We walk thousands of steps each day. We walk to do our daily activities, get around, and exercise. Having a problem with walking can make daily life more difficult.
THE PATTERN OF HOW YOU WALK IS CALLED YOUR GAIT. A VARIETY OF PROBLEMS CAN CAUSE AN ABNORMAL GAIT AND LEAD TO PROBLEMS WITH WALKING. THESE INCLUDE:
- Injuries, diseases, or abnormal development of the muscles or bones of your legs or feet
- Movement disorders such as Parkinson’s disease
- Diseases such as arthritis or multiple sclerosis
- Vision or balance problems
Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.
Highlights
The pattern of how a person walks is called the gait. Different types of walking problems occur without a person’s control. Most, but not all, are due to a physical condition.
SOME WALKING ABNORMALITIES HAVE BEEN GIVEN NAMES:
- Propulsive gait — a stooped, stiff posture with the head and neck bent forward
- Scissors gait — legs flexed slightly at the hips and knees like crouching, with the knees and thighs hitting or crossing in a scissors-like movement
- Spastic gait — a stiff, foot-dragging walk caused by a long muscle contraction on one side
- Steppage gait — foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking, requiring someone to lift the leg higher than normal when walking
- Waddling gait — a duck-like walk that may appear in childhood or later in life
Causes
Abnormal gait may be caused by diseases in different areas of the body.
General causes of abnormal gait may include:
Arthritis of the leg or foot joints
Conversion disorder (a psychological disorder)
Foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin sore, swelling, or spasms)
Fracture
Injections into muscles that causes soreness in the leg or buttocks
Infection
Injury
Legs that are of different lengths
Myositis
Shin splints
Shoe problems
Tendonitis
Torsion of the testis
This list does not include all causes of abnormal gait.
CAUSES OF SPECIFIC GAITS
Propulsive gait:
Carbon monoxide poisoning
Manganese poisoning
Parkinson’s disease
Use of certain drugs, including phenothiazines, haloperidol, thiothixene, loxapine, and metoclopramide (usually, drug effects are temporary)
SPASTIC (SCISSORS) GAIT:
- Brain abscess
- Brain or head trauma
- Brain tumor
- Cerebrovascular accident (stroke)
- Cerebral palsy
- Cervical spondylosis with myelopathy (a problem with the vertebrae in the neck)
- Liver failure
- Multiple sclerosis
- Pernicious anemia
- Spinal cord trauma
- Spinal cord tumor
- Syphilitic meningomyelitis
- Syringomyelia
STEPPAGE GAIT:
- Guillain-Barre syndrome
- Herniated lumbar disk
- Multiple sclerosis
- Muscle weakness of the tibia
- Peroneal neuropathy
- Poliomyelitis
- Spinal cord injury
WADDLING GAIT:
- Congenital hip dysplasia
- Muscular dystrophy
- Muscle disease (myopathy)
- Spinal muscle atrophy
ATAXIC OR BROAD-BASED GAIT:
- Acute cerebellar ataxia
- Alcohol intoxication
- Brain injury
- Damage to nerve cells in the cerebellum of the brain (cerebellar degeneration)
- Medications (phenytoin and other seizure medications)
- Polyneuropathy (damage to many nerves, as occurs with diabetes)
- Stroke
Diagnosis
The provider will take a medical history and perform a physical examination.
Medical history questions may include:
- Time pattern, such as when the problem started, and if it came on suddenly or gradually
- Type of gait disturbance, such as any of those mentioned above
- Other symptoms, such as pain and its location, paralysis, whether there’s been a recent infection
- What medicines are being taken
- Injury history, such as leg, head, or spinal injury
- Other illnesses such as polio, tumors, stroke or other blood vessel problems
- If there have been recent treatments such as vaccinations, surgery, chemotherapy or radiation therapy
- Self and family history, such as birth defects, diseases of the nervous system, growth problems, problems of the spine
The physical examination will include muscle, bone, and nervous system examination. The provider will decide which tests to do based on the results of the physical examination.
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