Activity, Injury Prevention, physical therapy

Do you really have a true leg length difference?

I get clients quite often tell me that their doctor, chiropractor, massage therapist, etc has told them they have a leg length discrepancy. Some of them have even gone as far and getting a heel lift for their shoe. Most of the time, their leg length problem isn’t really a true anatomical problem, but more functional. A true anatomical leg length discrepancy is cause by trauma (i.e. fracture), growth development such as growth plate dysfunction, or from surgery such as a knee replacement. A functional discrepancy is created by a mobility restriction and is correctable.

We are going to focus on functional discrepancies. If your pelvis is rotated on one side more than the other, it affects the entire chain all the way down. If the pelvis is rotated too far forward, then your leg will become “longer” than the other side. If the pelvis is rotated too far backward, then the leg becomes “shorter.” Check out these pictures. The left is a typical anatomical pattern that I often see. See how the left knee is bent? That leg is longer due to the position of the pelvis. Notice it affects the spine all the way up into the neck. The picture on the right is what it looks like in a real human. Do you like to stand like that? Then you most likely have a leg length discrepancy!

Leg length discrepancies aren’t necessarily bad as long as your pelvis can move in and out of that position. What do I mean by that? Can you stand on the left foot and recreate the same position on the other side? Or does your left side feel “stuck” and and often feel “off” or “out”? If the latter is the case, then you need to re-establish that motor pattern. There is a recipe of muscles that help you achieve that, the left internal obliques and left hamstrings being two of the big ones. Usually, the hip flexor and back extensor are very dominant on the left side compared to the abdominals and hamstring; and if they won’t let go, neither will your pelvis! Stretching the hip flexor will decrease the tension…until you take a step and then it will revert right back. You have to replace it by activating the abdominals.

To review, a functional discrepancy is more common and treatable with proper neuromuscular re-education exercises. The left leg tends to be longer in most people due to our anatomy and orientation of our organs. In order to correct a discrepancy, stretching alone doesn’t usually work. Muscle activation and strengthening has to replace the dominant and tight muscles keeping the pelvis restricted. It usually only takes 1-2 visits to correct the discrepancy, but a few more weeks after that to build the strength to maintain the new position.

If you are having back pain or hip pain and think you might have a leg length discrepancy, click here to contact me about appointments. If you don’t live in the area, but feel I may be the right person to help you, you can learn more about my online services here.

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