One arm is shorter than the other; disease. Shortening of limbs

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- this is a decrease in the length of both limbs or a reduction in one leg relative to the other, which disrupts the proportions of the human body. A slight shortening of 1-2 cm is widespread and has no clinical significance. This phenomenon is observed in 90% of people, imperceptible to the patient himself and is detected only during research.

Shortening the limbs by more than 3-5 cm causes serious inconvenience to a person when walking, as it causes a noticeable distortion of the pelvis. This defect, especially one-sided, leads to various diseases of the spine and joints.

Types and reasons

Experts believe that the causes of slight shortening of the limbs (1-2 cm), which occurs in most people, are:

• incorrect muscle stereotypes that influence the formation of the human body during the period of its growth;
• posture disorders;
• dominance of one of the cerebral hemispheres.

Shortening of one or two limbs by more than 2 cm is considered pathological.. The following types are distinguished:

1. Bilateral limb shortening:
   • Symmetrical. It manifests itself as a discrepancy between the proportions of the limbs and torso. Occurs with achondroplasia (underdevelopment of long bones leading to dwarfism) and other hereditary diseases.
   • Asymmetrical. This shortening is caused by developmental anomalies of the upper and lower extremities.
2. Unilateral shortening is caused by various diseases. The following types are distinguished:
   • true (anatomical),
   • relative (dislocation),
   • apparent (projective),
   • total (functional or clinical).

Anatomical (true) shortening

With such a defect, the total length of the tibia and thigh of one limb is less than the other. Occurs with organic bone lesions due to congenital deformation or certain diseases. The following reasons are identified:

• osteomyelitis, poliomyelitis;
• fracture of the tibia or femur;
• unilateral flatfoot, most often with pronation (turning the foot inward or outward);
• postoperative, neurogenic or post-traumatic (malunion of fractures) retraction in knee flexion;
• congenital dysplasia (underdevelopment) of the hip joint;
• congenital dysmorphism of the tibia and femur, accompanied by impaired bone growth.

Relative (dislocation) shortening

With such a defect, the relationships between limb segments are disrupted. This occurs due to displacement of the articular ends of the bone due to congenital dislocations or intra-articular fractures.

Relative shortening is characterized by the fact that one limb appears shorter than the other, but when measured, it turns out that the thighs and shins of the two legs are the same length. An example of relative shortening is hip dislocation, in which there is no difference between the anatomical lengths of the two limbs, but the defect is determined on the side of the dislocation.

Apparent (projected) shortening

It occurs due to forced flexion due to a fixed pathological installation in the spinal column or joints. Reasons for this bending:

• Post-traumatic contacture (stiffness), which appears most often due to the development of ankylosis. This disease is characterized by joint immobility, which occurs due to the formation of cartilaginous, bone or fibrous fusion of the articular ends of the articulating bones as a result of destruction of the joint due to trauma and wounds.
• Joint diseases (arthrosis, arthritis, tumor of the articular ends of the bone, etc.).

With projection shortening, as with relative shortening, the lengths of the legs seem different, but measurements show that they are the same. An example of such a defect would be the lumbar spine with pelvic distortion.

Total (functional or clinical) shortening

It is characterized by the fact that the patient experiences several types of limb shortening. For example, flexion stiffness of the knee joint (apparent shortening) may be associated with a decrease in femoral length following a malunion of a femoral fracture (true shortening).

Functional shortening can be eliminated. Most often it occurs due to imbalance at the level of the lumbar muscles and pelvis. Etiology of this defect:

• Iliosacral causes: unilateral flexion (flexion) of the sacrum on the opposite (contralateral) side of shortening, as well as posterior torsion (twisting) of the sacrum on the side of shortening and anterior torsion on the contralateral side.
• Lumbar causes: spasm of the quadratus muscle on the shortened side or lumbar convexity on the opposite side.
• Sacroiliac causes: posterosuperior displacement of the pubic bone on the contralateral side, posterior rotation (rotation) of the ilium on the side of shortening and anterior rotation on the opposite side.
• Muscular causes: retraction (shortening) of the quadriceps femoris or ischiotibial muscles.

Symptoms

Can be moderate or pronounced. The following signs of limb shortening are distinguished:

1. Unsteadiness while walking, accompanied by frequent falls. The symptom occurs in patients with slight shortening of the limbs.
2. Lameness. It appears and is clearly visible when the limb is shortened by more than 5 cm. With a less pronounced difference, this symptom may not exist, because the body compensates for it due to the curvature of the spine and tilt of the pelvis.
3. The difference is in the level of location of the greater trochanters, popliteal fossae, anterior and posterior superior iliac bones and the upper poles of the patellas.
4. Pain localized depending on the damaged area:
   • in the groin, thigh, sacroiliac joints;
   • in the lower back with radiation to the leg;
   • in the neck and shoulder area;
   • in the knee or ankle.

Diagnostics

1. Inspection

When examining a patient, a difference in limb lengths is almost always revealed, which is not always noticeable due to the compensatory curvature of the spine. Therefore, the relative length of the legs is measured (from the anterior superior iliac spine to the medial malleolus) and absolute (from the greater trochanter to the medial malleolus).

Visually, limb shortening can be determined by the following signs: different levels of position of the patellas and popliteal fossae, trochanters of the femoral bones, anterior and posterior superior iliac spines, iliac crests. The detected changes are assessed taking into account the position of the levels of the shoulder blades, shoulders and ribs, identifying scoliosis.

The diagnosis of “anatomical shortening” is made on the basis of the clinic, the height of the iliac crests, radiography and data obtained from measuring the legs. Functional shortening is determined using various tests:

• four parallel lines test;
• supine leg length test (shortening due to iliosacral causes);
• flexion tests sitting and standing (positive - for pathology in the sacrum, positive test standing and negative sitting - for iliac causes);
• leg length test lying on the stomach (sacroiliac causes).

2. Leg length measurement

The size of the shortening of the limb is determined by placing planks of varying thicknesses under the foot until the pelvis is in its normal position: the midline of the body should be perpendicular to the horizontal line that connects the anterior superior spines of the pelvis. After this, the total shortening is determined by measuring the height of the boards placed under the foot with a centimeter tape.

3. Carrying out tests

• Four parallel lines test. 4 lines are drawn through the points:
  • iliac crests;
  • posterosuperior iliac bones;
  • greater trochanters of the femur;
  • ischial tuberosities.

If the lines are oblique and parallel to each other, then anatomical shortening is diagnosed. Drawing at least one line that is not parallel to the others indicates functional shortening.

• Test lying on your back and stomach

The doctor wraps his hands around the patient’s ankles and palpates the medial ankles with his thumbs, assessing their rotation and relative position. After this, the patient sits down. If mobility in the sacroiliac joint of one of the legs is limited, the damaged limb in the lying position will be shorter than the healthy one or have the same length as it, and longer in the sitting position.

For a patient in a sitting position, the doctor measures the distance between the levels of the ankles. A difference of up to 2 cm is not a pathology. The same measurements are made with the patient lying on his stomach with his legs straightened. If one of the ankles is closer to the body, then there is sacroiliac pathology on this side, and with the same ankle level, there is no shortening.

• Standing flexion test

The patient stands with his legs straight. The doctor stands behind him and places his thumbs under the posterosuperior iliac spines on both sides.

If, when the patient bends forward, one of the sides goes up and forward, then the sacroiliac joint and sacrum are blocked,

and there is pathology.

• Sitting flexion test

Patient position: sitting, feet on the floor, legs bent at the knees at an angle of 90 degrees and spread so that the patient’s shoulders fit between them when bending forward. The doctor stands behind you and places his hands in the same way as in the previous test.

If the patient can bend forward and the posterosuperior spines do not change their relationship, then the dysfunction is in the lower extremities. If it is impossible to bend over, you should determine the location of the pain.

The pain may be localized in the lower extremities, pelvis or spine. A combination of painful areas is also possible, in which the doctor looks at the movement of the posterior superior iliac spines when bending forward. If their ratio changes, damage is diagnosed on the side going up and forward, and if the ratio does not change (negative test) or is less pronounced than during the standing test, then the damage is located at the level of the pubic symphysis, iliac bones or lower extremities to the talus bones. If the sitting test is positive, the injury is located at the level of the sacrum.

4. Additional research

The list depends on the suspected cause of limb shortening and its location. The following diagnostic methods are used:

• Radiography. Performed for tumor processes, old fractures, infections. Depending on the location, a picture of the thigh or lower leg is taken. For arthrosis, they are referred for x-rays of the hip or knee joint.
• Arthroscopy. The method is relevant for arthrosis of the knee joint.
• MRI. This is done if soft tissue damage is suspected.
• Consultations with specialists (infectious disease specialist, oncologist, venereologist, phthisiatrician, rheumatologist) according to indications.

