This video was shot in 1995. New videos from 2026 with updated information are at this link:
https://massagelibrary.com/category/new-techniques/leg-length-balancing/
There are two main reasons for a difference in leg lengths: an anatomical difference and a functional difference.
An anatomical leg length difference may be caused by a fracture of the femur or the tibia and fibula that healed shorter or by a congenital malformation such as club foot. The treatment is usually a heel lift or shoe insert to level the hips.
A functional leg length difference is caused by a pelvic torsion, where one side of the pelvis is rotated forward relative to the other. This causes the hip socket to drop on the forward-facing side, making that leg appear longer. Causes of this pelvic torsion include standing with weight on one leg, carrying items on the hips, accidents and injuries, and sitting on a wallet in the back pocket. This functional leg length discrepancy is so significant because it affects the way the sacrum sits between the two sides of the pelvis. The sacrum is like the keystone of an arch and is also the base of support for the spine. Therefore, if the sacrum is tipped, it affects everything above it. Pelvic torsion will also affect the hips, knees, and ankles, as they will track differently during walking or running.
To measure leg lengths, I shake out the legs so the client is lying flat on the table, then bring the legs together and compare the level of the medial malleolus on each side. If the medial malleolus is not visible due to fat or fluid retention, or the client is wearing socks, I place my thumbs on the same point on the medial malleolus on either side and compare how they line up.
Techniques 49 through 55 are different ways to correct pelvic torsion through stretches and soft-tissue work. They do not need to be done in order, as any one of them may be effective for a particular client. I find it helpful to have a variety of techniques, since every client responds differently. Suppose you are unable to achieve a correction with these soft-tissue techniques. In that case, you may want to refer your client to someone who can manipulate the skeletal structure, such as a good naturopath, chiropractor, or osteopath. These techniques can also be a good adjunct for someone already receiving manipulative treatment.