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Customized Insoles For Limb Length Discrepancy
Limb length or Leg length discrepancy or leg shortening
is the inequality between the lengths of the person’s arms or legs.
Excluding the rare cases, inequality in arm's length doesn’t usually
impact the function of arms and usually does not require any kind of
however, a discrepancy in leg length, usually becomes clear to parents
as their child grows and starts to walk on his/her own.
is an astonishing fact that only 25 % people in the world with two legs
actually have equal length of legs. In most of the cases, the
difference between the two is diminutive and the person will likely go
his/her entire life cycle without even being aware of the incongruity as
well as also not being affected by it.
It has been found out that the
differences in length of over 2 cm are rare. Some children are affected
by leg shortening since their birth. While in many other cases, some
kind of prolonged illness or even an injury causes a discrepancy in
length to develop over the gradual period of time.
An inequality of
minimal degree may not cause symptoms, but a significant difference
between the two can cause a discernible hobble and make it difficult for
a child to play, run or walk.
Treatment for a discrepancy varies
according to the extent of the leg shortening. In a lot of cases, an
insignificant difference in leg length can be covered by wearing a lift
in the shoe of the shorter leg. A child with a more significant
difference, however, may benefit from surgery to make his or her legs
the same length.
This can be done in a number of ways, but is most often
accomplished through a procedure that delays or eventually stops growth
in the longer leg.
Following are two major classifications of leg length discrepancy:
differences are found due to inequality in length measurement, normally
because of unevenness in the length of the femur present in the thigh
or the tibia and fibula bones present in the lower leg.
This may be a
defect from birth or it may occur after an accident in the leg, the
serious infection of any wound in the leg, or any kind of local damage
to one of the plates responsible for growth in a leg.
other, much general, type is observed when the legs themselves are of
the same length, but due to neuromuscular injuries in the pelvis or
upper leg, one leg or one hip is a bit higher and tighter than the other
one (known as hypertonicity in the muscle structure of the pelvis or
This shortened leg possessing tightened muscles causes the legs do
seem to be different lengths, even though careful measurement would
show no inequality between the lengths of the actual leg. This is known
as leg length alignment asymmetry (LLAA) and can be seen when the person
is lying down.
How Does Leg Length Discrepancy Occur?
At first sight, a back pain or lower leg discomfort in the patient could be a symptom of leg length shortening
and a lack of leg length symmetry issue. Lack of Leg length symmetries
appears to be the third most general symptom of injuries caused by
running and occurs in 60 to 90 % of the population.
While classifying leg length discrepancy, it could be divided into two primary categories: structural and functional.
Structural deformities occur due to biological shortening of bones.
Sometimes from a growth plate injury occurring in childhood or teenage.
fracture or other bone injury: an injury to the bone can delay the rate
of its growth, while simultaneously the bone in the other leg continues
to grow at a normal rate. Some fractures can also result in the
extended growth of bone during the healing process, usually with
injuries to the thigh bone.
Chances are greater to happen if the bone
was broken into multiple pieces. Also, if the skin and muscle tissue
surrounding the bone were injured and exposed to a high magnitude, as it
may occur in an open fracture.
Diseases of the bone: Osteomyelitis or
various similar diseases can damage the growth plate present in the
bone, causing a shortening that results in an observable difference,
gradually over time.
Some bone diseases may cause limb length
Multiple hereditary exostoses.
Bone Tumors and its treatment process can cause a leg length discrepancy too.
(one side too huge) and hemiatrophy (one side too little) are some
extremely exceptional physical conditions that may add to the length
error. In patients affected by these deformities, the arm and leg on one
side of the body are more unequal (either longer or shorter) than the
arm and leg on the counterpart side. A difference between the two sides
of the face may also be observed. In several cases, it is possible that
the exact cause of these conditions cannot even be determined. It is
also termed as “Idiopathic” or in simple terms unknown.
Juvenile Arthritis: Inflammation of bone during growth.
Spinal abnormality such as scoliosis.
infections occurring in growing children may affect limb length
discrepancy significantly. This is mostly true if the infection happens
in the infant stage of development.
Functional leg length discrepancy normally occurs due to muscle weakness.
Inflexibility at the pelvis or foot and ankle complex.
Equinovarus and rearfoot pronation.
Adduction or flexion contractures of the hip, genu varum.
environmental factors such as drainage crowns transformed into roadways
banked running surfaces, and excessive wearing out of shoes can create a
situation that can simulate the leg length difference.
Mode of running of an athlete.
Shifting of the center of gravity towards the shorter leg.
The compensations associated with leg length discrepancy:
Pelvic tilt (to the short side),
Lumbar scoliosis (convex to the short side),
Knee flexion (increased on the elongated side),
Genu recurvatum (on the short side),
Subtalar joint pronation (on the elongated side),
Ankle plantar flexion,
Foot supination (on the short side).
other causes affecting the lower extremity with a structural deformity
usually appear first on the long leg side and include
Symptoms affecting the short extremity include:
If the patient has only functional Leg Length Discrepancy, the shorter side will show symptoms earlier and may include:
Patellofemoral pain syndrome,
Ipsilateral sacroiliac discomfort with contralateral low back pain,
Iliotibial band syndrome
Medial tibial stress syndrome.
