What is it?
Leg Length Discrepancy (LLD) is when you have one leg that is shorter than the other. If the discrepancy, or difference in length, between the two legs is significant enough, it can result in painful back, hip and knee problems due to a total body & spinal misalignment; known as LLD induced scoliosis.
What causes it?
There are 2 types of LLD; Functional & Anatomical LLD. Functional is where pelvic obliquity due to tight muscles can cause uneven leg lengths and you’ll need manual therapy to adjust and you’re good to go.
However if you have anatomical or True LLD it could be congenital (meaning you’re born with it), due to infection or trauma that damaged bone growth, it could be that one leg actually grew longer than the other, or neural inhibition.
How to fix it?
After a thorough physical and x-ray exam by a trained limb lengthening surgeon, you can determine if you have a LLD and by how much.
The options include:
Leg shortening of the longer side
Induced growth arrest if caught early enough (not usually great idea)
Leg lengthening surgery of the shorter side (which is the best option) to ensure max height gain.
The leg lengthening procedure is the same as you well know. The surgeon will break the bone, use a lengthening device, like an internal nail like STRYDE and let it heal.
Before & After LLD Surgery
Most people have a slight discrepancy in their legs and if it is 1cm or less (less than ½ inch) then you may not need to worry. However if it’s 1.5 to over 2cm, it’s a good idea to get checked because...
If a large enough discrepancy is left untreated, especially if the person is active, the long term physical complications can include muscle imbalances, arthritis in joints, life-long limp, valgus deformities, torsional rotation and a plethora of back and neck problems above the pelvis.
Once a LLD is treated via lengthening surgery, the relief is almost immediate. It does take some getting used to, especially if there was some mild deformity that wasn’t corrected with an internal nail and some blocking screws, but the physical relief is life-changing.
While some CLL patients aim to avoid very minor problems and long term complications, the problems a LLD patient deals with on a daily basis for years on end, are in fact way worse, trust me.
Due to LLD being a health condition, insurance sees it as a necessity and most will assist in covering some portion of the procedure. This isn’t always the case, especially if a patient travels internationally to get it done, but typically insurance will assist and that’s a good thing because you really want to catch this as soon as possible and get it done before permanent complications arise.
Choosing a Doctor
I always say it’s a good idea to choose a doctor who is well versed in the world of both limb lengthening and deformity correction as they will use good surgical technique and be able to troubleshoot and adjust treatment should a problem arise.
It’s also a good idea to ensure that if you are getting CLL done, that you address any discrepancy prior to wrapping up your distraction phase so you don’t create a new problem after trying to solve another.
As most of you know, I had a LLD of nearly 4cm after a childhood accident where I broke my left tibia leading to damaged growth plates and malalignment plus some overgrowth of my right femur from another accident. I went on for years running, jumping and doing lifting on this imbalance causing all kinds of back, knee, hip and ankle problems, some of which occasionally rear their ugly head, but my surgeon; Dr. Janet Conway at the RIAO at Sinai Hospital in Baltimore, MD, did tibial lengthening via the original PRECICE nail and made me into the Cyborg I am today.
If you think you may have a LLD, I plead with you to setup a consultation with a LL surgeon who can examine you properly and if it’s severe enough you get treated to avoid long term complications. Because I’ll be honest, the complications you can get from LLD is way more likely than long term problems a CLL could get and will be miserable. So just get it done. Your long term health will thank you.