By Roberta Nole, PT, CPed
Founder, Stride Orthotic & Pedorthic Center
Leg length differences are more common than most people realize. For some, they go unnoticed. For others, they can quietly contribute to back pain, hip discomfort, knee issues, or an altered walking pattern. If you’ve been told you have a leg length discrepancy (LLD), you may be wondering: Should I use a heel lift—and if so, how much?
As both a licensed physical therapist and certified pedorthist, I’ve spent my career blending clinical insight with custom orthotic design. At Stride, we don’t believe in “one-size-fits-all” solutions when it comes to your feet or your alignment.
What Exactly is a Leg Length Discrepancy?
There are two types of LLD:
- A structural LLD is a true difference in bone length between the two legs—usually from genetics, past injuries, or surgeries.
- A functional LLD occurs when the bones are technically equal in length, but muscular imbalances or pelvic asymmetries create the illusion of uneven legs during standing or walking.
“A structural LLD can often benefit from a properly sized lift, but a functional LLD needs a different approach. That’s why a thorough biomechanical evaluation is key before adding a lift to your orthotic or shoe.”
– Roberta Nole, PT, CPed
If you’re unsure what kind of LLD you have, don’t worry. We work closely with referring physicians and physical therapists—and we perform in-house evaluations that include posture, gait, joint mobility, and even photographic analysis.
How Much of a Lift Should I Use?
This is one of the most frequent questions I receive. And the answer is: it depends on your body and your tolerance.
- We often start conservatively, using ¼” (6 mm)—about 50% of the total discrepancy.
- If symptoms persist and your body adapts well, we may gradually increase the lift over time.
- In many cases, this progressive approach avoids shock to your system and leads to better long-term outcomes.
“There’s no magic number. I’ve seen patients respond beautifully to small changes—and others who need more correction to feel balanced. My goal is always the same: improve comfort, posture, and function.”
– Roberta Nole, PT, CPed
Where Does the Lift Go?
Depending on your needs and your footwear, we may place the lift in different ways:
- Up to ¼” (6 mm) can usually be added directly to your orthotic heel post.
- Between ¼”–½” (6–13 mm) may require a separate tapered insole lift that goes inside the shoe, with the orthotic sitting on top.
- More than ½” (13 mm) typically needs to be added to the outside sole of the shoe by a trained cobbler. This avoids crowding the inside of the shoe and maintains proper alignment.
We’ll walk you through what your shoes can (and can’t) accommodate—and help ensure your footwear works with your orthotics, not against them.
Why Proper Evaluation Matters
Adding a lift without the right evaluation can create more problems than it solves. That’s why our team takes time to assess:
- Your foot structure and flexibility
- Your gait pattern and joint motion
- The type of shoes you wear every day
- And how your body responds to postural changes
If you’re already working with a physical therapist, great—we’re happy to coordinate care. If not, we can guide you toward one who can help identify the root of your LLD.
“I’ve built my practice on the idea that orthotic solutions work best when they’re part of a bigger picture—one that considers how the entire body moves and adapts.”
– Roberta Nole, PT, CPed
Final Thoughts
If you suspect you have a leg length difference—or have been told you do but aren’t sure what to do next—don’t guess. Come in for a full evaluation, and we’ll help you determine the best way to correct it safely.
A properly fitted heel lift, placed correctly and monitored over time, can reduce pain, improve alignment, and help you move with more confidence.
📞 Have questions? Contact us or visit our office in Middlebury, CT.
🦶 Stride Orthotic & Pedorthic Center — Helping your whole body start with better feet.
