Episode 16 - Leg Length Difference or Discrepancy after Hip Replacement

August 21, 2025

Leg length discrepancy after hip replacement surgery—why it happens, how it feels, and what you can actually do about it.

Leg Length Discrepancy After Hip Replacement: Causes, Pain, and What Actually Helps

Leg length discrepancy after hip replacement surgery is one of the most common—and least clearly explained—issues hip replacement patients experience during recovery. If you feel like one leg is longer than the other, notice changes in your walking, or develop unexplained pain in your hip, knee, or thigh, this episode of The Hip Replacement Podcast is for you.

In this episode, double hip replacement patient and host Chris Bystriansky breaks down leg length difference after hip replacement surgery in clear, practical terms. Drawing on more than a decade of lived experience, Chris explains why leg length discrepancy happens after hip replacement, how it’s different from having uneven legs your whole life, and why even a few millimeters can create real discomfort.

You’ll learn how hip replacement surgery can change bone length, implant position, pelvic angle, and muscle balance—and how those changes can ripple through your body. Chris shares what leg length discrepancy actually feels like after surgery, including symptoms like hip pain on the longer side, knee pain on the shorter side, IT band pain, muscle tightness, and gait changes that don’t seem to make sense at first.

This episode also walks through real, practical solutions for managing leg length discrepancy after hip replacement:

Shoe inserts and heel lifts
Stretching strategies for tight muscles
Foam rollers and percussion tools
Chair and seating adjustments
Desk work, driving, and daily movement tips

If you’ve been told “everything looks fine on X-ray” but still feel off, this conversation may finally connect the dots. Leg length discrepancy doesn’t mean your hip replacement failed—and in most cases, it can be managed successfully with the right approach.

Whether you’re weeks, months, or years after hip replacement surgery, this episode will help you understand your body better, reduce unnecessary pain, and move forward with more confidence.

The Hip Replacement Podcast is here to help you recover smarter, move better, and live fully—one step at a time.

New hips. New you. Let’s go.

Thanks for joining THE HIP REPLACEMENT PODCAST.

-Chris

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Episode Transcript

Episode 16 – Leg Length Discrepancy After Hip Replacement – Transcript

Welcome to The Hip Replacement Podcast, where recovery meets motivation and healing leads to a whole new lifestyle. I’m Chris Bystriansky, your host. I’m an author, athlete, and double hip replacement patient. I’ve been through the surgeries, the setbacks, and the comebacks—and I’m here to help you do the same.

Each week, I’ll bring you tips, tools, expert advice, and inspiring stories to help you take back your life one step at a time. Thanks for joining The Hip Replacement Podcast. New hips, new you. Let’s go.
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Welcome back to the Hip Replacement Podcast. I’m Chris Bystriansky, your host. I’ve had both of my hips replaced—one about 10 years ago and the other about 12 years ago—and I’m here to share my experiences with you.

Today, we’re going to talk about one of my favorite topics. It’s not exactly a pain-free topic, but it’s an important one: leg length discrepancy, often referred to as LLD.

Leg length discrepancy occurs when one leg is a different length than the other. Some people already have one leg slightly longer than the other before surgery, and that’s very common. I completely agree with that. However, the difference after hip replacement surgery is significant.
When you grow up with one leg longer than the other, your entire body develops around that difference. Your bones, muscles, and movement patterns adapt over time. But after surgery, the bone length may change suddenly—while the muscles, tendons, and tissues are not shortened or adjusted at the same time. That mismatch can cause problems.

The femur may be a slightly different length, or the implant may sit at a slightly different angle or position than your original hip. That can affect the angle of your pelvis, your gait, and how forces move through your hips and legs.
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I noticed my leg length discrepancy right away—but only after my second hip replacement. After my first surgery, everything felt normal. But after the second surgery, the surgeon told me they couldn’t place the hip exactly where it had been before and that I might notice a difference.

A few hours later, when I stood up for physical therapy, I felt it immediately. It felt like my left foot was standing in a hole. My left leg was shorter than my right.
During physical therapy, they measured it by stacking thin wooden platforms under my shorter leg until I felt level. The difference turned out to be 4 millimeters. That may not sound like much, but even small differences can cause issues over time.
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What I’ve learned over the years is that leg length discrepancy can create aches and pains in unexpected places. For me, the hip on the longer side aches, and the knee on the shorter side aches. The most significant pain I experience is along the side of my leg—specifically the IT band—on the shorter side.

If I don’t address it, that pain can be sharp and intense. At one point, I thought I had broken my femur. X-rays showed everything was fine. The issue was muscular.
Because the bone length changed but the muscles didn’t, those muscles can bunch, fold, or fire incorrectly. That imbalance still affects me today if I don’t stay on top of it.
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So how do we address leg length discrepancy and the pain that comes with it?

First, shoe inserts. I experimented with several until I found one that worked for me. Even a small lift can make a noticeable difference.

Second, stretching. I stretch the areas where I feel pain—especially the sides of my legs—every day. This helps the muscles lengthen and move the way they’re supposed to.

Third, muscle release tools. I use a foam roller and a percussion gun to work out tight spots and knots. These tools help keep the muscles from locking up.

I also noticed that chairs matter. The edge of my office chair used to press into the side of my legs and make the pain worse. Now, I rotate between an office chair, a kitchen chair, and an exercise ball. That alone made a big difference.

Driving can cause similar problems. If I’m in the car for a long time, I change positions or get out and stretch.
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Leg length discrepancy after hip replacement is common. Sometimes it’s minor. Sometimes it’s more noticeable. But with a little awareness and daily care—shoe inserts, stretching, movement, and position changes—you can reduce pain and live a very active, comfortable life.
Surgeons do the best they can, but once we leave the operating room, it’s up to us to take care of our bodies. Addressing muscle imbalances and movement patterns is a big part of long-term success.

I hope this was helpful. Thanks so much for tuning in to The Hip Replacement Podcast.

Until next time, I wish you the best recovery possible. Take care.

Episode 16 - Leg Length Difference or Discrepancy after Hip Replacement

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