PT on the Net Research

Leg Length Discrepancy


Question:

I have a client who has one leg that is about an inch to an inch and a half longer than the other one. I have not been able to find much research regarding training protocols and exercises that would be good to do as well as exercises to avoid. Any suggestions? Thanks!

Answer:

If you have not done so already, you may want to assess this client and make certain there is truly a physical difference in bone length within the legs and not a hip or pelvic issue. If it is not a true leg length discrepancy, you may want to refer this individual to a medical professional. It may prove beneficial to refer this individual out either way so he or she can get fitted with a shoe lift.

Rather than parallel bilateral stance activities, focus on unilateral and “stride out” (step forward with one foot) stance exercises. These types of activities will allow the client to level out the pelvis and evenly distribute load through the lumbar vertebra and discs.

Here are some examples of such exercises:

  1. Linear, lateral, angular lunges
  2. Split squat
  3. Linear, lateral, x-over, rotational step up
  4. One leg squat
  5. Dumbbell or low pulley one leg RDL
  6. Staggered stance squat
  7. Low step up with ankle band abduction
  8. One leg stability ball wall squat
  9. Lunge or staggered stance and press
  10. Lunge, staggered stance or one leg low pulley row
  11. Shoulder work standing on one foot for half the reps and other foot for last half or from a stride or lunge position
  12. Push ups of assorted types
  13. One arm stability ball dumbbell or cable bench
  14. Body rows
  15. Lunge, stride or one leg high pull one arm pull down
  16. Hyper extensions
  17. Stability ball glut ham raises

* For these exercises or variations, please search the PTN Exercise Library.

A large percentage of upper body exercises can be done standing on one foot (switching half way through) or in a stride or lunge stance. Similarly, with lower body exercises, think about these three types of stances in addition to stepping up activities.

As your client performs theses activities, make sure the pelvic position is controlled and the shoulders are kept square over the hips (unless it is not required for the exercise).