How Common Is Leg Length Discrepancy After Hip Surgery
Initially, after a total hip replacement, there can be an apparent leg length discrepancy. This may be due to muscle spasms resulting in the tilted pelvis and an apparent limb inequality despite equal limb lengths. But most resolve within 6 months from surgery. Therefore, patient reassurance and education are important with physical therapy. Sometimes a temporary shoe lift may help.
According to a literature review, leg length discrepancy is a common and a recognized complication of hip surgery. However, true leg discrepancy is often a problem following a total hip replacement. It can adversely affect an otherwise excellent outcome, making it a common reason for litigation against the orthopedic surgeon. According to research, the incidence of leg length discrepancy after a total hip replacement has been reported to range from 6 32%. The average discrepancy may vary from 3- 17mm, and around 6% of patients have required shoe corrections following surgery.
How Custom Insoles Help With Leg Shortening
Custom insoles play a major role in the treatment of leg shortening. The help in:
- Proper foot alignment.
- Managing tissue stress level to a tolerable level.
- Gait analysis proves helpful in designing custom insoles, which works towards restoring normal mobility of the patient.
- Providing support to the shorter leg.
- Distributing body pressure, hence managing abnormality caused by length difference.
- Reduce the pain and discomfort caused while walking or playing.
- Proper fit for each individual as they are custom designed.
- The highly elastic material, molds according to the surface on which the individual is walking on
Order Comfortable Leg Length Discrepancy Shoes
We know its not easy finding good shoes for uneven legs. Thats why we take great care to stock only the best in terms of both comfort and style. Browse premium orthopedic brands like Mt Emey, Drew, and Apex, and find exactly the size, width, and comfort features youre looking for. If youre not sure how to achieve the ideal fit, refer to our convenient shoe width sizing chart.
All orders qualify for free shipping, and you can exchange your shoes as many times as necessary for free until you achieve just the right fit. Explore our wide selection of leg length discrepancy shoes, and place your order today.
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What Is Leg Discrepancy
Leg length discrepancy quite literally refers to a condition that leaves one of your legs noticeably longer than the other. Its much more common in children but can also occur in fully developed adults.
Interestingly, its not unusual for our lower limbs to be unequal. In fact, studies predict that between 40% and 70% of the general population have a leg difference greater than 20mm. Much of the time, its just an anatomical quirk with little to no side effects but if your leg discrepancy is affecting your gait, making you limp, or is making standing or walking uncomfortable, it could begin to dramatically affect your quality of life.
Leg Length Discrepancy Surgery:
Surgical intervention depends on the patients age and how severe the discrepancy of the leg length is.
For children and adolescents, bone growth in the longer leg is stopped or slowed. This is surgically induced by blocking the epiphyseal plates around the knee joints. A bone resection procedure is preferred for adults or patients with skeletal maturity to shorten the longer limb.
Surgical limb lengthening is done if leg length discrepancy is more than 40- 50mm. It involves osteotomy followed by fitting an external fixation device to that limb. This device will apply continuous distraction longitudinally across the osteotomy site leading to limb lengthening.
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Best Insoles For Leg Length Discrepancy:
Our best option is to see a podiatrist for a set of custom insoles for leg length discrepancy.
- This treatment option can be combined with a comprehensive analysis of your biomechanics.
- A podiatrist can perform a full gait analysis and a comprehensive biomechanical exam to assess your unequal leg length.
If this is not an option for you, click on the following link to check our favorite premade insoles for leg length discrepancy.
Built Up Shoes For Shorter Leg
ãSatisfying the above characteristics has solved the problem of correcting the appearance. If you want to solve the psychological problem, the invisible increase is indispensable. The appearance is flat, and the invisible height is increased, making it difficult for others to see the defects of your feet and gradually overcoming psychological obstacles. Only by gradually breaking through yourself and slowly integrating into society can you achieve yourself and shape a complete life.
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Shoe Lifts For Length Discrepancies Caused By Surgery
If the leg length discrepancy is the result of a surgery, such as a knee or hip replacement, in many cases the full amount of discrepancy can be accommodated by a full-length lift. This means that if your left leg is 1 cm longer than your right following the surgery, we can often provide the full 1 cm of lift to the right leg, and it is quite comfortable.
Shoes For Uneven Leg Length
Appropriate footwear with adequate support and cushion is important during periods of exercise. In cases of LLD, it is imperative that you wear supportive footwear with your appropriate shoe lift height. Consult with your pedorthist regarding footwear that is appropriate for your foot type and selected activities. If your lift height has not yet been determined, or if you are currently working to resolve your symptoms, exercise programs should be undertaken with caution and qualified guidance.
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Shoe Lifts For Congenital Leg Length Discrepancies
When the discrepancy is congenital and not caught until later in life, providing a lift for the full amount of discrepancy is usually not well tolerated. The body will make adjustments to naturally accommodate for the discrepancy, which seems to make a full-height shoe lift intolerable. When this is the case, we typically start with 60-70% of the discrepancy and go up or down depending on how things look and feel at follow up.
