What is a Limb Length Discrepancy and What Can Be Done About It?
Dealing with issues related to limb length discrepancies can be challenging – this condition can affect your posture, which can cause other issues, and it can also affect the way that you walk.
In this article, we will explore the causes and symptoms of limb length discrepancies, as well as talk about how the condition is diagnosed and treated as well.
What is a limb length discrepancy?
A limb length discrepancy is when one leg or one arm is shorter than the other leg or arm. Many people are born with differences in the lengths of their limbs, however, for some people, the discrepancy can be significant and cause an imbalance, particularly if it is affecting your legs.
The imbalance can affect your overall posture, the way that you stand, your comfort and the way that you walk.
There are two types of limb length discrepancies – structural and functional. Structural discrepancies are when there are actual differences in the bone lengths between the limbs, while functional discrepancies are those caused by joint contractures or muscle tightness.
What causes limb length discrepancies?
Several factors, including genetic, injuries and lifestyle factors, can contribute to limb length discrepancies. The condition is commonly attributed to the following factors:
Congenital Conditions or Developmental Abnormalities
Some individuals are born with variations in bone growth that can result in differences in leg length. These conditions may include congenital limb deficiencies, hereditary conditions, or genetic abnormalities affecting bone development.
Growth Plate Injuries or Fractures
Injuries that occur during childhood, especially around the growth plates, can disrupt bone growth and lead to a limb length discrepancy. Fractures near the growth plates can impact the rate of bone growth in the affected limb.
Surgical Interventions
Surgeries involving bones or joints can sometimes result in differences in leg length if the procedure affects bone growth. This can occur when there are corrective surgeries for fractures or joint disorders may unintentionally alter the growth pattern of the bones.
Muscular Imbalances or Contractures
Conditions that cause muscle tightness or contractures can alter the alignment of your legs, leading to a limb length discrepancy. Muscular conditions like cerebral palsy or muscular dystrophy can affect muscle tone and length, resulting in an imbalance in leg lengths.
Degenerative Conditions or Diseases
Certain degenerative conditions or diseases that affect bone growth can contribute to limb length discrepancies. Examples include osteomyelitis (bone infection), bone tumours, or conditions like neurofibromatosis that affect bone growth and development.
What are the symptoms of limb length discrepancies?
Limb length discrepancies can present with a variety of symptoms and the severity of symptoms can vary depending on the extent of the discrepancy. Some of the more common symptoms include:
Visible differences in leg length when standing or walking. You may notice that one leg appears shorter or that your hips are not level when standing upright.
Uneven distribution of weight or pressure on the feet, causing discomfort or pain. You may experience pain or fatigue in the longer leg or foot due to increased stress on those structures.
Changes in posture, such as a tilted pelvis or a curvature of the spine (scoliosis). These postural changes occur as the body tries to compensate for the limb length discrepancy.
Gait abnormalities, like limping or an uneven stride. You may notice an altered walking pattern, such as favouring one leg or a noticeable limp when walking or running.
Joint pain or discomfort in the hips, knees, or ankles. The uneven distribution of forces and altered biomechanics can lead to joint pain or overuse injuries in these areas.
Diagnosis of Limb Length Discrepancies
A healthcare expert, like a doctor or podiatrist, can help to diagnose a limb length discrepancy. To do so, they will perform a comprehensive evaluation, which is likely to include the following steps:
Detailed Patient History: Your medical history, developmental milestones, and any previous injuries or surgeries will be assessed to understand the possible causes of the limb length discrepancy.
Physical Examination: Your healthcare provider will examine your posture, leg length, joint range of motion, and gait mechanics. They may observe you walking or ask you to perform specific movements to assess any functional limitations or compensatory mechanisms.
Measurement Techniques: In some cases, imaging techniques such as X-rays, CT scans, or specialized imaging may be used to quantify the limb length discrepancy and identify any underlying skeletal abnormalities. These measurements help determine the exact difference in leg length and guide treatment decisions.
Collaboration with Other Healthcare Professionals: In complex cases, your healthcare provider may collaborate with orthopaedic surgeons or physical therapists to ensure an accurate diagnosis and develop a tailored treatment plan. This interdisciplinary approach ensures comprehensive care and optimal outcomes.
How are limb length discrepancies treated?
When treating a limb length discrepancy, the main goals are to improve functional alignment, promote a symmetrical gait and minimise any of the symptoms the person with the condition may be experiencing, like pain and discomfort.
The way a limb length discrepancy is treated will be dependent on factors like the severity of the discrepancy, the person’s age and the cause of the discrepancy.
Some treatment options include:
Heel Lifts or Shoe Modifications
Minor limb length discrepancies can often be managed with the use of heel lifts or shoe modifications. These devices are inserted into the shoe of the shorter leg to provide support and help balance the leg lengths.
Physical Therapy
Physical therapy plays a crucial role in managing limb length discrepancies. Specific exercises are prescribed to improve muscle strength, flexibility, and gait mechanics. Physical therapists can develop customized exercise programs targeting the affected muscles and joints, aiming to optimize functional alignment and reduce compensatory movements.
Orthotic Devices or Custom Shoe Inserts
Orthotic devices, such as shoe inserts or custom-made shoe orthotics, can help optimize alignment, improve weight distribution, and enhance overall lower limb function. These devices are designed to support the feet and correct biomechanical abnormalities, thereby reducing stress on the joints and minimizing symptoms.
Surgical Interventions
In more severe cases or when conservative measures are ineffective, surgical procedures may be considered. The specific surgical technique will depend on the nature of the limb length discrepancy. In some cases, limb lengthening procedures, where the shorter bone is gradually lengthened using external or internal fixation devices, may be performed. In other cases, limb shortening procedures may be necessary to equalize leg lengths.
Can limb length discrepancies be prevented?
While not all limb length discrepancies can be prevented, there are steps you can take to minimise the risk of one occurring or prevent further complications:
Pay attention to your child’s growth and development. Regular check-ups and early medical intervention can help identify and address any potential issues affecting bone growth.
Maintain a healthy lifestyle and provide proper nutrition to support optimal bone development. An adequate intake of calcium, vitamin D, and other essential nutrients necessary for bone health can aid in a child’s healthy development.
Encourage a well-rounded exercise routine that includes weight-bearing activities and exercises to promote muscle strength, flexibility, and coordination.
Promptly address any injuries or conditions that may affect bone growth. Seek medical attention for fractures, infections, or other conditions that can disrupt normal bone development.
If you have a limb length discrepancy
If anything we’ve talked about in this article sounds familiar to you, consider visiting us here at Hurst Podiatry. Our podiatry team is highly experienced in diagnosing and treating various foot and lower limb conditions, including limb length discrepancies.
