Gaits

• Normal gait cycle = swing and stance phase:

  • Swing phase: when foot is lifted up and clears the group. Starts from when the toe leaves the ground (toe-off) to when the heel touches the group again (heel strike)
  • Stance phase: when the foot is on the group weight bearing. Starts from when the heel strikes the ground (heel strike), until the foot lifts off the ground again (toe-off)
• Trendelenburg gait:

  • Due to weakness of hip abductors e.g. damage to superior gluteal nerve, hip osteoarthritis, structural hip pathology
  • Weakness results in a drop in the pelvis on the contralateral side
  • Compensatory lurching to side of pathology to balance the body's centre of gravity and to manually lift the leg on the contralateral side
  • Trendelenburg sign = pelvis dips on opposite side to affected muscles
  • Trendelenburg gait = lurch towards affected side to compensate
• Waddling gait:

  • Weakness in hip girdle and upper thigh muscles bilaterally e.g. due to myopathy
  • Compensate in the same way as with Trendelenburg gait by lurching but as you need to do it on both sides this results in a waddling gait
• Antalgic gait:

  • Pain on affected side when walking
  • Patient not keen to weight bear on this side for long
  • Results in shortened stance phase on affected side which essentially causes a limp