Treatment

If there is slight shortening of the limb, it can be compensated with the help of individual orthopedic insoles or shoes. On the side of the shorter leg, an insole with a heel pad of a certain height is used. The use of such orthopedic devices is not recommended for functional shortening of the leg, since the heel support will fix the incorrect position of the pelvic bones and cause harm.

For anatomical shortening, insoles with heel pads are made after osteopathic correction of the pelvic ring. They keep the pelvis in a physiologically correct position and prevent pathological rotation. The heel pad must be manufactured with millimeter precision.

If a large difference is detected between the lengths of the limbs, leg lengthening is indicated using the Ilizarov apparatus, which stretches the thigh by 5-6 cm and the lower leg by 8-10 cm. If the operation is performed in a timely manner, the prognosis is favorable, but in the absence of treatment, disability is possible: the person is unable to able to move, as he experiences severe pain.

Installation and wearing of the Ilizarov apparatus

The basis of compression-distraction osteosynthesis is the law: the tension that occurs when bones and soft tissues are stretched stimulates the processes of growth and regeneration of bone tissue. Limb stretching is a long process, lasting 6-12 months. During this time, the bone lengthens and the regeneration zone ossifies.

During the operation, a section of the bone is made, which needs to be enlarged. The bone edges are connected with a gap of 1 mm and fixed using rods or knitting needles secured in half rings or rings of the Ilizarov apparatus. Then the bones are lengthened to the required size by 1 mm per day by adjusting the apparatus. The stretch zone is gradually overgrown with bone tissue.

The bone lengthening process can be painful and require painkillers. Over time, adaptation occurs and discomfort decreases.

Wearing the device is quite easy, as it maintains sufficient mobility, but during treatment the patient can only move a limited distance with the help of crutches. Installation of the Ilizarov apparatus on the thigh significantly limits self-care and movement, and is therefore more difficult to tolerate. In addition, the process of operating on the femur itself is dangerous due to the development of various complications (infection, bleeding), which is associated with a more complex arrangement of nerves and joints and a large volume of soft tissue in the thigh compared to the lower leg.

During treatment, patients should perform exercises to maintain joint mobility and prevent muscle atrophy (metered walking). After removing the device, restorative therapy is indicated: massage, physiotherapy, exercise therapy, etc.

Consequences

Inconvenience when walking and standing caused by shortening of the limb disrupts the normal anatomical relationships between parts of the body and leads to various diseases of the musculoskeletal system. The torso and legs twist and shift, the alignment of the joints is disrupted. To ensure a vertical position of the body, compensatory deformations are formed. The load on the longer limb increases, the pelvis becomes distorted.

First of all, the spine suffers, compensating for the defect of the legs. When the pelvis is tilted, it becomes at an angle to the horizontal line, but with a straight spine, the body begins to “fall” to the side. To prevent this from happening, the body bends it, trying to shift the center of the body as close as possible to its axial line.

With unilateral shortening of up to 1.3 cm, the spine forms a C-shaped bend, and more than 1.3 cm - an S-shaped bend. Over time, poor posture becomes fixed and secondary compensatory scoliosis develops, in which the muscles are in a state of constant increased tension. This leads to pain in the joints, back, muscles, heaviness in the legs and feet after walking. Blood and lymph circulation worsens.

With long-term pathology, deforming arthritis of the hip (coxarthrosis) or knee (gonarthrosis) joint, osteochondrosis (dystrophic disorders in articular cartilage) develops, and flat feet worsens. After these diseases occur, it is difficult for the patient to move due to intense pain, and he becomes disabled.

Many parents notice that their child has one shoulder higher than the other. This condition sometimes also occurs in adults. It always indicates a lateral curvature of the spine. Some people think that there is nothing wrong with this, what difference does it make what level the shoulders are at.

But in fact, such curvature is a serious pathology and without treatment can lead to dangerous health consequences.

The mechanism of occurrence of pathology

When one shoulder is lower and the other is higher, this is always associated with curvature of the spine. This pathology in medicine is called “scoliosis”. According to statistics, it occurs most often in children from 7 to 15 years old. After all, it is at this time that a huge load is placed on the not yet formed spine. The child is forced to sit at the table for a long time. His muscles cannot support the spine and become tired. Because of this, the child involuntarily bends his back, lowering 1 shoulder. Flexibility of the bones and laxity of the ligaments maintain the curvature, so it remains even when moving.

This pathology rarely occurs in adults, and even less often they go to the clinic with it. After all, it is difficult to independently control the symmetry of the shoulder girdle, and this condition usually does not cause discomfort. The deformity is detected in an adult with back pain, numbness in the legs or arms, lameness, dizziness and other consequences. In this case, it is almost impossible to correct the situation; you can only stop the progression of the deformity.

Causes

Most often, parents turn to the doctor asking why their child has one shoulder higher than the other. Only in rare cases, with congenital skeletal anomalies, can asymmetry of the shoulder girdle be detected immediately after birth. Usually, the baby also experiences other pathologies, such as torticollis or limb deformities. This condition also develops with cerebral palsy or rickets. But most often, spinal curvature is acquired and occurs due to an incorrect lifestyle.

If such a curvature in an adult is not a consequence of untreated scoliosis in childhood or weakness of the back muscles, then the causes may be more serious:

• osteochondrosis;
• herniated discs;
• spinal canal stenosis;
• osteoporosis or osteomalacia;
• osteomyelitis;
• consequences of spinal surgery.

When sitting at a table for a long time, the child involuntarily raises one shoulder to compensate for the increased load on the spine

How it manifests itself

Scoliosis in the initial stages is very difficult to recognize. It usually does not cause any back pain or discomfort at first. But the progression of deformation gradually leads to serious consequences. Therefore, it is very important for parents to pay attention in time to such a sign as asymmetry of the shoulders. In addition, you can notice that the child has one arm shorter than the other, the pelvis is tilted, which is why the hip joints are not in the same line. Asymmetrical placement of the shoulder blades, as well as protruding ribs, can also be symptoms of scoliosis. These signs are best seen if you ask the child to lean forward with his arms down. In this case, it will be clearly visible that the spine is curved, and one arm is longer than the other.

Children usually have no further symptoms, other than increased fatigue. But with such a deformation, adults may experience back pain, weakness in the leg muscles, numbness or tingling of the fingers. Changes in gait and difficulty moving may develop.

Most often, shoulder asymmetry is a manifestation of lateral curvature of the spine

What consequences does it lead to?

Sometimes only by this sign it is possible to detect spinal curvature at the initial stage. It is very important not to ignore different shoulder heights, as the pathology will gradually progress. Scoliosis is harmless only in grades 1 and 2, but then it can be cured, especially in a child. But once the skeleton has ossified, it will be almost impossible to correct the deformity. And the health of the spine determines the functioning of all organs, blood supply to the brain and the proper functioning of the musculoskeletal system.

The most harmless consequence of such deformation is headaches and dizziness. They signal compression of blood vessels due to curvature of the spinal canal. In addition, the nerves that control the function of the limbs may also be pinched.

Sometimes there are problems with the hip joint and knees. If there is a curvature of the spine in the thoracic region, and this is what causes one shoulder to become higher than the other, the functioning of the heart, digestive system, or respiratory organs may be impaired.

Treatment

Most often, conservative therapy to correct spinal deformity is used in children. Treatment methods are selected individually depending on the degree of curvature and the age of the patient. Typically this includes physical therapy, massage, physiotherapy and wearing corsets. Only in serious cases, when the spine is tilted more than 40 degrees, is surgical correction indicated. But according to statistics, such treatment is required only in 1 case out of 1000. For the rest, constant control over posture and muscle strengthening is sufficient. In the early stages of curvature, wearing reclinators or other orthopedic devices to control the position of the shoulders is effective.

It is very important to diagnose the presence of deformity in time and begin treatment

The same methods are prescribed for deformation of the shoulder girdle in adults. Only their effectiveness will be much lower. True, it is much easier for an adult to control the position of the shoulders and correct posture. But due to the fact that at this age the curvature most often develops against the background of other pathologies, specific treatment is also necessarily prescribed, for example, drugs against osteoporosis. Treatment of spinal deformities in adults may take not a year or two, as in childhood, but much longer.

And with scoliosis in children, all responsibility for the result of treatment falls on the parents. Therefore, it is very important to know what to do at home in addition to the procedures prescribed by your doctor.

