Will Treating a Leg Length Discrepancy With a Heel Lift Keep You Healthy?

This article will look at the scientific research on leg length discrepancy and whether treating a leg length discrepancy with a heel lift will help.Have you been told that you have a leg length discrepancy?

Many runners have, as it’s a fairly common phenomenon, affecting anywhere from 40-70% of the population, and is often blamed for causing running injuries.

A leg length discrepancy seems fairly easy to fix: just put a heel lift in on the shorter side. But is there any substance to this? And what’s more, is there any evidence that treating a leg length discrepancy with a heel lift actually results in a better outcome?

Today’s article will look at the scientific  research on leg length discrepancy , and as usual, things aren’t as simple as they may seem.

Scientific research on leg length discrepancy in runners

Measuring leg length discrepancy

The first issue at hand when discussing whether or not a particular runner has a leg length discrepancy is whether or not the leg lengths are being accurately measured. Sounds easy, but in practice, it’s anything but.

Most doctors and physical therapists use a measuring tape and bony prominences on the pelvis and the ankle to determine the absolute lengths of your legs. Then, subtracting the two, it can be determined whether or not there is a difference.

But research has consistently shown that this is an inaccurate and unreliable way to measure. In a 1991 review article by S.T. McCaw and B.T. Bates, the authors describe how tape-measured leg lengths can be off by up to half an inch! Another study cited showed that another manual measurement method was only within a quarter of an inch from the true value 25% of the time.

Leg length discrepancies, especially small ones, can only be accurately diagnosed with medical imaging. Both x-rays and CT scans have been demonstrated to be highly accurate.

So, the first lesson to take away from this research is that you can’t be sure of a modest leg length discrepancy if it was measured by hand.

Will your body compensate for having a leg length discrepancy?

But let’s say you do have a true leg length discrepancy—from a purely mechanical perspective, it would seem obvious that you’d be off-balance, just like a car with one wheel larger than the others. But the body is a reactive machine: it can adapt to changes in running surface, footwear, and muscle strength. What’s to say it can’t change in response to a leg length discrepancy?

Several studies have been conducted to examine the extent to which the body can effectively compensate for a leg length discrepancy.

In a 2002 review article by Burke Gurney of the University of New Mexico, data is cited that unsurprisingly show that there are some demonstrable asymmetries in walking and running gait in subjects with a true leg length discrepancy or an artificially induced one (like walking with one shoe on). But interestingly, when these leg length discrepancies are corrected with a heel lift, there does not seem to be a consistent benefit.

Gurney cites a few sets of (unfortunately unpublished) data from other researchers that appear to show that compensatory heel lifts in the shoes of runners do not seem to improve efficiency, at least as measured by oxygen consumption.

And in an older study of walking gait, impact forces actually increased after the subjects, who had leg length discrepancies ranging from about 5-20mm, were given a heel lift to correct their discrepancy. What’s more, this increase in impact forces persisted even after a three-week “break in period,” illustrating that the lifts may have been throwing the body off balance instead of stabilizing it.

Leg length discrepancies and running injuries

However, leg length discrepancies have been linked to a few injuries—possibly because of the aforementioned asymmetries in gait. Low back pain has been a heavily researched topic when it comes to leg length discrepancies, as it’s hypothesized that one of the ways the body compensates for a shortened limb is twisting or curving the spine.

But despite Gurney citing over a dozen studies on low back pain and leg length discrepancies, there’s still no clear answer: several have found a higher incidence of leg length differences in people with low back pain, while others, including a well-designed prospective study of 257 college athletes, have found no connection between the two.

Hip pain, however, is better connected with the presence of a leg length discrepancy.

One doctor showed that, of the 254 patients with a leg length difference at his clinic for hip pain, 226 had pain on the side with the longer leg.

Stress fractures have also been connected with leg length differences. In a study by Kim Bennell and coworkers at the University of Melbourne, a leg length discrepancy was twice as common in women with a stress fracture vs. those without. Interestingly, however, the location of the stress fracture was not related to which leg was longer. Other work has also connected leg length differences to stress fractures in military recruits.

Final notes on leg length discrepancy in runners

In all, I suspect that leg length differences are overdiagnosed and overcorrected—very few doctors or physical therapists use x-rays or CT scans to measure leg length discrepancies, which probably leads to people being given heel lifts they don’t really need.

