We had just gotten some fancy new walking analysis equipment, and set aside a work day to get up to speed on it. A colleague was called up to volunteer for a demonstration.
“Do you have any pain or other issues?” the instructor asked
“No.” My coworker walked for a bit using the equipment. No oddities there. We all looked over the results together. “Hmm, well then...” the instructor said with a furrowed brow, “You said you don’t have any leg pain? Because based on your results, it looks like you’ve got a leg length discrepancy.”
I’ll never forget the way my coworker’s face sank after being told this. He was young, fit, athletic, and without any aches or pains to speak of. Yet, those couple of words hit hard; his expression was that of someone that just realized they were inherently broken. For days, he’d continually bring up the topic out of the blue, seemingly unable to get it out of his mind.
This was a few years ago now, and brings me to one of my top 5 rules to live by as a healthcare provider: Do not, under any circumstances, scare the snot out of a person over something that may actually be NOTHING.
People often have this kind of strong reaction when told they have a leg length discrepancy. I think that for many people, this is because leg length discrepancies seem like this big, unfixable problem that will invariably cause issues somewhere down the road, if it hasn’t already.
But the question is…does it?
For all the concern about leg length discrepancies, they are theorized to exist in anywhere from 1/3 to 90% of people. As you can see, statistics are not consistent from one piece of literature to the next, but the major take home here is that they are very, very common!
For all the people who are diagnosed with a leg length discrepancy, there will be many more who go through their entire lives without knowing about it. In fact, many of these people will ultimately not run into any major issues!
At this point, I should mention that not all leg length discrepancies are created alike. Some originate from differences in the length of your leg bones, and/or how your bones fit into your joints. A structural discrepancy could be the result of trauma or surgery (like a hip replacement), but most are simply the result of normal anatomy. Whether it’s your legs or another part of your body, people just aren’t built to be 100% symmetrical. Unless a natural structural leg length discrepancy is very large, most people ‘grow into it.’ It becomes part of that person’s normal.
The other type of leg length discrepancy is a functional one. Here, something regarding muscles or movement patterns causes one leg to effectively be longer than the other. Since something modifiable causes the discrepancy, it should be able to be retrained and improved once the source is determined. Common interventions here may be focused on retraining habits, improving mobility, and training strength.
Beyond this, I will also urge people to consider that if you have a leg length discrepancy and develop an ache or pain, the discrepancy is only one thing to take into consideration. Your problem could still be caused by something completely different!
I say this because I’ve met people in the past who have had back or leg issues with a leg length discrepancy. Because the discrepancy was present, it was immediately ‘fixed’ with a shoe lift. But! Because the discrepancy was not the real cause of the problem, it did not fix anything at all.
What actually ended up happening was that the person would develop new or worse symptoms because they were correcting a discrepancy that their body was perfectly accustomed to dealing with. The shoe lift actually threw their body OFF.
For someone with lower body pain and a leg length discrepancy, a very thorough examination should be conducted to ensure the best results. This ought to include: 1. Getting the whole picture by examining the whole lower body. Before considering leg length as the root cause, other potential problems need to be ruled out. Most people I’ve worked with actually find their solutions at this step!
2. If leg length looks like it may be the problem, get an impression of whether it’s structural or functional. This will help determine the proper treatment methods. If it’s functional, specifically tailored interventions and activities are appropriate to correct it.
3. If it truly seems to be a structural leg length discrepancy that is causing symptoms, a more accommodative solution such as a heel lift or specialized footwear may be appropriate. These should be implemented gradually and monitored to ensure that the wearer is tolerating them well. By using a very detailed examination and treatment approach, I’ve actually found that the need for this is pretty rare.
Are you or someone you care about dealing with leg pain or a leg length discrepancy issue? If so, we would love to hear from you to see how we can help! Give us a call at (239) 232-8155, or send us an email at Contact@SerendipityPTW.com.
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