About Unequal Leg Length

Do You Need Help Diagnosing and Measuring Your Leg Length Difference?

If you're fortunate enough to have a capable doctor who comprehends your leg length difference, you can rely on their measurements and prescribed solutions. However, we understand that not everyone has access to such medical guidance or may have reservations about their doctor's recommendations. In situations where you wish to explore a professional medical opinion, we offer our years of expertise and connections as a valuable resource. You can tap into our extensive network of experienced doctors who specialize in addressing leg length differences.

While we cannot guarantee that these professionals will definitively assist you, they can serve as a valuable starting point in your search for solutions. We maintain a unique and trusted relationship with them, as they rely on us to provide buildups for their patients dealing with unequal leg length. Please feel free to mention that American Heelers referred you and extend our gratitude to them.

Call Us or Email Us to get a professional referral in your area who could measure your LLD.


Unable to Consult a Doctor? Perform a Standing Block Test at Home
How to Perform a Standing Block Test for Measuring Leg Length Difference (LLD)

Leg length difference (LLD) can be measured using the Standing Block Test, which involves using blocks of known height to equalize the pelvis. This guide will walk you through the steps to perform the test accurately.

Materials Needed:

  • Blocks of Known or Incremental Height (E.g., Wooden Blocks, Hardback Books, Magazines, or Tiles)
  • Flat and Firm Surface
  • Ruler
  • Full-Length Mirror (Optional)
  • One Assistant (Optional), a Friend or Spouse to Observe You


1. Select a Suitable Location:
Find a flat and stable surface to perform the test. Ensure that the area is clear of any obstacles that might hinder your balance.

2. Gather Your Blocks:
Choose blocks of known height. These could be wooden blocks, hardback books, or tiles. It's important that you know the exact height of each block or can accurately measure them later.

3. Prepare Yourself:
Stand with a comfortable pair of shoes on a flat surface, maintaining a neutral posture. Keep your feet hip-width apart and your arms relaxed by your sides. It is recommended that you do this in your undergarments or tight-forming clothing with your shirt lifted so that the alignment of your hips is clearly visible to you and your assistant.

4. Identify the Shorter Leg:
During the test, we will be adding blocks to this leg to increase its height.

5. Place the Blocks:
Carefully place one or more blocks under the shorter leg until you feel that your pelvis is even and you are well-balanced. The blocks should be positioned under the foot of the shorter leg, and the whole foot should fit on the block with room to spare on all sides. Adjust the number of blocks until you achieve a balanced sensation. This may require some trial and error. Your assistant can observe you from the rear, side, and front, and you can observe yourself in the mirror.

6. Step Off the Blocks:
When satisfied by taking into account both how you feel on the blocks and observable alignment of your hips and posture, step off the blocks.

7. Take a Measurement and Analyze and Consider Shoe Lift Size:

Measure and Determine the Right Shoe Lift Size:

To begin, use a ruler to measure the vertical distance from the ground to the top of the stack of blocks you've set up. This measurement provides a baseline for your leg length difference when you're in a neutral standing position. It's important to note that we are not medical professionals, and we make no claims about the absolute accuracy of this block test. However, based on our experience with over 20,000 patients with leg length differences (LLD) and feedback from over 4,000 medical professionals, this measurement serves as a useful starting point.

Once you have the measured leg length difference, you can begin considering the appropriate size for a shoe lift to help balance your pelvis and alleviate any discomfort or related issues. Keep in mind that functional leg length differences may not always match the measured leg length difference, so it's advisable to consult with a medical professional for the most suitable solution.

If you've never addressed a leg length difference before, it's a good idea to start with a partial correction. Allowing your body to adjust to a partial correction before progressing to a full correction can be beneficial. For instance, if the test indicates a leg length difference of 1 inch, it might be wise to begin with a shoe lift of ¾ inch or 7/8 inch. Please note that this is not a strict rule but rather a suggested starting point.

8. Consult a Medical Professional:

American Heelers

While the Standing Block Test can provide valuable information about leg length differences, it's essential to consult with a medical professional for a comprehensive assessment. They can provide expert guidance and recommendations for addressing any discrepancies.

General Information about Unequal Leg Length and Leg Length Difference

Types of Leg Length Discrepancies:

There are generally two types of leg length discrepancies:

1. Structural Discrepancy: This occurs when either the thigh (femur) or shin (tibia) bone in one leg is physically shorter or longer than the corresponding bone in the other leg due to a medical condition.

2. Functional Discrepancy: In this case, the leg lengths are equal, but there's an asymmetry somewhere above the legs, which affects their symmetry. For instance, developmental hip dislocation (DDH) can cause a functional discrepancy. DDH can make one femur appear lower than the other, leading to the appearance and symptoms of a leg length discrepancy. The wrong choice in size in hip or knee replacement surgery can cause this, too.

Causes of Leg Length Discrepancy:

Leg length discrepancies can result from various factors:

  • Injuries, such as fractures, that disrupt bone growth.
  • Some fractures can lead to excessive bone growth during healing, resulting in a longer bone.
  • Bone diseases, like osteomyelitis and Perthes, can damage the growth plate in a bone, leading to gradual discrepancies.
  • Some individuals are born with unequal leg lengths or bowed tibias, which contribute to leg length differences.
  • Congenital conditions, such as coxa vara and developmental hip dislocation, can affect hip alignment and lead to functional discrepancies.
  • Neuromuscular issues, like cerebral palsy, can impact alignment and posture, causing functional discrepancies.
  • Bone tumors and their treatments can also affect leg length. Tumors can invade growth plates, while treatments like chemotherapy can damage them.

Symptoms of Leg Length Discrepancy:

Symptoms of leg length discrepancy vary widely and depend on the underlying cause:

  • There is an obvious difference in leg length (although not always easily noticeable).
  • Posture problems leading to compensatory or functional scoliosis (e.g., tilting shoulders toward the shorter side).
  • Gait problems, such as limping, toe walking, or leg rotation.
  • Chronic hyperextension of the knee on the shorter side and flexion on the longer side.
  • Pain in the back, hip, knee, and/or ankle.

Diagnosis of Leg Length Discrepancy:

Diagnosis involves a comprehensive medical history and physical examination by an orthopedic surgeon, chiropractor, physical therapist, or podiatrist. The doctor will measure both "real" and "apparent" leg lengths and may use a block under the shorter leg to confirm measurements and estimate the correction needed. Diagnostic tests, including X-rays and CT scans, may be conducted for accurate measurements.

Treatment for Leg Length Discrepancy With Shoe Lifts:

Correcting leg length differences with a shoe lift offers several significant benefits. It's a fast, relatively inexpensive, and pain-free solution. While surgical options are available to some individuals, they often come with inherent risks. The choice of treatment depends on various factors, such as age, overall health, the extent of the discrepancy, and personal preferences. Some surgical procedures, like complex lengthening procedures, may carry a higher risk of complications. In contrast, our recommended approach involves non-invasive and cost-effective shoe modification techniques. These techniques provide an effective means of addressing leg length discrepancies without subjecting individuals to the potential complications associated with surgery.