Leg length inequality can bring on joint pain


DEAR DR. DONOHUE: I’ve been jogging with a group of men, all of whom are in their 50s, for a couple of years. This year, my knees have been giving me trouble. In talking with the other joggers, some say it could be that there’s a difference in the length of my legs. Is this for real? How do I get them measured? What do I do if they aren’t the same size? — B.B.

 ANSWER: Everyone has legs of slightly different size, just as arms are not the same length. If the difference causes no pain, you can ignore it.

 However, it can cause problems. It can lead to low back pain, arthritis of the knees and hips, and hip bursitis. The unequal legs cause the generation of great pressure when the feet strike the ground, and the abnormal pressure load exists for both the longer and the shorter leg. The inequality also causes the pelvis to twist and brings on back pain. Furthermore, when standing, unequal legs distort posture, and that can produce back and joint pain.

 The inequality doesn’t have to be all that great. In a recently published article on knee osteoarthritis, a difference of 1 centimeter (two-fifths of an inch) was linked to knee arthritis. I have to let you know that other authors define significant inequality at half an inch to four-fifths of an inch.

 To measure your legs, you need an assistant. Make a mark on the top part of both legs in exactly the same place. Make another mark at the same place on the ankles. Lie down and have your assistant do the measuring with a tape measure. For a really precise measurement, X-rays of the legs provide reliable figures.

 If there is a difference between your legs, you can even things out with a heel lift, a shoe lift or specially made orthotics.

 Let’s not go overboard with this. The causes of knee pain are many, and a better approach to your knee pain would be a consultation with your family doctor.

 DEAR DR. DONOHUE: Can people with high blood pressure safely lift weights? I have high blood pressure, but it’s controlled with the medicine I take. — L.D.

 ANSWER: If medicine controls your blood pressure, you can lift weights. When straining to lift, people do get a transient rise in blood pressure, 30 or more points. But the elevation is brief and not a source of concern.

 I’d like to know more about you to give you the go-ahead. How old are you? When’s the last time you saw your doctor and had your pressure checked? How’s your heart? If you’ve been seeing a doctor regularly and if you have no heart problems, then it’s OK to lift.

 DEAR DR. DONOHUE: I am 43, and my job requires hard physical labor. I lift heavy weights and work almost nonstop from morning to evening, with a half-hour lunch break. I sweat considerably. Is this enough exercise for me? My wife thinks I should be doing more when I get home. I am so tired out I can’t even think of doing exercise. — H.M.

 ANSWER: It sounds like you’re getting all the exercise you need.

 Aerobic exercise, the kind that benefits the heart, requires your heart rate to rise to a “training zone” and stay at the level for 10 or more minutes.

 Subtract your age from 220. Then multiply that number by .65 and by .8. The lower number is the heart rate that provides enough cardiac exercise, and the upper number is the heart rate you don’t want to exceed.

 If you’re moving around while doing this physical labor, not standing in one place, I’d say you’re getting more than enough exercise. You can assure yourself by taking your pulse and seeing how fast your heart is beating and if you’re in your training zone.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.