You might have heard that one side of our body is smaller (or larger) than the other side. It is pretty normal and likely not noticeable to most. However, when one leg is shorter than the other, and this is the case for a lot of people, it can cause problems.

Differences in leg lengths can be either structural or functional. Structural causes for leg length inequality include fractures, deformities, lesions, unequal growth rates and degeneration. Functional issues are generally caused from physiological responses secondary to biomechanical stresses on the body. When this happens, the musculoskeletal system struggles to compensate for the inequalities. About 90 percent of all leg length inequalities fall into the functional category. The most common cause being excessive pronation of the feet, meaning the foot rolls inward and the arch flattens. This is commonly referred to as dropped arches. When this occurs more on one side than the other, a functional leg length inequality results. The hips and pelvis must then compensate and the low back takes the brunt of the stress. Other causes or co-existing conditions include pelvic subluxations in which the hips rotate or tilt more to one side.

Because discrepancies in leg length can affect the entire body, symptoms can manifest anywhere. Common symptoms include: chronic or recurrent sciatic pain; hip pain, arthritis or other hip problems; low back pain, scoliosis, uneven hip heights; and pain in the thigh. Symptoms may also present up the body causing headaches and neck pain. These symptoms are generally worse after walking or standing all day. Symptoms are decreased in the morning after rest.

Treatment of patients with differences in leg length depends on severity and duration of symptoms as well as activity level and age of the patient. Correction of the problem must be gradual so that symptoms are not aggravated or worsened.

Most commonly, treatment includes custom fit orthotics to normalize the arches of the feet and restore a stable base for the rest of the body. In more severe cases, a heel lift may be required to compensate for difference in length. Specific stretches and exercises tailored to the patient's symptoms and imbalances will also be prescribed. The exercises will help retrain and coordinate the postural support muscles and encourage spinal mobility by stretching tight fascia and connective tissues.