“One of my legs is longer than the other!”
As one of the most frequent comments I hear from clients (second only to “I have a very high tolerance to pain”), I’m here to reassure you. Most people “look” like they may have a leg length discrepancy, but VERY few actually do.
The most frequent cause of one leg appearing to be longer than the other is pelvic asymmetry. When the pelvis is rotated it changes the orientation or angle of the hip socket. This little change in orientation affects everything below it (and a lot of things above it too).
For instance, if the left half of your pelvis rotates and tips forward, the left hip socket faces more forward. The femur/ thigh bone has to rotate out in order to keep the foot facing forward. This rotation glides the femur in the socket forward and can make it appear shorter. However, sometimes it can actually appear longer due to overly stretch ligaments in the front of the hip socket.
Left forwardly rotated pelvis: Neutral pelvis:
Left leg appears shorter Leg length is equal
There are a few cases that make me suspicious of a true leg length discrepancy that may need correcting for:
1) A total joint replacement or similar type of surgery
2) Genetic growth disorders/conditions
To figure out for sure if you have a leg length discrepancy, one needs an x-ray so the actual bone can be measured and compared to the other side. Keep in mind that fewer than 0.08% of people have an actual leg length discrepancy.
Many times this is corrected using a heel lift. However, I discourage the use of heel lifts because it does not lift the whole foot, only the heel. If you only lift the heel you are starting to change the mechanics of how that ankle moves. Its like wearing a slightly higher heel on one foot vs. the other, and who wants to do that? Instead I promote the whole foot being elevated. If it is a small degree of difference this can be accomplished with a shoe lift an insert for the inside of the shoe. If it is a greater degree of difference the shoe itself should be adjusted by the appropriate amount by your local shoe repairman. Talk to your therapist to figure out the right amount of adjustment.
If that is not you, rest assured, all you need is some help with that pelvic rotation!
Traditional custom orthotics are rigid, made of hard plastic and are designed to force the foot into one "ideal" position. But our feet are made to move and adapt to the ground. Rigid orthotics do not keep this in mind, nor do they respect the neurological system's response to a hard, often painful piece of plastic under the foot. When a rigid, unforgiving arch support is placed under the foot the foot often starts to pull away from it because it is painful. Overtime this response can result in the person weight bearing more on the outside of the foot rather than through the center of the foot.
Developed by Dr. Coffin, D.P.M. and Ron Hruska, M.P.T., Postural Restoration® orthotics are designed to work with your foot mechanics and your neurological system to gain the perfect balance of foot stability and mobility. They are non-compressible, flexible orthotics that are uniquely matched to the patient's structure, gait and activities. They not only affect the feet but will help align the knees, hips and back to decrease tension, torque and compression. They are best utilized when combining with Postural Restoration® therapies.
Shoe Shopping Rules:
If you wear orthotics:
Sarah’s Approval Shoe Tests:
Doctor of Physical Therapy