leg length – Perform Podiatry

We’ve all heard how most of us have one foot that is slightly longer than the other. It may be an unnoticeable difference, or it may be half a shoe size – or more. Well, the same goes for the length of our legs! Whether it’s our femur (thigh bone), our tibia (shin bone), or tight muscles that are causing an apparent shorter leg when we walk, many of us will have a shorter leg and not even know about it. But what does this mean? And will it cause any symptoms or pain? Today, the Perform Podiatry team are talking all about how leg length differences can cause a great deal of pain without you even knowing what is going wrong.

How limb length differences cause you pain

Picture yourself standing straight with one leg being longer than the other. The short leg will be completely straight, and the longer leg will have to bend slightly to compensate for the difference. Your pelvis will be tilted, and the stabilising muscles and ligaments around your hips and pelvis will eventually get used to this tilted position and adjust accordingly. The muscles and alignment of your back will be affected, and the way that you walk will be affected. The longer left leg will have to perform a compensatory movement when it straightens to avoid hitting down into the ground as you walk. You may hike your hip upwards or move the leg out and around as you swing through your step. As your body compensates and starts moving and using muscles differently, your risk for straining and overloading muscles and joints increases. For those whose leg length differences are big enough to cause symptoms, they may experience:

Hip pain
Back pain
Knee pain
Muscular strain and tendinopathies
Uneven loading and pressure distribution between the legs

How big does the difference need to be to cause pain?

There is no universal value for how many millimetres of difference causes you pain. It varies from person to person and depends on your body, too. In our clinic, when we suspect a limb length difference because a patient has come to us with pain, we usually measure a difference of at least ~6mm. With this said, we’ve also seen patients with a 6mm that don’t experience any symptoms. To confirm that you have a limb length difference, after identifying a notable difference in our clinic (we wouldn’t classify anything less than 3-4mm as ‘notable’), we then refer you for a scan where your bone lengths will be measured radiographically. You’ll receive the precise difference in limb length, and this will help to direct your treatment.

What can be done to help painful leg length differences?

Treating a leg length difference includes both helping to correct the difference, and treating any problems that it has already caused. We start with a comprehensive biomechanical assessment to find out exactly what muscles have been affected so that we know how to best direct your treatment. We often use custom-prescribed orthotics to help correct the difference by adding a raise to the orthotic for the shorter leg. This helps to equalise the leg length when wearing the orthotics and bring the pelvis and joints back into alignment. We can also make modifications to your shoes to add height to the shoe on the shorter leg. We’ll then work to help rehabilitate any painful and strained muscles that have become damaged because of the leg length difference. Our goal is to help you stay healthy, happy and pain-free not just now but also for the years to come. To book an appointment with one of our experienced Podiatrist, you can call us on 09 523 2333 or book online here. We’re located at the One Health building on Remuera Road, just up from Broadway, Newmarket.

A lot of us have heard that it’s not uncommon to have a slight difference in the size of our feet or even legs. We often advise patients to buy shoes to the size of the larger foot so that toes don’t get cramped and cause pain. But when it comes to having a slight difference in the length of the legs, does it make any difference or have any effect on the body? Let’s start with the basics about limb length discrepancies.

What effect does a leg length difference have on a person?

For some, having a small difference in leg length won’t cause any problems, and they may not even be aware of the problem. For others, it can cause painful symptoms, alter their gait pattern (the way they walk), contribute to the development of other complications and negatively impact their quality of life. The extent of the effect largely depends on the measurable difference between the two legs and how the body is functioning (or not functioning) to compensate for the difference.

What causes a difference in leg length?

Differences may be caused by:

Growth abnormalities
Bone injury that results in healing in a shortened position (like a break or a fracture)
Damage to the growth plate during childhood
Bone disease and infection
Neurological conditions
Inflammatory conditions affecting the joints (like arthritis)
Abnormal foot biomechanics
Tightness and contractures of tissues
Ligament laxity and weakness

You’ll notice that some of the above are talking only about muscles and tissues and not the bones – don’t worry, we haven’t made a mistake! This is because differences in leg lengths can have either a structural or a functional cause. Structural differences describe a difference in the bone length of the thigh bone or the shin bone. This can result in a tilt of the hips and affect various joints and bones throughout the feet and legs, as well as the spine. Functional differences describe an observed length difference when standing because of biomechanical issues involving the way the muscles, connective tissues and jones function together. These occur even if the bone length of the shin bone and thigh none are identical. This is often due to muscular contracture, particularly at the hips, as well as ligament laxity or tendon dysfunction that affects one foot more than the other.

What are the symptoms?

Symptoms can vary greatly depending on the extent of the difference and the resulting misalignment of the lower limbs. This position of the bones, joints, muscles and connective tissues will determine what structures are overloaded, stressed, stretched and limited in the way they move. Because of this, it is difficult to pinpoint precise symptoms, but may include:

Altered gait pattern such as limping
Shorter steps on the affected leg
Slower walking speed
Uneven loading and pressure distribution between the legs
Stress fractures
Muscular strain and tendinopathies
Hip pain
Knee pain
Back pain

What should you do?

The first step is to get your leg length difference professionally assessed by your Podiatrist. We measure both structural and functional differences and ensure to get to the root of the problem and can address any factors playing a role in the difference to get the best results for you both now and into the future. After determining the presence or absence of a difference and its extent, we’ll be able to formulate the best treatment plan for you, your age, your symptoms and the risk of future problems. This may include: Orthotics to help correct any functional abnormalities and help bring the limbs into alignment with one another Footwear modification, such as building up one shoe to bring the joints of the lower limbs into alignment Stretching and strengthening tight or weakened muscles to help improve biomechanical function If the case that the difference is severe and cannot be managed conservatively, surgical correction may be required – though this is much less common so don’t worry and just start with getting it checked out, so we all know what we’re dealing with. Either way, our expert team at Perform Podiatry will be right alongside you every step of the way! We specialise in clinical biomechanics and restoring great foot function and health. For more information or to book in, give our team a call on 09 523 2333 or visit us at the One Health building in Remuera, just up from Broadway, Newmarket.

Tag: leg length

What Having One ‘Slightly Shorter Leg’ Really Means For Your Body – And Pain