Are You Walking Right? Understanding Abnormal Gait

From strolling through the park to rushing along busy streets, walking is an essential part of our daily lives. But have you ever thought about the science behind the way you walk?

Your walking pattern, also known as your gait, can be divided into two phases: the stance phase (when your foot is on the ground), and the swing phase (when your foot is moving). Most individuals spend about 60% of our gait in the stance phase and 40% in the swing phase.

Understanding abnormal gait

An abnormal gait occurs when there is a change in the way you walk. We all have our own unique walking styles, but sometimes injuries or certain diseases can cause our gait to go off-track.

Signs of an abnormal gait include:

• Limping
• Dragging your toes
• Shuffling your feet
• Taking short steps
• Experiencing coordination problems
• Having trouble supporting your body weight.

What’s causing your abnormal gait?

There can be various reasons behind an abnormal gait. Common culprits include joint pain, leg and feet injuries, arthritis, and nerve damage. Even issues with your inner ear or vision can mess with your walking style.

Some medical conditions, such as stroke, Parkinson’s disease, multiple sclerosis, cerebral palsy, and herniated spinal disc, can also contribute to gait abnormalities.

Types of abnormal gait

There are many different types of gait abnormalities. Common gait abnormalities include:

Antalgic gait

Often known as the limping gait, this occurs when pain in the lower limb causes you to adjust your stride.

Parkinsonian gait

Usually seen in patients with Parkinson's disease, this gait leads to a shuffling walk, where the head, neck and lower legs are flexed forward with a rigid posture. Affected individuals usually take short, fast steps to maintain the centre of gravity.

Spastic (hemiplegic) gait

Caused by stroke on the opposite side of the brain, this gait results in stiff arms or legs as well as dragging or swinging of the lower leg in a semi-circular motion (circumduction) when the leg is lifted. It is very common in people diagnosed with cerebral palsy and multiple sclerosis.

Steppage gait (foot drop)

Also known as neuropathic gait, this gait is characterised by foot drop, with the toes pointing down and scraping the ground as the person walks. Affected individuals tend to compensate by raising the thigh higher than usual when walking.

Ataxic gait

These are broad-based gaits where the individual exhibits uncoordinated movement and inability to control distance, speed and range of motion due to cerebellar degeneration.

Trendelenburg gait

A weak hip abductor can cause the pelvis to tilt when the opposite leg is lifted, resulting in an abnormal gait.

How are gait abnormalities diagnosed?

Diagnosing a gait disorder starts with a thorough consultation and assessment with your doctor.

Step 1: History taking

To understand your gait better, the doctor will kick off the consultation by delving into your medical and drug history. They will ask about any past injuries, falls, and other relevant events, such as the use of walking aids and whether you’re able to perform daily activities independently. They will also enquire if you have any associated symptoms such as giddiness, weakness of the limbs, or numbness. All these information provide valuable context to identify potential triggers for your gait issue.

Step 2: Physical examination

Following history taking, it’s time for a head-to-toe physical examination. Your doctor will carefully assess every aspect of your body related to walking, starting with wear and tear patterns in your foot wear. They will assess your muscle strength, tone and power, balance and coordination, as well as the range of motion in your cervical spine to understand how these factors might be influencing your gait. Vital signs, such as blood pressure and vision assessment, are also important to ensure a comprehensive evaluation.

If needed, the doctor may also check for leg length discrepancy, such as in instances where an individual had artificial hip replacement done due to hip arthritis.

Step 3: Investigation

Based on your history and physical examination, the doctor will determine if further investigations are necessary. In some cases, additional tests like X-rays, CT scans, MRI scans or blood tests may be ordered to rule out any underlying medical conditions contributing to your gait disorder.

Step 4: Management

With all the information gathered, the doctor will recommend a personalised treatment plan to address your gait concerns. This may involve treatments such as pain medication, physiotherapy, walking aids, orthotics and splints/braces to improve your mobility and overall walking experience.

For instance, if you have a shuffling gait due to Parkinson’s disease, your treatment will be tailored to manage the underlying disease and control the shuffling gait. Similarly, an individual with an antalgic gait due to arthritis can be treated with pain relievers (analgesia) to improve the painful limping gait. For gait abnormalities caused by injury, physiotherapy and limb-strengthening exercises, along with proper rest, can be beneficial.

In advanced cases where the gait disorder is due to degenerative diseases such as hip or knee arthritis, surgery may be recommended.

Walking towards a better gait

The good news is that many gait disorders can improve with appropriate treatment. Injuries are common with an abnormal gait, so fall prevention is crucial. Assisted mobility devices, such as a walker, can be very useful to help you navigate independently when you are unsteady on your feet.

Remember, your gait is unique to you, and if you feel something’s not quite right, don’t hesitate to consult a healthcare professional. Embracing a steadier gait can make a world of difference in your daily life, boosting your overall well-being and confidence as you move through the world. So take care of your gait, and walk on!