What Should You do if Discover that You Have a Leg Length Discrepancy?

It’s quite common to have one leg that’s noticeably longer than the other. Differences in the length of one’s legs are referred to as a “leg length discrepancy.” Studies show that anywhere between 40-70% of the population has a noticeable leg length difference (LLD).

Leg length disparities can be as small as a fraction of an inch or as large as a few inches. When the discrepancy is large, the individual is more likely to have problems with their gait, posture, and pain. This blog post addresses the root of LLD as well as its symptoms. We also detail how to identify LLD and the various treatment options currently available for it.

Symptoms and Causes of LLD

In most cases, people with slightly different leg lengths experience no symptoms at all.

LLD is classified into two types: functional and structural. The root causes of each subtype vary.

Functional LLD

As the name implies, those with functional LLD have legs that are identical in length. But a problem in the hip, thigh, or knee causes one leg to look longer than the other. Other body parts that may cause a functional LLD include the pelvis, foot, or ankle. 

If a child is born with a condition that causes abnormal hip alignment, they may develop functional LLD. Back, hip, and knee issues brought on by arthritis or chronic pain are some of the most typical causes of functional LLD in adults.

Neuromuscular conditions that alter a person’s posture and make them stand or sit incorrectly may also be the cause of functional LLD.

Sometimes physical activity causes a functional LLD. Athletes may have functional LLD for a short time if the way they train causes muscle imbalances or weaknesses.

Structural LLD

When one leg is significantly shorter than the other due to a defect in the structure of the femur or tibia, we call it structural LLD. It may have several potential causes, including:

  • Fractured bones: Bone fractures can impede the normal development of the affected leg. This effect is more likely to happen if the bone was broken into more than one piece or if the muscles around it were hurt. When the bone heals around a fracture, sometimes an excessive amount of new bone forms. Femur fractures in young children are a leading cause of this overgrowth.
  • Injuries to the growth plates: The ends of the long bones have specialized cartilage known as growth plates. Injuries to the growth plate can cause the affected bone to develop at a different rate than bones on the other side of the body.
  • Diseases of the bones: The growth plate of a bone is vulnerable to injury from conditions like osteomyelitis. This deterioration ultimately results in LLD.

Symptoms of LLD: 

One of the most obvious signs of LLD is a leg that is noticeably longer than the other. The difference may be so slight that no other symptoms appear. However, research shows that even a 2-centimeter (cm) difference can force the pelvis to adjust in order to maintain a healthy stance.

In moderate to severe cases of LLD, you may also have other signs, like a limp or trouble walking. You may also feel more tired than usual and have pain in your hips, knees, or ankles. It’s important to remember that living with LLD can be debilitating.

Diagnosis of LLD:

Those who are concerned that one of their legs is abnormally longer than the other should get a professional medical opinion.

In the meantime, while you’re waiting for your appointment, you can use this at-home test to determine whether or not LLD is a possibility for you.

Checkup on the house

The following steps should be taken in order to conduct a successful home test:

  • Take off your shoes and socks.
  • Keep your legs together as you lie on the ground.
  • Ask a friend or family member to place one hand on each hip.
  • For about 60 seconds, have him move your hips gently in and out. This motion aids in the relaxation of tight muscles.
  • Let him take a look at how well your ankle bones are aligned.

Misalignment of the ankles may be a sign of LLD. A medical examination is required to confirm if it is structural or functional.

Medical examination

LLD can be diagnosed using a variety of methods. These are a few examples:

  • Physical examination
  • Study of the individual’s posture, stance, and gait
  • examination of gait
  • The LLD is determined by having the individual stand on blocks of varying heights until their hips are at a level position.
  • X-ray of the lower abdominal region or the legs
  • Leg CT scan for bone and muscle analysis

Possible Treatments: 

A patient’s treatment will depend on the specific form of LLD they have.

The Management of Functional LLD:

Functional LLD is often treated with physical therapy, massage, and exercises designed to strengthen weak muscles. Fixing slouched shoulders and back is also crucial. 

Depending on the type and severity of LLD, the exact type and number of interventions needed will be different for each case.

Physical activity and functional LLD:

Some functional LLDs may be able to be improved through exercise. Nevertheless, proper strengthening and stretching methods should be utilized. They also need to make sure to focus their physical activity on the side of the body that will help them overcome the LLD.

It might be a good idea to see a physical therapist to avoid more problems. The therapist will be able to pinpoint problem areas and suggest corrective measures.

The Management of Structural LLD:

Fixing structural LLD is more complicated. Most of the time, the length difference between the legs is the most important factor in figuring out the best treatment.

Possible methods of treatment include:

A shoe lift: Persons with mild LLD, defined as a difference of less than 1 inch, may benefit from a shoe lift, which is placed inside the shoe on the shorter leg. A shoe lift is an effective way to alleviate back pain and improve your gait. An orthopedic shoe repair specialist can also help you add height to the sole of your shoes for more comfort.

Surgery: Larger LLDs may require surgical intervention. It’s possible to choose from a variety of surgical procedures, each of which serves a different purpose:

  • Reduce the length of the longer leg
  • increase the length of the shorter leg
  • prevent the longer leg from growing

After surgery, patients need to schedule regular checkups with their doctors. They will also require intensive physical therapy and exercise to help them recover fully.


It is quite common to have one leg that is noticeably longer than the other. Both structural and functional factors can contribute to leg length inequality.

Minor discrepancies usually don’t cause problems. But moderate to severe asymmetry can make it hard to walk and stand straight, and it can make hip and back pain worse.

Anyone who is concerned that they or their child may have LLD should make an appointment with a doctor. A medical professional is able to provide an accurate diagnosis and treatment plan. Once the exact difference is calculated, the first thing you should look for is a shoe lift, as this is the best non-invasive option to make you walk normally.

In the event that you’re in need of orthopedic shoe repair in the United States, American Heelers is your best bet. We have been modifying shoes of all sizes, from the smallest to the largest, for well over a hundred years. We can do anything from a few millimeters to a five-inch heel lift. For more information, call 216-378-2686 or email info@americanheeler.com.