  • If your doctor or physical therapist suggests that you have a leg length discrepancy, see if they’re willing to confirm it with an imaging study. Burke Gurney’s review recommends that 20mm (just over 3/4 of an inch) is a good approximate breaking point for who’d benefit from a heel lift, but notes that this is only a guide.
  • Additionally, like any orthotic intervention, runners will react differently to a heel lift. Right now, we don’t have any reliable method of determining whether a heel lift will throw you off balance or put you on an even keel.
  • Do keep in mind the two conditions (hip pain and stress fractures) that have been reliably linked with leg length differences, however. For now, your best bet is to ensure that your leg length discrepancy truly exists, and if it does, give a heel lift a trial run. If it doesn’t fix your problems in a few weeks or so, you’ll likely have to look elsewhere for answers.
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References

1. McCaw, S.; Bates, B., Biomechanical implications of mild leg length inequality. British Journal of Sports Medicine 1991, 25 (1), 10-14.
2. Gurney, B., Leg Length Discrepancy. Gait & Posture 2002, 15, 195-206.
3. Schuit, D.; Adrian, M.; Pidcoe, P., Effect of Heel Lifts on Ground Reaction Force Patterns in Subjects with Structural Leg-Length Discrepancies. Physical Therapy 1989, 69 (8), 663-670.
4. Bennell, K. L.; Malcolm, S. S.; Thomas, S. A.; Reid, S. J.; Brukner, P.; Ebeling, P. R.; Wark, J. D., Risk factors for stress fracture in track and field athletes: a twelve-month prospective study. American Journal of Sports Medicine24 1996, 6 (810-818).

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55 Responses

  1. Well, not just a heel lift. That really changes the mechanics. I would opt for trying a lift that supports the entire sole of the foot – so that there is not additional pressure at the ball of the foot and toes.

    1. YES. YES, YES. Here’s advice from someone whose meniscus is now grade three arthritis, who has had a Morton’s Neuroma removed, and who had several chronic injuries over the years courtesy of idiot biomechanical “experts” who have incorrectly given me orthotics:
      A. Forget orthotics and wear minimalistic shoes that are very flexible, have large toeboxes and no large heels.
      B. Learn to run AND walk with a forefoot strike (this can take anything up to a year).
      C. If your original problems persist, continue with the above advice but also get a proper x-ray and scan to determine whether you have a functional (apparent) or anatomical (actual) leg length differential. If it’s the former and they give you orthotics, you are going to be in SERIOUS trouble and will develop several other problems that didn’t exist beforehand. Mine were too numerous to mention here. If it’s an anatomical leg length you have, depending upon the actual differential you may need orthotics. But here’s the deal: DON’T get any orthotics!! Just purchase a sheet of, say, 5mm deep EVA (more if your discrepancy is a lot) and cut it so that is mirrors your full-length insole. Anything else will ADD to the problem.

    2. So very true Celia. Especially if the discrepancy goes beyond 3/4″ such as mine where my femur is 1.5″ shorter. In the past, I have opted for the full lift to be taken care of by the shoe. Now, that I want to get back into running, I am looking into a lifted orthotic insert AND the remainder a lifted shoe from toe to heel.

  2. I’m a little surprised that you don’t mention how such discrepancies can be caused by temporary misalignments and that the first thing to try would be to work such things out through appropriate strength training, mobility drills, and/or chiropractic approaches. I’ve been told numerous times that I have around a 1/4″ leg length discrepancy responsible for all sorts of maladies from a strained hamstring to Achilles tendinitis. My one short foray into orthotics and heel lifts was a disaster, so I think such approaches should be an absolute last resort.

    1. True, Greg. John and I talked about this piece a bit and we couldn’t find a lot of specific research on strength and mobility helping leg length discrepancies. We both feel they are tremendous benefit, but we try and keep these articles to scientifically researched solutions. Pehaps we should do a follow-up article.

  3. After a massage therapist thought I had a LLD I checked it out. I found that I had 8 MM difference as measured by XRAY using proper alignment of my hips and femurs. It has been only 5 days since utilizing my lifted shoes and I have already noticed a great reduction in pain and myofascial tightness. I look forward to being more intense activity next week. I have full foot lifts, not just heal lifts.

  4. do lifts actually work? i’m always in great amount of pain when i walk for more than 20 mins. Would this help the pain that I get after sometime? I only wear my lift at work with runners but was wondering how they would work in other shoes?

