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British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 1991 Mar;25(1):10–13. doi: 10.1136/bjsm.25.1.10

Biomechanical implications of mild leg length inequality.

S T McCaw 1, B T Bates 1
PMCID: PMC1478813  PMID: 1913023

Abstract

The effect of mild leg length inequality (lower extremity length difference less than 3 cm) on posture and gait has been the source of much controversy. Many opinions have been expressed both for and against the need for intervention to reduce the magnitude of the discrepancy. This paper emphasizes the need for accurate and reliable assessment of leg length differences using a clinically functional radiographic technique, and reviews the biomechanical implications of leg length inequality as related to the development of stress fractures, low back pain and osteoarthritis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baum I., Spencer A. M. Limb dominance: its relationship to foot length. J Am Podiatry Assoc. 1980 Oct;70(10):505–507. doi: 10.7547/87507315-70-10-505. [DOI] [PubMed] [Google Scholar]
  2. Beal M. C. The short leg problem. J Am Osteopath Assoc. 1977 Jun;76(10):745–751. [PubMed] [Google Scholar]
  3. Blustein S. M., D'Amico J. C. Limb length discrepancy. Identification, clinical significance, and management. J Am Podiatr Med Assoc. 1985 Apr;75(4):200–206. doi: 10.7547/87507315-75-4-200. [DOI] [PubMed] [Google Scholar]
  4. Botte R. R. An interpretation of the pronation syndrome and foot types of patients with low back pain. J Am Podiatry Assoc. 1981 May;71(5):243–253. doi: 10.7547/87507315-71-5-243. [DOI] [PubMed] [Google Scholar]
  5. Brody D. M. Running injuries. Clin Symp. 1980;32(4):1–36. [PubMed] [Google Scholar]
  6. Clarke G. R. Unequal leg length: an accurate method of detection and some clinical results. Rheumatol Phys Med. 1972 Nov;11(8):385–390. doi: 10.1093/rheumatology/11.8.385. [DOI] [PubMed] [Google Scholar]
  7. D'Amico J. C., Dinowitz H. D., Polchaninoff M. Limb length discrepancy. An electrodynographic analysis. J Am Podiatr Med Assoc. 1985 Dec;75(12):639–643. doi: 10.7547/87507315-75-12-639. [DOI] [PubMed] [Google Scholar]
  8. DeBoer K. F., Harmon R. O., Jr, Savoie S., Tuttle C. D. Inter- and intra-examiner reliability of leg-length differential measurement: a preliminary study. J Manipulative Physiol Ther. 1983 Jun;6(2):61–66. [PubMed] [Google Scholar]
  9. Friberg O. Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine (Phila Pa 1976) 1983 Sep;8(6):643–651. doi: 10.1097/00007632-198309000-00010. [DOI] [PubMed] [Google Scholar]
  10. Friberg O., Koivisto E., Wegelius C. A radiographic method for measurement of leg length inequality. Diagn Imaging Clin Med. 1985;54(2):78–81. [PubMed] [Google Scholar]
  11. Friberg O. Leg length asymmetry in stress fractures. A clinical and radiological study. J Sports Med Phys Fitness. 1982 Dec;22(4):485–488. [PubMed] [Google Scholar]
  12. Giles L. G., Taylor J. R. Low-back pain associated with leg length inequality. Spine (Phila Pa 1976) 1981 Sep-Oct;6(5):510–521. doi: 10.1097/00007632-198109000-00014. [DOI] [PubMed] [Google Scholar]
  13. Giles L. G., Taylor J. R. Lumbar spine structural changes associated with leg length inequality. Spine (Phila Pa 1976) 1982 Mar-Apr;7(2):159–162. doi: 10.1097/00007632-198203000-00011. [DOI] [PubMed] [Google Scholar]
  14. Gofton J. P. Persistent low back pain and leg length disparity. J Rheumatol. 1985 Aug;12(4):747–750. [PubMed] [Google Scholar]
  15. Gofton J. P. Studies in osteoarthritis of the hip. IV. Biomechanics and clinical considerations. Can Med Assoc J. 1971 Jun 5;104(11):1007–1011. [PMC free article] [PubMed] [Google Scholar]
  16. Gofton J. P., Trueman G. E. Studies in osteoarthritis of the hip. II. Osteoarthritis of the hip and leg-length disparity. Can Med Assoc J. 1971 May 8;104(9):791–799. [PMC free article] [PubMed] [Google Scholar]
  17. Gross R. H. Leg length discrepancy in marathon runners. Am J Sports Med. 1983 May-Jun;11(3):121–124. doi: 10.1177/036354658301100303. [DOI] [PubMed] [Google Scholar]
  18. Grundy P. F., Roberts C. J. Does unequal leg length cause back pain? A case-control study. Lancet. 1984 Aug 4;2(8397):256–258. doi: 10.1016/s0140-6736(84)90300-3. [DOI] [PubMed] [Google Scholar]
  19. Ireland J., Kessel L. Hip adduction/abduction deformity and apparent leg-length inequality. Clin Orthop Relat Res. 1980 Nov-Dec;(153):156–157. [PubMed] [Google Scholar]
  20. Langer S. Structural leg shortage. A case report. J Am Podiatry Assoc. 1976 Jan;66(1):38–40. doi: 10.7547/87507315-66-1-38. [DOI] [PubMed] [Google Scholar]
  21. Light L. H., McLellan G. E., Klenerman L. Skeletal transients on heel strike in normal walking with different footwear. J Biomech. 1980;13(6):477–480. doi: 10.1016/0021-9290(80)90340-1. [DOI] [PubMed] [Google Scholar]
  22. Mahar R. K., Kirby R. L., MacLeod D. A. Simulated leg-length discrepancy: its effect on mean center-of-pressure position and postural sway. Arch Phys Med Rehabil. 1985 Dec;66(12):822–824. [PubMed] [Google Scholar]
  23. Radin E. L., Paul I. L., Rose R. M. Role of mechanical factors in pathogenesis of primary osteoarthritis. Lancet. 1972 Mar 4;1(7749):519–522. doi: 10.1016/s0140-6736(72)90179-1. [DOI] [PubMed] [Google Scholar]
  24. Singh I. Functional asymmetry in the lower limbs. Acta Anat (Basel) 1970;77(1):131–138. doi: 10.1159/000143535. [DOI] [PubMed] [Google Scholar]
  25. Sperryn P. N., Restan L. Podiatry and the sports physician--an evaluation of orthoses. Br J Sports Med. 1983 Dec;17(4):129–134. doi: 10.1136/bjsm.17.4.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Subotnick S. I. The short leg syndrome. J Am Podiatry Assoc. 1976 Sep;66(9):720–723. doi: 10.7547/87507315-66-9-720. [DOI] [PubMed] [Google Scholar]
  27. Vink P., Huson A. Lumbar back muscle activity during walking with a leg inequality. Acta Morphol Neerl Scand. 1987;25(4):261–271. [PubMed] [Google Scholar]
  28. Voloshin A., Wosk J. Influence of artificial shock absorbers on human gait. Clin Orthop Relat Res. 1981 Oct;(160):52–56. [PubMed] [Google Scholar]
  29. du Plessis M. P. Stress fractures and over-use syndromes. S Afr Med J. 1980 Oct 25;58(17):670–670. [PubMed] [Google Scholar]

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