Ask the Doc………
“I have one leg longer than the other and get knee, hip and some backpain. Could this be related?” We are not born perfect or symmetrical, so no one has equal leg lengths. A difference of a quarter of an inch is considered “normal” yet a recent study of three thousand patients followed for over 6 years showed that leg length differences can increase the risk of arthritis as much as seventy percent. Another showed that those with a leg length difference had almost twice the incidence of knee arthritis.
After treating arthritic patients for nearly fifty years, I’m still amazed at the powerful,positive impact of equalizing leg lengths. Even patients who are told that they have “bone on bone” arthritis of a knee or hip and that nothing can be done, when doing a simple squat with the proper amount of correction under their short leg, often have an immediate decrease in pain. Patients remain shocked at the remarkable improvement. That’s because despite what appears on an x-ray, in most instances the destruction does not go all the way across the joint’s entire surface. By equalizing leg lengths, arthritic patients can often be made to function on the part of their knee or hip joint that still hascartilage. This occurs in the same way that realigning the tires on your car enables you to ride on the tread that’s still there, thus improving ride quality and extending the life of your tires.
It’s even more important to correct leg length differences after a knee or hip replacement because this type of surgery very often results in a leg length that is even longer or shorter than it was before the joint was replaced! In most instances this is overlooked or inadequately treated, thus contributing to further joint problems.
Unequal leg lengths have the same powerful affect in sports. For example, if you’re aright handed golfer with a long left leg, it will be hard for you to follow through on yourgolf swing since you would be trying to do so “uphill.” Chiropractors and physical therapists are often helpful, but sometimes there is nopermanence to their corrections. It may be as simple as putting a lift in your shoe on the shorter side. But this should be done accurately with the same precision as prescriptioneye glasses, should not be corrected with a simple heel lift, and only prescribed by a physician specializing in such corrections or you could actually make your problems much worse.
Equalizing leg lengths is only one component to eliminating the structural abnormalities that are the true cause of osteoarthritis. Tight calf muscles, pronation or a flattening of the foot and other abnormalities are also critically important to correct as well. In our average lifetime we will walk the equivalent of four times around the surface of the earth. You would never, ever, consider driving your car with tires and wheels that were different sizes that distance, but we think nothing of walking throughout our lives with unequal leg lengths and are then surprised when problems arise. We might want to consider taking care of ourselves as well as we do our cars!
A former reconstructive foot and ankle surgeon, past Clinical Instructor of Medicine at Emory, and Fellow of the American College of Rheumatology, Dr. Pack practices inGreensboro and Atlanta. He treats athletes at all levels and works with patients whohave arthritis and want to remain active. In the 2004 Olympics he had a silver and gold medalist, and helped the UGA Golf Team (2005 NCCA National Champions). Forfurther information please contact him directly at 770-335-9201, via email at firstname.lastname@example.org, or see his website at www.drloupack.com. His new book, The Arthritis Revolution, Latest Research on Staying Active Without Pain Medication orSurgery, is available on LuLu.com or Amazon.com.