  5. I am a 65 year old woman who has been running for many years. I have scoliosis, and my left leg is shorter than my right. I have begun to have knee and back of knee pain upon walking and running. I should say it does hurt while I am active, but mostly afterwards.

    My doctor gave me a cortison shot which did take the pain away for about two months. I am going to give him a copy of this article. Do you think possibly my difference in leg length is finally catching up with me?
    Thanks
    Cinta

  6. I have a leg-length discrepancy. My right leg is shorter. I have a slight scoliosis, lower shoulder and neck shift. My right hip is twisted up and around in its attempt to make itself shorter (the other leg is incapable of making itself longer, and the body likes homeostasis or I’d be walking with a lean like some ads on TV).

    My NeuroMuscular Massage therapist in Clearwater, (NMT/NSM) first noticed this 14 years ago, measured the anatomical (as opposed to functional) difference (XRays confirmed his measurement.) and had me get .7 Full Foot lifts added to my shoes by a shoemaker. The NMT guru said heel wasn’t enough as I push off with and stand on my whole foot.

    I have an insert in my running shoes. I do experiment, wondering if it really IS important. I notice if I do NOT have an insert in (I still play with Dr. Scholls), or if I balance the shoes instead of my legs, I develop pain mid-run in my hip, knee , back, foot or achilles tendon, depending on what liner is in. So, I’m back to fulltime wearing that full foot insert.

  7. I really appreciate this article. I’ve had a PT therapist diagnose me with a short leg (based only on measuring tape measurements) and recommend a heel lift. However, I’ve had a lot of bad luck with switching even regular foot inserts in the past. I’m willing to give it a try, but I’m skeptical about how quickly (and with such little evaluation) these types of treatments are suggested, and appreciate having this extra information.

  8. I have recently visited a Chiropractor after years of pack pain. I had x-rays that showed my leg ( and hip alignment ) are 35mm out ! I am a 45 year old male. I fist had pain as a 16 yr old skinny tall ( 6ft 2 inch ) lad. By the time I was 19 i was given quarterzone injections. I have tried everything, from osteopaths, to shiatsu, chiropractors to crystal healers ( don’t ask ) including heal raises in my shoe. Trouble is, the heal raises make you walk more on the front of the foot, or flat footed. The Chiropractor believes he can get me straight with 10mm heal raises & 100 sessions……at £30 each. With this diagnosis, I feel I might resort to surgery. 29 years is quite long enough to go through this any longer ? Any suggestions would be welcome. It kinda makes you desperate.

    1. I ran into a similar chiropractic charlatan some years ago, wanted me to have 100 treatments for neck pain and wanted to make deals with me in advance, I told him off and reported him for totally lacking in ethics and what I consider malpractice if I had allowed it!

  9. Mr. Millar, Please don’t continue with this chiropractor. For one to make such a statement that you can be fixed with heel raises and 100 sessions is bordering on malpractice (in my opinion). In fact a chiropractor that felt he could “fix” my known and professionally diagnosed leg length discrepancy by whipping my leg over my shoulder has led to 5 years of chronic pain and thousands of $$$ of other medical bills trying to figure out the pain problem and fix it. Nobody should ever make such a declaration that he can fix you like that. Run away!!! My advice is to work with someone else. After spending years just taking meds to mask the pain and press on, I’ve actively researched my problem and started treatment. I recently read a book called “Explain Pain” by David S. Butler and Graham Lorimer Moseley that I found was really enlightening about how your brain processes pain. It’s really given me a different outlook and made me feel like I’m more in control (vs the pain controlling me). It turns out that my pain is myofascial pain. It’s taken me years to get this diagnosed (sadly, by me vs medical professionals who now agree this is my problem) . Acupuncture and massage therapy to deal with the trigger points (or small knots in the muscles) along with self-massage with a foam roller has helped tremendously. I’m also working with a therapist who specializes in “strain/counter-strain” (google it). I can’t tell from your post if the x-rays diagnosed an anatomic leg length discrepancy or if you are just out of alignment due to muscle imbalances, but it’s vital to know which it is as the treatment will be different. Within a year after the chiropractic debacle and failed physical therapy, I started working with a very knowledgeable strength trainer who specialized in functional movement. She was able to fix a multitude of imbalances, but my pain didn’t lessen which is why my research continued. Now on a good note, I’m much stronger and taller and can move much freer. It’s amazing how you don’t realize what abilities you’ve lost over time. Please don’t consider surgery before you’ve tried something else. You’d still need to work with therapy to fix all your muscles that are used to the way you presently are, so it would be better to start working some of that now. Please also find a qualified medical doctor who specializes in pain management as you can do so much more when your body doesn’t hurt so much. Just so you know, the acupuncture and massage therapy are working along with some positive attitude adjustments on my part (the brain is a powerful tool). I’m optimistic that things will get better and I’m back in control. Just so you know, I’m a runner and I’m older than you, so it’s likely these are things that you can do also. Good Luck!

