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​CATEGORIES OF LLD:

• Mild = 0-30mm
• Moderate = 30-60mm
• Severe = >60mm

SYMPTOMS OF A LEG LENGTH DISCREPANCY:

• Abnormal gait – limp or difficulty walking. This usually occurs when the discrepancy is greater than one centimetre.
• Pain in back, hip, knee or ankle.
• Scoliosis in lower spine
• Ankle deformities in one foot.
• Head or shoulder tilting to one side.
• Stress fractures in short leg (severe cases).

LEG LENGTH DISCREPANCY IS ASSOCIATED WITH MUSCULOSKELETAL DISORDERS INCLUDING:

• Lower back pain.
• Scoliosis.
• Hip pain.
• Knee pain.
• Arthritis of the hip and knee.
• Iliotibial band syndrome
• Tendinopathies of patella and achillies.
• Stress fracture
• Pronation and supination of the foot

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METHODS OF DIAGNOSING A LIMB LENGTH DISCREPANCY:

• History and physical examination.
• Gait analysis.
• Measuring the limb with a tape measure
• Diagnostic imaging such as an x-ray or CT-scan (most accurate method).

HOW CHIROPRACTORS CAN MANAGE YOUR LEG LENGTH DISCREPANCY:-

The type of medical management depends on the severity of the discrepancy, the type of discrepancy and if the patient is symptomatic. 

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• ​Mild and moderate SLLD can be treated with heel lifts up to 20mm but usually not more than 9mm. When the lift is more than 9mm some stability may be lost as it is a big correction for the patient, foot mechanics may also be altered. Heel lifts should be introduced gradually. A chiropractor can test biomechanically how much heel lift is needed, refer for custom orthotics and then re-test the bodies reaction and adaptation to the heel lift. In some cases, moderate may be dealt with surgically and severe case should be corrected surgically.

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• FLLD are usually caused by muscles in the hip and lower that have become chronically, involuntarily contracted. This is due to certain postures or movements that are constantly being repeated for long periods or a protective mechanism from an injury. The nervous system then adapts and causes these muscles to tighten leading to dysfunctional muscular patterns. Over a period of time this damages the physical structure of our bodies. A chiropractor can do the following for FLLD:

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1. Address the tight muscles around the hip and lower back that maybe rotating the hip making the appearance of one leg being longer than the other. These muscles include the adductors, glutes, erector spinae and quadratus lumborum.
2. ​​Make sure the sure joints of the foot, knee, hip and low back are moving properly.
3. Neuromuscular education to improve movement patterns and retrain the nervous system.
4. Stretches and mobility exercises.
5. Muscle strengthening.
6. Patient education – lifestyle factors, posture and ergonomics.
7. A heel lift is not used for FLLD as it can worsen the symptoms as muscular imbalances become more pronounced.​

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If you feel like you’re someone with a shorter leg or have any other musculoskeletal issues, please visit your local health care professional. If you are a local to health associates do not hesitate to ask or book in, we would be more than happy to help.

REFERENCES
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• Gurney, Burke. "Leg length discrepancy." Gait & posture 15.2 (2002): 195-206.

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• Bangerter, Christian, et al. "What are the biomechanical consequences of a structural leg length discrepancy on the adolescent spine during walking?." Gait & posture 68 (2019): 506-513.

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• Sekiya, Tatsuhiro, et al. "Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system: a prospective comparative study." Scoliosis and spinal disorders 13.1 (2018): 7.

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• Mahmoud, Asmaa, et al. "Functional leg length discrepancy between theories and reliable instrumental assessment: a study about newly invented NPoS system." Muscles, ligaments and tendons journal 7.2 (2017): 293.

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• Knutson, Gary A. "Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance." Chiropractic & osteopathy 13.1 (2005): 1-10.

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• Sabharwal, Sanjeev, and Ajay Kumar. "Methods for assessing leg length discrepancy." Clinical orthopaedics and related research 466.12 (2008): 2910-2922.

•  Leg Length Discrepancy Image - F.A. Davis Company, 2015

So you’ve reached that half way point. You find that flat spot with a killer view to sit down and enjoy. Getting that bag off your back feels so good and you know those goodies you packed for fuel are going to taste better than ever.

This view, the H2O and “aaaa-mazing” home made beef jerky your friend has supplied you with, promising no adverse affects, would all be perfect if you weren’t also wishing to find a new pair of feet at the bottom of that bag...

Whether you’re a competitive runner or humble walker on your own, with friends or with your family, here are some valuable HOT tips for hiking all year round!

• QUALITY GEAR: If you’re heading out for a HIKE rather than a walk, it is an absolute investment to gear yourself up with quality products. This doesn’t mean you need to go all out with a top of the range mini filtration system or most recent survival bracelet equipped with bottomless inventory! Invest in products that are going to take care of you so you don’t have to do it later.

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• NO NEW SHOES: Just a gentle reminder you should NEVER have to “break your shoes in”, let alone on a hike. If you have the right size and have been fit correctly, this shouldn’t be an issue. So just in case you haven’t discovered already the shoes were not fit correctly, don’t wear fresh shoes on a hike.

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• LACING: There are plenty of different ways to lace your shoes to accommodate different foot shapes.  Google can help with this research ;-)

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• SOCK(S): Merino wool and Bamboo are great materials for hiking socks. Thorlo and Bridegdale are brands highly recommended. Take into consideration the thickness of your socks, make sure they’re adequately dried and take more than one pair for those multi day hikes.

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•  ACTI-BLISS: You’ll find this blister prevention wool in many of our hiking shoes.

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•  MAGNESIUM POWDER: A heap of research shows that physical exercise depletes magnesium, leaving your energy metabolism efficiency impaired. So if you’re multi day hiking, you may benefit from supplementation. Consult with your GP if need be.

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• COMPEED BLISTER PACK: These can provide some really great relief for any sneaky blisters.

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• GORE-TEX: Moisture getting into your footwear is bad news! Gore-tex provides a waterproof lining keeping your feet dry and warm.

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• WALKING POLES: Depending how hardcore you’re going, and how uneven the terrain is, walking poles can really be the legs you need when you start to fatigue.  Kids are already great at this when they find a big stick to walk with;-)

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• GAITERS: Depending on the terrain and whether or not you’ve abandoned the beaten track, gaiters are a nice addition protecting your legs from branches, thorns, mud and even leeches and mosquitoes!

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• SKIN AND NAIL: Don’t head out with long and unruly nails. These can become super painful and cause further problems if they’re continuously hitting the end of your shoes. Any hard skin will also be uncomfortable and slow you down. Addressing both these after the hike is just as important as before.