Massage therapy · Kitchener–WaterlooLeg Length Discrepancy

It is very common to have one leg that is slightly longer than the other, and this is referred to as a leg length discrepancy. More than half of people have a small difference in leg length, and these mild differences usually do not cause problems (American Academy of Orthopaedic Surgeons, n.d.). Differences of less than about 2 cm (20 mm) are often symptom-free and are considered a normal variation (Applebaum et al., 2021). Larger differences can change the way you stand and walk, and can lead to problems such as a limp, back pain and a sideways curve of the spine known as functional scoliosis (Applebaum et al., 2021; American Academy of Orthopaedic Surgeons, n.d.).

Two types of leg length discrepancy exist (Applebaum et al., 2021)

• Structural discrepancies occur when the thighbone (femur) or the shinbone (tibia) in one leg is actually shorter or longer than in the other leg.
• Functional discrepancies occur when the bones of the legs are the same length, but the pelvis is tilted, which makes one leg seem shorter. This can be caused by tight soft tissues, stiff joints or muscles, loose ligaments or developmental dysplasia of the hip (a condition, present from birth, where the hip joint has not formed properly).

It's quite normal to have one leg slightly longer than the other, and the body usually makes up for a small difference without any trouble. Asymmetry in the body is quite normal. With a larger difference, the pelvis tilts and the spine curves slightly to the side to keep the body balanced. This is known as functional scoliosis. The spine itself is normal, and the curve usually improves fully or partly when the leg length difference is corrected. The greater the leg length difference, the more noticeable the curve may be (Applebaum et al., 2021). If the leg length difference is large, it needs expert attention.

The leg is the lower limb of the body, responsible for supporting the body when standing. It gives you the ability to walk, jump, run and engage in many other movements. The leg extends from the hip joint all the way down to the ankle and foot, and includes the thighbone (femur), the largest bone in the body. In most cases, the bones involved in a leg length discrepancy are the femur and the shinbone (tibia) (American Academy of Orthopaedic Surgeons, n.d.).

Physical therapy is used for functional leg length differences, where the pelvis is tilted because of tight soft tissues, stiff joints or muscles, or loose ligaments (Applebaum et al., 2021). I can help with the tight muscles, stiff joints and aches that often come with a leg length difference, although massage can't change the length of the bones. See the My Approach tab for how I work.

• Strengthening for the weaker side, starting with bridges, clams and side-lying leg lifts, then single-leg balance, step-ups and mini-squats
• Stretches for the tight side and core work, as a short home programme
• Looking at habits that add to the strain, like always standing on the same leg
• Helping you work out whether a shoe lift might help and how to get one, and pointing you to a chiropodist or podiatrist if you need a custom lift or orthotic