One Leg Longer than the Other Pain? [FIX Leg Length Discrepancy & LLD]

Signs that you may have leg length discrepancy: one shoulder sits higher than the other (compensatory scoliosis), uneven pant hem length, hip pain or back pain on one side, one hip higher than the other when standing, asymmetric shoe wear (wearing out one shoe faster or in a different pattern than the other), frequent lateral ankle sprains on one side, and asymmetric footprint when walking (one foot pronates more). Clinical tests: the podiatrist measures from the ASIS (hip prominence) to the ankle bone, performs the 'block test' (placing calibrated shims under the shorter foot until the pelvis levels), and observes gait. Imaging: standing X-ray of both legs with a ruler (scanogram) provides the definitive measurement. At Balance Foot & Ankle in Howell (4330 E Grand River) and Bloomfield Township (43494 Woodward Ave #208) — call (810) 206-1402.

Leg length discrepancy causes a wide range of musculoskeletal problems: low back pain (the most common symptom — sacroiliac joint dysfunction, lumbar scoliosis, facet joint overloading), hip pain (the longer leg's hip bears more load — hip osteoarthritis is more common on the longer side), IT band syndrome (more common on the shorter-leg side), trochanteric bursitis, sacroiliac joint dysfunction, piriformis syndrome, knee pain (runner's knee on the longer side), plantar fasciitis (more common on the shorter leg due to compensatory pronation), stress fractures, Achilles tendinopathy, and cervical spine pain from the compensatory head tilt. Identifying and treating LLD can dramatically improve many of these secondary problems simultaneously. Balance Foot & Ankle evaluates LLD and its musculoskeletal consequences — call (810) 206-1402.

Yes — LLD creates characteristic foot and ankle problems: shorter leg — foot overpronates (rolls inward) to effectively lengthen the limb, creating excessive stress on the plantar fascia, posterior tibial tendon, and spring ligament; this leads to plantar fasciitis, posterior tibial tendon dysfunction (progressive flat foot), tarsal tunnel syndrome, and tibialis anterior overload; the foot may also toe-walk (equinus posture) on the shorter side to compensate; longer leg — foot tends to supinate (roll outward) or adopt a higher arch (cavus) posture to functionally shorten the limb; this increases lateral ankle sprain risk and peroneal tendon stress. Shoe lift therapy for the shorter leg normalizes both feet simultaneously. Balance Foot & Ankle in Howell and Bloomfield Township, MI prescribes LLD shoe lifts and orthotics — call (810) 206-1402.

Shoe lift therapy for LLD is generally effective: most patients with symptomatic LLD experience significant improvement in back pain, hip pain, and gait-related symptoms within 4–8 weeks of consistent shoe lift use; full adaptation typically occurs over 2–3 months; the lift must be worn consistently (every day, in all shoes) for sustained benefit — sporadic use prevents adaptation and may worsen symptoms; the correction should be introduced gradually (start at 50% of the LLD measurement and increase by 25% every 2–4 weeks) to allow the muscles and joints to adapt; and the appropriate lift height is determined by clinical response, not simply the measured discrepancy. Children's LLD requires monitoring as they grow — lifts must be adjusted as the leg lengths change. Balance Foot & Ankle monitors LLD treatment progress — call (810) 206-1402.

Surgery for LLD is indicated when: the discrepancy is large (typically >3–4cm in children, where shoe lifts alone are impractical; >5–6cm in adults); in growing children when the expected final LLD based on remaining growth is significant, surgical epiphysiodesis (stopping growth of the longer leg) or lengthening of the shorter leg is performed; in adults with large discrepancies causing significant disability, limb lengthening surgery (Ilizarov technique) gradually lengthens the shorter bone through controlled bone formation; or when the underlying cause requires surgical correction (failed hip replacement with leg length inequality, malunited fractures). Surgery is complex with significant recovery time — it is reserved for cases where conservative treatment is insufficient. Balance Foot & Ankle manages conservative LLD treatment and refers for surgical evaluation when appropriate — call (810) 206-1402.