• First of all, it is important what the child sleeps on. Up to 15 years of age, and especially if there is a curvature of the spine, it is recommended to purchase a hard or semi-rigid orthopedic mattress. It will help slow down the progression of the deformity.
• For school textbooks you need to buy a backpack. After all, carrying a bag on one shoulder often causes it to become lower than the other.
• To do homework, you need to purchase a table that matches the child’s height and a chair with orthopedic properties.
• It is important to constantly monitor your posture, especially while doing homework. It is at this time that the child most often lowers or raises one shoulder to compensate for the work of tired muscles.
• You should regularly perform special exercises prescribed by your doctor.
• Nutrition should be complete, balanced, and fully meet the nutrient needs of a growing body.
• You should not look for how to correct the deformity on your own, use traditional methods or visit chiropractors. Only a specialist, after examining and determining the cause of the pathology, can prescribe treatment.

Massage is effective for strengthening the back muscles that support the spine in the correct position

Physiotherapy

Since the most common cause of curvature is weakness of the muscular-ligamentous apparatus, the pathology is treated with special exercises. In addition to them, swimming, skiing, and outdoor games are useful. And you need to do gymnastics every day. Therapeutic exercises can be included in morning exercises or performed during the day. When exercising, you should avoid strong stretching of the back muscles and increased stress on the spine. Each exercise is performed 5-7 times. When working only on one side of the body, be sure to repeat it on the other side.

So, the execution sequence is as follows:

• Stand straight, feet shoulder-width apart, arms down. Bend to the side, with one hand sliding down the leg, the other up into the armpit.
• In the same starting position, raise one arm up. Jump your arms back. Change the position of your hands.
• Get on all fours. Raise your right arm and left leg at the same time, stretching your body.
• In the same starting position, move your arms forward with a sliding movement, arching your back, then bring your hands closer to your knees.
• Lying on your stomach, spread your arms to the sides. At the same time, raise your upper body and bend back.
• Do the same by picking up a gymnastic stick and stretching your arms forward.
• Lying on your back, raise your arms above your head. Perform bicycle and scissor exercises.

When one shoulder is higher than the other, it may simply be a poor posture that can be corrected by controlling and strengthening the muscles. But sometimes this condition is a symptom of scoliosis. Pathology should be treated as early as possible, then complications can be avoided and the health of the musculoskeletal system can be maintained.

Why can one shoulder be higher than the other and how to fix it?

Scoliosis is a curvature of the spinal column in relation to the vertical axis of the body, with one shoulder higher than the other. In most cases, the disease manifests itself in childhood. If the pathology progresses slowly, symptoms appear in adulthood (with increasing physical activity). To develop an optimal treatment regimen for scoliosis, it is necessary to take into account the provoking factors, the degree and rate of development of pathological changes in the structure of the spine.

This pathology manifests itself in various ways. Spinal deformity due to development:

1. 1. Acquired - manifests itself at the age of 6-15 years during the period of intensive bone growth and skeletal formation. In girls, the disease is more common, but the reasons for its development have not been studied.
2. 2. Congenital - develops when the fetus develops incorrectly in the womb. Scoliosis often occurs due to disturbances in the formation of the hips and spine, and fusion of the ribs. Sometimes, during intrauterine development, a child develops an extra vertebra.

Disturbances in the structure of the spine according to the type of curvature:

• c-shaped scoliosis - the spine is curved to the left or right side in the shape of the letter c;
• z-shaped curvature of the spine - curvature of one or 2 parts of the spinal column in opposite directions;
• S-shaped deformity of the spinal column - curvature in 3 places, affecting the cervical, thoracic and lumbar vertebrae.

Division of scoliosis according to the degree of development of the disease:

1. 1. Scoliosis 1st degree - a barely noticeable curvature with a slight stoop, with the right shoulder slightly higher than the left or vice versa. This type of disease can be detected when examining the patient.
2. 2. Scoliosis 2 degrees - characterized by back pain and asymmetrical shoulder blades. It is the most common form of pathology.
3. 3. Scoliosis 3rd degree - unbearable back pain occurs. There may be a change in the shape of the body, manifested in the form of protrusion of the ribs.
4. 4. Scoliosis 4th degree - a rib hump is formed against the background of severe deformation of the back. This form is characterized by retraction or protrusion of parts of the rib skeleton.

Types of diseases divided by age categories:

• infantile vertebral deformity - manifests itself in children under 3 years of age;
• juvenile vertebral deformity - diagnosed between the ages of 3 and 10 years;
• juvenile deformity of the spinal column - found in adolescents under 15 years of age;
• spinal deformity in adults - recorded in mature patients after the complete formation of the skeleton.

Having noticed a stooped position in a child, worried parents resort to self-medication. Scoliosis is a serious disease of the spine. Therefore, unskilled therapeutic intervention can lead to impaired musculoskeletal functions. Incorrect posture can be evidence of various pathologies of the spine. An accurate diagnosis can be made by performing an X-ray examination.

The causes of the disease are associated with abnormalities of the central nervous system and musculoskeletal system. Spinal deformity can be caused by:

1. 1. Intervertebral hernias.
2. 2. Osteochondrosis.
3. 3. Rickets.
4. 4. Violations of tone and muscle spasms in the back and neck.
5. 5. Congenital curvature of the neck.

When examining a patient’s back, one can see the curvature of the spinal column, while in a healthy person the spine forms a straight axis. The main symptom of the pathology is pain when walking or standing. The longer a person stands, the worse the pain becomes.

Signs of scoliosis appear when the child begins to walk. There is a stoop, with the left shoulder lower than the right. Signs of illness:

1. 1. If you look at the child from the back, there is a deviation of the head to the left or right along the axis of the spinal column.
2. 2. Asymmetry of the shoulders, with an unequal distance between the shoulder and ear (both right and left). Due to the uneven line of the shoulders, one arm appears longer.
3. 3. The shoulder blades are at different levels, and one of them protrudes. With a slight tilt, they can stick out in different directions.
4. 4. The spine is curved along a vertical line from the occipital to the sacral region. Using a thread and a weight, you can determine the curvature. It is necessary to attach the thread to the central point of the cavity (on the neck), releasing the weight. The thread should pass strictly through the center of the post.
5. 5. In a straight stance, in a healthy child, the distance between the arm and the hip line is the same on both sides.
6. 6. If the child has a curvature of the spine, the hip line is uneven horizontally, that is, one hip is higher than the other. Possible asymmetric displacement of the hip bone.

Once one or more signs are detected, you should seek professional medical help.

To confirm or refute the diagnosis of scoliosis, an X-ray machine is used, which makes it possible to identify other diseases of the musculoskeletal system. When conducting diagnostics, it is important to determine the degree of curvature:

1. 1. Initial form (1st degree) - up to 10º.
2. 2. Medium form (2nd degree) - up to 25º.
3. 3. Moderate form (3rd degree) - up to 50º.
4. 4. Severe form (2nd degree) - up to 25º.

Treatment methods for spinal curvature include:

Surgical intervention is used in complicated cases of scoliosis. The disease puts pressure on internal organs, which leads to their deformation. To eliminate grade 1 curvature of the spine, it is necessary to pay attention to the development and strengthening of muscles. Exercise therapy, swimming and massage help normalize muscle tone.

Treatment of grade 2 scoliosis involves not only physical exercise, but also wearing a specialized corset. It is created in accordance with the individual parameters of the patient’s skeletal structure. The corset must be worn for several hours at first, and then throughout the day.

To cure stage 3 disease, long-term wearing of a corset is indicated. When the angle of curvature is more than 44º, surgical intervention is used. Specialists install a corrective system on the spinal column. It allows you to suspend and correct curvatures.

For grade 4 scoliosis, radical treatment methods are used, the main objectives of which are:

• eliminating the causes of scoliosis;
• maximum correction of spinal curvature;
• suppression of pain in the back and limbs;
• return of vertebral mobility.

Therapy is prescribed by a qualified specialist depending on the picture of the disease. In especially severe cases (against the background of the rapid development of pathology), doctors resort to the use of a muscle corset and surgery. The likelihood of recovery increases if you provide psychological support to the child.

Mud and sun baths, hydromassage, and baths with sea salts have a positive effect. It is necessary to constantly monitor the child’s posture and remind him that correct posture will make him feel better. Additionally, exercises are performed to correct flat feet and harden. At the same time, walks in the fresh air and active recreation are recommended.

Congenital scoliosis cannot be prevented, but measures should be taken to prevent acquired scoliosis:

One hand is smaller than the other in volume - what to do?!

After training for some time, you noticed that one arm is smaller in volume than the other, especially the biceps. What to do?

You should try loading your right and left arms separately. Thus, you will be able to equalize the strength and volume of the biceps due to the additional load on the lagging arm. Take a closer look at your neighbors in the room as they perform standing barbell curls.