  10. I am a 47 year old women and have been diagnosed with a 1.3cm LLD (CT scan confirmed). Having run for over 30 years and playing many high impact sports, my hip and hamstring pain is becoming unbearable. Many physicians imply that I am merely ready for the “used” heap – too old, too decrepit, but I refuse to accept this as a finality. Am I deluded in thinking there is an active, pain free existence in my future? (Please note – stretching is a regular part of my program)

    1. Don’t give up. Your condition can be corrected. With a 13mm structural leg length discrepancy I would look at a combination of a full shoe lift insert (not heel lift) and adding height to the sole of you shoes. Just be careful about how much weight you add to that shoe and maybe attempt to counter balance it on the other shoe as much as possible (something most people don’t take into consideration). I would seek out someone who in correctly trained in this area to perform a full assessment looking at everything from cranial alignment, TMJ, to spinal alignment.

  11. I’ve been a runner for 34 years. Here’s how my PT verified my LLD: when I’m standing on the heel lift and doing toe touches, my hip doesn’t click. He is having me put my longer leg in traction (involves a strap around my foot threaded under a door, and a block on the door frame I push against with my other foot). This is finally relaxing my hip on the longer leg and that’s such a relief. I had strained ligaments in my outer ankle on the longer side also, since I would roll out that leg to get my hip socket uncrowded. We’re hoping the hip clicking will resolve as I “unload and rest” the joint, otherwise it’s bad news. A stretch that has been really helpful is like a modified upward dog on the edge of the bed-just stretching the hip of the longer leg.

  12. 38 year old male runner, 5’7 142pds, been running 7 years. Last year I jumped up and ran a marathon in the spring and one in the winter.i tanked the first so I jumped my mileage up for the second! I did better, but have suffered all year with one injury after another! I feel I have a shorter leg on one side. I have now had to stop running due to pain/ my right leg( shorter one) goes numb as I run or set down as in driveing a car, also my hamstring gets so tight like it will tear! And my butt on the same side is always hurting! I’ve been to 3dr.s had MRI, x-rays, nerve conducted test, and nothing shows up! Been told I have periformiest syndrome?! But know one can tell me for sure! Dr. Bills are pilling up and I am still not running!what can I do????!!

  13. The method of manual testing described above is incorrect and will yield false results. With the correct method you can manually measure structural leg length discrepancy within 1mm, in most cases the measurement is exact. It’s a far more comprehensive assessment then just measuring medial malleolus to the ASIS. Another point made above in the comments is that a full shoe lift should be used and never a heel lift. Once corrected ankle biomechanics need to be addressed as often see ankle/foot biomechanics altered because of the leg length discrepancy. Also to note that we have found that any leg length discrepancy, even 2mm is problematic and should be corrected with an integrated approach look at the full body from head to toe.

  14. Jeff, Great article. I like how you explained everything and back it up with research. I would highly suggest full foot lifts instead of a heel lift. In every client we see we check for Lower leg length discrepancy and those that have get an x-ray to confirm it. Great article!

  15. I am 37 and I have had numerous testings and have been through numerous doctors during the past 14 years. There is no accurate diagnosis for my issues as far as I’m concerned. I’ve heard it all and by now I’m tired of it. There is so much pain everyday..but, this is an interesting article and I think I will also show it to my current treating doctor. My pain started in 2000 after pulling heavy boxes at work. During that time I lost flexibility of my hip. I’ve had back and hip problems since. I also have a compressed disk but I’m not convinced this is the true cause of my main pain. I have a curvature on my spine and a rotated hip, I’ve been told it could be a leg lengthy discrepancy back in 2002 and remember wearing a shoe lift with no success. Does anyone know if it it’s typical to see this curvature in the spine because of a leg length difference?

