Physical signs of true (anatomical) Leg Length Inequality (LLI)?

[loft33]

I was wondering what many of you think can be used as signs of a true (anatomical) LLI?

I ask because I've been having a flare-up of SIJ problems on my right side and ever since I was 20 I've noticed that my right leg always feels shorter (I feel as if I'm stepping down into a ditch on that side). I can swing it anteriorly and posteriorly (like a pendulum) while standing on my left leg and my right heel won't touch the ground. However, when I swing my left leg while standing on my right leg, the left heel always touches the ground (and won't even swing farther; i.e.: there's no way my left leg can even complete half of the pendulum swing).

Another (what I think is a) sign that I might have a short right leg is that my wear pattern of my shows differ greatly from right foot to left foot. My right shoe always wears down first and never in the heel. The wear pattern is always up by my metatarsals. I think this may be my body's way of compensating for feeling there's nothing below my right heel - it tilts the front of my foot down so the ball of my foot can "scout around" for the ground).

Another (what I think is a) sign of a short right leg is that my glute muscles on my right side are much, much weaker and not as developed as those on my left.

Now, I know that a functional LLI could present with all these symptoms, but my chiropractors always say my right leg is about half and inch shorter than my left even after they adjust me (before they adjust me it can be up to 1.5 inches shorter!).

Also my doctor did order a LLI X-ray and it came back as my right was 1.4cm shorter than my left. But the problem with that X-ray was that it was done laying down and they shifted the table between x-rays so my body might have shifted on one side, thus causing the discrepancy. I just had the x-ray redone in standing position, and will have those results this week.

I know the common line of thought is that if a true LLI were contributing to your back pain/SIJ pain, you would have had the pain all your life -- not just in your mid-30's, but one chiro did tell me that that is faulty logic. He said that as the decades go on it's more stressful for our body to compensate for small anatomical variations, so a true LLI could begin to cause more pain as we age.

I was just wondering what you guys and gals thought about his reasoning and what sings you would expect to see with a true anatomical LLI on the right side.

Thanks!

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[violablue]

Sometimes the muscles in your back can tighten up more on one side then the other causing the hip to hike up, so making it seem like the leg is shorter on that side. Loosen the muscles and do some traction and it usually balances out.

True leg length discrepancy is structural, so it is actually the bones, not muscles, which are causing the difference. Usually they say it's not a worry until you have about an inch difference and then you can be fitted for a wedge in your shoe.

To measure for true leg length discrepancy, have someone measure from your ASIS (the bony prominence at the front of your hip--being accurate in placement side to side) and your lateral or medial malleolus at the ankle.

If the xrays are right, 1.4 cm is not a huge difference for true leg length. However you may definitely have some muscular issues that are worsening functional movements for you by causing a non-true shortening of the one leg as evidenced by your chiro being able to change it. Wedging would only worsen the problem. Massage may be helpful.

[loft33]

So I got the results of my LLI X-ray today. I'm not quite sure what to make of it. I've attached an image of the report to this post.

It seems that the radiologist is saying I have a 9mm difference (right is shorter), but that it's not due to femur or tibia length, but due to rotation of the talus bone in my ankle? My podiatrist recommends a 9mm heel lift.

Does that make sense (using a heel lift, I mean)? Is there any way to "unslope" the talus bone?