Leg length discrepancies

Leg length discrepancies

Hello colleagues and other interested parties,

Question 1: How do you measure for leg length discrepancy, when asked to do
so?

I personally believe the use of standing blocks gives the most accurate
measurement, in the absence of weight bearing x-rays. Of course you
sometimes need to figure out where the discrepancy is, i.e., tibia, femur,
real or perceived (as with a fixed pelvic obliquity), etc. Some people
measure anatomical landmarks with the person lying supine.

Question 2: When asked to provide a heel lift, how much can safely be put
inside an adult shoe without causing the heel to come out of the shoe or
otherwise cause other problems, i.e., plantarflexion contraction, loss of
bi-pedal gait, etc. Folks who have a fixed planarflexion deformity are
excluded from this question.

As a rule, I personally believe that heel and sole elevations that are
incorporated between the sole and inner-sole are the best choice and try to
limit inside the shoe adult heel lifts to a maximum of 1/4. I realize that
people get by with 3/8 or more, on occasion, but I believe this may cause
more problems than it can helps.

Thanks for your responses.

Wil Haines, CPO