Technique: How to deal with different length legs

16 comments
By Triathlon Plus | Monday, Feb 15, 2010 4.00pm

Many riders have one leg that's slightly shorter than the other. For most people the difference is minor but for others, especially those who have suffered broken bones, it can sometimes be measured in centimetres rather than millimetres.

Here two experts, CycleFit technician Julian Wall and orthopedic surgeon Stephen Eastaugh-Waring, explain what you can do about it.

Bike fit options – Julian Wall

The first thing to look at is your bike setup, and a proper cycle fit by a qualified technician could help in several ways.

One of the most significant fixes would be through adjusting the position of the cleats. I would recommend moving the cleat position further forward on the shorter leg. The fore and aft of the saddle position would also make a difference here.

There are also cleat shims; thin plastic wedges that you can fix underneath the cleats, which mean you can correct leg-length discrepancies, but I’d advise you to always look at cleat position first.

Saddle choice is another factor; if your hip drops on one side it can be improved by a wider saddle, which can help to stabilise the pelvis. We also make custom footbeds for cyclists, which is another area that may help you.

It’s not simple to diagnose yourself; there are lots of factors to consider. Ideally you need someone experienced to take an objective look at you cycling. But the good news is that a proper bike fit can really help to make a huge difference to your cycling.

Medical options – Stephen Eastaugh-Waring

Having a short leg when you’re taking part in sports creates biomechanical problems, and can really restrict your ability to compete. In the case of a short tibia (lower leg) it is more common and more easily addressed with orthotics and shoe inserts. However, femoral (thigh) shortening is more of a problem.

Whatever you do with shoes, crank lengths and seat positions, the problem will still be that the knees are at different levels, thereby upsetting the body’s mechanics. This gives different levels of power transmission through pedal rotation, and tends toward stresses and curvature through the lower back at the lowest point when you’re pedalling.

So what can you do? We’ll leave the issues of bike setup until later (see Julian Wall’s section below), and will look at more long-term solutions. Choosing to have a surgical procedure depends on how short the femur is, residual deformity at the healed fracture site, and any abnormality of limb alignment. If there is malalignment, correcting this will help to prevent early wear and tear in the knee and lower back (constant malalignment of the lower back to compensate for the differences in leg length can lead to permanent deformity or more commonly, degenerative changes and pain).

Your choice of surgical options is between shortening the ‘normal’ leg or lengthening the short limb. The amount you can lengthen it is limited by the degree of difference between the limbs, and tends to involve greater risk. Most lengthening procedures mean you have to use an external fixator or frame, which can be cosmetically and practically limiting. The amount of time you’ll need to lengthen your leg is measured in weeks and months, and complications from infection are common, as are soft tissue scars.

Shortening the good leg sounds counterintuitive, but has many benefits. The amount of time you’ll need to invest for surgery and recovery is relatively short, measured in a few weeks. The ‘osteotomy’ or shortening site is often held together with a nail or plate fixed internally, and this can be done through small incisions, minimising cosmetic issues, and making life more practical during recovery.

The accuracy of equalising the leg lengths is good, with most studies showing restoration to within 1cm, from a difference as great as 4-8 cm. The maximum length difference that can be safely addressed is up to 16cm. Complication rates are fairly low, and you could be back out on your bike within around three months of having the procedure done.

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User Comments

There are 16 comments on this post

Showing 1 - 16 of 16 comments

  • Interesting article but I have the opposite problem which isn't addressed. One of my legs is longer than the other not shorter. I would welcome appropriate advice.

  • BrianTrousers, you owe we a new keyboard! PMSL!!!!

  • Ha funny comment but Triathlon Plus once again uses a problematic article.

    Cyclefit have a vested interest in what they write.....their inserts and wedges are a wee bit expensive for a bit of plastic etc!

    The questions to ask are:

    How does the leg length discrepancy affect cycling biomechanics and force application?

    Is an overuse pathology likely as a result of the discrepancy?

    What is the origin of the discrepancy?

    A misaligned hip, different bone lengths, muscle imbalances, misaligned saddle etc could all result in such a discrepancy. Only when this origin is identified should a treatment be prescribed.

    I am sure that the surgeon would agree that superficial examination is notoriously unreliable in identifying the origin or the discrepancy, and he would use a CT scan before surgery.

    Magazines should only allow medically trained practioners with expert knowledge in the area to write such articles, or at least give editorial control to these experts.

    This article only gives half a picture and is potentially neglegent as a result!

    A malaligned hip, different bone lengths, muscle imbalances, misaligned saddle etc could all result in such a discrepancy

  • Cyclefit are an excellent place to start. I've used them a number of times and they have made a difference. They will take your money but they are experts at their job.There was a woman cyclist in Cycle Sport(?) recently who had a leg discrepancy and recommended Speedplay pedals as helpful.

    Unfortunately, a Cyclefit may oly be the starting point but they can get you started towards a solution.

  • stupid, if this is the new reason you cant winning races or keeping up with your mates out on the trail ect get a new excuse book

    i bet mr armstrong or steve peat did not say

    "sorry you had to wait half a hour for me to catch you up but my left bum cheek is fatter than the right ,so the power does not transfer to the pedals evenly and this means i cant keep up"

    this seems mad that people are getting to this, i do understand that they will be the odd case where some poor person has one leg 3inches longer than the normal but come on most of us dont have a issue and this seems a waste of reporting

  • geminidisco12345... you may not believe it but there are people out there who get some value from this article. I have broken my right femur 3 times leaving my right leg 15mm shorter than the left. The imbalance has definitely not helped and creates pain in my left knee and hip. Orthotic inserts help but do not give me enough spacing to make up the difference so I will try the cleat positions and probably make a spacer.

