Receive a consulation from one of our medical partners or use a standing block test at home as described below.


You can search our database of surgeons, physical therapists, chiropractors and podiatrists who have diagnosed patients with leg length differences and recommend American Heeler shoe lift modifications.

Type in your zip code to see whom we recommend near you. If there are no search results, try the zip code of your nearest city.


Standing Block Test

A second method to measure leg length difference (LLD) is to use blocks of known height to even out the pelvis. Standing on a flat and firm surface, place the blocks under the shorter leg until feeling even and balanced. You can also use thin hardback books or tiles. Then step off the block and use a ruler to take a measurement. This amount is known as the functional leg length difference. This may be different from the actual leg length difference. It may take some trial and error for you to find the most effective shoe lift size. We recommend you consider the opinion of a medical professional along with your own analysis of your body function.


American Heelers have modified tens of thousands of shoes and that expertise allows us to work on all brands and all styles of shoes all over the world. With that said it is a good idea to select the shoe with some practical features.

For the best results it helps to have a shoe with a broad and beefy sole. This will allow us to split and put it back together effectively. It is also helpful for the shoe to be wide and stable, meaning the sole does not narrow out too much at the arch as well as a wide surface area with as much sole touching the ground as possible.

For the best possible color match, the best choice is a shoe with an all-black sole profile, this blends in the best. White is second best. We do our best to match the lift material to the shoe, but our #1 priority is effectiveness and functionality. We will choose a color that makes sense unless otherwise noted by you.

See the color chart here:

If you want the additional shoe lift to be the least noticeable we recommend a shoe with an all white or all black sole profile view. Those colors blend in the best. We do carry material in other colors like brown, grey, bone, almond, yellow, green, and red but these colors are not always the same shade of your shoe and will come out more noticeable. See the color chart so you can match up the shoe as best you can before you send it in. You can also see pictures of our work at this link here:


Our honeycombing service was first rolled out in 2013 to much delight from our customers. This method of shoe lift elevation involves partially hollowing out the shoe lift before it goes into the shoe. The effect is a more light weight shoe and a more flexible feel. The charge is $19.99 for this. You can see a picture of it below, however it will not be seen form the outside of the shoe. Check out the Feedback from our customers who have written about their shoe lift modification with honeycombing.

There are generally two kinds of leg length discrepancies.

  1. Structural discrepancy occurs when either the thigh (femur) or shin (tibia) bone in one leg is actually shorter than the corresponding bone in the other leg as a result of a condition that has either caused one bone to be shorter than normal or longer than normal.
  2. Functional discrepancy occurs when the leg lengths are equal, by symmetry is altered somewhere above the leg, which in turn disrupts the symmetry of the legs. For example, developmental dislocation of the hip can cause a functional discrepancy. In DDH, the top of the leg bone (femur) that is not properly positioned in the hip socket may hang lower than the femur on the other side, giving the appearance and symptoms of a leg length discrepancy.

What causes a leg length discrepancy?

The causes of a leg length discrepancy, even the most common ones, are numerous and varied. A discrepancy can result from an injury, such as in a fracture that damages the cells responsible for growth of the bone, while the corresponding bone on the other leg grows normally. Some fractures can also lead to overgrowth of bone during the healing process, resulting in a longer than normal bone. Overgrowth commonly occurs in young children with femoral fractures. Diseases of the bone, such as osteomyelitis, can injure a region in a bone, called the growth plate, where growth in length occurs, so that a discrepancy occurs gradually over time. Some children are born with legs that are of unequal length or bowed tibias that are accompanied with a leg length discrepancy.

Functional leg length discrepancy can also result from congenital (present at birth) problems, which alter alignment of the hips, such as coxa vara and developmental dislocation of the hip. Neuromuscular problems, such as cerebral palsy, which causes problems with alignment and posture, can also lead to a functional discrepancy. Bone tumors and treatments designed to irradicate them are related to leg length discrepancy. Tumors can invade the bone's growth plate like an infection and treatments, like chemotherapy, can also damage the plate.

What are the symptoms of a leg length discrepancy?

The symptoms of a leg length discrepancy vary widely and are often related to the underlying problem causing the discrepancy and the alignment problems that result from it. Keep in mind that everyone experiences symptoms of this condition differently. Always consult a physician for a diagnosis.

The following are symptoms of a leg length discrepancy:

  1. One leg is obviously shorter than the other (although this is not always obvious) problems with posture (i.e. shoulder may tilt toward shorter side) leading to compensatory or functional scoliosis.
  2. Gait problems, such as limping, toe walking, or rotation of the leg.
  3. A knee that's chronically hyper extended on the short side and flexed on the long side.
  4. Pain in the back hip, knee, and/or ankle

How is a leg length discrepancy diagnosed?

Diagnostic procedures include a complete medical history of the patient and a physical examination by an orthopedic surgeon. The doctor will use both of these tools to determine the underlying cause of the problem.

During the physical exam, your doctor will probably take two measurements of your legs with a tape measure. One measurement, to determine the "real" length of the leg will be taken from the middle of the hip down to the ankle. The other, the "apparent" length, will be taken from the naval area. The discrepancy determined by these two measurements might be different if the "apparent" length is affected by hip position, suggesting a functional discrepancy.

The doctor may also ask you to stand with a block under the shorter leg to confirm the measurement estimate the amount of correction that feels best. The doctor will also want to confirm the measurement with the following diagnostic tests:

X-rays - a diagnostic test, which uses invisible electromagnetic energy, beams to produce images of internal tissues, bones, and organs onto film. This is used to obtain an accurate measurement of leg length discrepancy.

Computerized tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called "slices"), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

How is a leg length discrepancy treated?

Specific treatment for leg length discrepancy will be determined by your orthopedic surgeon based on:

  1. Your age, overall health, and medical history
  2. The extent of the discrepancy
  3. Your tolerance for specific medications, procedures, or therapies
  4. Expectations for the course of the condition
  5. Your opinion or preference

Your feelings about the treatment are extremely important. Some techniques used to equalize leg length are simple and safe, but others, especially lengthening procedures, are complex with high complication rates.

This is why we recommend using our shoe modification techniques. It is a non-invasive procedure which is cost effective and more importantly pain free.