If the weight of the projectile is large enough, then when lifting the barbell begins to warp somewhat. This happens because one hand is stronger than the other. Keep in mind that the total weight of the weights that you can lift by working each arm one at a time is greater than the weight of the barbell if you were working with both arms at the same time.

And this means a greater load on the muscle, a more noticeable blood flow to it, and therefore greater progress. We present to your attention an approximate version of such a training (see table 1):

Do the same number of repetitions on your left and right hands, and also follow the correct technique for performing the exercises.

If you press the barbell crookedly, or lift the dumbbells crookedly, then the load on one side will be greater than on the other. Therefore, follow a clear technique in all exercises, control the execution of the exercises by looking in the mirror, or ask a friend to watch you do the exercise.

This disrupts your technique, trains you incorrectly, and can lead to injury. Moreover, if one side is weaker, then what is the point of taking more weight for it? It turns out that the strong side will not work enough, and the weak side simply will not pull too much weight. You need to train correctly, follow the technique and load the muscles equally, then the muscles will gradually equalize in size and will continue to develop evenly.

Exercise regularly, then you can straighten your muscles

Muscle development takes time, so be patient, train regularly and you will notice that your muscles will begin to develop harmoniously and proportionally.

Why one leg is shorter than the other, causes and treatment

Different leg lengths: causes and treatment

Different leg lengths are a fairly common phenomenon: short leg syndrome occurs in people of any age, gender and social status, and is more common in children than in adults. When one limb is only a couple of centimeters shorter than the other, this is not very noticeable, but a difference of more than five centimeters cannot be ignored even if one wants to: a person walks with a limp, swaying from side to side or leaning on a cane, his shoulders are located at different levels ( Many people develop scoliosis due to differences in altitude).

On slippery surfaces and in moving public transport, such people have difficulty maintaining balance, since their musculoskeletal system is unbalanced. Obviously, living with such a deviation is not easy. Not every person who has encountered a similar problem knows what to do if one leg is shorter than the other. Fortunately, there are ways to level out the difference in leg length - we will talk about them in more detail below.

Causes of short leg syndrome

You cannot envy a person whose limb is longer than the other: lameness, curvature of the spine, constant pain in the joints and back, a high probability of developing arthrosis and bursitis. Not life, but continuous overcoming of difficulties. So what to do if one leg is much shorter than the other, how can you protect yourself and your loved ones from a similar fate? To answer this question, you must first become familiar with the specifics of the disease, namely, the causes of the pathology and its varieties.

If one leg is shorter than the other by 3, 5 or more cm, then there may be many reasons for this development of pathology of the lower extremities, but they all relate to one of three factors. Experts identify three factors that influence the length of the lower limbs:

1 Anatomical factor (reduction in bone length).

2 Relative factor (dislocation, joint immobilization).

3 Combined effects (growth retardation or accelerated growth, due to which the length of both limbs changes at once).

Shortening of one of the limbs usually results from:

1 A disruption in the process of intrauterine development of the fetus, as a result of which the unborn baby develops clubfoot or hemophilic hemarthrosis, or a hip dislocation occurs.

2 Inflammation caused by tuberculosis, thrombosis of the veins of the lower extremities, arthritis, elephantiasis.

3 The tumor process can cause a difference in leg length in both adults and children.

4 Neuropathic factors can cause this pathology.

5 Damage to growth plates located on the heads of the tibia and femur. Children who find themselves hostage to such a situation have a harder time than adults: the difference in leg length continues to increase until the growth stage is completed. Adults have already experienced this stage of their lives, therefore the difference in the length of their limbs as a result turns out to be significantly lower.

When one limb is shorter than the other, the load on the spinal column is distributed unevenly. As a result, a person develops scoliosis and osteochondrosis, torsion of the pelvis occurs, as well as eversion of the fifth lumbar vertebra. Such deviations occur both when a certain section of the leg (thigh or lower leg) is shortened, or when the entire limb is shortened.

Difference in leg length in children, reasons why this happens?

The sooner parents notice that one of the child’s legs has become shorter than the other, the less time and effort will be required to eliminate it. Disorders of the musculoskeletal system in the fetus can be detected already in the early stages of pregnancy thanks to ultrasound, which all expectant mothers are required to undergo.

There are two types of abnormalities that can cause shortening of the legs in an unborn child:

1 Symmetrical developmental delay (the diameter of the head and abdomen, the length of the torso and thigh are within normal limits, but the size of the fetus is proportionally reduced).

2 Asymmetrical developmental delay (inconsistency of certain parts of the baby’s body with generally accepted standards).

After the birth of the child, checking the parameters is the responsibility of the local pediatrician. You can measure the length of your baby’s limbs without resorting to the services of a doctor. To do this, you need to lay the baby on his back, bend his legs at the knees so that the angle between the torso and thigh, thigh and lower leg is ninety degrees. If one of the knees is higher than the other, it means that the child’s hips are different in length. To determine the size of the shins, you need to lower the baby's legs, still bent at the knees, and press his feet to the surface of the bed. If one of the knees rises above the other, it means that the size of the shins also does not match and you need to consult a specialist.

In children, the height of the longitudinal arches of the feet often does not match, which is why children develop scoliosis. Curvature of the spinal column to the right or left side disrupts the structure of muscles, cartilage and ligaments, which is fraught with the development of serious diseases. If you suspect a deviation, you should immediately consult a doctor: the sooner the pathology is eliminated, the better for the child.

Treatment of short leg syndrome, what to do if one leg is shorter than the other

Modern medical technologies make it possible not only to lengthen short limbs, but also to correct the curvature of the legs that develops against the background of pathology.

There are several methods to achieve the desired result if one leg is longer than the other. Conservative treatment tactics for short leg syndrome, which is used if one leg is no more than two centimeters shorter than the other, involves:

1 Putting orthopedic insoles in shoes to compensate for the difference in limb length.

2 Visit a chiropractor to relieve muscle stiffness and pain.

3 Performing exercises aimed at strengthening muscles, joints, ligaments and tendons, preventing curvature of the spinal column.

4 Swimming in the pool and attending water aerobics classes to develop and strengthen the musculoskeletal system.

If one leg is significantly shorter than the other, surgery is performed. The most effective way to lengthen a limb is considered to be traction in the Ilizarov apparatus, which involves cutting the bone with subsequent fixation of the leg in the device. Almost immediately after the operation, the bone fragments begin to grow towards each other (at a speed of one millimeter per day). When the bone has completely healed (and this happens no earlier than six months after the procedure), the device is removed and the patient is sent for rehabilitation.

Traction using the Ilizarov apparatus is also used in aesthetic surgery clinics, whose services are used by absolutely healthy people who dream of lengthening their limbs. Such a procedure is not cheap, and its result does not always live up to expectations, which, in principle, is understandable. Any intervention in the body does not pass without leaving a trace. It’s good if you come across an experienced surgeon who, as they say, “ate the dog” when stretching his limbs. What if you get a newcomer? And then, even a professional with many years of experience is not immune from mistakes. So is it worth lengthening short legs if they don't cause problems? People with short leg syndrome have no other choice, but healthy representatives of homo sapiens do, and yet they take such a desperate step. It's a pity that few people think about the possible consequences.

In addition to traction using the Ilizarov apparatus, blocking of the growth zones of a healthy limb is also used. This method is suitable for children: thanks to the intervention of the surgeon, the difference in the length of the lower limbs is leveled over time, and when the growth phase stops, the need for any manipulation to straighten the legs disappears by itself.

Pathology such as asymmetry of the lower extremities can be diagnosed by competent specialists even during an ultrasound scan during pregnancy. In this case, the diagnosis and the prescription of a course of treatment will be made immediately after the birth of the baby.

If any developmental pathologies are identified by an orthopedist during a routine examination in the first months of the baby’s life, the doctor must register such a child and prescribe him the necessary therapy. If there are symptoms indicating hip dysplasia, when the child reaches three months of age, he will need to undergo an X-ray examination and ultrasound. Based on the results of these examinations, a diagnosis will be made and treatment will be prescribed depending on the severity of the pathology.

You can determine the presence of asymmetry in a child’s legs yourself at home. To do this, you should visually assess the symmetry and depth of the skin folds. It is most convenient to do this when the baby is lying on his tummy. Then you should turn the child onto his back, straighten his legs, bringing them together and again evaluate the symmetry of the folds on the inner surface of the thigh. The next stage is to spread the child's bent legs to the sides - in a healthy baby, each leg should touch the surface of the changing table. If you can’t spread your legs apart, this may be evidence of both increased muscle tone and hip dysplasia. You should also pay special attention to clicks during this procedure, as they always indicate a problem with the joints.

