on one side; it can be dramatic. As in above 10 cm.  

 

Diffs greater than about 1.5 cm sometimes are called significant, but it's unclear how or why. Some studies indicate they create functional/biomechanical outcomes, but as the earlier quotes indicate, it's very controversial. One patient can have large discrepancies with no clinical symptoms, the next can have comparatively small diffs and claim they notice. But in any case, the number of people who have not had a broken leg or knee/hip replacement or some congenital condition, just naturally have a discrepancy above 1.5 cm, is very small. Nothing like 92%. Also keep track of language: There's a big difference between having a slight inequality, and having one that creates dysfunction.

 

But if you think it's a problem for you, go talk to an orthopedic surgeon, preferably with a specialization in sports injuries, who will be able to do scans of your legs. Or not; personally I'd live with the inequality rather than the radiation. Which is substantial if you do both lower limbs. Hopefully with your crotch covered...wink.gif

post #5 of 12

Unless the leg length difference is severe (no I don't know how much that would be but I would guess enough to make you walk with a limp or require special shoes), why would it matter that much for turning while skiing?  Each time we turn the terrain is varied.  Even if both legs are perfectly the same length and there are no other issues, each turn is still going to be different with regards to legs flexing and extending.

 

If I turn left on a shallow pitch, as I turn, my uphill leg flexes and my downhill leg extends.  Same happens in the opposite direction.  I could be on the same trail and each turn could be a different pitch or turn shape.  So what.  My legs are going to extend and flex to stay in contact with the snow.

 

Where I think leg differences will make a bigger difference is on the flats or skating.  Even skating, your legs are flexed.  I would guess one will just flex a little more.

 

I purposefully looked for non world cup skiers.  These folks might be WC skiers but they aren't making WC turns.  I don't even think that is snow!  My point is that even in the most basic skiing style, the legs are almost always different lengths.  Even during the transition, one ski is uphill one down so the legs will be different lengths.  As long as the leg length issue isn't severe, it should be easy to compensate for without interfering with skiing performance, right?

 

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post #6 of 12

Two excellent answers.

post #7 of 12

it is the movements that are made to compensate for the LLD. fundamentally the body instinctively knows what it has to do for the skis to turn. LLD shows itself as the body creates tricks or ticks or exaggerations to get the skis to do the same thing in both directions.

 

at all levels of skiing, the effects of LLD can be observed from your feet to your head. 

 

asymmetrical turns

long leg pinky toe side hangs up on the uphill edge

predisposition of hip angle favoring either the long leg or short leg side

fore-aft balance compensations

tipping

leaning

excessive pole plant movement

asymmetrical excessive pole plant movement

excessive up motion

excessive down motion

think of monty pythons ministry of funny walks, except that we are talking about skiing.

 

as a boot fitter, alignment specialist, ski teacher and coach, i can tell you that overall balance and alignment in skiing is critical in the planes of motion that the body goes through to get down the mountain. LLD can and will be a factor in finding that balance that allows you to move comfortably balanced on any pitch, any terrain, any snow condition at any speed.

 

for ski teachers and coaches out here on epic, the single biggest improvement that you can make in your approach to your students is to eliminate the variables in equipment and its relationship to your skiers bodies, so that your time and energy is spent on technique and tactics that your clients can actually perform because there is little to no time spent fighting their equipment set-up.

 

jim

post #8 of 12
Quote:
Originally Posted by steveturner View Post

The Bootfitters forum says 92% of all humans have one leg shorter than the other. Almost all skiers make turns better to one direction than the other. I know which way I turn best but I do not know which leg is shorter. Sounds like a relatively easy fix to add a little spacer under the bindings to resolve the length issue. Only problem is it evidently requires a doctor to diagnose. Anyone know what kind of Doc? Can I get it checked at next physical? Has anyone actually done a study to see how much this issue impacts skiing? Do most high level competitive skiers address this issue?

 

 

Quote:
Originally Posted by starthaus View Post

it is the movements that are made to compensate for the LLD. fundamentally the body instinctively knows what it has to do for the skis to turn. LLD shows itself as the body creates tricks or ticks or exaggerations to get the skis to do the same thing in both directions.

 

at all levels of skiing, the effects of LLD can be observed from your feet to your head. 

