Our expert says:
This is a complicated situation because of the practical problems in trying to adjust for a considerable limb length inequality. Its hard to comment accurately without having seen your daughter's foot but I have several patients who have a similar condition.
Firstly the limb length difference: A built-up shoe should eliminate the hip and back pain so if she is still getting it, there is probably not enough correction. I would have an x-ray of the legs done in stance from the waist down and determine exactly what the difference in leg length is. It is important to eliminate the hip and back pain because this will cause ongoing problems. There are several ways to modify shoes to accomodate the difference, both inside and under the sole of the shoe, possibly a combination of both.
This becomes complicated because of the tight achilles tendon which is quite common with this condition. I suggest that you find a good physio that can work on the tendon. Its unlikely that there will be complete correction but you can make a big difference in achilles tendon length.
I also find that there is a tendency for the foot itself to be slightly deformed, which alters the way it functions when walking. This would also need to taken into account.
I have in similar situations made a prescription insole that supports the feet correctly, taking the achilles and foot shape into account. This would need to be able to fit into a built-up shoe. Unfortunatly this type of insole does limit the shoes that could be worn.
Hope this helps,
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal
advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.