Assessing LLD And Whether Shoe Lifts Can Have An Impact

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Author(s): 
David Levine, DPM, CPed

Final Words

The logistics of utilizing lifts is easier than fabricating orthotic devices. Once you make the recommendation to patients, have them give you a shoe. Send the shoe to a lab of your choice. It will be fixed and returned within a week. This allows you to maintain control of the treatment and effectively monitor the patient's progress.

   Leg length discrepancies are well understood and described in the literature. However, integrating the assessment and conservative treatment of LLDs into your practice is another matter. Look for LLDs in all of your patients with asymmetric findings. Look for it in patients who have undergone joint replacement surgery. Diagnose it with more frequency and start treating it with the modification of shoes. You will be pleasantly surprised how easy and gratifying this treatment can be for you and your patients.

   Dr. Levine is a Fellow of the American Society of Podiatric Surgeons, and the American Academy of Podiatric Sports Medicine. He is in private practice and is the director and owner of the Frederick, Md.-based Walkright and Physician's Footwear, a comprehensive pedorthic facility. For more information or to contact Dr. Levine, visit www.Levinefeet.com .

References

1. O'Brien S, Kernohan G, Fitzpatrick C, Hill J, Beverland D. Perception of imposed leg length inequality in normal subjects. Hip Int. 2010; 20(4):505-11.

2. Mahmood S, Huffman LK, Harris JG. Limb-length discrepancy as a cause of plantar fasciitis. J Am Podiatr Med Assoc. 2010; 100(6):452-5.

3. Harvey WF, Yang M, Cooke TD, Segal NA, Lane N, Lewis CE, Felson DT. Association of leg-length inequality with knee osteoarthritis: a cohort study. Ann Intern Med. 2010; 152(5):287-95.

4. Defrin R, Ben Benyamin S, Aldubi RD, Pick CG. Conservative correction of leg-length discrepancies of 10mm or less for the relief of chronic low back pain. Arch Phys Med Rehabil. 2005; 86(11):2075-80.

5. Brady RJ, Dean JB, Skinner TM, Gross MT. Limb length inequality: clinical implications for assessment and intervention. J Orthop Sports Phys Ther. 2003; 33(5):221-34. Review.

6. McCarthy JJ, MacEwen GD. Management of leg length inequality. J South Orthop Assoc. 2001; 10(2):73-85; discussion 85.

7. Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. Dtsch Arztebl Int. 2010; 107(49):875-83; quiz 884.

8. Brady RJ, Dean JB, Skinner TM, Gross MT. Limb length inequality: clinical implications for assessment and intervention. J Orthop Sports Phys Ther. 2003; 33(5):221-34.

9. Goss DL, Moore JH. Compliance wearing a heel lift during 8 weeks of military training in cadets with limb length inequality. J Orthop Sports Phys Ther. 2004; 34(3):126-31.

   Editor’s note: For a related PodiatryLIVE™ video by Dr. Levine, see http://www.podiatrylive.com/shoe_lift_LLD .

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