The Gaiety of Gait

As a physical therapist, I love reading people’s posture and analyzing people’s gait. The manner in which someone walks can tell you so much. It is fun. It is like a puzzle waiting for you to solve.

The gait pattern is a result of three different components: stiffness, weakness and compensation. If the knee joint is stiff, you cannot bend it. If the quadriceps is weak, you cannot stand on your leg without buckling. However, many people have stiff joints and weak muscles and yet they can still function. How? Because their body figures out a way to compensate for their problem. Let's examine three gait patterns to illustrate this point.

High Steppage Gait
If a person cannot lift up his foot due to weak ankle muscle, his foot will drop. It gives extra length to the limb and the foot will be dragged along the ground. It will also greatly increase the risk of fall. In order to avoid this problem, the person will purposely raise the knee higher than usual to clear the foot from the ground. In severe cases, people may use AFO (ankle-foot-orthotic) to correct this problem.

Circumduction Gait
If a person has both ankle and knee problem and is unable to raise the knee to compensate for the drop foot problem, he may use his hip instead. In this case, he may swing his entire leg in an arc to bring it forward to make a step. This form of compensation happens quite often in people after a stroke.

Trendelenburg  (trunk side bending)  Gait
If a person’s muscles on the side of the hip (gluteus medius) are weak, the pelvis cannot be stabilized and maintained at a leveled position when the leg on the other side is lifted up from the ground. The person may compensate by bending his trunk to the same side of weakness in order to keep the pelvis stable. Therefore, if the right side is the weak side, the person will sway his trunk to the right whenever the person stands on the right leg alone. This may happen after hip surgery and with inadequate rehabilitation. However, leg length discrepancy can also result in the same gait pattern.

Alteration In the gait means disturbing the symmetry and balance pattern. Discrepencies will end up in overstretching and overloading different muscles. Should the situation persist, micro-trauma will occur over time, which in turn leads to inflammation, pain and adhesion.

You can assess your own gait with “3 equals” rules.

  1. Equal weight bearing on each leg
  2. Equal time spent on each leg
  3. Equal strike length on each leg

If you are equal (or close to equal) in these three areas, then you are further from developing problems.

Have fun with your gait.

Peggy Hau, PT, MscPT is a licensed physical therapist at Mettler Center. Have questions about your gait? Ask an Expert. Gait analysis is best provided by a physical therapist who can detect functional problems and make the best possible recommendation for treatment. Call 217-398-9800 to schedule a free 30-minute consultation with a physical therapist or request an appointment online.