My wife was having some knee pain last week after riding her new bike for a few months. Turns out she has one leg 8mm longer than the other, so the LBS put 4mm worth of shims in her cleats and everything is cool. They thought a full 8mm would be too much of a shock, so 4mm was the choice, and shee feels much better. I would split the difference, but i am no doctor.

---

--------------------------------------------------------
John Behme
Charlotte, NC

You should definately look into a shim for your cycling shoes. I discovered about 5 years ago that i had a difference and now have a 9mm shim and it has done the trick. 6mm is not much your right, but try to go 3mm on that side and see what it feels like. Not many people have the same length legs out there, most are very minimal differences, but it only makes sense to look into getting into figured out. The LeWedges (I think) make shims that come in .5mm thickness. You'll also maybe have to get longer screws too for that cleat.
Good luck.

This was just discussed recently; you need a lift between your shoe and sole. Lifting only the heel is liking running in heels. I have a lift put between the shoe base and bottom. Also in my skis,cleats etc.

One question: how do you know you have a leg length discrepancy?

The only time I have seen it measured (I was lying on a table and an expert bike fitter tugged a bit and pulled my heels together) that it appeared to be so primative and "episodic" that it would seem inconclusive at best, problematic at worst.

There are so many different things that can contribute to leg length discrepancy hip angle, tightness in certain muscles and connecting tissues (yes, I have been rolfed ;-) that I would be reeeallllly cautious before shimming my shoes - and enforcing my body into an assymetrical model which might have been the result of a measurement on a bad day.

Has any one gotten valid stats on the percentage of people who have such actual skeletal discrepancies?

(on a similar topic, has anyone ever figured out if that girl who is called "big boned" really does have bones that are bigger than anothers'? ;-)

I had a sports chiropractor/physio do the measurement. Until now, he was convinced that any length discrepancy was due to tight/weak hip and other muscles. We did the measurement before and after his working my hip flexors, glutes, hamstrings, ITB, ankles, etc. and determined that the actual difference between legs was about 1/4 inch.

We'll periodically redo the test -

BTW, who carries the shims for cycling cleats online....no time to get to the LBS

and he's an expert in leg length discrepancy?

My right leg is 5 mm than the left. I use 1 mm additional layer in the right running and biking shoes and also 2 LeWedge shims (2x0.5 mm) in between the right bike shoe and the pedal. This does the trick for me. The polar right-left power balance measurement confirms the value of the adjustment. Be careful at the leg extension on the bike fit as, when the bike saddle is starting to be too high, the crotch is sliding towards the left of the top of the saddle to compensate for the remaining leg discrepancy. Hope this help.

Don't know that there is such a specialty...if there is, I haven't stumbled, or limped, across it.

However, you're right to be skeptical (if that's what you are) as we should be with anything medical care related.

This chiro is one of the ART folks you see at IMNA races.....Here's how I chose him - Practice is almost exclusively devoted to athletes, he's helped me before, is a runner/triathlete himself, has helped some of my training partners (including an ortho surgeon) with chronic and acute injuries, will admit when he's guessing or when you need to see another pro, has worked with local athletes on their gait, strength imbalance, flexibility issues.....and so forth.

Nonetheless - I continually ask a myriad of folks for opinions and experiences - and we'll revisit the leg length issue periodically. I'm north of 40 and have some joint diseases in my family history so I'm max attentive to these running injuries.

Ultimately, as with all things medical, "curing" is art more than science.

Heel lift or "full" orthotic in your running shoe?

full orthotics. I had a low arch issue (flat feet) and took the opportunity to add to the right foot orthotic the additional 1 mm under the ball of the foot to compensate the leg length discrepancy. Interestingly, I try to run on my toes (short stride, etc) and a friend of mine noticed that my right foot land shorter than the left, which makes sense and so far has not negative effect on my run.

sounds cool...I am totally skeptical when it comes to orthotics and the like, believing in the need for the body to "run with what it brung" while being very skeptical that building a discrepency into the body from the outside is a good idea.