There is another way to check for dysplasia - to do this, place the child on a hard surface on his back and bend his knees. If the baby’s knees are at different levels, then immediately contact an orthopedist to clarify the diagnosis and prescribe effective treatment for the problem.

Checking muscle hypertonicity at home is also quite simple. The child must be placed on his back and given his fingers so that he can grab them tightly. At the same time, a healthy baby begins to move his legs very actively, trying to take a sitting position. If the child constantly crosses his legs, then the likelihood of muscle hypertonicity is very high.

Increased muscle tone may be accompanied by other symptoms, including:

1 restless sleep;

3 too frequent regurgitation;

4 independent head holding from birth;

5 emphasis on toes in a vertical position;

6 active resistance when trying to spread your legs to the sides;

7 irritated reaction to extraneous sounds and lights on;

If a child has at least one of these signs, then he should definitely be shown to a specialist. In case of a fracture of the lower extremities, especially if it occurred in childhood, it is necessary to constantly monitor the fusion of bones by conducting an X-ray examination.

Another dangerous cause of asymmetry of the lower extremities is the presence of neoplasms of various types. However, differences in leg length may appear already at a late stage of the disease; much earlier, the child may begin to complain of excessive fatigue and pain when placing emphasis on the affected limb. Visually, you may also notice that one leg looks slightly thicker than the other. Any of these symptoms or their combination should be a reason to contact a medical facility.

Mandatory vaccination against tuberculosis has caused a reduction in the number of cases in the younger age category, but a decrease in the child’s body’s defenses and close contact with a sick person can lead to illness. Bone tuberculosis begins gradually, its first signs are quite vague and some children do not even pay attention to them. Seeing a doctor is mandatory if the child begins to complain of loss of strength, irritability, drowsiness, muscle aches, and absent-mindedness. Visually, you can notice the appearance of stoop, sudden lameness, or a change in the volume of one of the limbs.

To confirm the diagnosis, a tuberculin test should be performed, as well as MRI and radiography of the affected segment.

When is the difference in leg length not a pathology?

A slight difference in the length of the lower limbs is a variant of the norm; quite often shortening of the right leg is diagnosed in children who prefer to use their left hand. In addition, a healthy child is usually physically active. He spends a lot of time in motion, running, jumping, and riding various types of transport. Over time, one of his legs becomes the leading one, which is what he prefers to use when pushing off the ground. This uneven load leads to a slight shortening of the pushing leg. Over time, the length of the limbs becomes the same.

Complications associated with different lengths of the lower limbs

Severe asymmetry of the legs, especially in childhood, can cause curvature of the spinal column, resulting in scoliosis - a persistent deformation of the spine relative to its axis. In the absence of proper attention, this disease can lead to irreversible complications, for example, deformation of the chest, asymmetry of the pelvis, malfunctions of the cardiovascular system, respiratory system and spinal cord. Uneven distribution of the load also leads to the development of flat feet in the child.

Depending on the mechanism of development of the disease, several types of scoliosis are distinguished:

1 Dysplastic - occurs in childhood against the background of metabolic disorders in the tissues of the vertebrae and intervertebral discs.

2 Static - manifests itself as a result of bone and joint disorders in the legs.

In adulthood, asymmetry of the lower extremities can cause various pathologies of the musculoskeletal system, which can lead to hernia, vertebral prolapse and other complications. Such patients quite often complain of pain in the abdomen and back.

Muscle asymmetry. What to do?

My respect, ladies and gentlemen!

We owe this article to me, Pavel, Oleg, Valentin and the other male readers of the ABC of Bodybuilding project. They asked their question: muscle asymmetry, what to do? - through the feedback form and wanted to receive a detailed answer. Well, if you want it, then get it!

So, sit down, my dear friends, let's start broadcasting.

What is muscle asymmetry? A wild theory.

I think everyone reading these lines has had this situation in the gym when you are doing an exercise, for example, lifting a dumbbell one at a time for biceps, and suddenly you realize that your left hand is no longer lifting - it’s not pulling the weight, but your right hand can still calmly perform 2 exercises. 3 reps. Sounds familiar, doesn't it? Also, I’m sure some of you have encountered muscle imbalances or asymmetries - this is when you look at yourself in the mirror and realize that your left pectoral is larger than your right or your left biceps is larger than your right. In training, this manifests itself through the emergence of leading (load-taking) and driven (lagging) muscles. As a result of all this, the athlete cannot fully load the muscles, and one or another muscle group (its mirror analogue) always remains undertrained. In fact, upon visual inspection of your body, it turns out that one muscle is ahead of its fellow in development.

What to do, i.e. How to get out of this situation - to restore balance and in general - what muscle asymmetry is, we will consider further.

For better assimilation of the material, all further narration will be divided into subchapters.

Muscle imbalance is something that most people encounter during their training (and not necessarily specifically iron training). It implies that the strength (and/or size) of muscles on one side of the body is not the same/symmetrical on the other side.

Asymmetry can manifest itself:

• in a specific sport (for example, tennis, golf), where one side of the body is involved more than the other;
• when an athlete performs the same type of actions over and over again - this is the so-called biomechanical reason for repeated movements in one direction or prolonged poses;
• due to neuromuscular imbalance due to the predisposition of individual muscle groups to be strong or weak;
• in people with limbs of different lengths.

These are some of the possible causes of muscle asymmetry; the curvature of the spinal column also makes a significant contribution - deviation of parameters from the norm. Look at the physiological signals corresponding to muscle activity (EMG) and heat maps of the human body in an ideal and standard case.

Such images help doctors identify patients with soft tissue injuries, imbalances in muscle development, and the degree of spinal curvature.

It is worth saying that there are no ideally “even” people, and this is due to the intrauterine development of the fetus. We are all initially in a curled-up position in the womb, and already there the degree of “curvature” of our spine begins to be established. Therefore, if you think that scoliosis (lateral deviation of the spine from the normal straightened position) is purely your thing, then this is not so, almost everyone has it, only its degree varies.

So, we’ve sorted this out, now let’s talk in more detail and scientifically about...

Muscle asymmetry: what, why and why

Human movement and function require a person to balance muscle length and strength between the opposing muscles surrounding the joint. Most joints in our body have two or more separate and opposing sets of muscles acting on it. Muscular balance is equal amounts of opposing forces between muscles, which is necessary to maintain a concentrated (centered) position of a bone in a joint during movement. On the other hand, muscle imbalance occurs when opposing muscles provide different directions of tension due to tightness or weakness.

To understand what we are talking about, look at the following images.

As for the general asymmetry, it can be different, in particular the following:

• front and back - for example, the back lags behind the chest;
• left and right – one arm/leg is larger than the other;
• upper and lower body - massive top on chicken legs.

Regarding muscle groups, asymmetry is most often observed between:

• lower leg and arms;
• biceps and triceps;
• trapezius and shoulders;
• heads of deltas (anterior, middle, posterior);
• triceps heads (lateral, medial, long);
• forearms and upper arms.

Muscle asymmetry usually occurs in the early stages of training. As soon as you begin to perform an exercise, the brain makes an assessment of which side of the body is easier for it to complete the task. The body then establishes a favorable pattern of movement (stores it into memory), as a result of which the increase in strength and volume occurs unevenly - the most frequently used areas increase faster. Over time, the fine line increases, as a result of which the muscle group constantly “pulling out” the load becomes dominant (stronger, more resilient, more voluminous). This is how asymmetry arises.

How to prevent muscle imbalance? Practical advice.

Bodybuilding is not just muscle mass - it is, first of all, ideal proportions and symmetry. Of course, mere mortals do not necessarily become sculptures with ideal circle shapes, but acquiring some aesthetic physique would not be a bad thing.

Actually, let's do this.

So, there are two types of movements that can be done - bilateral and unilateral. Bilateral - when an athlete uses two limbs (arms, legs) at the same time, for example, lifting a barbell for biceps. Unilateral - when one limb is used, for example, lifting a dumbbell with a hammer grip. Sometimes muscles grow more on one side than the other, and this is due to the dominant side of the body. The presenter always tries to override and do all the work. If we talk about arms/legs, then for right-handers the leading one is the right one, for left-handers, accordingly, the left one.

To bring balance, i.e. to pull equally on different sides (and equalize the volumes), you must adhere to the following tips:

No. 1. Application of unilateral exercises

Add more unilateral exercises to your current PT - this will isolate one side of the body from the other. Use dumbbells, single cables, and any equipment that will help you focus on the weakest side of your body. Also, if possible, avoid machines and use free weights more.

Adjust the number of repetitions of the exercise according to your weakness. It is necessary to start the exercise with the lagging part and perform it until it (for example, the weak left hand) fails, while the right one can still perform it, but the approach must be completed. As a result, the dominant side will be slightly undertrained, which will allow the lagging side to progress and catch up.