 

asymmetrical turns

long leg pinky toe side hangs up on the uphill edge

predisposition of hip angle favoring either the long leg or short leg side

fore-aft balance compensations

tipping

leaning

excessive pole plant movement

asymmetrical excessive pole plant movement

excessive up motion

excessive down motion

think of monty pythons ministry of funny walks, except that we are talking about skiing.

 

as a boot fitter, alignment specialist, ski teacher and coach, i can tell you that overall balance and alignment in skiing is critical in the planes of motion that the body goes through to get down the mountain. LLD can and will be a factor in finding that balance that allows you to move comfortably balanced on any pitch, any terrain, any snow condition at any speed.

 

for ski teachers and coaches out here on epic, the single biggest improvement that you can make in your approach to your students is to eliminate the variables in equipment and its relationship to your skiers bodies, so that your time and energy is spent on technique and tactics that your clients can actually perform because there is little to no time spent fighting their equipment set-up.

 

jim

Jim, do you need a prescription from a doctor before you adjust a skier's boots to accommodate their LLD?  Steve Turner has been told that this is necessary.

If yes, what's that prescription look like and what kind of doctor usually writes it?  

Again if yes, do you know if the skier usually needs extensive testing before the doctor will create this piece of paper?

If not, does anyone know if this is a law that is different in different states?

post #9 of 12
Quote:
Originally Posted by LiquidFeet View Post

 

 

Jim, do you need a prescription from a doctor before you adjust a skier's boots to accommodate their LLD?  Steve Turner has been told that this is necessary.

If yes, what's that prescription look like and what kind of doctor usually writes it?  

Again if yes, do you know if the skier usually needs extensive testing before the doctor will create this piece of paper?

If not, does anyone know if this is a law that is different in different states?

 

to be clear, i am talking about solving a problem on snow. period. this does not call for examination by a doctor, an x-ray, a battery of tests, a script (prescription), an overnight stay in a hospital or sanitarium. (although anecdotal, i can say that many of the hardest cases of chasing alignment ghosts are with individuals whose success rate in balance problem solving could be increased by long term care of a psychiatrist and modern meds)

 

a great boot fitter, will get a sniff of a problem in the static environment of the ski shop. what can they see? maybe a knee that presents further forward on one side than the other? maybe when standing in front of you they can see that one sides hip or shoulder seem to be higher or lower or rotated in or out? they can test some possible solutions in that static environment to help steer them into an hypothesis of what may work on the mountain. simple stuff like adding a lift to the outsole of the ski boot, or adding a lift plate under one binding. but ultimately the solution has to be tested by the skier on the mountain, and the correct answer is when they can move the skis equally in both directions moving in and out of the fall line. without any of the silly head, neck, shoulder, hip, knee, or ankle movements that point to either an alignment issue, strength imbalance, or limb length discrepancy.

 

the fix we are dealing with in skiing is generally related to side to side movements in the frontal plane. the ability to put your skis up on edge equally.

 

a great ski instructor can do the same type of work right there on the snow where an obvious imbalance can be spotted from the chairlift by a coach or ski teacher with a great eye. they do not even have to meet you to know that you may have an LLD or some other body compensation that presents itself on snow like a LLD.

 

real limb length discrepancy is usually pretty obvious. like obvious to the naked eye kind of obvious. what presents itself to look like leg length discrepancy can be attributed to unlimited causes or compensations that the human body develops to maintain an upright balanced posture on planet earth. solutions to the "fakeout" LLD include chiropractic adjustment, strength training, improved core strength, stretching, yoga, acupuncture, specific release techniques, etc.

 

the real answer to your medical/legal line of questioning concerning LLD, is that in gait, walking, running, standing, messing with LLD should be dealt with by those trained to first of all discover the difference, measure the difference, then prescribe the recommended fix for the client to achieve the desired result in gait ( walking, running, standing for long periods ) in most cases that fix will deal with something in the footwear to achieve better balance from the ground up. usually that person is not your boot fitter. just so nothing is lost in the translation of my sarcasm, this stuff needs to be addressed by a medical doctor, preferably an orthopedic doctor that could explain using tools like a skeleton, and an x-ray to make your diagnosis accurate. and even after that is done and there is indisputable evidence to show that you have a limb length discrepancy, you only need to consult your boot fitter if you are not making equal pressure on your ski edges. it should also be pointed out that it needs to bother you that you are not turning equally in both directions. if it does not bother you then there is nothing to talk about when it comes to LLD in skiing. compensate away........

