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Leg Length Discrepancy

Uneven leg lengths usually stem from two main causes.

Common Signs & Symptoms

  • Pain or tightness anywhere in your legs or back
  • One leg feels shorter than the other when standing
  • One side of your pelvis is higher than the other
  • Uneven wearing of your shoes, or your trouser legs appear to be different lengths
  • Can be of gradual or sudden onset
  • Usually made worse by standing activities such as walking or running
  • Often accompanied by 'bad habits', such as locking your knees back, standing with weight through one side or walking with turned out feet
  • Problem keeps returning, despite treatment on the painful area(s)
  • A sideways curve of your spine (Scoliosis)

Description

Uneven leg lengths usually stem from two main causes.
A) The bones of your leg grow significantly longer on one side, this is a real leg length difference and is rare. This can happen following fractures in your leg or abnormal development and is called a true or structural leg length difference. Structural is less common and usually a difference of 3cm or less is not considered to be a problem.

B) Tightness in the muscles of your pelvis, hip and torso (usually the psoas, gluts and obliques) - this muscle tension can rotate the bones of your pelvis and give the impression that one leg is longer. This is where your legs just appear to be different lengths and is very common.

Leg length difference can be measured in lying or visualised in standing. Any leg length difference can increase stress on one side of the spine with walking or any activities in standing. Joint wear and tear is most common when one side of the spine comes become more stressed and compressed than the other especially during walking and standing activities. If the leg length difference occurs whilst you are growing, your body may develop in ways to compensate, such as a curve of your spine to the side.

Advice & Treatment

Treatment depends on the cause of your leg length difference as well as assessing the effect of any changes in your leg alignment (Malalignment & Altered Biomechanics) which are present too. This usually requires an assessment from a physiotherapist, to see which path you need to take:

If you have a true leg length difference you may need a small heel raise in your shoe to change the balance of stress in your pelvis and low back.

If your problem stems from the muscles in your pelvis, you may need specific stretches to release the muscles which are holding your pelvis in a twisted position. To relax tight muscles, you can use heat and/ or self massage with a tennis ball or foam roller. Stretching and strengthening exercises can also help.

Should your problem stem from malalignment of the bones and joints in your legs, you may need specific insoles, designed by a podiatrist or orthotist to change your biomechanics.

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