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Treating Leg Length Discrepancy

What Causes Leg Length DiscrepancyLeg length discrepancy

Leg length discrepancy describes a variation in the length of one leg compared to the other.  Leg length discrepancy can be functional or structural.  Let’s take a closer look at each of these definitions of leg length differences.

Functional leg length discrepancy is often secondary to another neuromuscular condition.  The neuromuscular conditions may be congenital, such as spina bifida or cerebral palsy, or may be acquired such as a lumbar injury that causes muscle splinting.

Structural problems that result in leg length discrepancies are also categorized as congenital or acquired.  Congenital problems that may contribute to a leg length discrepancy include scoliosis, injuries to growth plates of the legs or injury to bone such as a fracture or infection.

Treating Leg Length Discrepancy

Regardless of the cause of leg length discrepancy, the body will work hard to accommodate the discrepancy and insure an upright position of the spine.  As an example, think of a candle on a table.  The candle represents the spine and the table represents the pelvis.  Any change to the level of the table will significantly affect the position of the candle.  The same holds true with the pelvis and spine.  A leg length difference can have a significant effect on the level of the pelvis and subsequently on the opposition of the spine.

Treating leg length discrepancies can be accomplished with the use of lifts in the shoe or additions to the sole of the shoe.  As a rule of thumb, it will be difficult to achieve greater than ½” lift inside the shoe.  Any additional lift will need to be applied to the shoe.

How do you determine which heel lift is best for your needs?  The first step is to have help in understanding the testing for legHeel lifts for leg length discrepancy length differences.  And easy way to begin is to use books in varying thicknesses.  Stand in front of a mirror and add ½” under the suspected short limb.  As a rule of thumb, the short leg will have a high shoulder.   Add ½” book to the short side and the shoulder should begin to appear level with the other shoulder.  Continue to add books at ½” per stage and reassess shoulder height.

Products for Leg Length Discrepancy - Heel Lifts

Which heel is best for you?  First, be sure to realize that heel lifts and heel cushions are two distinctly different tools.  Heel lifts are firm and will not compress.  The Medi-Heel Lift, Adjust-a-Lift and Cork Heel Lifts are going to be the best choices for treating leg length discrepancy.

Jeff

Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Director
Myfootshop.com

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Comments
11/28/2018 8:05 PM
I've used shoe lifts that are more like an insole to add height to my shoes, but the price is a killer. Would stacking your heel lifts work instead?
11/29/2018 4:38 PM
Hi Mike,
The cost of Rx orthotics is certainly going to be upwards of $400. Fixing the leg lift issue though really depends upon the amount of lift needed. You can usually get 1/2 inch maximum in your shoe. After that you're going to need to put the lift on the exterior of the sole. Any good shoe repair shop can do this for you and it's not particularly noticeable. I'll try to motivate my patients who need more than 1/2" to go with the sole lift. Might cost $30-40 at a shoe repair shop but its an easy fix. Stacking the heel lifts isn't going to be that good of a solution.
The Adjust-a-Heel Lift might be the best choice for you in that it'll give you close to 1/2" lift with the ability to adjust the lift by 1/8" increments.
Hope this helps.
Jeffrey A. Oster, DPM
Medical Director
Myfootshop.com