Leg Length Discrepancy…Is it Real?

Leg Length Discrepancy…Is it Real?

In my 25 years of being a PT, I can count on one hand the number of times I’ve confirmed a leg-length discrepancy (one leg longer than the other). Yet over those years, I bet 100+ people have come into the clinic saying they had a leg-length discrepancy because their health care provider told them so. Most of these people ended up buying expense foot orthotics or special heel lifts to fix this. I even had someone come in with full lower body x-rays clearly showing one hip higher than the other while standing.

No. They didn’t have a leg-length discrepancy either.

So, what’s going on here? I think most people are measuring them wrong—like our x-ray person. The assumption is that if one side of the pelvis is higher than the other, and we’re standing on level ground, it’s because that leg is longer than the other. Nope.

If we measure leg length from the top of the pelvis to the bottom of the foot, we are measuring across three joints: the hip joint, the knee joint, and the ankle joint. The problem is these joints’ architecture allows rotations to occur that are then magnified along the shaft of the long bone or the pelvic bone. It seems that many practitioners don’t understand the interplay of the lower body system and how tightness/weakness at any part of the system can make it appear there is a leg-length discrepancy.

I measure from the greater trochanter, at the top of the thigh bone, to the bottom of the fibular head at the outside ankle. This means there’s only one joint to consider. This allows for a much more accurate measurement. Therefore, treatment is more precise to solve the rotations found along the lower body chain.

If you’re a health and wellness practitioner who wants to learn to see and solve the body as system, please sign up for my Heal Patients Faster online course. I think it will answer a lot of questions you might have. See you there.

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