DOES IT LOOK OR FEEL AS IF ONE LEG IS LONGER THAN THE OTHER?

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If this is indeed you, the most important thing to establish is whether the leg length discrepancy is structural or functional in nature.

Treatment simply cannot resume before the origin of the discrepancy has been established. Basic measurement with a measuring tape is a helpful tool to indicate whether there is a significant leg length difference and whether an X-ray is necessary. An X-ray is the only definitive and diagnostic way to truly measure a leg discrepancy.

STRUCTURAL LEG LENGTH DISCREPANCY implies a physically longer/shorter leg on the one side. This can be quite common post fracture or surgery, especially if the patient was still growing at the time. Hip and knee replacements can also cause this presentation. The important thing to note is that up to 80 percent of the population has a slight structural leg length discrepancy of less than 5mm. A difference of less than a 5mm margin is usually deemed negligible and in most cases WILL NOT WARRANT INSOLES OR HEEL LIFTS.

FUNCTIONAL LEG LENGTH DISCREPANCY implies that there is no (or only marginal) physical difference between leg lengths despite the one leg presenting notably longer. This occurs due to a dipping or a twisting of the pelvis on one side, causing a longer leg presentation. The patient may complain that ‘they look skew in the mirror’,’keep tripping over one foot,’ or ‘feel the need to hike one leg while walking.’ Lying these patients on their backs with legs totally extended and comparing the medial malleoli of the ankles, will often reveal a longer leg on one side. As mentioned, this is not necessarily physically or structurally so, hence, a functional difference.

Functional leg length discrepancies can be caused by a myriad of reasons including:
•Bad habits causing pelvic torsion or twisting of the pelvis such as :
Sitting with the legs crossed,
Standing with all the weight continually on one leg,
Continually sitting on an uneven surface, such as a wallet in the back pocket.
•Incorrect sporting/working actions favouring one side resulting in muscles being stronger around one side of the pelvis.
•Weakness/Inflexibility of the muscles around one side of the pelvis.
•Lumbar spine or sacro-iliac joint dysfunction resulting from bad posture/injury.
•Lumbar spine scoliosis.
•Foot problems such as excessive pronation on one side etc.

Thankfully Chiropractic specializes in identifying , diagnosing and treating the ROOT CAUSE OF THE PROBLEM. Your Chiropractor will go about restoring normal joint function , balancing uneven muscle strength/flexibility and correcting all actions potentially causing the problem. Prescribed exercises and home advice are vital for maintaining the treatment effect.

Every individual case is taken according to its merit -even in patients with significant leg length (over 5ml ) differences. However, if any patient does not show sustainable symptomatic progress or keeps relapsing despite corrective treatment -then it may be time for foot orthotic referral! This involves a slightly raised insole on the short leg side, it is extremely comfortable and the difference is often immediately notable. Larger structural differences over 10 ml are often referred immediately, especially in athletes.

So don’t panic if you suspect one leg to be longer than the other -odds are that it is a functional discrepancy and absolutely treatable! Written by Dr. E GREYLING