What Causes Short Leg


When finding out they have a short leg, one of the first questions a patient asks is, “What caused my short leg?”

Some causes of a short leg are:

  • Fractures of the lower extremity.
  • Hip and knee joint replacement or other surgeries to the lower extremity.
  • Flat feet.
  • Over-pronation.
  • Hip dysplasias.
  • Bone diseases.
  • Normal growth variant.
Short Leg Causing Pelvic Tilt

Short Leg Causing Pelvic Tilt

The most common causes of a short leg are flat feet, over-pronation, and normal growth differences.


Treat the Cause


Always attempting to find the cause of any ailment is very smart. All too often we search more for an easy or simple treatment but fail to ask what is the underlying cause? We spend our efforts looking for a relief and not searching for a remedy.

Once we are able to uncover the cause(s), a solution may then become obvious.

For example: If you have what appears to be a short leg, simply adding a heel lift may balance the pelvis, but...

Is that the best solution?

You need to ask, “What is causing my leg to appear short?”

If you truly have just a short leg then adding a lift to the shoe is probably your best choice and that should remedy the situation.

But what if the leg appears to be short, not because is is truly anatomically short, but because you have a flat and/or over-pronated foot that is creating a functional short leg? (To learn the difference between anatomical and functional short leg click here.)

In this situation, adding a heel lift may balance the pelvis and lower back, but it does nothing to correct for a flat foot or over-pronation.

The flat foot and the excess pronation will remain and continue to create misalignment in the knees and hips. These joints will therefor continue to suffer the consequences of the imbalances and undergo continued degeneration.

Yes, you may have balanced the pelvis and lower back, reduced the joint stress there, and slowed or halted the degeneration and pain. However, by failing to recognize the true cause of the short leg-the flat foot and/or over-pronation-you also failed to correct the misalignment of the knee and hip and allowed for them to continue to undergo abnormal wear and tear and subsequent degeneration. This will only increase your chances of needing knee or hip joint replacements sometime in the future.

You are winning one battle (lower back pain) at the expense of loosing another (hip and knee arthritis).

The best path to take would be to:

  • Fully analyze the lower extremities for actual leg length difference.
  • Identify the existence of flat feet or over-pronation.
  • Be fitted for custom-made stabilizing orthotics.
  • Add a heel lift to shoe if needed.

With a functional short leg, once you correct over-pronation and flat feet the apparent short leg will no longer be evident-the pelvis and lower back are leveled and balanced.

Only after correcting for flat feet and over-pronation can you accurately measure a short leg.

Only with correction of either an anatomical or a functional short leg will you more fully be able to level and balance the body.

Not only is the lower back stress and the associated pain reduced and feeling better, now there is less stress to the knees and hips joints because they too are properly aligned and balanced.


Longer Leg May Suffer More Damage

A short leg, whether actual or functional, causes the opposite long leg to bear more weight and impact while standing and walking. It is this added weight and joint impact, along with the misalignment, that cause unnecessary or accelerated knee and hip joint degeneration relative to its counterpart, the short leg.

Interestingly, it is often the longer leg that will demonstrate the most over-pronation. When the over-pronation of the long leg is corrected with stabilizing orthotics, the short leg will actually show more shortness and will be more evident.

This will allow the actual difference in the leg lengths to be assessed and measured more accurately and the appropriate heel lift can then be prescribed.

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