Addressing Structural Asymmetries: The Role of Heel Lifts in Gait Mechanics

How do you determine when a leg length discrepancy requires structural intervention? In this episode of Untold Physio Stories , Dr. Wells presents a case study of an 80-year-old patient managing the long-term effects of a complex total hip replacement. Following a revision surgery two decades ago, the patient was left with a 2cm leg length discrepancy on her right side. While she remained active with yoga and Pilates for years, a recent decrease in activity led to noticeable changes in her gait and discomfort in her lower extremities. Structural Findings : A functional and anatomical measurement confirmed the right lower extremity was 2cm longer than the left. Gait Observations : Assessment revealed a compensatory trunk lean to the right to facilitate clearing the left leg during the swing phase. Joint Mechanics : The patient exhibited significant pronation in the right ankle and a varus thrust in the left knee during ambulation. Strength Deficits : Evaluation showed weakness in the left gluteal and quadriceps muscle groups. Dr. Wells opted for a dual-track approach: Conservative Structural Support : A 0.5-inch heel lift was introduced to the shorter side to improve gait symmetry without causing discomfort or heel slippage. Targeted Exercise Prescription : Resistance training was initiated to improve quadriceps and gluteal strength, specifically focusing on knee tracking and core stability. We also contrast this with Dr. E’s experience managing a post-polio patient, where the goal was actually reducing an excessive 3-inch external lift to restore lost hip and knee extension. This episode explores the balance between providing structural support and maintaining joint mobility. Untold Physio Stories is sponsored by ⁠Comprehend PT⁠ - Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator does the rest! No need for accuracy or exact wording! It's a game changer and will give you more time with your patients! Use code MMT50 to save 50% off your first month. Free trial available at sign up! ⁠⁠ The Eclectic Approach Network⁠⁠ - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking. Check out ⁠⁠EDGE Mobility System⁠⁠ 's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual

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Addressing Structural Asymmetries: The Role of Heel Lifts in Gait Mechanics is an episode from Untold Physio Stories by Dr. Erson Religioso III, DPT, FAAOMPT.

This episode is 00:11:56 long.

This episode was published on Mar 10, 2026.

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