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Thursday, September 8, 2011

Short Leg Syndrome: Difficulty with Lifts (Email Advice)

Dr Blake,

      I'm interested in what you have to say about this problem.  I have had standing x-rays of my pelvis on several different occasions by chiropractors and have been told I have a 9mm difference, as in my left hip is that much higher than my right.  The problem is, this feels like a lot in a shoe and won't even fit in some.  I am using the clearlyadjustable heel lift. I have taken them in and out of my shoes over and again, hoping and praying that custom orthotics would correct the pronation and I don't really need the lift.  They never have helped.
      I have a large knot in my right forefoot area/calf pain and tightness and a stretched out, weak feeling in the front of my left hip with muscle pain and tightness in that glute/hamstring.  I'm experimenting with a 5mm heel lift under a custom orthotic on the right but it feels low.

I just want to get back to running and weightlifting(deadlifts and squats).
I look forward to your suggestions if you have time.

Jody from Canada


    Thank you for your email. To summarize, you seem to have 3 biomechanical problems, each with different causes and potential treatments. These are:

  1. A short right leg of 9 mm or 3/8th inch.
  2. Excessive Pronation requiring some amount of pronation control from orthotic devices.
  3. Weak Areas needing strengthening, bracing, or biomechanical changes.
Please use full length lifts for your athletics since heel lifts create their own instability and do not help when you are on the front of your foot (in running or weightlifting). If you go up 1/2 to 1 full shoe size, and choose your running shoes with good depth (like most Brooks, and some Asics), 3/8th inch correction is normally do-able.
I have to choose with my patients at times whether we start with lifts or orthotic devices. The question to ask is whether the symptoms are more related to the pronation or the short leg. A compromise is made at times if the severest pronation is on the short side to just use the orthotic devices on the short side for awhile. 

So, in the decision making with you, the following must be addressed:
  1. Can you go to bigger shoes?
  2. Can you use full length lifts instead of heel lifts?
  3. What symptoms are more important to treat first?
  4. Are those symptoms most related to over pronation or a short leg syndrome?
  5. Can I use lifts in my weight lifting shoes and orthotics in my running shoes or vice versa?
  6. Is the pronation worse on the right side so I possibly can try to correct the shortness with a right orthotic device and 1/8th extra full length lift?
Jody, I hope this at least is asking questions that can be answered in the next few months. Please read my posts on short leg syndrome for more info and email me back if you have more info to share. Good luck. Rich

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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.