I see a lot of my Houston patients after orthopedic surgeries. This is a fragile time for them. But, most often, they come in after a knee or hip replacement surgery with an odd complaint. They say their feet hurt!
Why is that the case? Well, let's think about it. As the old song goes, the foot bone's connected to the leg bone. The leg bone's connected to the knee bone...the thigh bone, and the hip bone. Are you starting to get it?
All the structures in your lower body can affect each other. Then, when you replace a major joint, it can change your gait in a major way. (Your gait is the way you walk.) So, what's behind the post-surgery change? It's often because of a change in the length of your legs. And when your legs change length, you may develop what we call a leg length discrepancy.
What is a Leg Length Discrepancy?
If you have a leg length discrepancy, it means your two legs are different lengths. This problem is more common than you think. And it causes people more pain than you might imagine.
This concern can affect anyone. You could be born with legs of different lengths. But changes in leg length are even more common after joint replacement surgery. Even worse? When it happens after surgery, this leg length difference can be significant. If so, you might develop a visible limp, along with other painful symptoms. But, while less obvious, even a small leg length discrepancy can still give you foot, ankle, knee, hip, or back pain. I can usually diagnose this condition because your pain may be on only one side.
Changes in Leg Length After Hip or Knee Replacement
Not every hip or knee replacement surgery changes your leg length. But when you do develop a limb length difference after surgery, remember: it's not your surgeon's fault.
In fact, leg length discrepancy is a well-known complication of knee and hip replacement surgeries. Your surgeon does everything possible during surgery to prevent this problem. And it's even likely that your legs were of even lengths when you were on the operating table. But that doesn't mean they will stay the same length after you return to normal activities.
How is that possible? Once you recover, you'll begin physical therapy and get back to your lifestyle. In these stages, your new joint can compress or expand. As a result, the soft tissue can adjust to the replaced joint. And that adjustment may cause your leg to shorten or lengthen.
Symptoms of Leg Length Discrepancy
There are two causes of leg length discrepancy symptoms. The first is when your actual femurs are two different lengths. And the second is when problems, like hip replacement, affect your leg's symmetry. Either way, symptoms are very similar.
With differences in leg length, you may notice:
- A limp
- Changes in posture (one shoulder tilts)
- Toe walking, especially in children
- Hyper-extended or flexed knees
- Hip, knee, back and ankle pain
Luckily, we can resolve most of your symptoms by addressing your leg length discrepancy. And we can bring you that pain relief without sending you back for more surgery.
Diagnosing and Treating Differences in Leg Length
Most people who come to my Houston podiatry practice with pain after knee or hip surgery don't even realize it's related to their surgery. But then, when we discuss it, things start making sense. Because, aside from a physical exam, I diagnose this problem by reviewing your medical history. This helps me identify problems, such as past surgeries, that could affect your leg length.
Been diagnosed with leg length discrepancy? No problem, I'm here to help! Luckily, I can treat leg length difference with common, non-invasive options. And you won't need further surgery.
For a large leg length difference following knee or hip surgery, I may need to send you to have your shoes built up. This is a simple and effective way to get you balanced and relieve your symptoms. I measure the difference in leg length and write a prescription for the right shoe height. (This is a simple fix that even Jackie Kennedy embraced!)
If you're already worrying about limits on shoe choice, please don't. It's actually rare to need specialty shoes for leg length differences. It's far more common that you would just need a lift placed inside your shoes. Still, you must remember that the leg length difference is just one element of the problem.
Because this is the real story. When you have uneven legs, it makes your feet and ankles work differently from one another. This causes an imbalance and instability in the rest of your body. And it's actually the imbalance that causes many of your painful symptoms.
So, if you want pain relief, we have to address your body's imbalances, not just the difference in your leg length. And, to do that, I usually work with a custom foot orthotic. Let's explore why a simple device can make such a big difference if your body is off balance after knee replacement surgery.
Orthotics for Leg Length Discrepancy ![Differences in leg length are painful, but easy to treat]()
A functional orthotic is a prescription shoe insert. It's custom-made for you to provide efficiency and stability to your foot and ankle. It also corrects the imbalance caused by your leg length difference. After being fitted for this device, you should get walking much more efficiently. Better yet? We can make custom orthotics made for any style shoe. And, no, you don't have to wear ugly orthopedic shoes in order to get the most from your orthotic. You can stick with the shoes you love, but say goodbye to the pain you hate.
Did you have had a hip replacement or knee replacement and are experiencing pain in your foot, ankle, knee, hip, or back? Don't sit around and suffer in silence. This is not a normal part of your recovery. But it could be a common side effect of knee or hip replacement surgery--one we can easily relieve. So call Tanglewood Foot Specialists for an evaluation. We will be able to find the source of your pain and get you feeling better fast.
