This post is a correction and elaboration on my post a couple weeks ago (Getting a leg up on Scoliosis). I met with our Podiatrist yesterday and he helped me understand a couple issues in greater depth.
1. I misspoke on the way that he measures leg length discrepancy. He does NOT measure a leg length discrepancy by measuring the hip level of a patient. I was incorrect on this – I guess I mis-heard and misinterpreted. He measures from the top of each femural bone, laser leveled to the floor. This is how he’s been measuring for 27 years and he claims it is extremely accurate. He feels the traditional and widespread use of full leg x-rays subject the body to much more radiation than is necessary and also costs much more. I applaud him for thinking about these details. So, after learning this, I was relatively comfortable with the accuracy of the test. He also said the place the x-ray is taken must be inspected and re-certified every so often to ensure things are still level. So, that makes sense.
2. I mentioned that our Podiatrist felt that for every 1mm of leg discrepancy, a patient’s spine could be affected. I wanted to elaborate on that. He actually did a large independent study, having an x-ray technician help him measure the x-rays of every single one of his patients (I can’t remember the sample set, but I think it was in the hundreds). Anyway, they compared the offset of the spine with the leg length discrepancy, and they found that for every 1mm of leg length discrepancy, that the spine was offset an average of 1.5 degrees, up to 10mm. After 10mm, the effects were lessened. So, it seems that even small amounts correlate with spinal offest. Correlation does not mean causation, but the findings of his study are noteworthy nonetheless. I also can say with quite a bit of certainty that my daughter’s 2.8mm of supposed discrepancy would only, then, account for 5 degrees of offset or curvature, which doesn’t really touch her 55 degrees of curvature, so it doesn’t appear that the 2.8mm of correction would hack away at such a curve.
Nevertheless, although he was not pleased with my decision to withhold from adding the lift to my daughter’s shoe orthotics, he was supportive and offered alternative things to try. One alternative was to put shoe liners in her shoe (at approxmiately 1mm each) and see how a gradual change might affect her. We will see. She will be getting shoe orthotics, though, that will hopefully help with her localized foot discomfort. In the words of this wise Doctor, “If you ask 10 Doctors the same question, you will get 11 different answers.” I wholeheartedly agreed with him – the problem was just that when you are a patient, or parent of a patient, you have to figure out which answer to listen to and act on. Unfortunately for him, I went against his best advice. But, we reached a compromise and I am happy we still have a good working relationship.
