Chronic overuse issues that remain persistent even after exhausting traditional treatments may be due to leg length discrepancy or LLD. LLD is a condition where there is a difference in the length of the left and right legs and cause of number of symptoms including chronic lower back pain. Since the symptoms of LLD may differ from person to person and vary in severity depending on the amount of discrepancy, it can be difficult to diagnose and treat. It is thought LLD may be present is some form in up to 60% of the population and is the third most likely cause for running related injuries.
The two major categorizations of LLD are structural and functional. A third more minor category is environmental.
In structural LLD there is an actual anatomical difference in the bones of the lower extremities where one side becomes shorter than the other. This type of LLD may be genetic, where the person is born in this way. In other cases it may be due to injury or infection through the growth phases of early childhood or adolescence. Some spinal abnormalities like scoliosis can also cause this condition.
Functional LLD is where the bones are not the cause of difference but a muscle or pelvic condition has the effect of weakening the leg on one side. Conditions that can cause this are muscle inflexibility, adduction contractures and pelvic obliquity (amongst others).
The third less severe category of environmental LLD is caused by discrepancies in the surface that the feet and legs are resting or walking on. Banked, uneven or curved surfaces can all cause environmental LLD.
In LLD the asymmetric nature of the legs in relation to hips and back caused the centre of gravity to shift from its natural position. This then results in the body attempting to compensate by either tilting the pelvic areas towards the shorter side, increased knee flexing on the longer side, flexion of the ankle plantar and foot supination towards the shorter side.
The most common symptom of all forms of LLD is chronic backache. In structural LLD the sufferer may also experience arthritis within the knee and hip are, flank pain, plantar fasciitis and metatarsalgia all on the side that is longer. Functional LLD sufferers will see similar conditions on the shorter side. A systematic and well organized approach should be used in the diagnosis of LLD to ensure all relevant factors are considered and no clues are overlooked which could explain the difference. To determine the asymmetry a patient should be evaluated whilst standing and walking. During the process special care should be used to note the extent of pelvic shift from side to side and deviation along the plane of the front or leading leg as well as the traverse deviation of the back leg and abnormal curvature of the spine. Dynamic gait analysis should be conducted during waling where observation of movement on the sagittal, frontal and transverse planes should be noted. Also observe head, neck and shoulder movements for any tilting.
After the leg length discrepancy has been identified it can be categorized in as structural or functional and appropriate remedial action can be instigated. This may involve heel lifters or orthotics being used to level up the difference. The treatment of LLD depends on the symptoms being experienced. Where the body is naturally compensating for the LLD (and the patient is in no discomfort), further rectifying action may cause adverse effects to the biomechanical mechanism of the body causing further injury. In cases of functional asymmetry regular orthotics can be used to correct the geometry of the foot and ground contact. In structural asymmetry cases heel lifts may be used to compensate for the anatomic discrepancy.
You can choose which foot you would like the extra support, left or right. Also the height of the heel lift, 4mm, 6mm or 8mm.
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They help reduce stress at key weight points, keep each foot properly aligned and cradle and stabilize your heels. A strategically placed heel insert made of poron foam absorbs the pounding foot shock of each step.
Dr Foot Pro 3/4 length insoles provide the support you need to insure prevention and treatment of limb length discrepancy while also supporting your feet.
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