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Leg Length Inequality

Implications for Running Injury Prevention

  • Injury Clinic
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Summary

Leg length inequality is a relatively common musculoskeletal malalignment related to structural, postural and environmental factors. The inequality is a plausible aetiological factor in the development of a variety of overuse injuries because it alters the magnitude and distribution of mechanical stress within the body. Leg length inequality has been linked with lower extremity stress fractures, low back pain, hip pain and vertebral disk problems of runners. The appropriateness of using inshoe lifts to reduce or eliminate the inequality has not been rigorously evaluated. Further research is needed to quantify the biomechanical effects of leg length inequality as it interacts with other factors related to running injury.

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References

  • af Geijerstam S, Meen D, Oseid S, Steinsland O. Possible causes of lower back trouble in young female gymnasts. Current Topics in Sport Medicine: 992–1001, 1984

    Google Scholar 

  • Beal MC. The short leg problem. Journal of the American Osteopathic Association 76: 745–751, 1977

    PubMed  CAS  Google Scholar 

  • Blustein SM, D’Amico JC. Limb length discrepancy: identification, clinical significance, and management. Journal of the American Podiatry Medical Association 75: 200–206, 1985

    CAS  Google Scholar 

  • Bottomley MB. Sacral stress fracture in a runner. British Journal of Sports Medicine 24: 243–244, 1990

    Article  PubMed  CAS  Google Scholar 

  • Brunet ME, Cook SD, Brinker MR, Dickinson JA. A survey of running injuries in 1505 competitive and recreational runners. Journal of Sports Medicine and Physical Fitness 30: 307–315, 1990

    PubMed  CAS  Google Scholar 

  • Cavanagh PR, Andrew GC, Kram R, Rodgers MM, Sanderson DJ, et al. An approach to biomechanical profiling of elite distance runners. International Journal of Sport Biomechanics 1: 36–62, 1985

    Google Scholar 

  • Clement DB, Taunton JE, Smart GW, McNicol KL. A survey of overuse running injuries. Physician and Sportsmedicine 9: 47–58, 1981

    Google Scholar 

  • D’Amico JC, Dinowitz HD, Polchaninoff M. Limb length discrepancy: an electrodynographic analysis. Journal of the American Podiatry Medical Association 75: 639–643, 1985

    Google Scholar 

  • du Plessis MP. Stress fractures and over-use syndromes. SA MedieseTydskrif 41: 670, 1980

    Google Scholar 

  • Friberg O, Koivisto E, Wegelius C. A radiographic method for measurement of leg length inequality. Diagnostic Imaging in Clinical Medicine 54: 78–81, 1985

    PubMed  CAS  Google Scholar 

  • Friberg O, Nurminen M, Korhonen K, Soininen E, Manttari T. Accuracy and precision of clinical estimation of leg length inequality and lumbar scoliosis: comparison of clinical and radiological measurements. International Disability Studies 10: 49–53, 1988

    Article  PubMed  CAS  Google Scholar 

  • Gibson PH, Papaioannou T, Kenwright J. The influence on the spine of leg-length discrepancy after femoral fracture. Journal of Bone and Joint Surgery 65-B: 584–587, 1983

    Google Scholar 

  • Giles LGF, Taylor JR. Low-back pain associated with leg length inequality. Spine 6: 510–521, 1981

    Article  PubMed  CAS  Google Scholar 

  • Giles LGF, Taylor JR. Lumbar spine structural changes associated with leg length inequality. Spine 7: 159–162, 1982

    Article  PubMed  CAS  Google Scholar 

  • Gofton JP. Studies in osteoarthritis of the hip: Part IV. Biomechanics and clinical considerations. Canadian Medical Association Journal 104: 1007–1011, 1971

    PubMed  CAS  Google Scholar 

  • Gofton J P. Persistent low back pain and leg length disparity. Journal of Rheumatology 12: 747–750, 1985

    PubMed  CAS  Google Scholar 

  • Gofton JP, Trueman GE. Studies in osteoarthritis of the hip: Part II. Osteoarthritis of the hip and leg-length disparity. Canadian Medical Association Journal 104: 791–799, 1971

    PubMed  CAS  Google Scholar 

  • Gordon G. Podiatry sports medicine — evaluation and prevention of injuries. Podiatric Sports Medicine 1: 401–416, 1984

    CAS  Google Scholar 

  • Gross RH. Leg length discrepancy in marathon runners. American Journal of Sports Medicine 11: 121–124, 1983

    Article  PubMed  CAS  Google Scholar 

  • Heilig DDO. Principles of lift therapy. Journal of the American Osteopathic Association 77: 466–472, 1978

    PubMed  CAS  Google Scholar 

  • Hoyle DA, Latour M, Bohannon RW. Intraexaminer, interexaminer, and interdevice comparability of leg length measurements obtained with measuring tape and metrecom. Journal of Orthopaedic and Sports Physical Therapy 14: 263–268, 1991

