One leg shorter than the other?

Limb Lengh Differences

What is a Limb Length Difference?
Having one leg shorter than the other.
Although it is well acknowledged there is a high prevalence of it amongst people, there is little consensus amongst literature as to the significance or the importance of it.
Causes:
Congenital (from birth) conditions include mild developmental abnormalities found at birth or childhood, whereas acquired conditions include:
  • Trauma
  • Fractures
  • Orthopaedic degenerative diseases
  • Surgical disorders such as joint replacement.
Treatments:
  1. Nothing! if it isn’t creating any pain or problems, theres good reasoning to not intervene at all.
  2. Simple build ups. In shoe or full length build ups on the shorter side. If the discrepancy is more significant, then getting a cobbler (shoe maker and modifier) involved to do an external build up can be helpful and more comfortable.
The second option is something that we as podiatrists get referred to from other professions a lot. It is best done as a gradual, trial and error/individualised approach to get a balance of comfort and effectiveness. This means being able to make raises and dispense them is useful.
In my experience build ups can be both powerful, or useless. It is important to realise that the Limb Length Discrepancy, even if identified, may not be involved with the presenting pain. Hence a logical, cheap, approach of trialing build ups over a few weeks should be clearly explained and adopted. Allowing the patient to be involved in the experiment and actively test the effect of the raise over enough time to confirm or deny if the raises are useful or not.
Another key point is that a full length raise is preferred over a heel lift. A heel lift doesn’t influence a shorter leg at toe-off when walking, and also asymmetrically effects ankle joint plantar flexion range of motion compared to a full length raise.
In summary, trialing raises for Limb Length Discrepancies should be guided by symptoms. A trial and error approach should be taken to finding the right height that is helpful, using full length raises. If theres no issues with difference in length, it is reasonable to not intervene with treatments.
Check out a great video below by E3 Rehab.
Justin - About us

Justin Smith

Podiatrist
Justin Smith is a highly skilled Podiatrist with a diverse and broad training background. Passionate about sports medicine, movement screening, exercise prescription & rehabilitation, Justin thrives in working with people with complex and difficult lower limb cases. In addition to his private practice work, Justin works with the University of Newcastle Podiatry Faculty in roles including Sports Podiatry Tutor, Clinical Educator and in various Research projects

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