leg length discrepancy?

[plansrme]

Would anyone care to share their experience with leg lenth discrepancy? My 10 yo seems to have an LLD of just under 1". A sports medicine dr. first noticed this but attributed it to a tight back muscle, which is why we were there. Upon further reflection, however, I realized that she always walks a bit, well, wonky, for lack of a better (or real) word. After the tightness relaxed, a physical therapist actually measured her leg length and determined there is a real, and significant, discrepancy.

 

The questions that come to mind are (1) what kind of dr. follows your child, and (2) what do you do about shoe inserts? But of course I welcome anything you would like to share.

 

Thanks,

Terri

[littlebug42]

We had a physical therapist swear to us at one time that there was something wrong with dd6's hip and that there was a leg length discrepancy. When we took her to her ortho for her regular visit, he measured it and even x-rayed it and there is some laxity in her hip but no leg length difference. If it concerns you, I would see an orthopedist. There are many out there that have leg length issues as a specialty.

ETA: Not sure where you are located but there are Shriner's orthopedic hospitals scattered throughout the US that will see any child with a need for orthopedic care for free. They recently have begun billing insurances but whether or not they pay, there is nothing out of pocket for you. They also have brace shops where you may be able to get custom inserts if needed. You can PM me if you want more information.

Edited August 1, 2010 by littlebug42

[Jean in Newcastle]

Our chiropractor always looks at my kid's leg discrepancies (as well as other things) before adjusting their backs. After chiropractic treatment their legs are magically matched.

[MeanestMomInMidwest]

Our chiropractor always looks at my kid's leg discrepancies (as well as other things) before adjusting their backs. After chiropractic treatment their legs are magically matched.

 

"magically" is the correct word. Leg length discrepancies are a very common chiropractic ruse.

 

Please do not read into this that I think nobody has a real, documented leg length discrepancy or that all chiropractors are shysters who received their degrees in strip malls.

[Dobela]

An orthopedic doctor is a great place to begin. In our area the physical therapists are the ones who then make the shoe inserts if the dr feels therapy is also needed.

[Paige]

I would not believe a measurement done by a physical therapist. If you believe she has a leg length discrepancy she should see an orthopedist who can do x-rays that will tell for sure. I'm not sure the ortho would do anything about one under an inch. My DD has CP and can have an apparent leg length discrepancy of 2in or so at times but on the x-rays it disappears. Her PT had us all worked up about it but then her orthopedist explained things and it is a non-issue. Right now, I don't think her LLD is more than a few centimeters which is within the range of normal. The orthopedist said 1/2inch is also common and normal. If you are only measuring 1/2 inch more than that, it could easily be measurement error. She would need a special series of x-rays so I wouldn't just have the regular pediatrician do it as he or she may not be familiar with what x-rays are needed. We have seen a lot of physical therapists that we like a lot but we have also had many of them try to diagnose my DD or tell us what she "should" be doing and we have learned to just nod and smile.

 

ETA- Another reason to start with the orthopedist is because if she does have a LLD, you will want to know why and monitor it instead of just getting some inserts.

[ThelmaLou]

We noticed a discrepancy in my 11 year old ds when he was a toddler. It's probably about 2.5 inches at this point. I think they told us way back when that it was about an 8% difference in both the femur and the calf, and that the discrepancy would continue to be about 8% until he's done growing. It's very noticeable to us, but he walks in his tiptoe on the short let to compensate. He doesn't like wearing a built-up shoe at all. No lift on the inside of a shoe will do much to address the problem, besides the fact that he has Barney Rubble feet (very wide and very thick top-to-bottom). The built up shoe (on the outside) helps him walk normally, but he thinks people stare.

 

At Texas Scottish Rite Hospital for Children, he is seen for free by the best of the best. They were seeing him every year, and now he's going in every 6 months. As a first option, they'll be cutting the growth plates in 4 different places to slow the growth on his normal leg. He will still continue growing in that leg, but at a lesser rate. His shorter leg will then have a chance to close the gap on the longer one. This might not completely address the issue, but it might get the two legs close enough that another procedure won't be necessary. If not, he'll either do a procedure called the Ilizarov (very drastic, 100% complication rate, very long recovery) or they'll potentially remove bone from his normal leg. We don't really like this option either, but we're taking it one year at a time right now. We don't want him to have permanent hip, knee, back problems as an adult. Oh, by the way, all 5 of my boys are likely to be at least 6 ft. 3 or so. For some kids, losing some height in their good leg is not a good option, especially if they're a boy and they're only expected to be, say, 5 ft. 9. But my son can afford to lose some length in his good leg, and he'll still be a tall man when it's all said and done.

 

The Dr's do say that some discrepancy is normal, but my son's is not. Something definitely needs to be done. I would have your child seen by a children's orthopedic specialist, or if you have a hospital near you like Scottish Rite or a Shriner's Hospital, I'd try that for a first opinion. Chances are, it's not a great enough difference to worry about, especially if you've not noticed it before now.

