In this case there is a discrepancy in length between the two legs. Leg length discrepancies (LLD) exist in most people, although they may be undetected and symptom free.
One can have a Structural LLD, or a Functional LLD.
Structural v functional leg length discrepancy
Structural is a fixed LLD, functional means apparent – it is not a real LLD.
A difference in the legs may manifest in a variety of symptoms that, if it is undetected, may mean chronic unresolved back, neck, knee or foot pain.
Leg length discrepancies can arise for a variety of reasons.
- Congenital LLD, caused by intra-uterine pressures on the developing foetus.
- Birth injuries during delivery.
- Osteochondritis – growth plate injuries in the hip joint called Perthes Disease in children.
- Injury, as in accidents.
- Surgery to legs – fractures can lead to shortening.
- Muscle imbalances, common in sports that are one sided, can lead to over-development of muscles on one side.
- Muscle spasm can cause a temporary discrepancy.
- Scoliosis can lead to an apparent discrepancy, due to spinal curvature.
Does leg length deficiency, or ‘short leg’, need to be treated?
The body has the ability to compensate and absorb a certain amount of LLD. It is possible that up to 1.5cm may be absorbable. I think each case must be taken on its merits, symptoms and activity.
There are various ways of examining LLD. The most accurate way is full length X-ray, but this is expensive, and involves high radiation exposure.
Measuring from the Anterior Superior Illiac Spines to the Medial Malleolus, basically from the hip crest bones to the inside ankle bones, can show LLD.
Measuring from the belly button to the medial malleolus can also show LLD.
Sometimes the Sacro Illiac joint is out of alignment, and this can give an apparent LLD.
Treatment for short leg
Treatment involves determining the injury sites and location.
- An assessment of the LLD.
- Biomechanical assessment to determine foot involvement as one foot may pronate more than the other.
- Heel lifts for the short side, shoe adjustments for structural LLD.
- Stretching and correction of muscle imbalances utilising a biokineticist opinion.
- Chiropractic adjustments can be useful where a functional LLD exists.