No. 3. Correct technique and flexibility

The correct form of performing exercises, taking into account anatomical features, will correct asymmetry. Warming up your muscles beforehand and cooling down/stretching at the end of your workout, focusing on your weaker side, will also help combat muscle imbalances.

No. 4. Strengthening internal muscles and ligaments

Do not forget about ligaments and internal muscles (deep-lying). Strong superficial muscles with weak ligaments/weak core muscles are like a large building without a strong foundation. Use exercises such as dumbbell rotations to strengthen the rotator cuff, side bends with a barbell on your shoulders, lifting your legs and body from a lying position, and a plank.

The greater the muscle mass of the athlete, the less visually noticeable are the disproportions and asymmetries, i.e. the differences are leveled out. So try to gain more lean muscle mass.

No. 6. Increasing the strength of the weak side

When performing exercises, try to consciously place a greater load on the lagging muscles, as if pulling them towards the dominant ones. So, for example, with asymmetry of the chest, you can perform a bench press with different weights on the sides, more, 3-5%, on the lagging one. For example, your left chest is larger than your right, in this case we throw 50 kg on the left, and 52 kg on the right and press in this mode. You can do the same with dumbbells. Regarding biceps asymmetry, you can do this. During the biceps curl, move the hand with the smaller biceps muscle closer to the center of the bar, and leave the other in place.

Training program to get rid of muscle asymmetry

The basic rule that you need to remember to eliminate muscle imbalance is that while working out the following muscle groups, you also need to train their antagonists (and not necessarily in the same workout). Here is a list of such muscle groups:

• chest and back;
• abs and spinal extensors;
• biceps and triceps;
• quadriceps and hamstring muscles;
• calves and tibial muscles.

Make sure your current PT is giving the antagonist muscles an equal share of the training load. This way you will restore balance and build a harmoniously developed body.

In addition, understanding the issues of muscle anatomy and their kinesiology (functions and movements) will help you wisely select exercises and integrate them into your training days. As an example, let’s take the bench press, which in addition to the pectoral muscles also affects the front deltoids and also works the triceps. And so in many other exercises, non-core muscles are indirectly loaded. In this case (during the bench press), the rear deltoids fall out. Therefore, on days of separate shoulder training, it is necessary to work out the posterior bundles (as those that receive less load in the main exercises during the week), and not “hammer” the front and middle heads.

Now let's look at specific routines aimed at correcting muscle imbalances.

PT No. 1. We remove chest asymmetry.

PT No. 2. We remove the asymmetry of the deltas.

Between sets, 1 minute of rest and soon you will be able to see a picture of the growth of lagging areas.

In general, to avoid asymmetry (preventive measures), it is necessary to use a special type of training - a balanced training program. This is a PT that simultaneously focuses on several muscle groups.

It might look like this:

This program should be repeated periodically (twice a week, every 2-3 months), then you will definitely not have any muscle asymmetry.

Well, that’s probably all I’d like to report on, all that remains is to sum it up and say goodbye :).

Afterword

Today we looked at muscle asymmetry issues. Now you will be as even and proportional as possible, which means you will look more impressive.

Somehow, I was glad to write for you, see you again!

PS. Is everything the same for you or do you squint a little?

With respect and gratitude, Dmitry Protasov.

Arthrosis is a chronic pathology of the joints that occurs in a degenerative-dystrophic manner, caused by a number of provoking factors. Arthrosis of the elbow joint is diagnosed less frequently than lesions of other large articular joints, due to lower loads on this joint. This diagnosis accounts for a significant percentage of diagnoses of articular pathologies in older patients.

Causes of the disease

Arthrosis is characterized by a decrease in the production of synovial fluid, which causes increased friction of the articular surfaces, a decrease in the joint space and the growth of bone spines. These processes lead to problems with the mobility of the elbow joint, causing pain and dry crunching during physical activity. Arthrosis affects all joint elements, nearby muscles and tendons, and the epiphyses of bones.

If you do not consult a doctor in a timely manner, the joint may completely lose mobility, pain increases in intensity, which greatly worsens the patient’s quality of life and leads to disability.

Causes and provoking factors for the appearance of arthrosis:

• Elbow injuries: fractures, bruises, dislocations, meniscus damage, ligament tears. Traumatization can occur at a young age and make itself felt many years later, when post-traumatic arthrosis develops.
• Metabolic pathologies that cause insufficient nutrition of joint tissues.
• Rheumatoid arthritis - with this pathology, the elbow joint is affected, among others.
• Low fluid intake into the body, nutritional deficiency (deficiency of essential substances).

• Chronic processes - tonsillitis, dental caries, gastritis, cholecystitis.
• Infectious inflammation of joint elements, bursitis.
• Changes in muscle and bone tissue associated with age.
• Working conditions, lifestyle, inappropriate loads - in this case, the right elbow suffers more often, as it is the most loaded, the left one less often.
• Heredity.
• Intoxication due to poisoning.
• Diseases associated with blood clotting disorders.
• Frequent acute respiratory infections.

Elbow arthrosis is also caused by hormonal imbalances in menopausal women.

Neurologist M.M. Shperling from Novosibirsk talks on his video channel about a very serious problem - arthrosis of the joints:

Clinical picture

Symptoms accompanying arthrosis of the elbow joint fall into four main groups:

1. Pain. It is noted during movement, at the moment of flexion and extension of the arm, when turning the limb and walking. In the first stages of development of the pathology, pain symptoms are not particularly pronounced and appear only with additional stress. The progression of the degree of arthrosis is expressed in almost constant pain, even at rest. The pain may radiate to the neck and can be felt when pressing on the elbow area.
2. Crunch. The sound of a dry crunch is caused by friction of the bone surfaces of the joint. As the process of arthrosis worsens, the crunching becomes more audible, accompanied by pain. Sometimes a crunching sound is confused with clicking in the joint when performing any movements with the elbow, but clicking is normal and is not a sign of disease.
3. Limited elbow movement. It becomes difficult for the patient to move his arm or turn it. It is caused by impaired motor amplitude due to the growth of osteophytes, reduction in the size of the joint space, and muscle spasms. With elbow arthrosis, Thompson's symptom is noted: the patient is unable to hold the hand in a fist in a dorsal position, and he quickly straightens his fingers. Another typical symptom of elbow arthrosis is the Vetla symptom, characterized by the inability to freely bend and straighten the limb at the level of the lower jaw.
4. Deformation of the elbow joint. Due to the random proliferation of osteophytes, inflammation, which increases the volume of joint fluid, the joint swells, externally this manifests itself as tubercles on the surface of the elbow, redness of the skin.

The severity of the clinic depends on the severity of the disease. Arthrosis of the elbow joint develops in the stages described below:

1st degree

Unexpressed pain in the joint during physical effort; arthrosis does not appear externally. The doctor may note a slight decrease in muscle tone and some difficulties in moving the arm back, flexion and extension in the elbow area. With such symptoms, additional instrumental studies are already required. An x-ray shows a slight narrowing of the space between the articular surfaces. Arthrosis at this stage must be differentiated from tunnel syndrome and cervical osteochondrosis.

2nd degree

There is noticeable pain, so patients already turn to doctors for help and begin treatment. Pain and discomfort are also felt at rest, and are accompanied by a dry crunching sound when moving the joint. The patient practically cannot bend his arm at the elbow or move it back. There is slight muscle atrophy, and it becomes difficult for the patient to do simple household things, which greatly affects the quality of life.

The image shows multiple osteophytes, articular tissues are deformed. External changes have not yet been observed or swelling of the skin in the elbow area is noted, as a rule, during periods of exacerbation.

3rd degree

Pain accompanies the patient almost constantly, including at night, becoming aching and intense. The range of movement is severely limited. In the absence of appropriate treatment, some patients immobilize the limb to relieve pain symptoms.

More details

An x-ray shows destroyed cartilage, lack of joint space, and many overgrown osteophytes. Changes in the shape of the joint are noticeable externally - except for the swollen elbow joint, one arm becomes shorter than the other, the muscles atrophy. The patient can no longer perform usual everyday activities. At this stage, complete recovery is almost impossible.

In this video you will find passive gymnastics for the elbow joints, which can also be used for arthrosis:

Deforming arthrosis of the elbow joint

About 50% of identified arthrosis are deforming arthrosis. Patients complain of pain in the joint, with increasing intensity as the pathology develops. The x-ray shows signs of joint deformation according to the following stages of development:

• Osteophytes are localized in the area of ​​the distal epiphysis of the humerus, although throughout the course of the disease their significant increase is not observed in this segment, in contrast to the joint area, where the growth of bone spines can complicate arm movements already at the onset of the disease. Depression of osteophytes into the ulnar fossa and their localization in the region of the coronoid process of the humerus does not allow patients to straighten the arm.
• The bone growths are distributed evenly around the elbow joint, and movement in the elbow is still observed. Dysfunction occurs gradually. Osteophytes may involve the head of the radius.
• Overgrown osteophytes are accompanied by sclerosis of adjacent bone lobes.

