Leg Length Difference

A leg length difference (LLD), sometimes called leg length discrepancy, is when one leg is functionally or anatomically longer than the other. Even a small difference can change how you walk, where your weight lands and how forces travel through your feet, knees, hips and lower back — and it can show up as one-sided pain or uneven shoe wear.

What is a leg length difference?

LLD comes in two broad types:

• Structural LLD — a genuine anatomical difference in the length of the bones between the two legs. This can be present from birth, follow a fracture or growth-plate injury, or develop alongside certain conditions. In children, inflammatory processes can also influence limb growth and contribute to a discrepancy [1].
• Functional LLD — the legs are anatomically similar, but the effective length differs due to tight muscles or joints (often around the hip), pelvic positioning, or how the foot rolls in or out. There may be no true bone-length difference at all.

Understanding which type you have matters, because the management is quite different.

What are the signs and symptoms?

Common things to look for with either type include:

• One foot rolling inwards (pronating) or outwards more than the other
• Uneven wear patterns on the soles of your shoes
• One-sided pain in the foot, ankle, knee, hip or lower back
• A sense of unevenness when walking or running

A proper assessment is the only way to confirm the type and likely cause, and to guide sensible treatment.

Can LLD cause foot pain?

Yes — in both functional and structural cases. With a discrepancy, the body adopts compensation strategies that alter foot mechanics and concentrate stress in certain areas, which can lead to discomfort or overuse pain over time. Addressing the underlying contributors usually helps settle these symptoms.

How does Blueprint Podiatry assess and treat LLD?

Our podiatry team takes a thorough, biomechanical approach. Every one of our podiatrists holds a Bachelor of Podiatry, is trained in Foot Mobilisation Therapy and is a certified Level 1 Running Coach — so we can assess your standing posture, joint mobility and how you actually move with a genuine gait and running analysis, not just a static look at your feet.

Once we've identified whether your LLD is functional, structural or a mix of both, treatment may include:

• Foot mobilisation therapy and targeted exercises to address joint tightness and muscle imbalances contributing to a functional discrepancy
• Custom orthotics or heel/sole lifts to support alignment in structural cases — our orthotics are designed from a weightbearing 3D scan, modelled as patient-matched left/right devices, and 3D printed in-house (no external-lab delay)
• Adjunct therapies available at the clinic, such as shockwave therapy or dry needling, where clinically appropriate for associated overuse pain

The goal is to help manage your symptoms and improve how forces move through your lower limbs.

When should you seek help?

If you've noticed persistent one-sided pain, uneven shoe wear, or that one leg "feels" longer, it's worth getting assessed — especially in growing children, where ongoing monitoring can be important.

Related services

• Customised Orthotics
• Biomechanical Assessment