Edited August 1, 2010 by ThelmaLou

[plansrme]

ETA- Another reason to start with the orthopedist is because if she does have a LLD, you will want to know why and monitor it instead of just getting some inserts.

 

The concensus seems to be to go straight to the orthopedist, which I will do. I guess the "why" is my primary concern, so your and the other opinions were very helpful.

 

And just to clarify: there is a real discrepancy; it is even visible to the untrained eye. It is not PT or chiropractic magic, though I definitely appreciate hearing that side of the issue as well.

 

Terri

[plansrme]

Chances are, it's not a great enough difference to worry about, especially if you've not noticed it before now.

 

You are probably right, we are nowhere in the realm of 2", but of course, now that I know it's there, I do notice.

 

Best of luck with your son's treatment.

 

Terri

[Heather in AL]

I have mild scoliosis, so my legs are slightly different lengths.

 

I agree with others who said to find an ortho who will take x-rays (maybe one of the back, too). With your dd being 10, this is when scoliosis starts to appear in many kids. In my case, I started to 'grow' around 11 and one side grew faster than the other, resulting in one leg being slightly shorter than the other.

 

I'm not saying your dd has scoliosis, but it's something to think about. Have you looked at her back? The thing that the docs all had me do was strip to my bra and bend over and touch my toes. Usually, one can see & feel the curvature... sometimes it's hidden, though. Are your dd's hips and shoulders the same height?

 

It has never bothered me, and it's not noticeable unless I tuck in a shirt (my hips are uneven) or wear a shirt or skirt with horizontal stripes (uh, never! :tongue_smilie:). I never needed correction.

 

Best wishes to you & your dd.

[plansrme]

I'm not saying your dd has scoliosis, but it's something to think about. Have you looked at her back? The thing that the docs all had me do was strip to my bra and bend over and touch my toes. Usually, one can see & feel the curvature... sometimes it's hidden, though. Are your dd's hips and shoulders the same height?

 

Her back is straight--the sports medicine dr. and the PT confirmed that. They even x-rayed her spine to confirm that she did not have a stress fracture causing her back pain (apparently they are not uncommon among adolescent swimmers). I assume, but of course will double-check, that they could have seen any curvature in those x-rays.

 

Thanks for your input.

 

Terri

[Guest ME-Mommy]

I had a LLD -- about an inch or so -- until this past spring when I started going to a chiropractor. Within a few visits, it was corrected and I haven't had any more trouble with it since. The chiropractor said it had probably been that way for a long time.

 

This was AFTER I had been to my orthopedist, a physical therapist and my regular doctor...NONE of them could find any reason for my pain. :glare:

[TeenagerMom]

My 7 year old DS has a LLD due to a missing fibula bone in his left leg. I would recommend seeing a pediatric orthopedic surgeon. There are MANY conditions that can cause a LLD & a peds ortho is going to have run the gamut of helping diagnose those conditions.

 

If her difference is less than 1", a shoe lift is a definite option. For us, DS's LLD at age 4 was 3.5 cms & he was continuing to lose about a cm a year. So we had to go the route of having an Ilizarov Limb Lengthening at almost age 5.

[Heather in AL]

Her back is straight--the sports medicine dr. and the PT confirmed that. They even x-rayed her spine to confirm that she did not have a stress fracture causing her back pain (apparently they are not uncommon among adolescent swimmers). I assume, but of course will double-check, that they could have seen any curvature in those x-rays.

 

Thanks for your input.

 

Terri

 

That's great, Terri. I'm sure the docs would have seen a curvature since they were looking for fractures. I just thought I'd toss it out there for you to consider.

 

I hope you are able to find a doc with answers and who can help.

[LauraGB]

I don't have a lot to add, but ds has this issue; there is about an inch difference. When ds was complaining of hip and knee pain last year, we took him to the dr (family practice). He suggested we "wait and see", but he also noticed his arches had fallen, one more than the other. He suggested either going to an orthopaedic specialist or buying a set of $10 inserts at the store (he also said that Nike and Adidas had great arch support). So, we bought the arch supports for his old shoes, and a pair of Nikes, and his pain has completely disappeared. We haven't measured his legs in a while, though.

[wendybird]

DS(11) has a 1.5 inch discrepancy due to a severe femur break. His orthopedic surgeon measured it, the physical therapists were supposed to help but they just said to get inserts for his shoes forever. He hates the inserts and has overcompensated since getting out of the body cast. Back to the ortho. He said that it is possible that when he is 16 or so that his body will do a major growth spurt and it may lessen. Other than that he feels that Christian will limp, that is just how it is. We are looking at chiropractic care just to make sure the overcompensation doesn't cause further problems.

Sorry so long, I hope you are able to get a good ortho and that you have cohesive care from any other practitioners.

[Rosie_0801]

Our chiropractor always looks at my kid's leg discrepancies (as well as other things) before adjusting their backs. After chiropractic treatment their legs are magically matched.

 

Same thing happens to me at times, but I don't attribute the correction of the problem to magic ;) but to my pelvis being put back to it's proper, non wonky, position.

