Curvature of the spine (scoliosis) is commonly referred to in medical texts as “idiopathic scoliosis” This means that the cause is unknown. Medically, scoliosis is managed using various types of rigorous physiotherapy exercise programmes, uncomfortable spinal braces or very invasive surgical procedures that place steel rods on either side of the spine to stabilize the spine. In some cases there may be an underlying biomechanical problem that could help to manage scoliosis in a more functional manner.
The underlying biomechanical problem that is often seen in people with scoliosis is Anatomical or Functional leg length inequality (ALLI or FLLI). When the leg length is unequal this causes the pelvis to tilt and the spine to curve in response to this tilting.
ALLI is due to a congenital (from birth) shortening of the leg or due to trauma (usually a fracture of the femur or tibia) which causes a change in the leg length. . The only definitive, evidence based method for determining the anatomical leg length is with ana full long bone x-ray.
FLLI is a result of tilting and twisting of the pelvis from muscle imbalance. There are many reasons for the muscles to become unbalanced. However a common cause of muscle imbalance is abnormal movement of the feet, which causes the legs to twist, which then causes the pelvis to twist, which then causes the spine to twist as a compensation.
Therefore, the solution is often a combination of a lift under the entire sole of the foot (not just the heel), and custom Orthotics to balance the foot function, which then balances the pelvis and allows the spine to balance and decrease the curvature. The sole lift is required if there is an ALLI as the bone is permanently short and therefore a lift is required to balance the body.
However, if there is also a FLLI due to faulty foot mechanics then a custom orthotic is required to balance the torsional stress that is created by over-pronation of the foot. This can be very specifically assessed with a thorough clinical examination looking at the function of the entire kinetic chain, plus a gait analysis using a pressure plate system to assess the movement and function of the feet. This information can then be used to prescribe custom functional orthotics to balance the foot movement and optimise the function of the body from the ground up.
If so, and you are suffering with a chronic problem that is worse with long term standing, walking or running, give us a call and we will have a look to see if it is related to your underlying gait.