|A majority of people have a measurable leg length
difference of 1/4" or more, although most people adapt to the difference with no
apparent ill effects. Unfortunately, some do not, and the effects range from low back or
sacroiliac pain to hip, knee, or foot problems.
A number of
causes can contribute to leg length discrepancy, including:
- Any bone in the leg ever broken, particularly during growth years,
- Congenital differences or uneven growth,
- Disease-caused shortening of the muscles and
connective tissue, a common after-effect of polio,
- Surgically-induced differences, especially common
after hip replacement surgery,
- Compensation for problems elsewhere in the body,
such as pelvic or spinal scoliosis.
These biomechanical adaptations and compensations
for even a slightly short leg can have long-term side-effects, manifesting as lower back
pain, hip and knee pain, uneven gait, and various foot and lower leg problems. These
problems are often related to the bodily adaptations that occur due to continuing
unbalanced movement, and can be aggravated by the extra stresses of sports
activities such as running.
The diagnosis and treatment of such leg length
differences and their effects is the subject of volumes of medical history and research,
and is not the subject of this document. The use of heel lifts should generally be
prescribed after thorough medical evaluation.
The intent of these recommendations is
simply to assist you in choosing among the wide variety of in-shoe heel elevating
products, and in recommending how to use them for your personal needs.
Short leg syndrome or anatomical (structural) or
functional (adaptive) leg length discrepancy, is often treated using heel lifts or shoe
Heel lifts, also known as shoe lifts, are firm wedge-shaped
inserts for shoes, which attempt to better balance the lower body by adding to the length
of the short leg at the point when the heel strikes the ground while walking.
Treating Leg Length
Discrepancy Using Heel Lifts
- Heel lifts for leg length compensation will only be
required for the short leg, i.e. in one shoe. This can make the two shoes fit and feel
different, particularly if the heel lift adds cushioning in the shoe. You will be most
comfortable if no additional cushioning is added by the heel lift.
- Because leg length compensation will typically be
needed permanently, long-term comfort and minimum stress on the foot is very important -
see Selecting Heel
Lifts and Shoe Lifts - A Guide for more information on choosing heel lift products.
- As much as possible, the same elevation should be
added in all shoes that are regularly worn, including house-slippers and flip-flops. You
will probably need more than one type of heel lift or modification for various
- It is generally accepted that no more than 12mm
(1/2") of heel elevation can be used in a shoe without affecting
The maximum height you can use in a pair of shoes will be affected by the style and fit of
the shoes, as well as your foot size. Laced shoes will permit more heel
lift height, for example.
- If you require more than 10-12mm of compensation, part of
the additional height should be added to the external sole and heel, rather
than inside the shoe. This will cause less stress on the foot and lower leg. More than
12mm should be added as a full-foot lift, either inside or outside the shoe, or both,
rather than just a heel lift.
- When introducing your body to the use of heel lifts, increase to the target height slowly - add 2-3mm each week on the short leg side,
to allow the body to adapt to the change. Adjustable shoe lifts are useful for this
- The ideal height for your specific needs should be
determined by experimentation over a long time. You may find that a difference of 1-2mm
greatly improves your overall comfort both in the shoe, and in the other effects of your
leg length discrepancy. Try changing the shoe lift height slightly and evaluating the
effects for a few days or weeks.
- It is often recommended that the starting point for
heel lift height be one-half of the measured difference in leg length. It is my personal
belief that this should be modified based on the length of time that the difference in leg
lengths has existed:
- In the case of an uncompensated leg length difference that has existed for a long time,
the body will have adapted to the imbalance, and completely compensating for the leg
length difference may make these changes maladaptive - you may cause new problems by using
a heel lift of the full height of the measured difference, at least initially.
- For recent changes, such as surgically-induced leg length
differences, or in children, where bone growth is still occurring, I believe that the heel
lift height should fully compensate for the difference, to minimize adaptive changes if
- Use of heel lifts is a medical and personal
decision, but it is strongly recommended that a health care professional be involved in
the evaluation of the need and in monitoring the results.
|The Clearly Adjustable heel lift is a very comfortable adjustable heel
lift that is ideal for long-term compensation for leg length discrepancy. You can
Adjustable lifts online or by a 1-800 call.