Having one leg longer than the other, like the England soccer captain, can put your body under stress. Barbara Lantin reports


Nobody's perfect - not even David Beckham. The footballer revealed recently that his left leg is significantly shorter than his right and that this discrepancy is the likely cause of his continuing back problems.

Beckham is not alone. "Humans are not symmetrical down the midline and it is probable that everybody has one leg longer than the other,'' says David Nunn, consultant orthopaedic surgeon at the London Clinic. "A difference of 1cm or less is normal and unless you use an X-ray or a scan, it is in any case very difficult to measure leg length accurately.''

Experts diverge over the likely effect of a disparity. "A great many bodily ills are ascribed to having one leg longer than another by a variety of practitioners, but a 1cm difference is probably of no particular consequence,'' says Nunn.

"If you had a back problem, it might make it more symptomatic, but it's unlikely to be the root cause. A more than 1cm difference might be problematic because if you spend your life walking around with your pelvis tilted, your spine could also be skewed.''

Fred Beaumont, spokesman for Britain's Society of Chiropodists and a lecturer in biomechanics, disagrees. "People say a 1cm difference doesn't matter because your body will compensate and adjust, but we have begun to realise that compensating puts your body under stress. American research among athletes found a difference of about a quarter of an inch measurably affected performance. If the shorter leg is on the inside of an athletics track, it gives you an advantage, and if it is on the outside, you are at a disadvantage. Rugby and football players will tend to favour the shorter leg and turn on that side without being aware they are doing it."

Sedentary types may not notice a minor discrepancy. It is those who spend all day on their feet or who do serious weight-bearing exercise who are likely to suffer, according to Wayne Edwards, a musculo-skeletal podiatrist at Health and Fitness Solutions, part of the City of London Medical Centre.

"The more active you are, the bigger difference a discrepancy will make. We would routinely test leg length in any overall postural examination and we often use video analysis. Sometimes, you can see the leg shake when people land on their short side. We would look at the effects of leg length and make a judgement about if it was significant or not in terms of the pelvis and the spine before deciding whether to correct it.''

A true discrepancy is when the leg bones are actually of differing lengths. But one limb may appear shorter than the other because of a disorder of the hip or an in-rolling foot. Among the childhood conditions that can lead to disparity are a dislocated hip, scoliosis — curvature of the spine — and fracture. "Paradoxically, a fracture in a long bone tends to cause it to grow longer rather than shortening it," says Nunn.

The appropriate method of correction depends partly on the underlying cause. The simplest solutions are either to insert orthotics — custom-made insoles — into the shoes or to build up the heel. Orthotics are intended to strengthen the muscles of the feet and legs and thus correct imbalances in posture.

Brian Casey, 58, a solicitor from London, has been wearing a pair for the past four months, since discovering that his left leg was "significantly'' shorter than his right. "I had a hip resurfacing operation and was walking peculiarly afterwards. My legs have probably always been different lengths but it did not trouble me until I had the operation. It may have contributed to the problem in my hip by causing it to take more wear. Since having the orthotics fitted, I feel much more comfortable.''

Where leg length discrepancy causes serious disability, surgery is possible. A hip replacement operation can sometimes even out leg length. More sophisticated is a procedure known as the Ilizarov technique, which involves running a wire through the bone and attaching it to an external ratchet mechanism.

The patient turns the ratchet a millimetre each day over several months, thus "stretching'' the bone. The operation carries a risk of damage to nerves and muscles. The contraption worn by the patient is cumbersome, but growth of several inches is possible using this method.

Meanwhile, David Beckham, who says he cannot bear wearing insoles of any kind inside his football boots, will doubtless have a special boot made for his shorter leg. Just imagine how well he will play once his disability has been corrected.

© The Telegraph Group Limited, London 2004