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Leg length discrepancies

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Are your legs the same length?

The truth is probably not, but for most of us, it doesn’t really matter. It is likely that most people have small variations in leg length and indeed in foot length between the left and right sides. Our bodies though, are very good at compensating for this, especially if the differences have been there since birth.

If you feel like you are “not level” or that one leg is “longer than the other”, there are usually several reasons.

True differences in leg length are either congenital (you were born with it), in which case you have likely lived with it and/or known about it your whole life, or they are acquired (usually due to an injury or infection to the bones when you were growing or surgery such as a hip replacement).

These are examples of true leg length differences however, many people also present in clinic with functional leg length differences. These are when the legs feel or even look to be different lengths, however the problem is actually due to something such as a pelvic or back problem or a foot problem, causing your legs to feel or appear uneven in length.

True and functional leg length differences can cause pain anywhere in the body from knee pain to hip pain and back, neck and shoulder symptoms too.

When to see a Podiatrist?

A podiatrist is able to test leg length through several methods. Measurement with a tape measure can be helpful but the accuracy is dubious. A “supine to long sit” test can be useful and can also help distinguish if the difference is true or functional. Ultimately, having both legs x-rayed may be the only truly accurate way to be sure of leg length, however this is not always practical or safe to do.

If there is a true leg length difference that is causing a problem, a podiatrist may provide a heel raise or foot orthotic, or may recommend footwear modifications if the difference is too great to be added inside your shoe.

Having shoes that are deep with supportive soles and fastenings such as lace or Velcro, will enable your podiatrist to offer you more of a raise in the shoe than if you only have slip on or lower backed footwear.

If the leg length difference is functional, then input from other professionals such as physiotherapists may be required.

If you have had hip surgery, it is generally a good idea to get a podiatrist to assess you after you have recovered and check for any asymmetry or knock on effects from the surgery.

If you book an appointment, it is wise to take the footwear that you wear day to day to help with the assessment and any treatment options.

Limb length inequality