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leg length discrepency

Posted by Sandy H. on 5/17/02 at 09:36 (084291)

Is there any specific treatment for PF caused by leg length discrepency? My left is 1cm longer than the right apparently and chiro reckons it would have been acceptable had I not run marathons. Does that mean if I just rest it and never do such long distances again the foot can go back to roughly how it was before or do leg length discrepencies have of that length kick in at some point and cause permanent pain. I'm 34.

Re: leg length discrepency

Carmen on 5/17/02 at 13:43 (084316)

I'm not a doctor but have heard that Leg length disc. is something most of us have (in some it's barely noticeable in some VERY noticeable)....In MY experience only I have had Chiros tell me in the past that this is causing allll kinds of problems..when in reality it wasn't causing anything abnormal.
I would ask an orthopedic about the difference being significant.

Re: leg length discrepency

Kathy G on 5/17/02 at 16:41 (084357)

Sandy,

Certainly the doctors will better answer this than I, but I have one leg shorter than the other and just about every doctor I've ever gone to has mentioned it to me. It's due to some scoliosis in my spine which was never treated. I've got three different curves. I'm 50 and so we didn't have checks done when I was in school, like they do now, but I always had regular medical care. I can remember my pediatrician saying that the curve was so slight that it didn't need correction. The consensus of opinion from the doctors who have mentioned it is that it's something that probably causes some of my back pain, but it's not severe.

And no, to my knowledge, it has absolutely nothing to do with Plantar Fasciitis. Certainly I would question why it wouldn't have been a problem if you hadn't run long-distance marathons. It would seem logical that if one leg is shorter than the other now, it's always been shorter than the other!

Re: leg length discrepency

Ed Davis, DPM on 5/17/02 at 20:57 (084398)

The foot on the longer leg tends to react by additional pronation while the foot on the shorter leg pronates less. As such plantar fasciitis tends to be more common on the long leg side. Treatment of PF in such situations must include lifts to neutralize the effects of the limb length discrepancy.
Ed

Re: leg length discrepency

Rachel W. on 5/18/02 at 06:50 (084426)

I was recently told that my left leg was slightly longer than my right, yet it was my right foot that was in pain with PF first. My pod noticed it and brought it to my attention. She never really said whether it was the cause of my problems, but as you said, I must have always had different leg lengths and it hadn't caused me any problems before.

Re: leg length discrepency

Julie on 5/18/02 at 16:19 (084470)

There are two different types of leg length discrepancy: actual (where the leg really is shorter) and functional (where the legs may be the same length but appear to be different, and, functionally, are, because of scoliosis. A built-up shoe can help in the former case. In the latter, it can worsen the scoliosis.

Re: leg length discrepency

PaulF on 5/18/02 at 22:32 (084529)

I have a 1/2-inch leg length discrepancy. (It's also called LLI - Leg Length Inadequacy). A good physiotherapist can determine if you have a functional LLI or an actual one. If it's functional, I understand the imbalance can usually be treated with physio, exercising and stretching. If it's an actual leg length difference, like mine, then I've heard that the rule of thumb is to use a heel lift that's a height of half the difference. So a 1/2-inch discrepancy would be treated with a 1/4-inch heel lift. Beyond 1/2-inch, I remember hearing that a full-length lift is required, and I believe that they usually lift the forefoot by 1/2 the height of the heel. So if you had a 1 inch difference, you would be fitted with an insert or custom shoe with a 1/2-inch heel and 1/4-inch forefoot.

I had plantar fasciitis for two years, (I still have it at the central PF insertion point and I'm thinking about more ESWT) and I found that the cork heel lifts that are routinely prescribed take away from the arch support of your shoe, and put more strain on the fascia, making the PF worse, so I use off-the-shelf gel insoles that I cut at the forefoot to end up about 2/3 the length of my shoe. It gives me the lift without the heel pain.

-Paul

Re: leg length discrepency

paula on 5/18/02 at 22:54 (084531)

i can't seem to find off the shelf gel insoles, where do you get them?

Re: leg length discrepency

Ellen J. on 5/19/02 at 18:15 (084600)

My father has one leg that is 2 inches shorter than the other due to a bad auto accident that broke both tibia and fibula. The hospital didn't set the leg properly so the leg juts out at an angle and is shorter. However, he has run all his life (no marathons though), and once the doctors created some orthotics for him, he has been able to continue to run. He is now 81 years old and the accident happened when he was in his 50s. He was running right up until last year but is now recovering from major abdominal surgery so he's sidelined at this time. Just letting you know that, as the doc said, you could get orthotics made that make up the difference in leg length.
Ellen

Re: leg length discrepency

Carmen on 5/19/02 at 18:56 (084611)

Most sports stores, running stores and some Walreens have them.

Re: Maybe I'll try it.

Sandy H. on 5/19/02 at 20:50 (084626)

Maybe I will try wearing a soft sorbothane insole in one shoe and not the other to give me the lift. How will I know if I am making things worse is my worry.

Re: Maybe I'll try it.

