Overcompensation for a one-sided injury can lead to back pain and neck pain, so it may be useful to seek chiropractic for limping.
Causes of Limping
Limping is a way of walking that is abnormal. This gait can be jerky or labored. The cause may be structural, a serious condition, or just a minor injury. Hobbling, pain, putting on less foot pressure, irregular walking, or avoiding walking are signs of limping. In children, a limp may be triggered by an ankle sprain or a muscle strain, a fracture, hip problems, different leg lengths certain diseases or infections, arthritis, cancer, or spinal problems (such as Spondylolisthesis and Spondylolysis).1 Some people may limp because of a broken toe. That injury usually does not last long. Treatment is RICE (rest, ice, compression, elevation), and perhaps a pain medication (ibuprofen, acetaminophen). Some patients may need a boot or crutches.2 This injury, though short-lived, can still lead to limping and overcompensation for the injury. A sprained ankle is treated similarly and could lead to the same overcompensation issues. Additionally, even after RICE, a sprained ankle could be severe enough to become “permanent ankle instability”. That is why rehabilitation is important to make sure that range of motion, strength, and flexibility are restored.3 For some patients, a limp will be more chronic, such as with juvenile rheumatoid arthritis, some cancers, transient synovitis (“reactive arthritis of the hip”), osteomyelitis (bone infection), Lyme disease, or hip dysplasia.4
There are many similarities between sprains and strains, but different parts of the body are involved. If the ligaments are torn or stretched, that is called a sprain. Ligaments are fibrous tissue bands that connect the bones in the joints. Ankle sprains are the most common type. Exercising or walking on an uneven surface can cause this type of sprain. Pivoting while doing an athletic activity can trigger a knee sprain. Both of these can cause limping. The symptoms of sprains include pain, bruising, swelling, and limited movement. If the tendons or muscles are torn or stretched, that is called a strain. Tendons are the fibrous tissue cords that connect muscles to the bones. It is not uncommon for the lower back and hamstring muscles to be strained. An abrupt or unusually far stretch is a cause of an acute strain. Risky activities for this type of strain include running, throwing, jumping, slipping on ice, or awkwardly lifting a heavy object. The chronic strain is caused by repetitive movement, such as golf, rowing, gymnastics, tennis, or activities from work. Strains create symptoms such as pain, swelling, and limited movement, as well, but also muscle spasms. Most of the time, strains and sprains can be treated at home, if they are mild. As noted earlier, the RICE method is the typical treatment method. A healthcare professional should be contacted if the patient “can’t walk more than four steps without significant pain” or “can’t move the affected joint”, and if they “have numbness in any part of the injured area”. If a strain or sprain is severe enough, however, surgery may be required to repair torn muscles, tendons, or ligaments. The risk factors of strains and sprains are poor conditioning, fatigue, improper warm-up, poor equipment (bad footwear, for example), and environmental conditions (such as uneven or slippery surfaces).5
Hip Dysplasia and Leg Length Issues
Hip dysplasia might occur as a developmental disorder or in adults. A normal hip is a functional “ball-and-socket joint”. If this has not developed normally, the “ball” at the top of the femur fits too loosely in the socket and dislocates easily. This may be apparent at birth or during the first year of a child’s life. One of the causes of this is actually improper swaddling, with the hips and knees straight. Developmental Disclocations (Dysplasia) of the Hip, or DDH can be mild (subluxatable, or movable), dislocatable, or the severe case of being dislocated. The left hip is more often affected. Those more likely to have DDH are first-born children, girls, breech babies, those with a family history, and babies who had low amniotic fluid levels. There may be no symptoms, or their might be different leg lengths, “uneven skin folds on the thigh”, one-sided less flexibility or mobility, toe walking, waddling, or limping. Non-surgical treatments include a Pavlik harness for infants, other bracing or harnesses for babies under 6 months of age, or even casting or skin traction for children up to 2 years. The complications of DDH treatments (such as harnesses or casting) are skin irritation and delayed walking, and surgery still may be necessary after these treatments. DDH is best treated early, or else osteoarthritis, pain, decreased agility, or a “duck-like gait” could occur.6 Adults can wear out the hip joint, and hip pain or even “pain deep in the front of the groin” can be a sign of hip dysplasia. Over time, a limp may develop. Lifestyle changes and weight loss could decrease the wear-and-tear, but if the hip becomes too painful, joint injections or surgery may be required. Other non-surgical options include the patient choosing swimming and cycling instead of “high impact sports”, and physiotherapy.7
Chiropractic for Limping
Chiropractors can help patients who have musculoskeletal pain resulting from limping. The uneven gait that patients present with means that the body overcompensates. This causes stress on the other side of the body. Back, hip, knee, and neck pain may be a result. When the body lacks flexibility, nerve impingement could occur. The symptoms of nerve impingement include spasms, weakness, tightness, tingling, burning, numbness, and pain. It is usually foot-related conditions that cause limping.8 Chiropractors see patients with abnormal gaits (propulsive, scissors/spastic, steppage, waddling, ataxic/cerebellar). Medical doctors may also refer some patients with abnormal gaits to a chiropractor for treatment. Chiropractors can help patients with adjustments, rehabilitation stretches, and exercises as part of the treatment plan.9 Overuse injuries could be treated with the Graston Technique and Active Release Technique (ART), as well. Pain medications mask the problem, and for some cases of limping, resting too long is not helpful. Seeking chiropractic treatment is an option for many patients. The earlier treatment is sought, the better the outcome.10
Chiropractors may be a key part of a rehabilitation program for patients who have been limping. Chiropractic correction methods are comfortable and safe. Manipulation and adjustments fall into this category of treatment. Physiotherapy, ultrasound, and electro-muscle stimulation are other techniques. Some chiropractic offices offer massage therapy, which is another conservative and natural treatment option. Muscular therapy and massage are tailored to the individual patient and are meant to reduce swelling, increase circulation, relax the muscles, alleviate spasms and pain, and aid in improving range of motion. Chiropractors often give guidance and advice for what patients can do at home to maximize the benefits of their treatment, such as corrective exercises, lifestyle and nutrition advice, and suggestions regarding posture. Nutritional advice might include recommendations about supplements and vitamins. In terms of lifestyle, it is important that patients learn which activities to avoid due to aggravating the injury. Exercises can be adjusted to any level of fitness, and chiropractors can make sure the patient is able do the specific exercises and stretches properly at home, between appointments.11
Find out more about chiropractic for injury recovery.