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Wednesday, May 18, 2011

Short Leg Syndrome: Email Advice

Good Afternoon Dr. Blake,

I saw one of your videos on You Tube and finally felt that I was NOT crazy. I hope you can help me.
(Dr Blake's note: please see my You Tube channel entitled drblakeshealingsole)
I had surgery on my left knee at the age of 8 to remove a benign bone tumor. Of course, as you can guess, my left leg is now longer than my right leg. I am 46 years of age and have suffered from a sense of clumsiness, no coordination, “can’t dance”, falling into walls and down stairs most of my life.
(Dr Blake's note: surgery in a young child can either stimulate bone growth so that side becomes longer, or stunt growth so that side becomes shorter).

I had an MRI of my left knee back in March, 2011 to check for medial meniscus tear. Thank goodness, there wasn’t one. Just a week later, my left foot swelled up and started hurting. I saw a local podiatrist right away. Had two sets of foot x-rays about 9 days apart to check for stress fracture. Again, none found.

I was told I needed orthotics since I have a much shorter right leg. Wore a heel lift for about 10 days waiting for the orthotics (which I now know from watching your video is a NO NO!). My symptoms kept getting worse even after I got the much hated orthotics. They make my knees and feet HURT so bad even though I broke then in according to the schedule (1 hour the first day, etc.).
(Dr Blake's note: heel lifts for the treatment of short legs is not the best way, full length lifts are much more stable. Also, you never need orthotics (some version of an arch support) for the treatment of a short leg, only lifts. The orthotics are for the treatment of something else and usually go in both shoes). The pressure from even a good orthotic on a swollen painful foot can be very painful.
I have been in physical therapy for the past three weeks, but the pain keeps getting worse. I am being treated for weak ankles and now knee pain. The left inside of my knee is weak due to the right foot pushing out when taking steps, I am guessing?
(Dr Blake's note: Orthotics and Lifts work the best in the Restrengthening Phase of an Injury. You, on the otherhand, are in the Immobilization/Anti-Inflammatory Phase. You are breaking the one of the Golden Rules of Rehabilitation: Create a painfree environment to allow healing to occur. You should be on crutches, removable boots, rest, etc, along with anti-inflammatory measures. The lifts and orthotics will be important in a month or two. Get the pain under control. Read my post on Good vs Bad Pain).

I’m seeing my local podiatrist this coming Friday and am going to tell him to “stuff” his stupid orthotics. They are causing major gait issues and compounding the knee, foot, and ankle instability problems. Apparently, I also have extremely flexible ankles which is not a good thing.
(Dr Blake's note: They could be the wrong orthotic, but they may be just the wrong timing. Spend the time talking right now about getting the pain under control. Xrays are so poor at recognizing a more subtle soft tissue injury, discuss with him or her about getting an MRI).

I am wondering if I can purchase one of those “3 step” sole inserts you showed in one of your videos. After watching your procedure, I am pretty sure it would make my life much less painful.
(Dr Blake's note: see my You Tube video on Manufacturing of Full Length Lifts. I am happy to mail you 3 but first have the podiatrist review the video and see if he/she will make it for your short side. If not, it will be my pleasure).

PLEASE, PLEASE, PLEASE help me. I don’t think I can live like this; I can’t walk, can’t exercise, and my quality of life has gone down the drain.

Any information you can provide would be most appreciated.

For the record, I am 5’5”, 149 pounds, and wear a size 7 or 7 ½ shoe depending upon the manufacturer.

If you can’t sell me the inserts, can you please let me know where I can purchase them? (Dr Blake's Note: You can always buy 2 pairs of Spenco Inserts in your size. Stand on each one and mark between your toes. Cut out the toe area, since it is most important to lift the heel and ball of the foot only, and not crowd the toes. The third one will have to be a left flipped over (place that one on the bottom).

Many thanks!
Thank You.


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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.