The best treatment for leg shortening
Epiphysiodesis is a trustworthy treatment method that stops the growth
of the longer leg. It is advised against the skeletally mature patients,
and the final leg length discrepancy and the extent of growth
inhibition need to be predicted and are subject to errors.
procedure effectively shortens the longer leg and is commonly performed
on the unaffected side, it could be discomforting to the patient and his
can be performed after skeletal maturity to gain leg length equality.
Shortening can be performed in the proximal femur using a hip screw or
blade plate, in the mid-diaphysis of the femur using a closed
intramedullary technique or in the tibia.
Non surgical treatments:
the patient’s leg length shortening is medium in magnitude, generally
less than one inch, it is usually treated without the involvement of
devices may work well for some patients with a very large magnitude of
deformities who would not benefit from other lengthening or shortening
procedures being done to the affected person.
Procedures to shorten the longer leg are highly recommended for leg
length discrepancies that are expected to be between two and six
centimeters when the child grows up to adolescence.
operation includes displacing a section of bone in the longer leg so
the legs are equal length. It can be done on adults or adolescents who
are no longer developing in size.
Internal fixation (PRECICE Nail):
For this treatment, the bone in the shorter leg is dissected into two
and the surgeon inserts a magnetic motor powered nail in the bone. The
bone then gradually lengthens using an external magnetic circuit.
How Custom Insoles Help With Leg Shortening?
Custom insoles play a major role in the treatment of leg shortening. The help in:
Proper foot alignment.
Managing tissue stress level to a tolerable level.
Gait analysis proves helpful in designing custom insoles, which works towards restoring normal mobility of the patient.
Providing support to the shorter leg.
Distributing body pressure, hence managing abnormality caused by length difference.
Reduce the pain and discomfort caused while walking or playing.
Proper fit for each individual as they are custom designed.
The highly elastic material, molds according to the surface on which the individual is walking on
Orthotics 3D Custom Technology and Design
insoles are manufactured from the thermoplastic polyurethane material
that promotes both soft and non-binding components to be joined into a
concluded insole. This process is still used at a large level throughout
the orthotics design industry.
The orthotics are an amazingly
manufactured, fitted into the individual’s shoe. Commonly known as
"orthotics", these orthoses give the hold for the foot by re-assigning
ground reaction forces as well as re-positioning joints while any
physical mobility like walking, running or various other motor
very scientific conclusion is that the orthotics might be used to treat
people with foot problems as well as they have the impact on various
other spine and back-related discrepancies are just extraordinary.
are used by almost everyone affected from leg length discrepancy ranging
from athletes to the elderly people, for the function of enhancing
mobility, motor capabilities and for healing a vast variety of soft
tissue inflammatory conditions.
when used in association with suitable orthopedic footwear, they act in
the prevention of leg pain and discomfort caused in LLD.
As we know how leg length discrepancy shoe insoles can add to your comfort and health, and the crucial role comfortable and correctly-fitting leg length discrepancy insoles can make.
In case of leg length discrepancy, instead of making leg discrepancy insoles, science has further been enriched to manufacture leg shortening insoles, which can be applied to the longer length instead of the shorter one.
Leg shortening insoles are
designed to delay the growing process of the longer leg. Hence,
effectively removing the inequality in a long duration of time. Leg
shortening insoles are hard to design and require complex processes,
which are carried out by subject experts.
They sometimes are available
with a nano-molecular structure which could be custom designed according
to the condition of the leg, individual’s metabolism and leg length
structure. If the leg length difference is higher than 2 centimeters, it
is not advised to use these insoles.
Relief from any kind of discomfort or pain.
Enhanced mobility and freedom in walking/playing or just standing.
Proper body support.
No limp while walking.
Customized Insoles (Shapecrunch)
3D Printed Custom Orthotics
- 6 months warranty
- Lasts for two years
- Anti - Microbial
- Shock absorbing and Flexible
- Custom made
- For Sports and Business Shoes
custom orthotics 3D printed orthotic insoles to fit your feet perfectly
to relieve foot and joint pain and prevent future biomechanical issues.
Enjoy excellent arch support, cushioning, and breathability from your
custom made shoe inserts.
like you are walking on air with Shapecrunch Orthotics' innovative
custom 3D printed orthotic insoles - they're fully customized to suit your
individual foot pronation and biomechanic needs and very comfortable to wear.
Everyone's feet are unique, so custom orthotics is the best way to
treat your own individual foot problems and prevent them from
Say goodbye to foot pain and hello to comfort
with these custom flat feet insoles today.
Price: SGD 230
By appointment only - contact us for enquiries and appointments
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Phoenix Rehab Physio Services
Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
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