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Leg Length Difference

June 16 2020

Leg Length Difference – Structural vs Functional

A true, structural leg length difference (LLD) can play havoc with your body, often around your hips and low back. A structural LLD may occur after a leg fracture, a total hip or knee replacement, injuries to growth plates and sometimes there is no obvious cause – it just happens.

It’s important to note that there are 2 types of leg length discrepancies – a true, structural LLD and a functional LLD.  Are true structural LLD is exactly that – there is a true difference in the length of the legs with one being longer and one being shorter. This affects your posture and how you stand and walk. A true structural LLD may result in a scoliosis forming in the back.

A functional LLD on the other hand – which is very common – is not a true difference in the actual leg length. It occurs when the low back and pelvis are ‘out of whack’ which creates the appearance of a LLD.

It is important to differentiate between a structural and functional LLD. Placing a heel raise under a short functional leg is not advised as it would hold the body in this ‘out of whack’ position.

Our Townsville Podiatrists can refer you to Queensland Xray for an EOS scan, which is the most accurate way of measuring structural vs functional LLD. We are very fortunate to have this machine in Townsville as there are only 3 machines in Queensland. This scan is very quick and simple, has minimal rays and when referred by a Podiatrist it is bulkbilled.


In the photos above, our lovely patient has long standing, awful low back pain with disc damage. When we watch her stand, walk and move it is obvious she has a significant true structural LLD – which would be a major contributing factor to her back pain.

Hayley has made heel raises for her different shoes, starting at a small height with the prospect of increasing the height if her body adapts to it. This is all done in our in-house lab at our Townsville Podiatry clinic.

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