    1. Pulling heavy boxes will put the spine out of alignment. Find a Chiropractor that can put you in traction while massaging the lower spine. The massaging will relax the muscles around the spine and allow it to realign. May take 2 or 3 treatments, especially since it happened so long ago. There is no reason to believe that it won’t correct itself now. Choose a Chiropractor that understands what is required! They do not make money on healthy people so many acerbate the problem, instead of fixing the patient and letting them go away.

    2. Yes, I have scoliosis as a result of structural LLD (13mm). I am still experimenting with shoe lifts/heel lifts. Physio therapy is helping me strengthen my muscles. I have seen countless specialists including a new one tomorrow (orthopedic surgeon turned ostepath). My sister has LLD but her scoliosis is very very mild (lumbar vertebrae rotation only, no lateral curve).

  16. A leg length discrepency, without question, will eventually cause a problem somewhere. Will more than likely present first as same side hip pain, will eventually cause a scoliosis (depending on how bad the discrepency). The body is no different than any machine, malalignment eventually causes problems and the body will always adapt to it’s alignment. The whole foot needs to be lifted, not just the heel. Problem is you just can’t call up Nike or Teva (last time i checked) and have them build a shoe with a simple lift in the sole…no you have to have an orthotist or cobbler deconstruct one at great cost and with materials that are suboptimal. I’m very unimpressed with heel and insert lifts.

  17. My leg length discrepancy has been monitored since I was around 5 years old – now 17 (it used to be more severe, now it’s about 20mm) and I notice that after wearing my lift for about 3 days in a row I get horrible achey pain in my right hip joint which stops after about a week of nt wearing it again – is the pain something that will go away if I wear it continuously? (The longest I’ve ever made it in a streak was 2 weeks before the pain became too much for me)

    1. How big is the orthotic? 20mm? If so, this may be causing you problems. I have the same issue (leg length discrepancy) and doctor was very adamant that I should not get a 20mm heel raise despite my leg being that much shorter. He advised me to only get 10mm and increase to 15 mm after 4 months as he felt that 20mm would just cause me more pain than relief. I have been wearing 10mm for a week now and it is has reduced to pain for me an incredible amount. Hope all goes well

  18. My son has a LLD that has been confirmed through specialized XRays. He is 15 and has scoliosis that is related to the LLD.
    He runs less than 5 miles per week but wishes to train with the cross country team. This means he will start to run many miles per week and I am concerned about long term damage to his body from LLD issues. Should he be advised against this?

  19. I never really noticed that my legs were different lengths until a few weeks ago. Looking back though, it seems quite obvious. The curves on my body have always been uneven and it finally dawned on me that it is because my hip bones are at different heights. Therefore, my right leg is shorter than my left. I figure I must be putting more pressure on my left leg when I run as it is longer. I am 20 and wanted to get back in shape. I have been running around 1-2 miles. When I was in cross country at age 15, I developed a limp as I ran. I went to a sports med doctor who gave me inserts and told me the problem was due to collapsing arches. Could my different leg lengths be a contributing factor? I also have had about 3 years of back pain. From an mri I took, the issue was a bulging disk thst may have possibly been hitting a nerve. Occasionally pain would should down my leg. Always the left. Could my posture and body stance have contributed to the added pain down just my left side? (When I stand I tend to stand upright on my right leg with me left leg extended outward). I would live to get back in shape I am just worried that the limp and pain from before will happen. Even with the inserts the limp continued when I ran and even with time off it still hurt. I am in no way ready to run long distance (and I hate running! ) but if I do run distances what can I do to prevent my limp from occurring?maybe a new pair of running shows? What brand would you reccomend?

  20. I have a LLD since I was 10 years old. This was due to a broken femur. The total length difference is 1.25. Seems like a lot. For years I did not wear a heal lift at all and I never really could tell a difference. I am not 41 years of age and have had heal lifts and also have gone and had a shoe insert made by a orthotics outfit which was not all that great because they make it from a form that you press your foot into. It is actually very painful to wear and pushes on that tendon on the bottom of my foot so I typically go home and sand this shit out of it till I get it to how I like it. I work on a warehouse floor (COSTCO) and I typically walk about 7-9 miles a day just at work. I have checked this with a pedometer out of pure curiosity. I have worked there for 19 years. I am not over weight but I do work out so I do have some weight and typically have a 22 BMI. I have no back issue nor hip issues. The only thing that I can say that I feel when I do not wear my lift which is only .5 inches at that is a numbness in my quad muscle. So in my opinion if you have less than half a inch LLD do not change a thing your body will compensate. If you are having back issues. Look elsewhere for the problem like posture or a weak back. I did myself a whole lot of good by keeping fit even if my joints sometimes hurt a bit. Good luck to you all.

