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"... anatomical short legs are common"

Dear Editor,

Dr. Daniel Batchelor is to be commended for his article discussing short leg in athletes.¹ While I can appreciate the time and effort that went into the paper, there are some significant errors in it that merit discussion, the most glaring being that Dr. Batchelor does not reference his material. Given my own past involvement in studying short-leg syndrome, this is a blatant oversight, for I cannot find any reference to support some of his contentions, and these contentions jibe with the research I have read.

In particular, I refer to his comments concerning functional and anatomic short legs. Dr. Batchelor states that anatomical short legs are uncommon and arise from polio, fracture or congenital malformation. My research demonstrated that anatomical short legs could be found in 82 percent of entering students at National University, all of whom were asymptomatic.² This work found similar results to the studies of Beal,³ Marscher,⁴ and Rush and Steiner.⁵ Patently, anatomical short legs are extremely common. However, Dr. Batchelor does not define anatomical short leg; in the case of my own study, we chose a 2mm leg difference as an indication of short leg. The point remains: Anatomical short legs are common.

Given that nearly 80 percent of the population has an anatomical short leg, it is therefore difficult to assess the concomitant presence of functional short leg. Dr. Batchelor claims that three out of every five people have functional short leg. I am not aware of any such reference for this statement. This figure seems completely unreal to me. And to complicate matters even more, I have argued in the past that some chiropractic concepts regarding functional short legs do not make anatomical sense, i.e., pelvis unleveling creating the "functional" change. I do not think that the SI joint moves enough to create this so-called discrepancy. However, I will delay that argument for another time. My point here is to examine the support for Dr. Batchelor's general statements.

Having said all this, I still enjoyed the paper and, as a father of two elite distance runners, one of whom just won his first marathon, I pay close attention to running biomechanics. But let us be sure we keep our facts straight.

1. Batchelor D. Short-leg syndrome in runners. Dynamic Chiropractic 2002;20(19):32. www.chiroweb.com/archives/20/18/02.html
2. Lawrence DJ. An evaluation of a method of evaluating short-leg mensuration. J Am Chiropr Assoc 1984;18(6):57-59.
3. Beal MC. The short-leg problem. JAOA 1977;76:745-751.
4. Marscher E, Figner G. Measurement of leg length. Prog Orthop Surg 1977;1:121-127.
5. Rush WA, Stiener A. A study of lower-extremity leg-length inequality. Am J Roentgenol 1946;55:616-623.

Editor's note: Art Eberting,DC, of Clinton, MO, wrote to inform us that he has been treating a patient now for many years with VA approval and reimbursement. "This patient presents every week for his much needed spinal adjustment," Dr. Eberting wrote.

Attached to his letter was a letter from the Department of Veterans Affairs in Kansas City, MO, to Dr. Eberting's patient, authorizing the patient to receive evaluation and treatment for chiropractic care.

The patient authorization letter reads in part:

"You have been approved for care at a local facility at the request of your VA physician. Please take this letter with the enclosed authorization and consult to the facility of your choice.

"You should take the attached authorization form with you to your appointment. This will notify the other facility that the VA is responsible for payment. You do not need to provide any other insurance information to the other facility. The VA Medical Center is responsible for payment in full."

Dear Editor,