Guest guest Posted January 15, 2009 Report Share Posted January 15, 2009 - Thank you for posting this inquiry. I have a patient who has a 1/2 " lift orthotic shoe and after adjusting his SI his PSIS, Iliac Crest and heels are even (with shoes off). Seems to me like the shoes are CAUSING a misalignment. I can visually observe him stepping up and over the lifted shoe after his adjustment! Unfortunately, he doesn't have a normal pair of shoes that don't bother his feet, so they want me to analyze his LLI and make a note for his orthotic folks at the VA. So, how best to get the true LLI? I was trained in Gonstead xray measurements at Life West and it seemed like a reliable system. I could be wrong. The short of it (paraphrased from Textbook of Clinical Chiropractic: A Specific Biomechanical Approach Plaugher et. al. and Wilkins 1993 pp.125-127) was to measure the femur head height differences to the nearest .5mm(apparent LLI), then measure the distance from iliac crest to ischial tuberosity, bilaterally. This is all done on AP full spine view, but for LLI purposes, I would only expose the pelvis, with proper shielding. The side with the greater measurement between top and bottom of the inominate is considered the posteroinferior Ilium. Now measure the lateral deviation of the center of the pubic symph from a vertical line marked at S2 or S3. The side of deviation is considered the internally rotated ilium. This is where it gets interesting: For every 5mm of AS or In misalignment, the ipsilateral femur head height measurement will be raised 2mm. For every 5mm of PI or Ex misalignment, the ipsilateral femur head height measurement is lowered 2mm. The end result is considered the Actual LLI. One could get more accurate within this system, but I think these measurements would get you very close to your desired values. Any comments, correctons or more accepted methods? Please reply to group for discussion's sake. Dr. Ian Jarman D.C.Family Wellness ChiropractorCafe of Life @ Florence, Oregon(541)997-5100www.cafeoflife.com " Live as if your life depends on it " -Werner Erhard Quote Link to comment Share on other sites More sharing options...
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