No one has ever been able to tell me how many pros use orthotics or wedges, despite many orthos (yes even the most sports-experienced) claiming that everyone has something wrong that needs them.

IIRC there was an article in either Triathlon or Inside Tri last year about Peter Reid and his leg length difference and how it effected his cycling. they shimmed his shoe and it added some watts to his cycling power.

As for determining a leg length measurement there are a couple ways. One is to measure from the belly button to the medial ankle, two is measuring from the Anterior Superior illiac Spine on the pelvis to the medical ankle and third is to get an x-ray study done where they actually take an image of the bones and measure then on the x-ray.

Typically anything more then a 1/4 inch is seen as significant. To a small degree we all have a difference as we are not built perfectly semetrical.

As for treatind a leg length difference, you can do a couple things. I would really recommend a lot of stretching. Your chiro may be able to help with some of it. But something like a yoga class might also help. Some Stretching and some core strength work could go along way.

---

Fighting gravity on a daily basis

My right leg is a full 1" shorter then the left, due to some dumb a**hole that ran me over about 26 years ago (I'm old) while I was a cop and directing traffic.

I was wearing a heel lift in my regular and running shoes and shim in my cycling shoes (under the sole at the cleat) for many years. I spent a few years reducing the shims and as of this date I no longer need either one. My hips, knees and back have compensated for the 1" and I have NO problems. its been about 6 years without shims/lifts.

---

.
.
Paul

I have the same problem but where do you get these shims you speak of?

I have the same issue--left leg is slightly shorter than the right. I kept getting injured on the left side until I got orthotics and got a real bike fit with wedges and all.

specialized makes some foot beds to fit different arches and makes wedge inserts to correct for valgus and varus--tilt of foot--pronate or supanate. Usually the shorter leg will supante to try and make itself longer.

This makes a huge difference in how your whole leg moves through the pedal motion--make sure your leg tracks straight up and down and doesn't move much side to side. You can check this in a mirror on a trainer.

I think reggiedog is making a good point. I am not comfortable diagnosing my patients as leg length challenged until I can be certain of anatomical leg length differences. For me, I need to have x-ray to view and measure the literal anatomic length of the tibia and the femurs. I don't suggest lifts for functionally short legs (apparent). Only anatomical discrepancies. Once (if) you find out a shim is for you, you'll get more than balance. Depending on the extent of one's current anatomic asymmetry, you'll be looking at increased wattage from the short leg that was 'reaching' for the pedal, your heel will stop wiggling (easier on the AT) and your knee will track in an improved way (more power to the pedal as a result of both). Saddle sores that are often seen on the short leg side from the rubbing/rocking hip will clear up and your low back will get a rest. Increased comfort going long! That's a nice benefit. Cleat placement, fore and aft, can also have an effect. Cleats move around. Check their positions often and replace them before they wear out (like runners).

Interesting...so you'll measure the bones in the xray itself? Would the relative amounts of cartilage in the knee joints contribute to any leg length differences?

If the xray doesn't show differences in femur-tibia lengths, but there is a difference due to another factor, what do you generally prescribe / how do you approach?

<< Would the relative amounts of cartilage in the knee joints contribute to any leg length differences? >>

Relevant only to that extent -- in other words, not much.

<< If the xray doesn't show differences in femur-tibia lengths, but there is a difference due to another factor, what do you generally prescribe / how do you approach? >>

Determine the reason(s) for functional difference and remove it/them. Chiropractically adjust sacro-illiac joint, treat/remove muscle imbalance, etc.

Mine is a full inch difference. I no longer use a shim in either my running or cycling shoes. It took about 12 years for my back and hips to adjust ( I was hurt in a hit and run accident that made the 1" booboo). During those 12 years I was using a shim in both running and cycling shoes. Over time I dropped the shim from the running shoes, then dropped the shim from the cycling shoes and now use nothing.

BTW - my seat height is adjusted to the longer leg. My pedaling has adapted to the seat height and I pedal more toe down on the short leg side. As they say on ST - "your seat is too high". Its very true in my case.....but it works geat for me!!

---

.
.
Paul