Leg length discrepancy is a very common condition. As many as 70% of people have some degree of leg length discrepancy. It’s a naturally occurring issue, and most people with leg length discrepancy live with such a mild discrepancy that they never really notice.
A small percentage of people with leg length discrepancy (LLD) will experience adverse effects as a result of the condition. Significant discrepancies have a tendency to cause discomfort, and some of that discomfort can be ameliorated through the use of orthotics.
What is Leg Length Discrepancy?
Leg length discrepancy (LLD) is the medical term for having one leg longer than the other leg. Technically, almost everyone has leg length discrepancy. It’s typically not noticeable if the discrepancy is 1.1 centimeters or less. Symptoms become more noticeable with greater discrepancies. There are two different types of LLD, and their treatments will significantly differ.
The Difference Between Structural Leg Length Discrepancy and Functional Leg Length Discrepancy
Leg length discrepancy can come as a result of bone length (structural LLD) or muscular issues (functional LLD).
In structural leg length discrepancy, the femur, the tibia, or both will measure significantly differently in both legs. Some individuals are born with leg length discrepancy. Others may wind up with discrepancy as a result of a surgical procedure, a degenerative bone disease, or a significant injury.
In functional leg length discrepancy, all of the bones are essentially the same length. Any number of muscular issues can cause alignment problems, making the legs function as though they’re different lengths when the measurements are technically the same. The symptoms of functional LLD are nearly the same as structural LLD, but when a few added discomforts.
People with functional LLD are more likely to develop their LLD symptoms from conditions like spinal scoliosis. Their muscular condition may result in or stem from muscles around the hip joints, making the leg feel higher on one side at the hip.
What Are the Symptoms of Leg Length Discrepancy?
Leg length discrepancy, whether functional or structural, will typically lead to a number of uncomfortable symptoms.
Pain in the lower back is common and lower back or leg injuries without a clear cause are common in people with LLD. They also often find it painful to bend over, lift objects from a low height, or stand up straight for an extended duration.
Pain in the foot, knee, or hip on the impacted side of the body is common. Many people feel like they’re slightly leaning to one side, or that they need to shift their weight to maintain their balance while they walk. Because of this overcompensation, walking or moving for a long span of time can easily fatigue people with LLD.
Avoiding Discomfort Associated with Leg Length Discrepancy
In order to avoid pain and discomfort associated with LLD, people who live with the condition should avoid certain activities.
Heavy lifting, as well as any physical activity that involves bending or twisting the body, should be avoided. Many sports and workout programs can exacerbate the painful symptoms of LLD. Low impact exercise utilizing proper athletic wear, proper shoes, and the right kind of body support can minimize undue strain while allowing people living with LLD to remain active.
The right kind of physical activity is important for people who live with leg length discrepancy. Being or becoming overweight or obese can place significant strain on the joints and muscles. This strain will drastically exacerbate LLD pain. If you’re overweight or obese and dealing with LLD, ask your doctor about what steps you can take to safely reduce your weight and reduce your pain.
Improper footwear, using the wrong orthotic device, and using orthotic devices inconsistently can also contribute to worsening LLD symptoms. When you have LLD, it’s important to properly support your foot in a structurally sound shoe. Slides, slippers, and flip flops will not provide your feet with the support they need.
Shoes and foot lifts for people with LLD need to be made with extreme accuracy. Using the wrong kind of lift, the wrong height of lift, or only using your lift occasionally may make uncomfortable symptoms worse. It’s important to note that lifts are only the proper solution for structural LLD. If you’re experiencing functional LLD, a lift will provide no relief. It will merely cause pain.
How Custom Made Orthotics Can Help
Orthotics can help to manage a significant amount of pain associated with structural LLD. The shorter leg needs to be made even with the longer leg, so when both legs are bearing weight, they can better distribute the load.
First, an experienced orthotist will work with an x-ray to examine the bone discrepancy, and accurate measurements will be taken. After all scans and measurements are complete, your orthotist can create a custom orthotic lift for your shoe.
If the lift exceeds 1 centimeter, special considerations will have to be made. Larger lifts tend to be placed in the shoe’s midsole, with the outsole being reapplied after the lift in in place.
If you were born with congenital LLD, your treatment plan may be different. The body is excellent at adapting, but it does so slowly. Over time, your body likely adjusted to your leg length discrepancy to make it more comfortable for you to walk and move. These adjustments don’t correct the problem – they simply help to mitigate the symptoms.
When your body is used to your leg length discrepancy, you’ll likely need a series of supportive orthotics. Starting with a full correction can be painful. The best course of action is to subtly graduate from a 60% correction to give the body an opportunity to get used to relying on the lift, rather than changing its mechanics to overcompensate. A successive series of lifts can be carefully measured for and utilized to achieve the best longterm outcome.
Are You Living with Structural Leg Length Deficiency?
If you’re living with structural LLD, ask your doctor if custom orthotic lifts can become a part of your treatment plan. If he or she feels you would benefit from using lifts, contact us at Tony Martin Limb and Brace. We work with patients to create custom lifts for structural leg length deficiency, whether you need a single lift or a series of lifts to help you achieve ease of motion and reduced pain.