Leg Length Discrepancy
A leg length discrepancy, where one leg is measurably shorter than the other, is more common than most people realise, and often goes undetected until it starts causing pain elsewhere in the body.
At Emerald Hill Podiatry, we assess the full picture, from the feet up through the hips and spine, to determine whether a discrepancy is contributing to pain or imbalance, and correct for it where needed.
What Is a Leg Length Discrepancy?
A leg length discrepancy is a difference in length between the left and right leg, ranging from barely noticeable to significant enough to visibly affect posture and gait. Minor differences of a few millimetres are extremely common and usually don’t cause any problems. Larger discrepancies, however, can force the body to compensate in ways that lead to pain and dysfunction well beyond the legs themselves.
Structural vs Functional Discrepancy
Leg length discrepancies fall into two broad categories, and distinguishing between them is essential to treating the condition correctly:
- Structural discrepancy — an actual difference in the physical length of the bones in one leg compared to the other, whether present from birth or resulting from an injury, growth disturbance, or surgery
- Functional discrepancy — the legs are the same length, but one appears shorter due to how the body is positioned, often caused by muscle imbalance, joint restriction, pelvic tilt, or abnormal foot mechanics such as overpronation
A functional discrepancy can sometimes be corrected by addressing the underlying muscular or postural issue, while a true structural discrepancy is more often managed with external support such as a heel lift.
How an Uneven Base Affects Your Whole Body
Because the legs form the foundation for the rest of the body, even a small discrepancy can have effects that ripple upward. With one leg shorter than the other, the body compensates by tilting the pelvis, curving the spine, or altering the way weight is distributed through the hips, knees, and feet with every step. Over time, this compensation can lead to:
- Uneven wear and strain on the joints of the longer or shorter leg
- Lower back pain from a compensatory spinal curve
- Hip and knee pain from altered joint loading
- Changes in foot mechanics, such as excess pronation on one side
For more significant stress fractures, a period of immobilisation in a CAM boot may be recommended to fully offload the bone while it heals, alongside rest, ice, and compression in the initial stages.
Signs of an Unbalanced Stride
- A visibly uneven gait or limp, particularly when walking barefoot
- One shoulder or hip appearing higher than the other
- Uneven wear patterns on the soles of shoes
- Recurring pain on one side of the back, hip, knee, or foot
- A sense of feeling "off balance" or favouring one leg
When to See a Podiatrist
See a podiatrist if:
You notice uneven wear on your shoes or an asymmetrical stance
You have recurring one-sided pain in the back, hip, knee, or foot without an obvious cause
A leg length difference has been mentioned by another healthcare provider but hasn't been formally assessed
You've had a leg injury, surgery, or growth-related condition that may have affected limb length
Get Your Leg Length Discrepency Properly Assessed
Relieve Pressure on Foot, Hip, and Back
Treatment depends on whether the discrepancy is structural or functional, and how much it’s affecting your gait and posture.
Options include:
- Biomechanical Gait Assessment — measures how the discrepancy is affecting your walking pattern and identifies any compensations that have developed over time
- Heel Lifts and Custom Orthotics — built into footwear to even out leg length and restore more balanced posture and gait
- Gait Analysis and Correction — ongoing monitoring and adjustment to ensure the correction is relieving strain rather than creating new imbalances elsewhere
What to Expect at Your Assessment
Your podiatrist measures leg length, examines your standing posture and gait, and determines whether the discrepancy is structural or functional before recommending a correction. Where needed, we coordinate with other specialists for a broader assessment of the hips and spine.
