Leg length discrepancies can vary in size. The greater the discrepancy, the more a person must compensate his or her normal posture and gait (walking pattern) in day to day life. The body will attempt to compensate for any postural imbalance. The degree of compensation probably depends on whereabouts in the body it occurs. This can lead to a variety of symptoms, such as functional scoliosis (spine has a sideways curve), hip, knee and ankle problems.
Long term imbalances will not only contribute to chronic pain, but lead to problems causing postural changes in the body from the back down to the foot. Walking with a short leg increases energy use, places increased stress on the longer leg and can cause a compensatory functional scoliosis. The foot is also a great compensator and will alter its functional position to even up the leg length. This is a contributor to foot pathology.
Small, seemingly inconsequential leg length differences (LLD) are often considered irrelevant. Our experience has yielded a different result. Minimal leg length discrepancy can contribute to significant symptoms of gait abnormalities and pain.
Leg length discrepancies occur in a large percent of the population. Although they do not always lead to problems, any discrepancy needs to be taken into consideration when undergoing assessment for postural anomaly and foot pathology. Interestingly a leg length discrepancy is a common cause of running injuries.
There are generally two kinds of leg length discrepancies:
Structural (actual) discrepancy occurs when:
- Either the upper (femur) or lower (tibia) bone in one leg is actually shorter than that of the other leg.
- Structural discrepancies can result from a growth plate injury during childhood or adolescence, fractures or genetic and acquired conditions that affect bone growth. Some fractures can lead to overgrowth of bone during the healing process, resulting in longer than normal bone.
- Surgical procedures such as knee or hip replacement can result in a leg length discrepancy.
Functional discrepancy usually occurs as a result of:
- Muscular weakness or inflexibility, at the pelvis or foot and ankle.
- Over a number of years, one side of the spine, and muscle structure supporting it, may develop more strongly than the other. Overuse of one side such as sleeping or carrying items on one side; or lifting suitcases or carrying children to one side
- It may be the result of a scoliosis and pelvic tilt.
Healthy feet provide the foundations for a healthy body and an active life!
Dr Peter Shelton BSc Hons. Accredited Podiatrist.