Short Leg Syndrome and Email Advice

Dr Blake,


I have LLD. 6mm short on the right side.

I purchased custom orthodics 3 months ago with a 3mm heal lift (1mm hard material and 2mm compressable material).

I am uncertain whether my pelvis is in alignment and whether the 3mm lift is the correct height.

I have been experimenting with adding another 2mm lift but my right hip is beginning to hurt.

I don't know whether I need a 6 mm lift or if the 3mm lift is sufficent.

Any general recommendations with lift height vs LLD discrepancy?

Please help!
Thanks,

Josh


Dear Josh, I wanted to publish this email directly since there are so many key rules. Most of the information is spread throughout some of my earlier posts, but this is a good place to summarize my thoughts.

Point #1: Do not have the heel lifts attached to the orthotic devices. They should remain separate for separate experimentation of what causes pain, and what produces the best stability. Also, some shoes can only take a certain extra lift height, whereas another shoe could take more. So, see if the practitioner can take off the lift on the orthotic (you can also use a local shoe repair shop).

Point #2: Try to stay away from heel lifts as lifts for short legs. Use full length lifts whenever possible. Heel lifts add more ankle instability and possibly more heel impact shock than full length lifts. Your hip pain can be do to heel lift instability more than the actual height.

Point #3: If you are using lifts for a purpose, and there is room in the shoe (most athletic shoes take up to 9 mm), why would you not use the full correction. You are 6 mm so I would use 6 mm full length lifts (usually 2 one-eigth inch lifts suffice).

Point #4: When you use full length lifts for a short leg, patients get enough biofeedback from their bodies as they walk and run to know when they are at the right amount. So, listen to your body, what is it telling you. When you walk with just the orthotic devices (see why we need them separate), do you feel uneven. When you put in 1/8th inch (3 mm), do you feel more even? When you go higher, do you feel better or worse? You must feel it or you are at the whim of generalizations someone (like me!!) is using.

So, in summary, I would do 4 things:

1. Separate the orthotic from the lift for experimentation
2. Use full length lifts over more unstable heel lifts
3. Stay in 1/8th right full length lift for 2 weeks, then add the next 1/8th lift to go to full correction
4. Listen to your body about what the lifts are doing. The person who measured you could have been wrong and it is the other leg that is short.