  21. Hi I have a discrepancy of 1.8cm confirmed through a CT scan. Does anyone have any information regarding leg shortening surgery?

    Thanks

    1. 2.2cm here, I’m curious about this myself. Not that much info out there; I guess it’s a rare condition!

      1. We have given you all we could find Jorge. Hopefully it provided some help for you, you are right, there are not too many studies out, once we find some more, we will report back.

    2. Spoke to my doctor regarding this issue. From what I can remember, he assured me it was a very simple surgery with very rare consequences arising, with the following 3 months walking with crutches and no sport for around 6 months. He said he had performed around 120 of these surgeries in the past year and all have had successful outcomes helping with prior pain problems.
      Hope all goes well

  22. Hi. I presented to an orthopedist when I had outer hip pain and was diagnosed with bursitis. He suggested the probability of LLD and said I “might benefit” from a slight heel lift. OK.. Rather than going that route, I got benefit from the PT by strengthening and stretching my butt muscles and was told that weak gluteus muscles can cause the same hip and butt pain and weakness I was experiencing. Yes, but WHY were they weak?? So, now I’m back to thinking the LLD is the root of the problem. I’m wondering what kind of doctor is best to consult. The orthopedist wasn’t much help. I’m wary of chiropractors. Any suggestions? Thanks!

  23. I had the heal lift before deployment to Afghanistan in 2012. Running uphill my Achilles was hyper extending because my toes were still at same original level which cause me to tear my Achilles vertically. A year later my long leg also tore. At 42, I now have a full lift on my entire 1/2 right shoe and it helps. Even though my discrepancy is 1 inch, I found 3/4 cumbersome and uncomfortable on my hips. I now run regularly with the military 3-6 miles every other day. Not as much as I use to but I’m still able to. Thanks for allowing to post some info.

    1. Ouch! Sorry to hear that Chris! Glad the heal lift seems to be working for you, and hopefully this information was able to confirm that you are doing the right thing. It always makes us happy to hear people continue to run. Thank you so much for your input, your advice will help others too! Have a wonderful day!

  24. I have a LLD over 1cm and have experienced many of the same issues described by posters here. I am particularly interested in any more specific recommendations this group has on full length lifts — brands/models, custom options, best materials, etc. Thank you.

    1. Hi Edward, thanks for reaching out. We will look into this in a future post for you, and hopefully some of the other readers will give you some further information on their brands of choice. Keep checking back!

  25. With respect, measuring a leg length difference with an XRay will not be any more effective than measuring by hand. XR is a two-dimensional image of a three-dimensional body. If the pelvis rolls forward on one side then a different sillouette of the pelvis will show on XR relative to the normal position of the pelvis. This will show a different length of the pelvis (top to bottom). As the pelvis rolls forward, the hip socket is displaced and changes the angle of the femur which will change the two- dimensional sillouette of the femoral length. Same with the tibia. The image will show a change in length relative to the other side but not with any more precision than a good therapist skilled at determining leg length difference. Further, a good therapist can completely remedy a leg length difference in one short treatment.

    1. Thanks for your feedback Lynda. We are reporting based on our findings. There are always going to be other perspectives on each topic, thank you for sharing yours.

  26. A heel lift is rarely the answer with a functional (not structural) leg length discrepancy. Nor is a chiropractic adjustment. I have treated a ton of runner’s in my 20 yrs as a sports physical therapist and certified athletic trainer and 90%+ of these patients have responded very well to muscle energy techniques and addressing strength and flexibility deficits. And yes, sometimes with orthotics. They are not for everyone, but selected for the right individual (and I never use rigid orthotics in runners—you guys need shock absorption and lots of it) they work very well.
    The problem with most runners is that they don’t feel a need for, or will accept, rest days/cross training/strength training. It is just run, run, run all the time. But a heel lift is the WRONG solution. Propping up a deficit doesn’t CORRECT the problem. It is as maddening for me as seeing soemone that has had a bunionectomy and never had the mid-foot problem that CAUSED the bunion in the first place addressed. Guess what is coming back? The bunion is back and everyone is puzzled why.

