Uneven leg length is quite common, and often a few millimeters is not going to cause major problem, and probably will go unnoticed. However, for some even a small limb length difference can cause problems in the hips, back and neck, which is why it is important to have your legs measured if you are struggling with these problems.
At Lindsey Ebbs Podiatry we will often check for the possibility of a limb length difference as part of our MSK/Biomechanical Assessment.
In addition to this, we have to work out if it’s a True limb length (Anatomical) difference or what we refer to as an Apparent limb length (Functional) difference.
A true limb length difference means the actual bones in the lower leg, when measured, are different lengths. Whereas an apparent limb length difference means the bones in the legs are the same length, however when you stand it looks like one leg is shorter than the other, and the hips look visually uneven.
An apparent limb length difference is normally caused by muscles tightness in the lower back. This muscular tightness pulls the pelvis upwards, making the hip level look uneven when you stand.
The good news is this can be helped over a period of time by stretching the tight muscles. A podiatrists will also investigate why it occurred in the first place and will give you exercises to help prevent it happening again.
Here’s what we use in clinic;
A best way, is to manually measure the right and left legs by selecting a particular point in the front of the pelvis, and a second point on the inside of the ankle bone.
This method will give a more accurate guide as to determining if there is a true limb length difference exists. If they measure the same length, but visually your hips look uneven, then we can confidently say that you have an apparent limb length difference.
Here’s where our skill as podiatrists comes into play and what sets us apart from every other health profession. A patient can have both, meaning the legs can be different lengths and there can also be muscle tightness in the lower back.
If a true limb length problem is identified, a simple heel lift can be made, to the appropriate height requirement, and placed within the shoe.
A heel lift, can easily be made on the spot during a consultation, or the heel lift can be added to an existing orthotic insole device. We tend to increase the heel lift incrementally as too much too soon can also cause a problem. Heel lifts greater than 10mm may need to be added to the outside of the shoe as well, by a cobbler or an orthotist
If you have an apparent (functional) limb length difference, long-term use of heel lifts is not a good idea as it can lead to further muscular problems in the back.
If you’ve had ongoing hip and back problems that have not responded to other treatments, please consider seeing a podiatrist to see if a limb length difference is the problem?
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