It is mainly the periphery of the humerus that is deformed; osteophytes mostly grow near the glenoid cavity. Painful symptoms and severe limitation of motor amplitude in deforming arthrosis are indications for surgery.

Diagnosis and treatment of elbow arthrosis

The diagnosis is made on the basis of anamnesis, x-rays, and laboratory tests. If necessary, arthroscopy and MRI may be additionally prescribed.

Treatment of arthrosis of the elbow joint in non-advanced stages is carried out using conservative methods. The goal of treatment is to eliminate pain symptoms and limited movement. Treatment of arthrosis is complex and long-term, including several methods. During treatment, the arm is immobilized with a special bandage.

Principles of arthrosis treatment:

• Performing physical exercises to restore mobility of a sore joint;
• Elimination of loads on the joint;
• Drug treatment to eliminate inflammation and pain.

If conservative treatment is ineffective, surgery is prescribed. Patients can also treat arthrosis with traditional medicine at home to alleviate the condition.

Drug therapy

Drugs for the treatment of elbow arthrosis include the following:

1. NSAIDs.
2. Ointments containing medicinal substances.
3. Chondroprotectors.

Non-steroidal anti-inflammatory drugs for the treatment of joints, relieving inflammation and pain. They can be prescribed in the form of injections intramuscularly and into the joint capsule, tablets and locally acting ointments. The most commonly used injections are diclofenac, indomethacin and their analogues - voltaren, ortofen, ibuprofen. In the acute period of the disease, it is advisable to administer NSAIDs by injection, after a few days switching to tablet forms, as the inflammatory phenomena subside. It is worth considering that too long a course of treatment with NSAIDs can negatively affect the gastric mucosa.

• Containing salicylates and relieving inflammation. Works well for bruises. This is salicylic ointment, solcokerasal, hemosol.
• Containing capsaicin and thereby warming the painful area, which stimulates blood supply, improves tissue trophism and relieves pain. These ointments include Nicoflex, Nyser, Nyz, Kutenza, Espol.
• Containing biologically active substances based on bee or snake venom, with a combined effect - they relieve swelling and pain, warm and reduce the likelihood of tissue necrosis. Famous representatives of the group: apisatron, viprosal, ungapiven.

Chondroprotectors

Chondroprotectors for joints are substances that promote the restoration of joint cartilage tissue. They are prescribed as injections into the joint capsule and as ointments. The most commonly recommended drugs for treating joint diseases are glucosamine sulfate, chondroxide, ostenil and structum. Chondroprotectors are used for a long period of time, the course of treatment is usually at least six months.

Treatment of arthrosis Read more >>

Physiotherapeutic methods of treatment are used during the period of subsidence of acute phenomena and during rehabilitation after treatment. Among the methods used, the following are effective:

• Paraffin therapy, which warms the soft tissues in the joint area and thereby stimulates blood flow;
• Electrophoresis with drugs for their penetration into the joint capsule;
• Laser – reduces the growth of osteophytes and destroys existing ones, due to which the joint regains mobility;
• Mud compresses prescribed to eliminate atrophic changes in tissues;
• Acupuncture - the impact of needles on certain points projected on the body, which reduces pain, reduces inflammation of the elbow, and restores muscle tone;

• Massage - at the rehabilitation stage, manual techniques have a beneficial effect on the condition of the joint and surrounding muscles, restoring limb mobility and relieving pain;
• Therapeutic gymnastics is a special set of physical therapy exercises, which is compiled by a specialist; the exercises are also performed under the supervision of an instructor; they can be done both at home and in the clinic.

Additional treatments for arthrosis

To reduce pain and swelling, you can use a traditional treatment recipe, these are ointments, compresses, baths and tinctures:

• Propolis ointment: mix 50 grams of vegetable oil and propolis, dissolve in a water bath. Rub the resulting product into the elbow overnight, after covering it with a piece of polyethylene and wrapping it in a towel.
• Compress from birch leaves: pour boiling water over dry or fresh leaves and leave to infuse for 2-3 hours, then drain the water. Apply the leaves to the sore joint, wrap with gauze and warm cloth.
• Pine needle bath: boil spruce and pine needles in water for 10 minutes, cool slightly, lower the sore hand into the bath so that the elbow is covered with water.
• Herbal infusion: to treat arthrosis, you can make infusions of elecampane and cinquefoil.

Folk remedies for the treatment of arthrosis should complement the main course. In addition to the treatment complex, annual sanatorium treatment is recommended for patients with arthrosis of the elbow joint.

Gymnastics for the treatment of pain in the elbow and elbow joints from Dr. Evdokimenko:

The physiology of newborns differs significantly from the adult body. The ligamentous-muscular system of infants develops during the first year. Increased flexibility of bones and clicking of joint ligaments are common phenomena for babies. Often, inexperienced parents know little about this, so after the first incident, they immediately turn to specialists with questions.

Development of joints in infants

After birth, small children are little adapted to life outside the womb. The infant's internal organ systems and musculoskeletal system function poorly.

The dynamics of development of the entire organism is not always proportional. Breasts gain weight, which interferes with the strengthening of bone tissue. After six months, the babies begin to move actively and gradually lose weight. Most children by this time learn to sit, some of them are already starting to crawl. Fat goes away, muscles and tendons appear, bones become strong and strong. By the end of the first year of life, the child will be able to stand confidently on his feet. The development of the articular and ligamentous apparatus is a long process that lasts for several years.

Causes of crunching in joints

During exercise, you can hear the baby's arms or legs clicking. Mothers begin to wonder why their child’s joints are cracking.

The main reason is the physiological characteristics of infants. The skeletons of a newborn and an adult are significantly different. Immature joints and bones act as a defense mechanism. In case of an accidental fall or bruises, flexible tissues are less susceptible to damage.

Insufficient joint lubrication can also cause crunching. The rapid growth of children is not always good. The child is actively growing, bones are stretched, joints are enlarged. The skeleton becomes larger, but the body does not have time to adapt to it, and continues to secrete joint lubricant in the same volumes, but there is not enough of it.

Severe bruises and injuries can provoke joint deformation, which causes crunching. If such situations occur, you need to take an x-ray and consult a doctor.

Diagnosis of the problem

The clicking of immature cartilage is more natural and is not a cause for concern. In rare cases, the cause is a disease such as dysplasia. This is a congenital disease in which the head of the femoral joint does not fully connect to the socket. The patient’s bones develop slowly; without proper treatment, the skeleton is formed incorrectly, which can lead to disability of the child.

Signs of dysplasia:

• There is a clear asymmetry of the folds on the baby’s legs.
• Clicking when legs move to the sides.
• One limb is shorter than the other.

This disease is hereditary, most often transmitted from mother to daughter. Girls get sick four times more often.

Arthritis, arthrosis, rheumatism can also cause crunching in children. They can be triggered by metabolic disorders, sometimes they are complications of previous infectious diseases.

Survey plan

Experienced specialists are able to recognize dysplasia within a few days after birth. The presence of external signs in children is not enough to make a final diagnosis. The child should be examined by a specialized doctor: a surgeon or an orthopedist. An ultrasound examination will help clarify the medical report. X-rays are only applicable for children over 8 months of age.

Dysplasia is a serious disease that requires good comprehensive treatment and special care. If violations are detected, you must follow all the doctor’s instructions, do physical exercises, massage, warm baths, and physiotherapeutic procedures.

Prevention

The baby's body develops at a rapid pace. Full growth of bones, strengthening of muscles and ligaments is impossible without nutrition rich in all necessary vitamins and microelements. The daily diet should include the daily norm of all useful substances, for this you need to eat:

• dairy products;
• dried fruits;
• eggs;
• cereals;
• sea ​​fish;
• beef liver;
• fruits.

It is clear that it is impossible to feed the baby with the listed healthy products, so the mother must make sure that the baby can get everything he needs with milk.

Physical exercises for infants will help strengthen the bones and muscle system. You can do the exercises as early as 3–4 months. Most sets of physical exercises are aimed at stretching ligaments, strengthening muscles, and developing the vestibular apparatus.

If your child has cracking joints, this is not a cause for concern. Up to a year this is quite common. Children grow and their musculoskeletal system develops until approximately 18 years of age. Limbs in infants click, usually due to natural skeletal features or a lack of vitamins.

