NUTRITION
INTERNAL HEALTH: A Chiropractic Specialty
The Lower Extremities—Part I
by Howard F. Loomis, Jr., D.C., F.I.A.C.A.
UCCESSFUL DOCTORS TREAT THE
cause of the problem, not the
symptoms. They are able
to quickly and accurately
determine the source of the patient’s
stress, devise a plan of treatment, and
confidently convey their findings to
the patient. They specialize in helping
problem cases—the ones no one else
can help. They solve these cases by
identifying the specific cause(s) of the
patients’ symptoms that have not been
identified elsewhere.
So allow me to ask you, what
tests do you perform in your office that other practitioners do
not? Oddly enough in my years
of lecturing, I have discovered
that very often the quickest and
simplest physical tests are not routinely used. Yet it is these
very procedures that reveal hidden sources of stress that
prevent correction.
One incredibly important area of concern in our profession
is the finding of unequal leg length not related to fracture or
surgery. Such a finding is the source of continual stress on
the body whether standing or sitting. It is imperative that
the cause of this inequality is found and corrected if we
are to expect satisfactory therapeutic results. So with that
preamble in mind, I will begin the first of a three-part series
on a convenient screening examination you will find useful
regardless of your office procedure.
However, it should not be assumed
that any leg deficiency is permanent. Unless there is a past history
of surgery or fracture in the lower
extremities, these inequalities should
be considered as functional and can
be corrected with specific exercises.
The Supine Examination
Standing at the patient’s feet, we
can quickly determine structural
stress coming upward from the legs.
We will describe, in order,
the Allis Test for determining
the short leg, examination for
a long 2nd toe or Morton’s
Syndrome, internal and external hip rotation fixations, and
ankle fixations. All of these
problems, if overlooked, will render your therapy ineffective
for lasting correction.
While lying supine, have the patient bend their knees and
place the soles of their feet flat upon the table. Determine
that the feet are properly aligned to each other at the heels.
S
So allow me to ask you,
what tests do you perform in
your office that other
practitioners do not? “ ”
The Short Leg Syndrome
Inequality in the length of the legs is a continual stress to
the body and undermines virtually any other condition the
patient may have.
Studies have consistently and repeatedly shown the fol-
lowing statistics for the prevalence of short legs in an as-
ymptomatic population:
• 71 percent of the population has a leg deficiency of
1/16”
• 33 percent of the population has a leg deficiency of
3/16”
• 4 percent of the population has a leg deficiency of
7/16”
• 3/16” to 1/4” of leg deficiency is considered to be
sufficient to produce low back pain
Problems Above the Knee
Place your hands on the front of the knees, over the patella
and compare. The hand closest to the pelvis indicates that
the cause of the short leg probably is in the hip. We then
check for limited hip range of motion, in particular, limited
internal and external fixations.
Have the patient straighten their legs. Stand at their feet
and cup the heels in the palm of your hands. Raise the legs
off the table slightly and rotate the legs first inward and then
outward. Compare the rotation of one side and then the other.
Restriction indicates muscle and ligamentous contraction and
also indicates probable rotation of the ilium on the sacrum.
• Limited Internal Rotation indicates the ilium is fixated in internal rotation on the sacrum. I recommend
palpating the medial thigh, medial surface of the tibia
(where the deep fascia attaches) and the medial surface
of the calcaneus to locate a possible source of stress.
• Limited External Rotation indicates the ilium is fixated in external rotation. I recommend palpating the
lateral thigh, the lateral fibula, and the lateral surface
of the calcaneus to locate a possible source of stress.
