Leg length difference

Hi there,
I have a functional leg length discrepancy. meaning when i lie down my legs are of the same length but when walking there is an obvious difference. My physio said my hip tilts when i'm walking due to muscle imbalances in my left and right legs. and i have functional scoliosis. i've been doing exercises and a whole lot of stretching but the condition has not changed. i've started experiencing lower back pains and i am not flexible. even when i am standing my hip is tilted, making my right leg appear shorter than my left. this makes walking and standing very uncomfortable, even painful. I'm using an arch support in my shoe. it makes me feel more comfortable but doesn't solve anything. I regularly go for physio treatments, but it helps only for a few days.
Please offer suggestions.

Hi Ishen7! Firt of all Apart from physical thérapist, am also podiatrist, and maybe i can offer you another point of view and try to add new solutions to your problem.
As i have understood from your review, youve been doing stretchings to rule out that the musculature supports the difference in length, working also with foot arch but no work, isn't it?

The functional difference of length in legs is caused by many factors. The main of them is a greater pronation of one subastragaline joint comparing it with the other. Sometimes is caused by a congenital shorten-member, that can only be treated (non surgery) with foot orthosis. Depending on the cause, the orthosis would have diferent pieces. (Either a Medial Heel Skyve or a Rise to level the sacrum and relieve the pain.

I hope I've helped you. Any other question, please send a private. :D

Hi

If your physio is right about the muscle imbalances then usually the functional leg length discrepancy along with a scoliosis means you have:

• over development or shortening of the muscles that pull your leg in to the other one on one side (hip abductors)
• lengthening or weakness of the muscles that pull the leg out to the side (hip abductors)
• The opposite pattern on the other leg
• likely shortening of the muscles on one side of the spine and lengthening/weakness on the other side (could be a number of muscles but quadratus lumborum is often the culprit)

It could be any or any or all of these things. Have a look at these muscles in an anatomy text or website. If this is the case and there is not true leg length discrepancy (ie thigh bone and shin bones are all equal length) and the bony pelvis is even then the rational treatment is strengthening in the shortened position of the lengthened/weakened muscles and lengthening exercises of the shortened muscles. You usually also need some help with changing your patterns of movement which probably underlie the development of this problem.

So... your physio should have given you such a programme. It takes time (several weeks to months), you have to adhere to the programme, and is very specific but can be effective. that is all considering if this is the problem. The stretching component should be gentle and sustained over a long period of time. If you are getting sore from the exercises then something is wrong. A build may help in the overall management but in itself is not such an effective strategy as it isn't really dealing with the underlying problem.

Looking at your age this is a great time to get on with this - it may save you suffering later in life as well as improving your enjoyment of walking, running etc.

A leg length difference can be a true difference, which is in the size of the femur bone, or it can be due to imbalanced bony alignment at the hip joint.