 

jim

 

jim

post #10 of 12

I sent a PM to the OP about this last week...

 

I have a right leg that is a strong 1/2" shorter than the left leg as a result of a shattered right femur about 25 years ago.  I never was able to find a definitive answer about how the leg length difference would effect me and what I could do about it.  I didn't have health insurance at the time and feel lucky to have had my life saved at all, I wasn't too worried at 25 about pressing for PT and other things that would cost money that I truly didn't have.  I was diligent about going to the gym, managing my own unsupervised rehab, and not allowing myself to limp when I walked.  Most people don't realize that I have a leg length difference until I show them.  I ski at a pretty high level.  I can notice the difference sometimes when I turn left especially on steeper slopes as I have to flex the left leg more deeply to get it out of the way so I can move my CM inside the turn.  Not a big deal for me as I have spent many seasons skiing over 100 days/season and have adapted to it.  Some, but not all, trainers notice a slight asymmetry in my turns.  Very few of these trainers can pin point the root of this asymmetry until I tell/show them.

 

It is probably possible to make an adjustment to the boot sole to add or subtract length from the lower leg.  I'm assuming the LLD means lower leg discrepancy?  I would think this route is far better than messing around with shims, lifts, or ramp inside the boot.  I also dislike the idea of messing with the bindings as I like to switch skis from foot to foot and occasionally will borrow or demo skis and don't want a "specialized" set up on the ski itself.  In my case the length discrepancy is in the upper leg and seems harder to fix.  The good news is I've become used to it.

post #11 of 12

LLD = Lower limb discrepancy. Whole leg. 

post #12 of 12

beyond and starthaus, great posts because LLD is not a hard and

fast science without clear xrays to measure things out.

...so often docs, chiros etc just 'guesstimate'; and yet a good bootfitter

can  help alleviate the symptoms, too, with tweaking one's gear.

 

sometimes, too, ''lld'' can be a pelvic tilt/twist...so hard to truly pin down without xrays.

 

I also a right LLD of 2/3" (right is ''longer'' one)....and a bit of scoliosis too (i turn left a bit)

heck i can't cleat into pedals anymore    when cycling I am forever fidgetting on a stationary bike

as the right leg is longer/turned inward, ball of right foot rests 2" past pedal, and the left foot, being shorter

seems to always be ''reaching'' for a secure point on the pedal...i'm  a mess..

 

as a result i am seeking chiro treatment at a top notch 'high performance' 

facility newly opened here in burnaby bc (fortius)

http://fortiussport.com/

...engaging in ATR (active tissue release) treatment, too, with my chrio,

since misallignent throws the other side of the body off

e.g., my right hip upper leg/glute can get tight.

 

imo if your LLD will never go away if it's real skeletally best to learn to best adapt and live with it proactively

....engage in more core strength/stabililty exercises,

check out foam rolling and other techniques at home to stretch and apply pressure to release tension in affected areas

(hugely important)...keep stretching stretching and then stretching some more....consider pilates and yoga, along

with swimming and weights.

 

that's the great thing about seeing a quality chiro or physio; by learning your 

body's imbalances you can engage in strengthening/conditioning to best counteract your ailments.

 

when skiing i just have to adapt my stance better on the ''longer'' side and be more aware of it in my turns

as well as frequently stretching out the left and right sides before, during and after skiing to keep things loose.

 

this said i'm wearing diabello cross boots (3 yrs old) which can't take shims...left foot is slightly wider too

and experienced  'morton's neuroma midway 'last yr (had to have my boots punched out 2x yet still had pain)

... that i was 45lboverweight i'm sure didn't help (down now 25 lb on track to have 40 off by dec which i hope will help

...and yes i do have molded ski insoles)....

 

back to LLD...so if things don't work do buy my next pair of boots i'll ensure the sole

can be shaved off to allow shims


Edited by canali - 9/2/13 at 12:04pm
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