Health & Wellness
June 19, 2024

Leg Length Discrepancy: Causes, Symptoms & Care

by
ATLAS Team
legs of people both sitting and standing inside a train

Leg Length Discrepancy (LLD) is an often overlooked condition even though it affects many people. According to recent statistics by the Canadian Chiropractic Association, LLD affects about 60-90% of the population, with varying degrees of severity. While some people may not  be aware of their LLD, others may experience pain, discomfort, or mobility issues. Various factors, including genetics, trauma, infections, or developmental disorders, can cause leg length discrepancies. 

In this blog, we will explore the causes, symptoms, diagnosis, care options for leg length discrepancy, and some practical tips to manage this condition and improve your quality of life.

What is Leg Length Discrepancy? 

It’s a common condition in which one leg is longer or shorter than the other, either structurally or functionally. The difference in length can occur at any point from the hip down to the ankle and can range from a few millimetres to several centimetres. While some people may have no symptoms or issues, others may experience back pain, hip pain, knee pain and foot problems. The causes of leg length discrepancy vary, ranging from developmental issues to trauma and medical conditions. It can affect anyone regardless of age, gender or fitness level. 

What Are The 3 Types of Leg Length Discrepancy? 

1. Structural Leg Length Discrepancy 

Structural leg length discrepancy occurs when there is a physical difference in the length of the bones in the legs. This can happen for various reasons, such as congenital disabilities, injuries, or surgery. Structural LLD can interfere with activities such as walking or standing, as the shorter leg may bear more weight and lead to pain and discomfort. 

2. Functional Leg Length Discrepancy

Functional leg length discrepancy is a type of LLD where there is a difference in alignment of the pelvis or spine, leading to one leg appearing shorter. Muscular or skeletal imbalances, poor posture, or uneven weight distribution on the legs can cause this. Unlike structural LLD, there is no physical difference in the length of the bones in functional leg length discrepancy. Without effective care, functional LLD can lead to leg pain, discomfort and problems with mobility. 

3. Apparent Leg Length Discrepancy

Apparent leg length discrepancy is seen in the differences in posture or how someone stands or walks. This can make one leg appear shorter than the other, even though the bones in both legs are the same length. Apparent LLD can be caused by scoliosis, muscle weakness or uneven weight distribution on the legs. 

Symptoms of Leg Length Discrepancy

Leg length discrepancy can cause various symptoms, depending on the severity of the condition. Common symptoms include an uneven gait, limping, hip or back pain, knee pain, foot pain, and muscle fatigue. Individuals with LLD may also experience numbness or tingling in the legs and a decreased range of motion. 

Children with leg length discrepancy may have difficulty keeping up with physical activities or avoid sports due to pain and discomfort. In severe cases, leg length discrepancy can lead to scoliosis or other spinal deformities, further exacerbating the symptoms. If you are experiencing any of these symptoms, seeing a healthcare professional for proper diagnosis and treatment is essential.

4 Causes of Leg Length Discrepancy

1. Congenital Conditions 

Some individuals are born with a difference in leg length due to a congenital condition, such as hemihypertrophy or skeletal dysplasia. These conditions can affect the growth and development of the bones and result in one leg being shorter than the other.

2. Growth Disorders 

Growth disorders, such as achondroplasia or Marfan syndrome, can also cause leg length discrepancy. These conditions can affect the growth of the bones and cause one leg to grow more slowly than the other, resulting in a difference in leg length.

3. Injuries 

Injuries to the bones or joints can also cause leg length discrepancy. For example, a broken leg or hip can cause the affected leg to be shorter than the other due to the bone healing process.

4. Surgical Procedures 

Some surgical procedures, such as hip or knee replacement, can cause leg length discrepancies. This can occur if the surgeon does not correctly align the replacement joint, resulting in a difference in leg length.

Care for Leg Length Discrepancy 

Caring for leg length discrepancy involves various methods to correct or manage the condition, depending on the type and severity of LLD. Here are 5 ways to alleviate pain and discomfort, improve mobility, and prevent complications from leg length discrepancy. 

1. Shoe Lifts

Shoe lifts are one of the non-surgical treatment options for leg length discrepancy. They are designed to compensate for the difference in leg length by adding extra height to the shoe's sole on the shorter leg. This helps balance the legs and redistribute weight more evenly, reducing pain and discomfort associated with LLD. Shoe lifts come in different sizes and materials and can be customised to fit each individual's needs. They are easy to use and can be worn in most shoes. However, consulting with a healthcare professional before using shoe lifts is essential, as they may only be suitable for some and require adjustment over time. 

2. Surgery 

In cases of severe structural leg length discrepancy, surgery may be recommended. Surgery aims to equalise the length of the legs by shortening the longer leg or lengthening the shorter leg. Surgery can involve techniques such as bone cutting, bone grafting, or an external fixation device. While surgery can effectively correct LLD, it also carries risks and requires a lengthy recovery period.

3. Physical Therapy 

Physical therapy is a non-invasive treatment option for leg length discrepancy. It involves a range of exercises and techniques designed to improve muscle strength, flexibility, and range of motion. Physical therapy can help correct muscle imbalances and improve posture, reducing the symptoms associated with LLD.

4. Bracing

Bracing is another non-surgical option for correcting LLD. It involves using orthotic devices, such as shoe inserts or leg braces, to correct the difference in leg length. Bracing can be effective in managing LLD and preventing further complications, but it may not be suitable for all individuals.

5. Chiropractic Care

Chiropractic care involves spinal adjustments and manual therapies to improve spinal alignment and balance out the legs. Chiropractic care can be helpful in cases of functional leg length discrepancy, which is caused by muscular or skeletal imbalances rather than physical differences in leg length. Chiropractic care can also help manage pain and improve mobility in individuals with LLD.

Managing Leg Discrepancy is Possible with Proper Diagnosis and Care

With the help of medical professionals and chiropractors, individuals with leg discrepancies can find the best treatment path tailored to their needs. This often includes leg length discrepancy exercises, strengthening and stretching, assistive devices, bracing, and in some cases, surgery. With the correct diagnosis and care, individuals can manage their leg discrepancy and improve their mobility and quality of life.


References

  1. Chisari, E., Reish, M., & Damiano, N. (2020). Leg Length Discrepancy: A Review of Causes, Evaluation, and Management. Journal of paediatric orthopaedics, 40(1), e1-e5.
  2. El-Sayed, M. M., & El-Sayed, S. S. (2018). Leg length discrepancy: clinical implications for assessment and intervention in patients with low back pain. Journal of pain research, 11, 463.
  3. Paley, D. (2018). Principles of deformity correction. Springer.
  4. Sabharwal, S. (2008). Methods for assessing leg length discrepancy. Clinical orthopaedics and related research, 466(12), 2910-2922.
  5. Sabharwal, S., & Kumar, A. (2013). Methods for assessing leg length discrepancy. Clinical orthopaedics and related research, 471(4), 994-1002.
  6. Schoenecker, P. L., Cole, H. O., & Herring, J. A. (2017). Leg Length Discrepancy. The Journal of Bone and Joint Surgery-American Volume, 99(17), 1496-1510.
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