How To Measure High And Low Feet
1. It is necessary to measure the gap between the two legs to calculate how much height that foot needs to make up.Prepare a stack of A4 paper or flat books and place it on a level ground. 2. Put long feet on the floor, short feet on the paper, adjust the number of papers, until you confirm that your shoulders are balanced and your feet are evenly stressed and feel comfortable. 3. Compact the paper and measure the height of the paper with a ruler to get an accurate foot gap.
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How To Prevent Unequal Leg Length
The best way to prevent joint pain and degeneration associated with leg-length discrepancy is to take preventive measures. If you suspect misalignment in your feet or posture, we strongly advise you to see a podiatrist, who will determine whether treatment is needed and establish a personalized plan.
No ones legs are exactly the same. Its no big deal!
Its true that most people have slightly unequal legs. However, if the difference is 5 mm or more, your posture can be affected, causing pain and eventually leading to permanent structural damage.
Best Heel Lifts For Leg Length Discrepancy:
We believe that heel lifts for leg length discrepancy are not the best option for a functional limb length issue.
- The issue with leg length discrepancy lifts is that they will correct an imbalance by placing it somewhere else.
- The key is to get to the root of the problem and hold the feet, the ankles, and the legs equally while correcting the original imbalance.
- This means a podiatrist biomechanical analysis combined with leg length discrepancy exercises and reassessment to correct the original problem.
- We are much bigger fans of custom orthotics for leg length discrepancy. It is also possible to get premade full-length insoles for leg length discrepancy.
For this reason, we believe leg length discrepancy lifts alone are not the best treatment option.
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Prescription Of A Scanogram And Standing Pelvic X
Scanograms are used to confirm structural leg length discrepancy. The process involves taking a series a three x-rays of your hips, knees and ankles while you lie down with a graduated ruler under your legs. Scanograms can provide accurate measurements of your femur and tibia bones, without the length being affected by a curved spine or flat foot.
Leg Length Discrepancy Shoes & Orthotics
Quite often patients can have difference in their leg lengths. This is not normal but extremely common.
If you feel unbalanced or experience limb pain, you could have a leg length discrepancy. Obtaining orthotics for leg length discrepancy such as a leg length discrepancy shoe or leg length discrepancy lifts can help ease your pain and treat this condition.
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How Are Lifts Added To A Shoe
Depending on the amount required, the lift can either be applied within the shoe underneath the footbed or orthotic, or directly to the midsole of the shoe.
Shoe Lifts Added to the Footbed or Orthotic
Assuming the shoe has adequate depth and full-length volume, lifts up to approximately 1cm can be placed within the shoe. This type of lift is nice because it doesnt add much weight to the shoe and is completely hidden within the shoe underneath an orthotic or insole.
Shoe Lifts Added to the Midsole
When shoe lifts exceed 1 cm, they are more typically applied to the midsole of the shoe. If this is the case, the midsole of the shoe is split, the full-length lift is added and the outsole is reapplied to sandwich the lift into the midsole of the shoe. This type of shoe lift can be performed by a Canadian Certified Pedorthist and is tailored to the design of the shoe in order to provide esthetic appeal.
Leg Length Discrepancy Test:
The best leg length discrepancy test is to get seen by your podiatrist, biomechanical specialist, or a physical medicine and rehab specialist for a biomechanical evaluation. We specialize in gait analysis to assess for functional limb length discrepancy.
It is rare that a bone measurement with yields useful information. We find that most unequal leg length is due to muscle, tendon, or soft tissue causes.
This means that it manifests and shows itself during walking and running. Thus it is not as simple as just getting a shoe lift, shoe insert lift, or a heel lift to fix the problem. The true solution is to identify why there is an imbalance and correct the soft tissue problem.
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Leg Length Discrepancy Exercises:
In the video above, we detail our favorite leg length discrepancy exercises.
Exercises can be some of the best ways to loosen up sore muscles and tendons that can be causing a functional contracture.
We believe that exercises and stretches can be the best options to get to the root cause of a functional limb length discrepancy or functional unequal leg length.
Customized Insoles For Limb Length Discrepancy
Limb length or Leg length discrepancy or leg shorteningis the inequality between the lengths of the persons arms or legs.Excluding the rare cases, inequality in arm’s length doesnt usuallyimpact the function of arms and usually does not require any kind oftreatment.
Buthowever, a discrepancy in leg length, usually becomes clear to parentsas their child grows and starts to walk on his/her own.
Itis an astonishing fact that only 25 % people in the world with two legsactually have equal length of legs. In most of the cases, thedifference between the two is diminutive and the person will likely gohis/her entire life cycle without even being aware of the incongruity aswell as also not being affected by it.
It has been found out that thedifferences in length of over 2 cm are rare. Some children are affectedby leg shortening since their birth. While in many other cases, somekind of prolonged illness or even an injury causes a discrepancy inlength to develop over the gradual period of time.
An inequality ofminimal degree may not cause symptoms, but a significant differencebetween the two can cause a discernible hobble and make it difficult fora child to play, run or walk.
This can be done in a number of ways, but is most oftenaccomplished through a procedure that delays or eventually stops growthin the longer leg.
