LLD - mechanical or structural?

[Dr Damien]

dear evosy1978

Yelufem and stewart gp are quite right with the advice they have given. Stewartgp is correct in suggesting that your LLD is possibly "apparent" rather than real based on the assessment you describe. By real LLD we mean that one leg is actually shorter than the other such as you would have after a surgery to a lower limb long bone, a fracture to a long bone or sometime congenital hip problems. By apparent LLD, we mean that the legs are actually the same length and the problem is coming from faults in the pelvis or above.

yeluflem suggests that a possible SIJ dysfunction can offset the symmetry of the pelvis causing an LLD. This is quite true, and infact can cause back pain sometimes chronic back pain. there is more to the story and if Yeluflem will pardon me I will explain further...

Often enough, apparent LLDs are mostly caused by spinal dysfunctions or deformities. This causes an obliquity in the pelvis that can put some strain on the SIJ. True SIJ dysfunction without a faulty spine often comes from trauma i.e falling on your bottom, landing on one leg from a significant height etc. If you are having a true SIJ dysfunction without trauma, then arthritic changes should be considered... when people think of arthritis they often think of major joint changes however degenerative changes occurring in surrounding tissues indicates some onset of arthritis and these you would get with age...

So the question would be where is this stiffness coming from that would put unneccessary strain on the SIJ? This is still going with the hypothesis that the problem is from the SIJ

You mentioned that you have an overpronated foot...

I would suggest that an indepth assessment of your posture is needed, identifying areas of stifness in your lumbar spine, the shape of your lumbar spine, what happens when you load each limb, my guess is you probably have some scoliosis...or a rounded shoulder...

if the problem you have is postural then perhaps a shoe raise worn over a few weeks might make a difference to your chronic back pain...