    Mr Rex...good points but I will try the changes and see if this helps for now. If it desn't I will try and find a local cycle specific specialist. I don't know if there are any in South Wales?

    Cheers

  • Businesses like CycleFit rely entirely on their word-of-mouth reputations and no amount of positive articles on bikeradar will convince enough people to make a difference if they don't have a good grass roots reputation. They don't charge a huge amount and they'd be the first to refer a case to a specialist if they thought it appropriate. I don't have affiliation with bikeradar (or CycleFit for that matter - just a now-happy client) but I do know that cyclists who happen to work in the cycling media are just as interested as any other cyclist to see other riders, especially new ones, sorted out properly. There's no big conspiracy to see here, move along.

  • Good article as I have a 3in difference in my legs, luckily it's in the tibia and doesn't affect me as much as it could. I get the odd numbness after a few hours in the saddle. I have tried building wooden shims for my cleats but they just make my calf ache. Can't believe nobodys said the "do you just ride in circles" joke??

  • Hey Nick

    I agree that CycleFit are probably as professional as you will get in the UK.

    What you must remember is that FuturePublishing and its advertisers have a vested interest in most things that are published, for example in Pro Cyclist when a glowing review of a bike is published and two pages earlier, the manufacturer has taking out a whole glossy page of advertising.

    My point could have been better made but what I am saying that all articles related to medical issues should be reviewed/edited by an expert in the area, not by some editor who may or may not have adequate knowledge to make appropriate decisions.

  • I am a manual therapist (Chiropractor) who deals with cyclists, and cycling related injuries, and one very common aspect which is not mentioned is a "functional leg length discrepancy". This is usually related to pelvic rotation, and therefore, if the pelvis can be balanced out, the functional leg length problems can be addressed. Surgery would be totally inappropriate for functional leg length issues.

  • I've had my leg lengthened following an accident, best part of 3cm. I'd suggest that it really isn't an option to be considered unless it’s for medical reasons.

    Back on the bike within 3 months is a joke!! The most the bone could be stretched in a day was 0.075mm a day & you do it yourself with a set of Halfords spanners & that's only after the horrific operation to have an ilizaov frame fitted.

    Oh yes & then there's the changing of dressings every 3 days, the sleepless nights & the morphine to keep the pain at bay.

    If it were me I'd go to Cyclefit to sort it out rather than the hospital. Anyone wanting to try the hospital approach should check out www.ilizarov.org.uk

  • Small discrepancies certainly don't require surgery!

    I have a discrepancy of about 0.5" so asked someone I know who works with pro coaches and the BC paracycling team. He suggested I try changing cleat position before shims (which, even if you can stack them adequately, won't necessarily work). As per the article, shift cleat for the short leg towards the toe and the longer leg backwards towards the heel.

    I've also read of people using different crank lengths but not read any expert advice on that subject.

  • geminidisco12345

    "stupid, if this is the new reason you cant winning races or keeping up with your mates out on the trail ect get a new excuse booker does not transfer to the pedals evenly and this means i cant keep up"

    Geminidisco, you've made an asinine comment. Take this is a lesson to think a bit before being so critical. Let my experience be your guide.

    At age 9 I broke my tibular and fibula which was repaired with an external fixator (insertion of 4 metal screws held in place by a fixing rod).

    I started riding seriously at age 22.

    After racing for the last 5 years, the pain in my hip (left) and knees had gotten so bad that I couldn't ride for 60 minutes at recovery pace without severe discomfort.

    I finally sought the help of an expert located locally in Tucson, Arizona, USA, that has helped hundreds of riders, had a legendary reputation, works with top US pro teams, and had personally fitted and helped 10 of my friends.

    He assessed that I had a 12mm leg length discrepancy from a collapsed arch in my left foot in combination with my right leg being 6mm longer. I now ride with a 6mm shim and a left footbed with a raised arch. My cleats were moved back with my left cleat being a bit offset (can't recall if it's forward or backwards). In addition I'm now using fixed cleats with different angle of rotation between legs. I also had my saddle moved back about 2 cm.

    Now my hips sit square on my saddle, my knees don't track as much on a horizontal plain and the pain in my left hip is significantly reduced. While I'm still adapting to the insoles and the new position I'm hopeful that over the year I'll continue to see improvements with a stretching regiment.

    While it's to early to tell if everything is "fixed" i can certainly say that things are improving, and I'm hopeful that I'll experience the right kind of pain when I'm racing and training. Dead legs, and tired lungs.

    If anyone is interested in the gentlemen and business that helped me his name is Bill Peterson and he runs Foot Fitness - http://www.wedofeet.com/. I believe he's helped various pro teams with fits including Team Type 1, United Health Care and Bissell. I'm not associated professionally with them, just very grateful for the help I have received.

    Anyway, I applaud this article for encouraging people to seek out professional help to at least evaluator pain they may experience. The biomechanics of cycling are tricky, and I wish I had sought help years ago. Who knows what kind of pain I could have avoided if I was riding more aligned.

  • Interesting article this and comments, i have a left hip rotation and leg length problem has well has back pain and hip pain, i have seen countless physios and a few doctors, NHS who say is to do with my discs? mid back or L1 S1 joint, they can`t make there mind up whats going on!! been like this for 5 years now since starting cycling again, whether i have had a injury and my body and it has adapted who knows? My right leg hits the top tube, and i am sat to the left side, i have pissed about with my bike position every week, can`t get comfy, if i get the back position right my neck hurts i can`t get on the drops properly, i get constant rib pain which i take naproxen for.

  • i love the way this article alludes to surgical leg length equalising as being relatively straightforward and common place.

  • got a mate of mine who's in to metalwork to make me an aluminium shim for £0, as other folk have said the commercial ones are not cheap.

    apparently it's best to go for about half the length difference (not sure why).

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