Gait Disorders and Abnormalities

What is a gait?

A gait is your pattern of walking. When you walk, your muscles balance and coordinate your movement.

What is an abnormal gait?

An abnormal gait is a change to your walking pattern. Everyone’s natural walking style is unique. However, injuries and medical conditions can affect your walking pattern. Anything that affects your brain, spinal cord, legs or feet can change your gait. Some common examples of an abnormal gait include:

• Limping.
• Dragging your toes.
• Shuffling your feet.
• Short steps.
• Difficulty supporting the weight of your body.
• Trouble with coordination.

Another term for an abnormal gait is ambulatory dysfunction.

What are the types of gait abnormalities?

There are several different types of gait abnormalities, the most common include:

• Antalgic gait: An antalgic gait is the result of pain. It’s the most common type of abnormal gait. It makes you limp (avoiding stepping with or putting pressure on your affected leg or foot).
• Propulsive gait (Parkinsonian gait): This type of gait affects people diagnosed with parkinsonism or Parkinson’s disease. Characteristics of a propulsive gait include a stooping, rigid posture and your head and neck bending forward. Your steps are usually short and fast to maintain your center of gravity (festinating gait).
• Scissors gait: This type of gait gets its name because your knees and thighs hit or cross in a scissors-like pattern when you walk. Your steps may be slow and small. This type of gait usually affects people diagnosed with spastic cerebral palsy.
• Spastic gait (hemiplegic gait): A spastic gait causes you to walk with one stiff leg. When you lift that leg to walk, it either drags or swings around in a semicircular motion (circumduction). This type of gait is common among people diagnosed with cerebral palsy, multiple sclerosis or hemiplegia.
• Steppage gait (neuropathic gait): This type of gait causes a high step, where you elevate your hip to lift your leg higher than normal. Your foot may appear floppy when it drops. Your toes usually point down and scrape the ground when you walk. Muscle atrophy or a peroneal nerve injury (like from spinal stenosis or a herniated disc), can cause a steppage gait.
• Waddling gait: A waddling gait causes you to exaggerate the movement of your upper body, which creates a waddling or duck-like walk. Progressive muscular dystrophy or hip dislocation present from birth can produce a waddling gait.
• Crouching gait: A crouching gait causes your ankles, knees and hips to flex while you walk. It can look like you’re about to bend down as you’re walking. Your toes may drag. This type of gait is common if you have cerebral palsy.

Other types of gait abnormalities include:

• Ataxic gait: This type of gait occurs with cerebellar degeneration. It causes irregular steps that affect your ability to walk in a straight line when you walk heel to toe. You may feel unsteady if you have an ataxic gait.
• Shuffling gait: Shuffling is walking without lifting your feet completely off the ground. It causes your feet to drag. You may shuffle if you feel off balance or have an injury that prevents you from lifting your feet off the ground when you walk.
• Lurching gait: A lurching gait is common among people affected by paralysis or weakness of the gluteus area (the muscles near your hips and butt). It causes a slow and long stride. Your upper body can jerk forward or backward to lessen the weight on your affected leg.

How common are gait abnormalities?

Gait abnormalities are more common as you age. Around 15% of people experience a gait abnormality by age 60. However, more than 80% of people over age 85 have a gait abnormality. Children are less likely to have a gait abnormality unless they have an underlying health condition or experience an injury.

What are the symptoms of gait abnormalities?

Signs and symptoms of gait abnormalities vary based on which type of abnormality you’re experiencing. Some of the most common symptoms include:

• Dragging or shuffling your feet.
• Feeling out of balance when you walk.
• Stiff muscles or joints in your hips and legs.
• Swaying side to side with each step (waddle).
• Walking with your head and neck bent toward the ground.
• Taking higher than normal steps and dropping your feet with each step.
• Taking small steps.
• Pain when walking.

What causes gait abnormalities?

There are a lot of possible causes of and contributing factors to gait disorders or abnormalities. The most common causes include:

• Joint pain.
• An injury (including bone fractures or sprains).
• Sores on your feet, calluses, ingrown toenails, warts and corns.
• Shoes that don’t fit properly.
• Inner ear issues.
• Nerve damage.
• Vision problems.