 

Rosie

[Jean in Newcastle]

"magically" is the correct word. Leg length discrepancies are a very common chiropractic ruse.

 

Please do not read into this that I think nobody has a real, documented leg length discrepancy or that all chiropractors are shysters who received their degrees in strip malls.

 

Same thing happens to me at times, but I don't attribute the correction of the problem to magic ;) but to my pelvis being put back to it's proper, non wonky, position.

 

Rosie

 

The word "magically" was actually tongue in cheek. I can see the difference between pre chiropractic treatment and post chiropractic treatment myself. And yes, it is due to the pelvis and hips being put back in their proper, non wonky, position.

Edited August 2, 2010 by Jean in Newcastle
left out a word

[teamturner]

I also agree to check with a chiropractor. The other thing is I wonder if at some point he had a growth plate fracture that was undetected and didn't heal properly? The chiro route would be less invasive and probably a lot cheaper than going first to an ortho.

[plansrme]

I also agree to check with a chiropractor. The other thing is I wonder if at some point he had a growth plate fracture that was undetected and didn't heal properly? The chiro route would be less invasive and probably a lot cheaper than going first to an ortho.

 

That is an interesting thought, but I don't think so. We adopted her from China at 15 mos., and I suspected at the time that she had had rickets before we got her. She did not test positive for it then, but she had other signs--curved shins, a rounded forehead (which corrected as she grew--she now has a perfectly lovely forehead), and an intestinal parasite that likely caused malabsorption. Dr. Mom here thinks that the shortage is in her shin, possibly due to the fact that the "shorter" bone curves more than the other one.

 

Her swim team does have a team chiropractor, so while I wait on an orthopedist, I will have him take a look at her as well. It can't hurt!

 

Thank you all for the input. It has been very helpful. As the PT noted, we are very fortunate that she is in a non-weight-bearing activity. I could not have picked a better activity for her if I'd tried (as opposed to stumbling into swimming more or less by accident, which is what happened).

 

Terri

[Paige]

And just to clarify: there is a real discrepancy; it is even visible to the untrained eye. It is not PT or chiropractic magic, though I definitely appreciate hearing that side of the issue as well.

 

 

What I meant was that an apparent LLD (visible and drastic to the eye) may not be an actual bone length issue but may be caused by a different underlying issue. If this second issue is treated, the LLD may disappear or be significantly reduced. Also, my DD's doctor told us that while her LLD was not caused by actual differences in her bones, if the muscle tightness causing the apparent discrepancy was untreated then it would begin to cause a difference in the bones' growth rates.

[gingersmom]

I have one leg that is shorter than the other and also have scoliosis.

 

When I was a child they wanted to give me lifts in my shoes and these ugly, awful orthopedic shoes. Not a chance that was happening!! I don't remember the exact reason for the shoes but they probably thought it would help with my back pain.

 

I don't notice any difference but I have had many doctors notice when looking at me sitting/standing.

[BeckyFL]

I have mild scoliosis, so my legs are slightly different lengths.

 

I agree with others who said to find an ortho who will take x-rays (maybe one of the back, too). With your dd being 10, this is when scoliosis starts to appear in many kids. In my case, I started to 'grow' around 11 and one side grew faster than the other, resulting in one leg being slightly shorter than the other.

 

I'm not saying your dd has scoliosis, but it's something to think about. Have you looked at her back? The thing that the docs all had me do was strip to my bra and bend over and touch my toes. Usually, one can see & feel the curvature... sometimes it's hidden, though. Are your dd's hips and shoulders the same height?

 

It has never bothered me, and it's not noticeable unless I tuck in a shirt (my hips are uneven) or wear a shirt or skirt with horizontal stripes (uh, never! :tongue_smilie:). I never needed correction.

 

Best wishes to you & your dd.

 

Same here... some mild scoliosis and a 2 cm leg length difference that you (really just I) can see in the right dress. Never bothered me until lately as I have gotten older. I was trying to walk 2 1/2 miles daily in the past couple of years and I now have mild arthritis in both hips along with bursitis (ouch). I have switched to water exercises. If I had had the shoe lifts it may have helped but I'm not sure. We'll see how I can hold up as I get older. I'm hoping with the decreased walking, I can save myself from future hip replacements, etc. It might be worth getting some expert opinions on the shoe lifts though.

[Pippen]

I had a LLD -- about an inch or so -- until this past spring when I started going to a chiropractor. Within a few visits, it was corrected and I haven't had any more trouble with it since. The chiropractor said it had probably been that way for a long time.

 

This was AFTER I had been to my orthopedist, a physical therapist and my regular doctor...NONE of them could find any reason for my pain. :glare:

 

I'm glad to hear this because I just had my 17yo at my chiro because of a loud pop in his foot/ankle area every time he stepped. It started some months ago but is now so loud you can hear it across the room. I didn't know what it was but knew it could be no good for long term, and thankfully he has no pain yet. She showed me a discrepancy in leg length so she's going to work on that area as well as the hip. I'm going to start with this route and see if it helps.