Advanced Therapeutics

Excellence in Pain Relief

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Info for Parents

When a bone length asymmetry is discovered in  the legs or pelvis of an adult, the bones have already reached their final size and have stopped growing, so the only thing that can be done to address the situation and alleviate any resulting chronic pain is to use a lift on the shorter side, either in the shoe when standing or under the buttock when sitting, or both, as required.

However, if the bone length asymmetry is discovered in a child whose bones are still growing, research has shown that if a supporting lift is placed under the shorter side, in many cases the shorter bone tends to lengthen and often equal the longer bone, thus eliminating the need to use a supporting lift.

Here is a paragraph taken from a medical text, Myofascial Pain and Dysfunction: The Trigger Point Manual by Janet Travell, M.D. and David Simons, M.D. (Vol. 1, p. 107):

Noteworthy was Redler's observation that 1.3-1.9 cm (½-¾ in) leg-length discrepancies in children between 1½ and 15 years of age were outgrown (disappeared) in 7 of 11 children when leg length was equalized with a heel correction for 3-7 months. This evidence for need of a structural correction in growing children by the temporary addition of a compensatory heel lift was supported in a later 3-year study of elementary, junior and high school boys. Research is needed into the mechanism by which leg-length inequalities in children disappear with correction.

While not every child with a leg length difference benefited from having a lift, the majority certainly did, so if it might be possible to help a child by using a simple lift to help the leg lengths to equalize, we think it’s worth a try.  It’s easy to try, inexpensive, and if it works, it could save the child from either a lifetime of chronic pain, if no lift is ever used, or a lifetime of having to use a lift to help prevent pain.  In our practice, whenever we discover a leg length or pelvic asymmetry in a child, we explain to the parents how much lift to use, then suggest that the parents bring the child in for a 15-minute evaluation once every six months or once every growth spurt, whichever occurs first.  That way, we can monitor the bone lengths and either adjust the lift thickness or even remove the lift entirely if the legs appear to be equal.

We understand that this is probably a new concept to most parents, so we welcome any questions you may have in this regard.  If you’d like to know some possible signs of skeletal asymmetry to check for before you call us, please click here.  Otherwise, please feel free to contact us at your convenience if you have a child you’re concerned about or might like to have evaluated.  We’re always glad to help when we can.