We come across leg length imbalances quite frequently here at the clinic, and they can have quite a significant effect on cases of back pain or leg pain as the body tries to compensate for this imbalance. Often patients have heard from other sources if they have a leg length imbalance, but without thorough examination this can easily be misinterpreted. Unfortunately, we have come across cases where leg length has been miscalculated in the past, with orthotics prescribed and the patient has ended up in more pain. This is because there is actually two main types of leg length differences. There can be a structural difference in the legs actually being measurably different lengths, but there may be cases where the legs are actually measuring the same length but due to dysfunction in the pelvis there may be one hip that is holding one leg higher than the other.
How to Measure A Leg Length Imbalance
If an imbalance is found, invariably it has been found with patients lying down, with the leg being measured between the bony part of your leg at the front of your pelvis and the ankle. However, this can be quite an ineffective and inaccurate measurement, especially as these bones can become rotated in any way which can potentially give you an artificially false treading. Leg length imbalances can also be detected through shoulder height imbalances, but this can also show cases of scoliosis so would only signal that further investigation is needed.
The best, and most accurate, way to measure leg length imbalance is in fact through X-ray imaging, although the patient will need to show clinical relevance that an X-ray is required. Usually a practitioner will conduct a preliminary examination to examine any foot involvement. Sometimes the arches of your feet can have an effect on the accuracy of the reading – so the practitioner should assess this first. If an X-ray is clinically indicated (usually the potential benefits of having the X-ray outweighs the risks), the patient ideally should have their heels together to get the most accurate reading. The practitioner should then examine the hip angles, at the top of the leg bone. The difference is then usually an accurate representation, and can be quantified so that a resolution to the problem can be found.
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