‍When Should You Consider Treatment? Leg length discrepancy (LLD) refers to a condition where one leg is shorter than the other, and it’s more common than people realise. While a small difference in leg length is typical and often goes unnoticed, larger discrepancies can lead to various physical problems over time. But how much of a difference is worth treating, and what are the potential knock-on effects of LLD?

‍What is Leg Length Discrepancy? LLD can occur due to several factors, including congenital issues, trauma, or medical conditions like hip dysplasia or bone infections. It may also develop gradually as a result of surgeries, fractures, or other health conditions affecting bone growth. Leg length differences can be classified as either:

• Functional LLD: A difference in the way the body functions, often due to issues like pelvic tilt or muscle imbalances.
• Structural LLD: An actual difference in the bone length of the legs, measurable through scans or X-rays.

When Does LLD Start to Matter?

‍Most people have a slight leg length discrepancy, typically less than 1 cm, and it usually doesn’t cause any significant problems. However, when the difference is greater—around 2 cm or more, it can start to impact posture and movement. At this stage, many people may begin to experience symptoms such as:

• Pain in the hips, knees, or lower back
• Abnormal gait or limping
• Fatigue when walking or standing for long periods
• Increased risk of joint issues and injury

How Much Difference Requires Treatment?

‍Experts generally agree that a leg length discrepancy of 2 cm or more may require treatment, especially if it’s causing pain or affecting daily activities. However, the threshold for treatment can vary based on individual factors, such as overall health, activity levels, and how the body compensates for the difference. For some, even a small discrepancy might result in discomfort if it alters gait mechanics significantly, while others with a larger discrepancy might experience no noticeable symptoms. Early diagnosis and monitoring are crucial in preventing long-term damage, especially for children and adolescents, as their bodies are still developing.

‍Potential Knock-On Effects of Untreated LLD

‍Ignoring a significant leg length discrepancy can lead to a cascade of health issues, particularly in the musculoskeletal system. Over time, LLD can cause:

• Lower back pain: One leg being shorter forces the pelvis to tilt, which can strain the muscles and spine, leading to chronic back pain.
• Knee and hip problems: Compensating for the shorter leg often puts extra pressure on the joints, increasing the likelihood of developing arthritis or joint degeneration.
• Postural imbalances: The body will often adapt by shifting weight distribution, leading to poor posture and an increased risk of injuries, such as ankle sprains or muscle strains.
• Foot pain and plantar fasciitis: The uneven load on the feet can lead to conditions like plantar fasciitis or overuse injuries.

Treatment Options

‍If you or someone you know is experiencing discomfort or symptoms related to LLD, it’s worth exploring treatment options.Here’s what can be done:

• Shoe lifts: For discrepancies of 2 cm or less, wearing a shoe lift on the shorter leg can help balance posture and alleviate pain.
• Physiotherapy: Strengthening exercises and stretches can address any muscle imbalances and improve overall body alignment, reducing the strain on joints and muscles.
• Surgery: For more significant discrepancies (over 3 cm), surgical options, such as leg lengthening or shortening, may be considered, though these are usually only for severe cases or in children with growing bones.

Leg length discrepancy can have significant impacts on mobility and quality of life, especially if the difference is large enough to affect posture and movement. If you suspect LLD is causing pain or affecting your daily life, it’s worth seeking advice, whether that’s with one of our Real Health Partners, GP, physiotherapist, or orthopaedic specialist. Early intervention can prevent the knock-on effects and help maintain long-term health and mobility.

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