Do you think that your one leg is shorter than the other? Differences in leg lengths, shoes sizes, and eyeglasses prescriptions are common. What matters is the extent of the difference. Should you be worried about one leg longer than the other? You should seek help if the difference is significant. This condition is also referred to as leg length asymmetry. Many people ignore this asymmetry, yet it is a major cause for ankle, hip, knee and back pains. Athletes are at high risk of this condition. The symptoms, classifications, causes and treatments of leg length asymmetry are outlined below.
Some people have insignificant discrepancies in leg lengths, which may not cause back pains. In such cases, the difference is below 5 millimeters. Any difference above 5 millimeters will cause lower back pains. If the difference is above 9 millimeters, your risk of suffering an episode of pains in your lower back is six times greater. Some of the symptoms of leg length asymmetry include:
There are two kinds of conditions where one leg is longer than the other. Each of these classifications is outlined in this section.
This condition occurs when legs have actual differences in length. These differences are caused by differences in the length of fibula and tibia bones that are located in the lower leg. Differences in the length of femur and birth defects will cause structural differences too. Other causes include broken legs, damages of the growth palates and infections.
Functional short leg syndrome is a condition in which both legs have the same length but one leg appears shorter than the other because of the postural changes in the pelvis and hips. The postural changes may result from neuromuscular injuries in the leg or pelvis. Consequently, one hip or leg is held tighter and higher. The condition is also called leg length alignment asymmetry.
Watch the video below to know how to check leg length:
There are many reasons why you may have the condition of one leg longer than the other.
Injuries to a bone in the leg may cause leg length discrepancies if the injuries heal in a shortened position, especially if the injury breaks the bone into many pieces. They may also results if muscle and skin tissues surrounding the bone are exposed and injured severely. When a child's bone is broken, it grows faster after healing and becomes longer than the uninjured bone. The growth maybe slower if the bone breaks through its growth center at the end of a bone and this leads to a shorter leg.
Children that suffer from bone infections may have significant discrepancies in the length of their legs. The risk is high if the infections occur at infancy. Joints inflammation such as juvenile arthritis causes leg length differences.
Some other bone diseases that cause unequal leg lengths include ollier disease, multiple hereditary exostoses, neurofibromatosis, neurologic conditions and arthritis.
If you have one leg longer than the other, you can use surgical and non-surgical treatments to rectify the condition. These treatment options are discussed below.
Minor or insignificant differences in limb length do not require treatment because the risks of treatment are higher than the benefits. Doctors do not recommend surgical treatments when length discrepancies are below one inch. Instead, they recommend a shoe lift where the patient inserts a lift in his or her shoe. The lift makes running and walking more comfortable. It may relieve back pains that result from unequal leg lengths. The advantage of shoe lifts is that they are inexpensive and the patient can remove them if they are ineffective.
If your uneven legs are functional, you should learn how to align your hips and learn to walk correctly and normally. Watch this video to learn why you have functional uneven legs and how to align an uneven hip line:
In this surgical procedure, a physician slows down the growth of the longer leg using two small incisions on the knee. The incisions are done under X-ray control at two growth sites. The results of this procedure are not immediate but the difference in leg length decreases gradually as the legs grow. The shorter leg will grow in length and catch up with the longer leg. The success of this procedure depends on the timing. The two legs must have the same length by the time the patient reaches mid to late teenage. Normal growth ends at this age.
The shortcomings associated with this procedure include over or under correction of the length discrepancies. The procedure may reduce the patient's height in adulthood, which would have been higher if the shorter leg was lengthened. In addition, the patient may appear disproportionate if the discrepancy was significant.
An alternative way of dealing with one leg longer than the other is shortening the longer leg, which is referred to as osteotomy. However, a major reduction in length weakens the leg's muscles. Three inches of femur or the thighbone can be shortened at most. Two inches of the shinbone can be shortened at most. This procedure is recommended when a patient has reached his or her skeletal maturity. It is also recommended when the limb length discrepancy is severe.
In this procedure, the bone is lengthened by using a fixation device. This device is applied on the external part of the shorter leg. This device has a scaffold-like frame, which is connected to the leg bone using pins, wires and sometimes both. The next procedure is to make a small crack in the bone. The external frame creates tension when the caregiver or the patient turns the frame's dial. It is done several times in a day.
The lengthening process starts 5-10 days after surgery. The bone's length increases by a millimeter daily or by an inch in a month. The process is slower if the bone had previous injuries or operations. It is slower for cigarette smokers and patients prone to blood vessel conditions.
The patient wears the frame for three months until the bone is strong enough. The risks involved include stiff joints, infections from wires and pins, and over or under correction of limb length. The procedure requires consistent consultation with the physician, rehabilitation, adjusting the frame several times daily, and cleaning the areas near wires and pins.