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To the Editor.—
I have been intrigued for many years by the misinterpretation of the alleged shortening of the affected lower extremity in the sciatic syndrome.In the first place, the measurement from the hip bone to the inner ankle is not the length of the extremity, it is the length of the distance from the iliac crest to the ankle. "Shortening" on the affected side will almost invariably be found in patients with disk problems, for example, resulting from a slight, often imperceptible involuntary flexion of the knee and plantar flexion of the foot. This is designed to relieve sciatic pain to a degree of releasing the stretch on the nerve root, particularly where it is compressed intraspinally by a disk protrusion or other form of pinching. This habit posture may become so chronic as to produce actual anatomic shortening of the hamstrings and of the Achilles tendon. A
Murphy JP. 'Short Leg' and Sciatica. JAMA. 1979;242(12):1257–1258. doi:10.1001/jama.1979.03300120011006