Leg length often poorly evaluated

By Dr. Lou Pack

“I have one leg longer than the other. Should I be concerned?”

Although certainly not on a par with cancer or heart disease, the importance of equalizing leg lengths is greatly underestimated, poorly evaluated, and if found, usually left uncorrected. This is especially true if it’s less than a quarter of an inch, which is considered normal.

But “normal,” means average and that’s not necessarily synonymous with healthy. As you probably know, the average person also has high cholesterol, weighs more, and is less active and more stressed than a healthy person should be. So I don’t think we really want to be “normal.”

Unequal leg lengths can be due to structural or functional causes, and it’s important to differentiate these and treat them appropriately.

Now, after treating arthritic patients for nearly 40 years, I’m still amazed at the powerful, positive impact of equalizing leg lengths. For example, when a patient with an arthritic hip or knee does a simple squat with the proper amount of correction under their short leg, often there is an immediate decrease in pain.

That’s because abnormal alignment causes excessive wear on the joints, which results in destructive arthritic changes and subsequent pain. As a matter of fact, a recent study showed that those with an above average leg length differences had almost twice the incidence of knee arthritis.

But by equalizing leg lengths, arthritic patients can often be made to function on the part of their knee or hip joint that still has cartilage. This occurs in the same way that realigning the tires on your car enables you to ride on the tread that’s still there, thus improving ride quality and extending the life or your tires.

Although often overlooked, it’s even more important to correct leg length differences after a knee or hip replacement, because this type of surgery very often results in a leg length that is even longer or shorter than it was before the joint was replaced! This causes additional stress on the new joint, as well as the other weight bearing joints of the feet, ankles, knees, hip and back.

Unequal leg lengths have the same powerful affect in sports. In golf, equalizing leg lengths can increase performance and decrease injuries. For example, if you’re a right handed golfer with a long left leg, it will be hard for you to follow through on your golf swing since you would be trying to do so “up hill.”

Chiropractors and physical therapists are often very successful in alleviating back pain and other problems by adjusting leg lengths, but sometimes there is no permanence to that correction. So if you’re interested in preventative health, decreasing the stress on your weight bearing joints, or improving sports performance, equalize your leg lengths on a more permanent basis. Sometimes it’s as simple as putting a lift in your shoe on the shorter side; but this should be done accurately by a physician specializing in such corrections or you could make your problems worse.