Leg length discrepancy (LLD) is where one leg is shorter than the other. This inequality can be structural, meaning the actual bones are different lengths or functional, where there may be a pelvic tilt or other factors causing the appearance of uneven leg lengths.

Woman with leg length discrepancy holding her leg.

Causes of Leg Length Discrepancy

There are many reasons why one leg can be longer or shorter than the other leg. Problems can include birth defects, posture issues, degenerative issues, and surgical errors. Some of these problems can be corrected. Others may represent a longer road.

Some possible causes can include the following:

  1. Developmental Factors: Some people are born with a structural difference in leg length. This can be due to genetics or abnormal development in the womb.
  2. Posture and Muscular Imbalances: Poor posture, muscle weakness or imbalances, and habits like standing or sitting with uneven weight distribution can contribute to functional leg length discrepancies.
  3. Injuries or Surgeries: Fractures, dislocations, or surgical procedures involving the legs or pelvis can sometimes lead to a difference in leg lengths.
  4. Degenerative Conditions: Conditions like arthritis or joint degeneration can change the length of bones over time.

Symptoms of Leg Length Discrepancy

  1. Pain and Discomfort: LLD can lead to pain in the lower back, hips, knees, or feet. The longer leg may experience more stress, and the shorter leg may experience compensatory strain.
  2. Gait Abnormalities: Individuals with LLD may have an altered walking pattern. This can include limping, a noticeable lean, or an uneven stride.
  3. Muscle Fatigue: Muscles on one side of the body may have to work harder to compensate for the length discrepancy. This can lead to fatigue or muscle imbalances.
  4. Joint Problems: Over time, LLD can potentially lead to joint issues like osteoarthritis due to abnormal stress on joints.

Treatment Options

The most common treatment for LLD is using shoe lifts or orthotic inserts. These are specially designed to even out leg lengths and provide better balance. A patient is often directed to a pedorthist or foot specialist who can specially measure the foot and help design an insert or lift that will even the two legs.

However, if a person has ignored the problem too long, more intensive interventions may be required. These can include the following:

Shoe lifts for a person with leg length discrepency.
Shoe lifts are a common way to handle LLD.
  1. Physical Therapy: Therapeutic exercises can help strengthen muscles and improve flexibility to compensate for the leg length difference. Patients may need to see a physical therapist if they get shoe inserts or a shoe lift. Their muscles may have been weakened from years of overcompensating for misaligned legs. A physical therapist may also need to address issues in other body regions, like the back or core.
  2. Surgical Intervention: In severe cases, surgery may be recommended. This could involve lengthening the shorter leg, shortening the longer leg, or combining both. This isn’t a simple solution. It may require physical therapy to regain movement and walking ability.
  3. Monitoring and Management: Regular follow-ups with a healthcare provider are essential to monitor any changes in leg length and adjust treatment plans accordingly.

It’s important to note that not all leg length discrepancies require treatment. The approach depends on the degree of discrepancy, the underlying cause, and how it affects an individual’s quality of life. If you suspect you have a leg length discrepancy, it’s crucial to consult a healthcare professional for an accurate diagnosis and appropriate management plan. They can provide tailored advice based on your specific situation.

Additional Resources