Following are two major classifications of leg length discrepancy:
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Simple Technique To Adapt Shoes For Uneven Legs
Having legs that are uneven is not that uncommon, as there are several reasons why this could be. Some people may be born with a dislocated hip that causes the unevenness, develop an infection or tumor, or perhaps they may fracture the hip. And, another category of people who may have uneven leg length is those who have had hip replacements. Having a shorter leg after a hip replacement isnt necessarily a given, it also isnt an unusual outcome.
Studies of hip replacements have shown that some people end up with a leg length difference of more than 10 millimeters in three to 29 percent of patients, or 10 to 15 mm difference in 32 percent of patients. While the difference may not be bothersome for some people, it is for others. Uneven legs can cause other problems, including strain on the other hip and back pain. The solution for many is to put a lift on to the shoe for the shorter leg, but this can be difficult, depending on the style shoe to be adapted and it can be quite expensive, particularly if you own several types of shoes.
There are three steps to the process:
One: Wrap the shoe on the toe end with a towel or protective sheet to protect it. Use this part, the toe that is now protected, to mount the shoe into a vice. This is needed to keep the shoe from moving when you cut it.
Two: Mark the shoe for the desired thickness. Rather than measuring what it to come off, you want to measure what is staying.
What Causes Leg Length Discrepancy
Broken thigh bones and/or shinbones that have healed in new positions are often responsible for leg discrepancy. If illness or injury damages the growth plates that sit around either of the bones in the leg, they may begin to grow at a slower or faster rate.
- Inflammatory conditions such as juvenile arthritis, which can affect joint growth
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Treatment Of Functional Leg Length Discrepancy
Treatment of functional discrepancies resulting from muscular tightness or imbalance typically involves stretching and strengthening provided by a physiotherapist and/or massage therapist. Functional discrepancies resulting from alignment issues, such as asymmetrical foot movements, can be remedied with custom foot orthotics or off-the-shelf foot orthotics provided by a pedorthist, podiatrist, chiropodist, or orthotist. Functional discrepancies resulting from scoliosis may be treated with custom foot orthotics from one of the above foot care professionals, with other lower extremity or back orthotics from an orthotist, or a stretching and strengthening routine provided by a physiotherapist. For some individuals, whether it is a structural or functional discrepancy, chiropractors can be helpful with alignment issues.
Functional Leg Length Discrepancy Treatment Video Summary:
Do you have one leg longer than the other? Uneven hips? Hip misalignment? Or unequal leg length? We review leg length discrepancy and the BEST treatment!
There are 2 types of leg length discrepancy: a functional leg length discrepancy and an anatomical leg length discrepancy. We review leg length discrepancy exercises,leg length discrepancy shoes, leg length discrepancy symptoms & how to use a shoe lift for leg length discrepancy.
0:00 Leg length discrepancy LLD diagnosis & treatment0:41 Uneven hips, hip imbalance & hip misalignment symptoms1:03 knee pain caused by hip alignment1:28 One leg longer than the other2:09 One leg shorter than the other2:38 One leg bigger than the other3:25 How to measure leg length, 4:14 Scoliosis hip pain and uneven hips4:30 What causes one leg to get bigger than the other5:47 how top fix uneven hips6:13 Hip misalignment & one hip higher than the other6:34 leg shortening surgery, can you get surgery to get shorter7:47 leg length discrepancy exercises9:19 unequal leg length treatment & uneven legs treatment10:07 one leg shorter than the other shoes11:20 Best insoles for short leg syndrome11:58 Best custom orthotics for the leg length difference12:45 Best ankle braces for hip misalignment symptoms13:01 Best shoes for hip imbalance & one leg in one leg out13:29 Misaligned pelvis & hip misalignment treatment14:08 uneven hips exercises & uneven knees exercises
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Imaging For Leg Length Discrepancies
Depending on the source and type of LLD, treatment options vary. If your healthcare provider or primary care physician suspects a structural discrepancy but is unsure, a scanogram x-ray is one of the best ways to determine presence and amount of discrepancy. This type of x-ray superimposes a ruler directly onto the image in order to measure the bones and joint spaces in your lower extremities allowing the radiologist to compare sides. There is still a chance for measurement error with this method but it is commonly quite accurate.
Can Scoliosis Cause Leg Length Discrepancy
Scoliosis means a laterally curved spine or a sideways curvature of the spine, which is diagnosed often in adolescents. Although the cause for childhood scoliosis is unknown, it can occur in patients with cerebral palsy and muscular dystrophies as secondary scoliosis. It can make your pelvis uneven, known as pelvic obliquity. This can make one of your legs appear longer than the other, even though both your legs are actually the same length. Therefore scoliosis gives a functional type of leg length discrepancy.
Sometimes when there is a true leg length discrepancy, your pelvis may tilt to compensate. Therefore the spine may get curved functionally, and scoliosis may result. Therefore scoliosis can be either caused or exacerbated by leg length discrepancy.
If there is a true leg length discrepancy, keeping the patient supine will help measure the bony landmarks. But there will be no difference in measurements if it is an apparent leg length discrepancy due to pelvic obliquity due to scoliosis.
References:
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