- this is a decrease in the length of one limb relative to the other or a decrease in the length of both limbs, which disrupts the proportions of the human body. Minor shortening (1–2 cm) is common and has no clinical significance. Significant shortening of the lower extremities, especially unilateral, is manifested by disturbances in support and walking, and can provoke a number of diseases of the joints and spine. The diagnosis is made after special measurements. Correction is possible with insoles and orthopedic shoes; in case of severe shortening, the limb is lengthened using the Ilizarov apparatus.

ICD-10

M21.7 Q71 Q72 Q73

General information

Limb shortening is a widespread phenomenon. A slight difference in the length of the lower limbs is detected in 90% of people. Among the reasons are the dominance of one of the cerebral hemispheres, poor posture and incorrect muscle patterns that influence the formation of the body during the growth of the child. A difference in leg length of up to 1-2 cm is imperceptible even to the patient himself and is discovered only during special studies. Shortening one limb by more than 3-5 cm causes a noticeable distortion of the pelvis and causes discomfort to a person when walking.

Causes

Shortening of the limbs can be unilateral or bilateral. Symmetrical bilateral shortening is detected in achondroplasia and some other genetically determined diseases and is manifested by a discrepancy in the proportions of the torso and limbs. Asymmetrical bilateral shortening is observed with developmental anomalies of the upper and lower extremities. The cause of unilateral shortening may be traumatic injury, tumor, infectious process or developmental defect.

Classification

Diagnostics

To clarify the severity and nature of the shortening, measure the absolute and relative length of the limb and the length of each segment, using visible bony protrusions (anklebones, upper pole of the patella, articular space of the knee joint, greater trochanter and superior anterior iliac spine) as landmarks. Measurements are taken with the legs fully extended, with alternate flexion of the hip and knee joints and with simultaneous flexion of the large joints of the limb. To identify relative and apparent shortening, special tests are used.

The list of additional studies depends on the location and presumed cause of the shortening. For old fractures, tumor processes and infections, it is prescribed

The Ilizarov apparatus allows you to lengthen the tibia by 8-10 cm, and the thigh by 5-6 cm. It should be borne in mind that the increase in the length of the segment is carried out gradually and can last up to six months or more. Installation of the device on the lower leg is relatively easy for patients to tolerate, since it allows them to maintain sufficient mobility and does little to interfere with movements in the joints of the limb, etc. Installation of the device on the thigh is more difficult to tolerate, since it significantly limits movement and self-care. During the entire treatment period, patients perform special exercises aimed at preventing muscle atrophy and maintaining joint mobility. Functional results are good.

Most often, parents are the first to notice asymmetry: while changing clothes, bathing or playing with the baby, it is noticeable that the baby’s folds are unevenly distributed. Suspicions immediately arise that one leg is shorter.

Situations like this are not uncommon. They can indicate both true and false shortening.

Causes of pathology if one leg is shorter than the other

The diagnosis can only be made if the difference is at least ½ cm. When the bones of one leg are shorter than the other, true shortening occurs. The reasons for this are hidden in the underdevelopment of bone tissue, that is, in developmental anomalies; as a result of purulent-inflammatory diseases of the hip joint.

Pathology in children under 8 months of age is eliminated through splints, massage, and staged plaster casts. Further therapy depends on the diagnosis, but most often it is necessary to perform surgery.

Dysplasia

In this case, false shortening occurs when the bones are the same in length, but one limb stretches upward.

In children of the first year of life this most often happens due to:

1. hip dysplasia;
2. partial/complete subluxation, hip dislocation.

The doctor determines the pathology, as they say, “by eye.” Difficulties in diagnosis arise in the first 2 months of life. It is easier to detect a unilateral dislocation at the age of 3-4 months.

• Treatment up to 9 months of age involves manual massage to correct the pelvic bones.
• Older children take longer to be treated and may need to wear a special splint.
• Dysplasia goes away after physiotherapy, massage and exercise therapy.

If left untreated, the pathology will progress.

1. Parents should not swaddle their baby tightly;
2. Forcefully straighten limbs;
3. Get back on your feet ahead of schedule;
4. Avoid vertical loads, as there is a risk of worsening joint deformation.

Hip dislocation

• Congenital pathology is eliminated by gradual reduction and plaster casts or splints.
• The duration of therapy is individual, ranging from several months to a year. The treatment complex includes manual therapy: selective, acupressure, special exercises.
• The pregnancy calendar allows you to find out how the baby should develop; accordingly, the expectant mother can find out about the congenital disorder through an ultrasound scan and begin treating the baby immediately after his birth.

Manual therapy is resorted to some time after reduction. The chiropractor must strengthen the weakened muscular system and prevent degenerative changes in joint tissue. After removing the bandage, they strengthen the muscles that were weakened during its use, and also prepare the joints for the upcoming loads.

Treatment of congenital dislocation is most effective in the first 3 months of life. When the child is much older, surgery has to be performed.

Muscle hypertonicity

The reasons for false shortening may be hidden in the increased tone of one limb. This is noticeable after six months of age.

In turn, hypertension provokes:

1. increased intracranial pressure;
2. fetal hypoxia;
3. anemia of the brain.

This condition is often observed in babies born during traumatic birth and asphyxia.

Pathology can be suspected when the baby lies in the fetal position in the first months of life, the arms are bent in all joints, pressed to the body, the legs are bent, slightly moved to the sides, the head is thrown back.

Parents can separate the limbs several times; if there is no resistance, then the tone is normal.

When a child stands on tiptoes with support and curls his fingers, a consultation with a neurologist is needed. The child needs exercise and possibly medication.

When the legs are different: normal options

Minor deviations generally do not indicate pathology. There is such a thing as physiological shortening of the lower limb. For example, shortening of the right leg is often observed in children with severe left-handedness and vice versa.

In order for a baby to grow and develop well, he must be physically active. Jumping, running, movements lead to the fact that one limb becomes the leading, pushing one, that is, it bears a greater load than the other. That's why the push leg is a little shorter. A stronger limb develops faster. Later this difference will disappear.

One leg is shorter: the reason is heredity

This feature can be passed on from generation to generation. If parents or close relatives have it, it can also occur in the child. You can take measurements yourself, but you can’t take a measuring tape; just lie down on a hard surface. The head should be in the midline of the body, the legs should be together. You need to pay attention to whether your ankles and heels are at the same level.

How to independently determine which leg is shorter than the other

You can detect the violation at home, without much experience.

Parents may well do some of the testing themselves.

• It is necessary to position the baby correctly before the examination. Optimally - on the table surface. The latter needs to be covered with a diaper or blanket, but so that the baby does not “drown” in soft blankets;
• You need to choose the right time. It is often difficult to put children to bed without interference, because they do not understand at all what is wanted from them;
• The baby should be placed belly down. You can stroke his back to relax his muscles. Then he is turned over on his back. You need to pay attention to whether he is comfortable in this position. You need to let him grab your fingers. If the baby actively grabs, tries to pull himself up, moves rhythmically, and automatically moves his limbs symmetrically and in full, then the child is healthy. With increased muscle tone, its legs will cross;
• Next, you need to pay attention to the restrictions in spreading the limbs: you need to bend your legs at the knees and hips, and then carefully spread them apart. If you have dysplasia, this will not be possible;
• Dysplasia can be diagnosed by placing the baby on its stomach. You need to bend his legs, as when crawling. In this position, pronounced pathology will be noticeable. Parents should pay attention to whether the folds of skin on the thighs are symmetrical and whether there is a difference in the length of the limbs. It is worth conducting such a study several times a day;
• If the baby is older than six months, you need to examine his body for asymmetry, and also examine the symmetry of the joints;
• In children older than one year, the symmetry of the muscles of the lower extremities is checked. If one of them is thinner in volume (in the thigh and lower leg), it means that it is subject to less stress.

If you have any doubts, you should definitely tell your doctor about them, for example, a pediatric surgeon or orthopedist, or a neurologist. Based on the cause of the pathology, treatment will be selected.

Consequences for the baby if one leg is shorter than the other

Many people mistakenly think that different limb lengths will necessarily lead to lameness. It is not always so.

1. In the child's body, if the pathology is not treated, metamorphosis will occur: the existing defect will be compensated by tilting the pelvis towards shortening.
2. In the future, such a condition will lead to curvature of the spinal column, the consequences are no less serious than dystrophic changes in the joints.
3. As a result, the spine will bend in the form of the Latin letters “S” or “C”, one shoulder will also bend towards the affected limb.

What to do if your baby has one leg shorter than the other

When a disorder is detected in a timely manner, that is, during a period of active growth of the body, the chances of eliminating the pathology are quite high.