Every person?s body is unique and will show different symptoms due to a short leg. Athletes are able to distinguish the negative effects of a leg length that is just 3 mm shorter then the other. A whole host of negative effects can occur to the body that can create chronic pain and may necessitate surgical interventions. The effect of a short leg can be seen almost everywhere in the body.
Common causes include bone infection, bone diseases, previous injuries, or broken bones. Other causes may include birth defects, arthritis where there is a loss of articular surface, or neurological conditions.
LLD do not have any pain or discomfort directly associated with the difference of one leg over the other leg. However, LLD will place stress on joints throughout the skeletal structure of the body and create discomfort as a byproduct of the LLD. Just as it is normal for your feet to vary slightly in size, a mild difference in leg length is normal, too. A more pronounced LLD, however, can create abnormalities when walking or running and adversely affect healthy balance and posture. Symptoms include a slight limp. Walking can even become stressful, requiring more effort and energy. Sometimes knee pain, hip pain and lower back pain develop. Foot mechanics are also affected causing a variety of complications in the foot, not the least, over pronating, metatarsalgia, bunions, hammer toes, instep pain, posterior tibial tendonitis, and many more.
Limb length discrepancy can be measured by a physician during a physical examination and through X-rays. Usually, the physician measures the level of the hips when the child is standing barefoot. A series of measured wooden blocks may be placed under the short leg until the hips are level. If the physician believes a more precise measurement is needed, he or she may use X-rays. In growing children, a physician may repeat the physical examination and X-rays every six months to a year to see if the limb length discrepancy has increased or remained unchanged. A limb length discrepancy may be detected on a screening examination for curvature of the spine (scoliosis). But limb length discrepancy does not cause scoliosis.
Non Surgical Treatment
People with uneven leg lengths may be more prone to pain in their back, hips, and knees; uneven gait; and lower leg and foot problems. Due to its risks, surgery is typically not recommended unless the difference is greater than one inch. In cases where the difference is less than one inch, providing the same support for both feet is the most effective. This can be achieved by getting custom-fitted orthotics for both feet. Orthotics are inserts that you wear in the shoes. Your chiropractor will request to measure your feet and possibly your legs. You can step on a device that will take the measurements or you might have a plaster cast of your feet taken. Orthotics are typically made from plastic and leather, and function biomechanically with your foot. If a leg length discrepancy is not properly corrected with orthotics, your chiropractor may recommend a heel lift, also known as a shoe lift. You simply place it in the back of your shoe along with the orthotic. Typically, you will only wear the heel lift in one shoe to assist the shorter leg.
Surgical options in leg length discrepancy treatment include procedures to lengthen the shorter leg, or shorten the longer leg. Your child's physician will choose the safest and most effective method based on the aforementioned factors. No matter the surgical procedure performed, physical therapy will be required after surgery in order to stretch muscles and help support the flexibility of the surrounding joints. Surgical shortening is safer than surgical lengthening and has fewer complications. Surgical procedures to shorten one leg include removing part of a bone, called a bone resection. They can also include epiphysiodesis or epiphyseal stapling, where the growth plate in a bone is tethered or stapled. This slows the rate of growth in the surgical leg.