Limb Length Difference

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What Is A Limb Length Difference?

A leg length discrepancy (LLD) refers to a difference in the length of the legs, from the hip bone to the feet. Small variations in leg length (ranging from 0.1mm to 0.5mm) are quite common and may not cause any issues. However, when the discrepancy is more significant (>0.5mm), it can affect a person’s gait (the way they walk), lead to pain or complications, and potentially impact their quality of life. Limb Length Difference

Whats Causes A Limb Length Difference?

The cause of a leg length discrepancy (LLD) can vary, and the first step is to determine whether the LLD is functional or structural.

Functional LLD occurs due to differences in the biomechanics of the feet, which causes a perceived leg length difference when standing. However, when lying down, the legs may appear the same length. An example of this is posterior tibial tendon dysfunction, where the tendon in one foot is affected, causing one foot to be flatter than the other.

Structural LLD refers to a physical difference in the length of the bones, typically the tibia or femur. This type of discrepancy can be measured both while standing and lying down.

In recent years, many individuals have benefited from joint replacement surgery, particularly for knee or hip joints damaged by degenerative osteoarthritis, trauma, or infection. While this surgery often brings life-changing benefits, it can sometimes result in an LLD due to size differences between the prosthetic joint and the natural joint. Despite efforts to maintain the leg length, there is no guarantee of perfect alignment due to the precise positioning of the new joint

Symptoms Of A Limb Length Difference

Not all leg length discrepancies (LLD) cause symptoms, but when they do, they may include:

Lower back pain, particularly when standing for extended periods (functional scoliosis)
Hip pain
Scuffing of one foot or tripping frequently
Bending one knee while standing to find comfort
Soreness in the arch or ankle
Raising the hip to try to clear the ground
Shorter steps with the affected leg
Slower walking speed
Uneven distribution of pressure and load between the legs
Stress fractures
Muscular strain and tendinopathies
Knee pain

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Diagnosing & Treating Limb Length Difference

A leg length discrepancy can often be identified by a trained eye. The podiatrists at Priority Podiatry Clinic are skilled in assessing this condition and will evaluate you both standing and lying flat. By comparing these assessments with your symptoms and biomechanical information, we can determine if a discrepancy exists and whether treatment is necessary.

If treatment is needed, it typically involves addressing the leg length difference with an in-shoe raise or custom-made foot orthotics. These treatments can often provide immediate correction of gait issues and help alleviate muscle or tendon overuse injuries, promoting healing.

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