Most people are slightly asymmetrical. In fact it is estimated that 90% of people have a leg length discrepancy (LLD). Studies haves shown that the right leg is usually longer than the left. The difference is often negligible and does not need to be treated. The body generally adjusts using several compensatory mechanisms to keep the pelvis level. Some of these compensations take place in the spine, pelvis, hips, knees and even the feet.
If the LLD is too much for your body type and activities, then you may have symptoms in the form of back, hip, knee or foot pain. Depending on the severity of your symptoms one can choose a) not to treat the problem, b) conservative treatment or c) surgical treatment.
Conservative treatment usually involves using ‘lifts’ in your shoes, either in your shoe, or on your shoe, or both. The amount to adjust must be carefully considered because the body has compensated over time. If someone has 2 centimetre difference and symptoms, then the adjustment should not be for the full 2 centimetres otherwise new problems may arise. A graduated approach should be taken and your foot specialist should consider the impact of your other treatments such as physiotherapy and chiropractic.
As a foot specialist I see patients suffering from heel or arch pain which is much worse on one foot. After initial assessment I often see a small leg length discrepancy for which the patient is compensating by pronating the foot on the side with the long leg (which shortens the long leg and levels the pelvis). This pronation is creating the downstream problem of plantar fasciitis. A mild heel lift sometimes reduces the pronation and eases the plantar fascia ligament. It is usually wise to provide leg stretching exercises in conjunction with any ‘lift’ or other orthotic therapy.