So what should you do if you think you might have a leg length discrepancy (LLD)?  Remember that there are two types of LLDs (read Lopsided Legs Part 2 for more details): functional LLDs and structural LLDs. First of all, see someone who can diagnose it for you. Keep in mind that only doctors are qualified to diagnose medical conditions. Other allied health professionals (such as trainers, therapists and pedorthists) can just assess what they observe; taking into account your symptoms and performance. If you have been assessed as possibly having an LLD, you might want to bring this information to your doctor just to have them verify it with an official diagnosis.

For treatment purposes, there are only a few options for lessening the effect of an LLD. Except for the following examples, LLDs are not corrected – they are just dealt with in such a way as to reduce your symptoms.

–          If you have a functional LLD that stems from a misalignment of your hips, this can possibly be lessened with chiropractic adjustments.

OR

–           If you have a very severe structural LLD stemming from a birth defect, traumatic accident or past surgery, the bones in your shorter leg can be surgically extended with the use of titanium rods. As you can probably guess, this is a very invasive procedure and it not performed under normal circumstances.

Other types of LLDs have to be compensated for at the ground level. In other words, you can’t make the leg stretch longer so instead you have to build up the “floor” under your shorter foot.

Here is an analogy for you: in the famous movie Casablanca, Humphrey Bogart was significantly shorter than his co -star Ingrid Bergman.   In order to make up the difference, Bogart wore platform shoes during filming. (Source)

This is exactly what needs to be done for your legs: the shorter one has to be built up so that it will not be at a disadvantage to its “co-star”

If you have an LLD of less than ½”, it is relatively easy to build a lift into the inside of your shoe. The most effective way to do this is to have a pair custom orthotics molded to fit your feet. The orthotics will provide support to the arches of your foot (which may correct some of the problem, since it is possible for a foot with a collapsed arch to effectively shorten your leg). An appropriately sized lift can then be glued directly to the bottom of the orthotics; this allows you to swap your orthotics into many different pairs of shoes.

Here comes the tricky part: lots of types of medical professionals make orthotics, and not all orthotics are created equal. (But that is the subject for another blog, read this for just a taste of the controversy)…all you need to know for now is that whoever fits you with a pair of orthotics should Watch you walk both with the orthotics and without them, they should also be able to make modifications and changes to the orthotics based on what they observe about your gait.

If you have an LLD that is more than ½”, any lifts that you get will probably be put onto the outside of your shoe. Do yourself a favor and save some money by going directly to a cobbler once you find out how much lift you need. Cobblers are usually highly skilled at making adaptations to shoes and they can often do it at much a cheaper rate than an orthotist or pedorthist. However, keep in mind that cobblers are craftspeople – not medical professionals, so you should take your newly modified shoes to someone who understands the human body and can evaluate your gait. This person could be a therapist, chiropractor, physician, trainer or pedorthist.

Once your short leg has been “lengthened” with a lift, your body will feel much more balanced. You should be able to notice a reduction in your symptoms right away. Remember to have your LLD re-evaluated every year or so because as your body ages it can “settle” just like the foundation of a house. It is important to be in tune with these variations so that any issues that crop up can be corrected right away. Small problems often escalate easily and keep us from engaging in the active lifestyles that are key to enjoying good health.

Walk Well.

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