    PubMed  CAS  Google Scholar 

  • James SL, Bates BT, Osternig LR. Injuries to runners. American Journal of Sports Medicine 6: 40–50, 1978

    Article  PubMed  CAS  Google Scholar 

  • Jones CL. The damaging effects of a disaligned musculoskeletal system. Journal of the American Podiatry Association 61: 369–381, 1971

    PubMed  CAS  Google Scholar 

  • Kibler WB, Goldberg C, Chandler TJ. Functional biomechanical deficits in running athletes with plantar fascitis. American Journal of Sports Medicine 19: 66–71, 1991

    Article  PubMed  CAS  Google Scholar 

  • Langer S. Structural leg shortage. Journal of the American Podiatry Association 66: 38–40, 1976

    PubMed  CAS  Google Scholar 

  • Lawrence D. Lateralization of weight in the presence of structural short leg: a preliminary report. Journal of Manipulative and Physiological Therapeutics 7: 105–108, 1984

    PubMed  CAS  Google Scholar 

  • Mahar RK, Kirby RD, MacLeod DA. Simulated leg-length discrepancy: its effect on mean center-of-pressure position and postural sway. Archives of Physical Medicine and Rehabilitation 66: 822–824, 1985

    PubMed  CAS  Google Scholar 

  • Maquet PGJ. Biomechanics of the knee, Springer-Verlag, New York. 1984

    Book  Google Scholar 

  • Matheson GO, Clement DB, McKenzie DC, Taunton JE, LLoyd-Smith DR, et al. Stress fractures in athletes: a study of 320 cases. American Journal of Sports Medicine 15: 46–58, 1987

    Article  PubMed  CAS  Google Scholar 

  • McCaw ST, Bates BT, Singer KM. The concordance between mild leg length inequality and ground reaction force data asymmetry during running. In Gregor et al. (Eds) Proceedings of the XII International Congress of Biomechanics, 1989

    Google Scholar 

  • Messier SP, Davis SE, Curl WW, Lowery RB, Pack RJ. Etiologic factors associated with patellofemoral pain in runners. Medicine and Science in Sports and Exercise 23: 1008–1015, 1991

    PubMed  CAS  Google Scholar 

  • Neumann DA. Biomechanical analysis of selected principles of hip joint protection. Arthritis Care and Research 2: 146–155, 1989

    Article  PubMed  CAS  Google Scholar 

  • Pinshaw R, Atlas V, Noakes TD. Nature and response to therapy of 196 consecutive injuries seen at a runners’ clinic. SA Mediese Tydskrif 65: 291–298, 1984

    CAS  Google Scholar 

  • Powell KE, Kohl HW, Casperson CJ, Blair SN. An epidemiological perspective on the causes of running injuries. Physician and Sportsmedicine 14: 100–114, 1986

    Google Scholar 

  • Reid DC, Smith B. Leg length inequality: a review of etiology and management. Physiotherapy Canada 36: 177–182, 1984

    Google Scholar 

  • Rzonca EC, Baylis WJ. Common sports injuries to the foot and leg. Clinics in Podiatric Medicine and Surgery 5: 591–612, 1988

    PubMed  CAS  Google Scholar 

  • Soukka A, Alaranta H, Tallroth K, Heliovaara M. Leg-length inequality in people of working age: the association between mild inequality and low-back pain is questionable. Spine 16: 429–431, 1991

    Article  PubMed  CAS  Google Scholar 

  • Subotnick SI. The short-leg syndrome. Physician and Sportsmedicine 3: 61–63, 1975

    Google Scholar 

  • Subotnick SI. The short leg syndrome. Journal of the American Podiatry Association 66: 720–723, 1976

    PubMed  CAS  Google Scholar 

  • Terjesen T, Benum P, Rossvoll I, Svenningsen S, Isern AEF, et al. Leg-length discrepancy measured by ultrasonography. Acta Orthopaedica Scandinavica 62: 121–124, 1991

    Article  PubMed  CAS  Google Scholar 

  • Viano DC, King Al, Melvin JW, Weber K. Injury biomechanics research: an essential element in the prevention of trauma. Journal of Biomechanics 22: 403–417, 1989

    Article  PubMed  CAS  Google Scholar 

  • Vink P, Kamphuisen HAC. Leg length inequality, pelvic tilt and lumbar back muscle activity during standing. Clinical Biomechanics 4: 115–117, 1989

    Article  Google Scholar 

  • Woerman AL, Binder-Macleod SA. Leg length discrepancy assessment: accuracy and precision in five clinical methods of evaluation. Journal of Orthopaedic and Sports Physical Therapy 5: 230–239, 1984

    PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Health, Physical Education, Recreation and Dance, Illinois State University 5120, Normal, IL, 61761, USA

    Steven T. McCaw (Assistant Professor, Biomechanics Laboratory)

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  1. Steven T. McCaw
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McCaw, S.T. Leg Length Inequality. Sports Medicine 14, 422–429 (1992). https://doi.org/10.2165/00007256-199214060-00008

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  • DOI: https://doi.org/10.2165/00007256-199214060-00008

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