Difference in Leg Length
Difference in Leg Length Treatment
Most patients have been told by a chiropractor, trainer or physical therapist about an apparent difference in leg length, which could cause some issues in their performance. People have asked me about how can I, or anyone else, help correct this issue other than with an shoe insert. To answer this question we have to dive into what is the true cause of a difference in leg length.
It is important to understand there are only 2 ways the body can have a difference in leg length, just as with scoliosis:
- Functional
- Structural
Which one you have will dictate which type of treatment would be correct for you.
What is a Structural (i.e. Anatomical) Leg Length Discrepancy?
This is where the bones of the body are actually shorter on one side than the other. It can occur at birth, but also with trauma, pathology or surgery.
What is a Functional Leg Length Discrepancy?
This is when a leg length changes based upon the body position. It is dynamic and is more so from dysfunction, weakness, and flexibility issues rooting in the soft tissues of the body.
Regardless of the reason for the difference in leg length it may not have an effect whatsoever on the way you feel. In 2005, a research article in Chiropractic & Osteopathy states any differences less than 20mm are not a likely cause of symptoms requiring treatment. This study based its conclusion on the structural variety, which 9% of the population have (averaging 5.2mm). (Knutson, 2005)
So how come most people have been told their Difference in Leg Length is the root cause of their body’s aches and pain?
I can’t speak for the other camp, but I for one believe the body has the unique ability to adapt to the conditions it has been given. If you stand on a flight of steps with each foot on different steps, you will not fall over and the only reason is because the body will shift to keep you upright.
Dynamic, or functional, a difference in leg length occurs from muscles being too tight and too weak. Here is a short list of a few muscles attaching to the femur and the pelvis, which can alter length of the leg.
Quadratus Lumborum
Psoas
Iliacus
Gluteus Maximus
Gluteus Medius
And the list goes on….
Recommendations for a Difference in Leg Length:
If you have been told you have a difference in leg length and been fit for a heel lift without confirmation the issue is 100%, without a doubt, a structural issue, I would seek a second opinion. Without correction of muscular issues which maybe causing a difference in leg length, the issue will only become set in stone. Muscle memory occurs over time and the tissue can be more resistant to change as time goes on.
Treatments for Difference in Leg Length:
- Structural difference in leg length
- Heel lift
- Functional difference in leg length
- Soft tissue mobilization
- Joint Mobilizations
- Stretching
- Strengthening
References:
Knutson, G. (2005). Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. part i, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance. Chiropractic & Osteopathy, 13(11), Retrieved from http://chiromt.com/content/13/1/11
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