Ellen J. on 5/20/02 at 18:00 (084704)

My father had orthotics made for both feet, but the one for the shorter leg was made thicker. That way they were both corrected.
Maybe the doctors can answer your question about whether or not it would make things worse. Maybe having one leg shorter is not such a serious thing if it's only 1/2 inch or so but I don't know.
Hope your podiatrist can help you with that issue.
Ellen

Re: leg length discrepency

Carmen on 5/17/02 at 13:43 (084316)

I'm not a doctor but have heard that Leg length disc. is something most of us have (in some it's barely noticeable in some VERY noticeable)....In MY experience only I have had Chiros tell me in the past that this is causing allll kinds of problems..when in reality it wasn't causing anything abnormal.
I would ask an orthopedic about the difference being significant.

Re: leg length discrepency

Kathy G on 5/17/02 at 16:41 (084357)

Sandy,

Certainly the doctors will better answer this than I, but I have one leg shorter than the other and just about every doctor I've ever gone to has mentioned it to me. It's due to some scoliosis in my spine which was never treated. I've got three different curves. I'm 50 and so we didn't have checks done when I was in school, like they do now, but I always had regular medical care. I can remember my pediatrician saying that the curve was so slight that it didn't need correction. The consensus of opinion from the doctors who have mentioned it is that it's something that probably causes some of my back pain, but it's not severe.

And no, to my knowledge, it has absolutely nothing to do with Plantar Fasciitis. Certainly I would question why it wouldn't have been a problem if you hadn't run long-distance marathons. It would seem logical that if one leg is shorter than the other now, it's always been shorter than the other!

Re: leg length discrepency

Ed Davis, DPM on 5/17/02 at 20:57 (084398)

The foot on the longer leg tends to react by additional pronation while the foot on the shorter leg pronates less. As such plantar fasciitis tends to be more common on the long leg side. Treatment of PF in such situations must include lifts to neutralize the effects of the limb length discrepancy.
Ed

Re: leg length discrepency

Rachel W. on 5/18/02 at 06:50 (084426)

I was recently told that my left leg was slightly longer than my right, yet it was my right foot that was in pain with PF first. My pod noticed it and brought it to my attention. She never really said whether it was the cause of my problems, but as you said, I must have always had different leg lengths and it hadn't caused me any problems before.

Re: leg length discrepency

Julie on 5/18/02 at 16:19 (084470)

There are two different types of leg length discrepancy: actual (where the leg really is shorter) and functional (where the legs may be the same length but appear to be different, and, functionally, are, because of scoliosis. A built-up shoe can help in the former case. In the latter, it can worsen the scoliosis.

Re: leg length discrepency

PaulF on 5/18/02 at 22:32 (084529)

I have a 1/2-inch leg length discrepancy. (It's also called LLI - Leg Length Inadequacy). A good physiotherapist can determine if you have a functional LLI or an actual one. If it's functional, I understand the imbalance can usually be treated with physio, exercising and stretching. If it's an actual leg length difference, like mine, then I've heard that the rule of thumb is to use a heel lift that's a height of half the difference. So a 1/2-inch discrepancy would be treated with a 1/4-inch heel lift. Beyond 1/2-inch, I remember hearing that a full-length lift is required, and I believe that they usually lift the forefoot by 1/2 the height of the heel. So if you had a 1 inch difference, you would be fitted with an insert or custom shoe with a 1/2-inch heel and 1/4-inch forefoot.

I had plantar fasciitis for two years, (I still have it at the central PF insertion point and I'm thinking about more ESWT) and I found that the cork heel lifts that are routinely prescribed take away from the arch support of your shoe, and put more strain on the fascia, making the PF worse, so I use off-the-shelf gel insoles that I cut at the forefoot to end up about 2/3 the length of my shoe. It gives me the lift without the heel pain.

-Paul

Re: leg length discrepency

paula on 5/18/02 at 22:54 (084531)

i can't seem to find off the shelf gel insoles, where do you get them?

Re: leg length discrepency

Ellen J. on 5/19/02 at 18:15 (084600)

My father has one leg that is 2 inches shorter than the other due to a bad auto accident that broke both tibia and fibula. The hospital didn't set the leg properly so the leg juts out at an angle and is shorter. However, he has run all his life (no marathons though), and once the doctors created some orthotics for him, he has been able to continue to run. He is now 81 years old and the accident happened when he was in his 50s. He was running right up until last year but is now recovering from major abdominal surgery so he's sidelined at this time. Just letting you know that, as the doc said, you could get orthotics made that make up the difference in leg length.
Ellen

Re: leg length discrepency

Carmen on 5/19/02 at 18:56 (084611)

Most sports stores, running stores and some Walreens have them.

Re: Maybe I'll try it.

Sandy H. on 5/19/02 at 20:50 (084626)

Maybe I will try wearing a soft sorbothane insole in one shoe and not the other to give me the lift. How will I know if I am making things worse is my worry.

Re: Maybe I'll try it.

Ellen J. on 5/20/02 at 18:00 (084704)

My father had orthotics made for both feet, but the one for the shorter leg was made thicker. That way they were both corrected.
Maybe the doctors can answer your question about whether or not it would make things worse. Maybe having one leg shorter is not such a serious thing if it's only 1/2 inch or so but I don't know.
Hope your podiatrist can help you with that issue.
Ellen