Leg Length Discrepancy and Yoga After Hip Replacement Surgery

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Hip joint replacement

BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons

Hip replacement surgery offers relief from chronic pain, but sometimes it can lead to a new challenge: leg length discrepancy (LLD). This happens when one leg ends up longer than the other after surgery. A study published in Current Reviews in Musculoskeletal Medicine reports an incident rate of between 1% and 27% with the LLD varying between 3 and 70 mm. This is a pretty expansive range of both chance of it happening and the severity of the discrepancy. Symptoms of LLD can include back pain, sciatica, gait disorders, hip dislocation, and early loosening of components. While concerning, it’s important to know this is a common occurrence, and there are ways to manage LLD—yoga is one such strategy.

Why Does Leg Length Discrepancy Happen?

There are three main reasons for leg length discrepancy after hip replacement:

  • Implant Size: The size of the implants used can alter leg length.

  • Stability Needs: Surgeons prioritize a stable joint over perfect symmetry. Soft tissues around the joint have to be stretched into place to keep the joint in position. The length of the tissue can result in differing leg lengths.

  • Pre-existing Conditions: Arthritis or spinal issues like scoliosis could have caused a minor discrepancy prior to surgery, but post-op the discrepancy could become more noticeable.

Mitigating Symptoms with Yoga

Yoga poses can help improve flexibility and mobility, strengthen core, hip, and back muscles, and improve body awareness, all of which can help compensate for a slight leg length difference. Though asymmetric poses are helpful for those with LLDs, I recommend working initially on symmetrical poses after a hip replacement surgery. Here are two key poses to focus on:

Chair Pose with heel lift on shorter leg

Chair Pose

  • Mountain Pose (Tadasana): This foundational pose strengthens the core and improves posture. It is a very functional position and should be practiced regularly. Standing and trying to balance evenly between both sides of your body can be uncomfortable, because you are naturally tilting to one side and making adjustments to compensate for asymmetries. Stand tall with feet hip-width apart, ground down through your feet, and lengthen your spine up. Hold for several breaths, focusing on keeping your hips level. Doing this pose against a wall is a great way to sense the differences between each side of your body—something I demonstrate in my Mountain Pose post.

  • Chair Pose (Utkatasana): Chair Pose strengthens the legs, hips, and core muscles while helping you practice an everyday movement. The transition to and from a seated position can pose a risk for losing balance and injury. You can practice this pose with the help of a chair or wall and you don’t have to bend your knees deeply. Focus on finding steadiness while going in and out of the pose. Stand with feet hip-width apart, bend your knees, bringing your hips behind you, and raise your arms to hips, heart, or by your ears, keeping your chest lifted, and hold it for a couple of breaths. I detail how to do this in my post on Chair Pose with leg length discrepancy.

Additional Tips

  • Listen to your body: Slowly reduce the intensity if you experience pain.

  • Use props: Use lifts, books, or a folded hand towel under your shorter leg to help even out your leg lengths and therefore hips as you practice.

  • Work with a qualified team: Work with a doctor, physical therapist, or yoga instructor who is knowledgeable about working with hip replacements and LLDs. This will help them tailor poses and exercises to your specific needs.

Remember, LLD is a common condition, especially after hip replacement surgery, and there are ways that can help manage symptoms. Incorporating heel lifts and body movement (yoga being an option) can help make the condition less impactful on your life.

Disclaimer: I am not a doctor and this information is for educational purposes and based on my own experience working with LLDs and those with hip replacement surgery. It isn’t a substitute for professional medical advice. Make sure to work with your doctor, especially after surgery.