Underlying health conditions that can cause gait abnormalities include, but aren’t limited to, the following:

• Parkinson’s disease or parkinsonism.
• Multiple sclerosis.
• Stroke.
• Arthritis.
• Cerebral palsy.
• Hemiplegia.
• Spinal stenosis, herniated disk.

Some abnormal gaits have more than one cause.

What are the risk factors for gait abnormalities?

You may be more at risk of developing gait abnormalities if you:

• Are older than 60.
• Have a condition that affects your movement, joints, bones, muscles, brain or spinal cord.
• Experience an injury.

What are the complications of gait abnormalities?

The complications of gait abnormalities could include:

• Increased risk of falls or injuries.
• Muscle weakness.
• Sudden inability to walk.
• Pain.
• Reduction in ability to maintain independence.

How are gait abnormalities diagnosed?

A healthcare provider will diagnose gait abnormalities during a physical exam. They’ll take a complete medical history, as well as:

• Assess your muscle strength, tone and coordination.
• Check the length of your legs (for example, artificial hips can cause different leg lengths).
• Examine your vision and blood pressure.
• Examine your neck and spine.
• Assess your balance.
• Assess the range of motion of the joints used for walking.

A healthcare provider may run different types of tests to learn more about the type of gait abnormality you have and what’s causing it. Imaging tests like an X-ray and laboratory tests may be necessary.

How are gait abnormalities treated?

Treatment for gait abnormalities varies based on the type of gait and its cause. Treatment options could include:

• Medications to treat the underlying condition like arthritis, Parkinson’s disease or multiple sclerosis.
• Resting if you have an injury.
• Physical therapy and strengthening exercises.
• Surgery, including hip or knee replacements.
• Using assisted mobility devices, like a cane or a walker.
• Adjusting footwear (wearing shoe lifts) or using splints or braces.

If you have an abnormal gait, your healthcare provider will give you instructions to prevent falls and injuries.

Are there side effects of the treatment?

Talk to your healthcare provider about the side effects of treatment before you begin. You may experience pain, swelling or scarring after surgery. You might also experience side effects that vary based on the medication that your provider prescribes.

Can gait abnormalities be prevented?

You can’t prevent gait abnormalities caused by an underlying medical condition. You can reduce your risk of injury by:

• Wearing protective equipment when playing sports or working at your job.
• Listening to your body and taking breaks or stopping activities when you feel sore.
• Resting after an injury to prevent further irritation or damage.
• Training for strenuous activities by using a proper technique, strengthening your muscles and increasing your flexibility.
• Getting your vision checked regularly.

What can I expect if I have a gait abnormality?

Some gait abnormalities are temporary and go away when your body heals, especially after an injury. Others can be lifelong and need continued maintenance.

The most important part of your outlook focuses on preventing falls. Injuries are common if you have an abnormal gait. Your healthcare provider will give you guidance on how you can reduce your risk of injury if you have a gait abnormality.

Many people find assisted mobility devices, like a cane or walker, helpful. These devices improve your ability to navigate independently. They can also improve your confidence if you’re unsteady on your feet without support. If you have trouble completing your daily tasks due to a condition that affects your mobility, talk to a healthcare provider, occupational therapist or care team about resources that can help you at home.

When should I see a healthcare provider?

Visit a healthcare provider if you:

• Have changes to your walking pattern.
• Experience pain when walking.
• Feel out of balance when standing up.
• Can’t walk as well as usual.

When should I go to the ER?

Visit the emergency room or call 911 (or your local emergency services number) if you experience an injury that causes severe pain or swelling or you’re unable to get up or move. Contact emergency services immediately if you experience a fall or another trauma.

What questions should I ask my doctor?

• What caused the gait abnormal gait?
• Do I need surgery?
• How often should I go to physical therapy?
• Should I use a cane or walker?
• How do I keep myself safe and prevent falls?

A note from Cleveland Clinic

Gait abnormalities are common and increase as you age. Some gait abnormalities are the result of an underlying health condition that may go away or lessen with treatment. Others may require lifelong care. If you have a gait abnormality, you may be at an increased risk of injury and falling. Take steps to protect yourself and reach out to a healthcare provider for guidance.