Using Heel Lifts Post Total Knee Replacement

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Recovering from a total knee arthroplasty (TKA) is a major milestone, but it can come with a short leg." One of the most common complaints post total knee replacement surgery is the feeling that one leg is suddenly longer than the other.
While it’s often a temporary sensation, a true Limb Length Discrepancy (LLD) can sometimes occur. Here is how a simple tool—the heel lift—can be a game-changer for your recovery.

Why Does One Leg Feel Longer After Surgery?
Before reaching for a lift, it’s important to understand why this happens. There are two main types of LLD:
Functional Discrepancy: This is the most common. Before surgery, your knee may have been bowed or collapsed (varus/valgus deformity). Once the surgeon straightens the joint, the leg is physically longer than it was pre-op. Your pelvis and muscles, used to the "shorter" crooked leg, need time to recalibrate.
Structural Discrepancy: This is a literal difference in the bone measurements. While surgeons strive for perfect symmetry, minor variations in hardware placement or bone resection can result in a slight millimetric difference.

How Heel Lifts Help
If your physical therapist, podiatrist, chiropractor or physician confirms a discrepancy, a heel lift (a firm insert placed inside the shoe of the shorter leg) provides several key benefits:
1. Realigning the Pelvis
When legs are uneven, the pelvis tilts to compensate. This tilt creates a "functional scoliosis" in the spine, which often leads to lower back pain. A heel lift levels the "foundation," allowing the pelvis to sit neutrally.
2. Normalizing Gait Mechanics
Walking with uneven legs causes a "limp" or a "vaulting" gait, where you hop slightly over the longer leg. This puts undue stress on the hip and ankle of the prosthetic side. A lift smoothens the transition from heel-strike to toe-off.
3. Reducing "Edge Loading" on the Knee Replacement Spacer
A balanced gait ensures that weight is distributed evenly across the new polyethylene plastic spacer in your knee. By correcting LLD, you prevent uneven wear and tear on your new implant, potentially extending its lifespan.

Tips for Using Heel Lifts Correctly
Start Small: Don't try to correct a 10mm gap overnight. Start with a 3mm or 6mm lift to let your soft tissues adapt.
The "Wait and See" Rule: Most surgeons recommend waiting 6 to 12 weeks post-op before committing to a permanent lift. Often, the "long leg" feeling disappears once the swelling goes down and hip muscles loosen up.
Firmness Matters: Use a lift made of firm rubber or leather. Soft foam compresses under your weight, rendering the correction useless while you walk.
Check Your Shoes: Ensure the lift doesn't push your heel so high that your foot slips out of the shoe. You may need shoes with a deeper "heel cup" or removable insoles
Atlas Biomechanics is an USA based manufacturer of medical grade Heel Lifts. They are the most prescribed heel lifts by medical professionals.