Sean FitzGerald | Special to the Fitzhugh
Got one leg longer than the other? Have you wondered if a Leg Length Discrepancy (LLD) is something you should worry about? We get this question at least a few times a month from our patients, so here are some facts about leg length:
First off, the vast majority of LLDs are minor and guess what? Our bodies are asymmetrical and it's OK. Ninety-five per cent of people have an average leg length discrepancy of about five millimetres. Research examining pain and dysfunction indicates that unless LLD is one centimetre or longer it should be ignored as it is an unlikely source of pain or dysfunction.
You can have an anatomical or structural cause to your asymmetry due to surgery, congenital deformity, growth plate fractures etc. Or you can have a functional cause due to muscle imbalances, or other minor issues. It is important to note that an anatomical cause is unchangeable. As for functional causes of LLD the big question is, “Do we need to change it?”
Studies conducted on LLDs and how they can affect those that have a difference greater than one centimetre show widely varying results. Some studies show issues more prevalent with the longer leg and others show a higher prevalence with the shorter leg. There was even a study which introduced a three-centimetre LLD in healthy patients and found a wide variety of adaptations to the new biomechanics, but there was no increase in pain as they adapted to the change. Our bodies are phenomenally adaptable to change, and most of us do just fine with our small asymmetries.
So, what to do if you have a LLD greater than one centimetre? Treatment can be as simple as using a $20 heel lift to correct the deficiency. If the LLD is less than approximately one centimetre, don’t sweat it, as mentioned earlier our bodies are designed to adapt to minor asymmetries. LLDs are not a reason to spend your hard-earned cash on continuous treatments, or searching Google or YouTube or anything else in search of a “fix.”
Trust your body and its ability to withstand minor asymmetry and adapt to change. Chances are if you have back, hip or knee pain, your pain is coming from some other cause than your LLD. If you feel it's a major issue, you can see a physiotherapist for an assessment, find out whether your LLD is "functional" (usually muscular) or "true" (bony) and potentially invest in an inexpensive heel lift. Physiotherapy can also help to assess and treat underlying causes of musculoskeletal pain that you may have attributed to your LLD until now.
Sean FitzGerald is the owner of Jasper Physiotherapy & Health Centre.