  27. I was diagnosed with a 22mm discrepancy after X-ray imaging after I complained to my doctor about leg and hip pain. My doctor said to try orthotics, but after a half year on them, I’m not sure they’re ideal, and orthotics don’t help at all for barefoot activities. I’m considering leg shortening surgery but being in Canada, I can’t get it unless I go on the waiting list and my doctor refuses to give me a referral to go see a specialist as he believes the orthotics are good enough. What are my options?

    1. Hi Jorge, it would be impossible for us to answer that for you, you would be best to talk to your doctor about this, all we can do is give you something to think about with the topics we research to make sure you have covered all the bases. Sorry we could not help more. Best of luck!

  28. BE WARNED. I had an xray which revealed a 13mm LLD. I had often been asked if i had a limp and had a slight shoulder drop etc. So I assumed this was causing all the injuries i had ever had. SO….I had a small 3mm insert placed in my shoe and later increased it to 6mm. When walking I felt better, smoother, noticed the slight ‘limp’ was gone. Thought it was great.
    At roughly the same time,or a month or so after, I was felled by about 3 injuries all around the R side (the side i added a lift on). My hip and groin are a mess and i have hamstring and glute issues that I had never had before. I have been unable to run for months now due to pain.
    I now realise that my body has spent its entire life with this 1.3cm difference and has moulded, adapted and adjusted to this difference. My R hip is internally rotated to adjust for the difference and my r foot turns in slightly. LIke the article says, my body had already adjusted to the difference and then I threw in this 6 mm lift which has just thrown everything off and ruined my hip. I now have a labral impingement which probably requires surgery. SO i would proceed with caution before making any changes that arent needed. I agree that if it is 20mm plus then maybe it is worth trying but damn, i wouldnt.

    1. Hi Dom, thanks for your comment. Sorry to hear you had so many issues with this, hopefully you are now figuring out a plan of how to move forward. It is important for anyone to make sure they really think about anything serious like this, to make sure it is definitely the right decision. Best of luck with your future.

  29. Hello all of you;

    i’m running for about 15 years now and about 20 years ago my legs were measured an there’s about 20mm length difference between them.
    Having very long legs, this is about 2 %

    My problem with insoles is they create a difference between the feel of the shoes, the absorbtion of the shoes and the fitting of the schoes towarts the ankles.

    If theres any form of scientific recearch these effects should be taken into account, especialy for off-road running.
    IMO the shock absorbtion shouldn’t differ between both shoes, a difference created by an insole.

    To my surprise i cant find peoples experience with fitting a few millimeters underneath the sporting shoe itself in order to correct this defect.
    IMO this is the way to keep both shoes more alike.
    The obvious downsides apart.

    1. Hi Jeroen, thanks for sharing your story. Hopefully others will find comfort from your words. Sorry you have not had much luck with insoles in the past, but it is good you have learned what works for you!

  30. As a chiropractor for 20 years I have several points to offer here.
    1. 100 sessions prepaid for anything is unethical & ridiculous.
    2. 1 session promises for alleviating LLD is also just as ludicrous.
    3. As with ALL problems it is imperative the CAUSE of the problem is determined to get the most effective treatment outcomes. The real difficult cases are those in which the original problem is not addressed soon enough and then diagnosis & treatment must address the original problem AND all the compensatory problems that have developed. Far too often people let problems linger and worsen far too long before getting professional help.
    4. The neuro-musculoskeletal systems are extremely integrated but the Nervous system is the boss. First approach must be to identify & correct any biomechanical issues in the skeleton ( not just the spine!) causing nerve interference and then address the weak and tight muscles.
    5. Never forget that pain is subjective, very often refers/radiates to other areas and Pain may also be caused by other underlying issues for ex. Low bone density and unless that is addressed (with optimal supplementation AND exercise) Pain will persist regardless of other attempts.
    Yours in health.

  31. I have the same problem like people above. I had a X-rays – my right leg is shorter about 11mm. And i have problem because i don’t have a good pads for my runshoes. I have pads 10mm only for heel but it’s not good for running on the forefoot. Anybody have some example?

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