This topic was discussed in Saturday's training session. Can it be diagnosed at the tents on Saturdays? Heel lifts were specified as options when there are actual bone length differences. What is treatment if it is a muscular/hip alignment issue? I have know for a couple of years I had a discrepancy and was interested to learn it is probably the source for the back on knee pain that drives me insane. It is time to explore and correct this issue.

LisaGT,

A significant leg anatomic length difference approximately 5 or more millimeters can be seen when checking your leg length while lying down and again when seated. It is a gross measure and an x-ray is the best option to get measurement down to the exact millimeter difference. Heel lifts start at 3mm and go to 12mm, after than the shoe should be modified to the correct height.

There are two types of leg length differences functional and anatomic. A functional difference looks like one leg is shorter in the bone length but when measured with x-ray the bones are of equal length. The appearance of one leg shorter comes from un-leveling and muscle imbalance within the pelvic region. Treatment for this includes adjustments, muscle work and often exercises to strengthen and balance muscle tone and joint mobility.

An anatomic difference on x-ray will show the exact distance of each femur, tibia and knee joint space. It is common to have a mixture of lengths that adds up to one leg overall being physically shorter than the other.

At the clinic we treat once or twice to see if we can level the legs, if they don’t level we get a x-ray to determine functional or anatomic. About 90% of the time the difference is anatomic and a lift is needed. Treatment for an anatomic difference is easy, we usually treat a few times with muscle work and adjustments to recalibrate everything that has been compensating and add a small $6 heel lift when it is less than 12 millimeters to the short side. Most people accommodate the new balance within 6 treatments and feel much better.

Hopefully this helps, please stop the tables and we can take a look for you.

Cheers,

Dr. Bryan