Pathological gait
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Pathological Gait - PowerPoint PPT Presentation

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Pathological Gait. Excessive Plantarflexion. Causes Triceps surae contracture Triceps surae spasticity Pre-tibial weakness Voluntary/compensatory 2 0 weak quadriceps. Loading Response Deviations. FF contact sustained. FF contact  foot flat (rigid ankle)  knee hyperextension.

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Excessive plantarflexion l.jpg
Excessive Plantarflexion


  • Triceps surae contracture

  • Triceps surae spasticity

  • Pre-tibial weakness

  • Voluntary/compensatory 20 weak quadriceps

Loading response deviations l.jpg
Loading Response Deviations

FF contact sustained

FF contact  foot flat (rigid ankle)  knee hyperextension

FF contact  rapid foot

flat (flexible ankle)

FF = fore foot

Midstance deviations l.jpg
Midstance Deviations

Foot flat w/ restrained


Fwd. trunk lean, short contralateral step


heel rise

Terminal stance deviations l.jpg
Terminal Stance Deviations

Pelvic obliquity  high on side of deviation

Excessive heel rise

Mid swing deviations l.jpg
Mid Swing Deviations

Compensatory  hip and/or knee flexion

Toe Drag

Excessive dorsiflexion l.jpg
Excessive Dorsiflexion

  • Weak triceps surae

  • Ankle joint fusion at neutral

  • Excessive knee flexion

Loading response deviations8 l.jpg
Loading Response Deviations

Higher heel rocker

 knee    quad demand

Loading response deviations 2 0 rigid afo l.jpg
Loading Response Deviations 20 Rigid AFO

Rigid AFO  knee and hip flexion

Terminal stance deviations10 l.jpg
Terminal Stance Deviations

Prolonged heel contact

 knee  w/ heel rise


Pre swing deviations l.jpg
Pre Swing Deviations

Sustained heel contact   plantarflexion

Inadequate knee flexion excessive extension l.jpg
Inadequate Knee Flexion / Excessive Extension

  • Quadriceps weakness

  • Pain

  • Quadriceps spasticity

  • Excessive ankle plantarflexion

Pre swing and initial swing l.jpg
Pre Swing and Initial Swing

 ankle dorsiflexion w/

prolonged heel contact

Toe Drag

Midstance l.jpg

Retraction of tibia (soleus)

and femur (gluteus max)

when knee lacks

hyperextension range

Inadequate knee flexion 2 0 excessive plantarflexion l.jpg
Inadequate knee flexion 20 excessive plantarflexion

Overall disruption of normal coordination

between the knee and ankle

Inadequate knee extension excessive knee flexion l.jpg
Inadequate Knee Extension / Excessive Knee Flexion


  • Hamstring spasticity

  • Knee flexion contracture

  • Soleus weakness

  • Excessive ankle plantarflexion

Excessive knee flexion loading response l.jpg
Excessive Knee Flexion - Loading Response

Resulting in  ankle dorsiflexion

Excessive knee flexion midswing l.jpg
Excessive Knee Flexion - Midswing

As a compensation for

 ankle plantarflexion

Inadequate knee extension midstance and terminal stance l.jpg
Inadequate Knee Extension – Midstance and Terminal Stance

Accompanied w/  ankle dorsiflexion   limb

and body advancement

Inadequate hip extension excessive hip flexion l.jpg
Inadequate Hip Extension – Excessive Hip Flexion

  • Hip flexion contracture

  • Iliotibial band contracture

  • Hip flexor spasticity

  • Pain

  • Voluntary/Compensatory

Inadequate hip extension tst l.jpg
Inadequate Hip Extension – TSt


 step length and

body advancement

Excessive hip flexion msw l.jpg
Excessive Hip Flexion - MSw

Compensation for 

ankle plantarflexion

Inadequate hip flexion l.jpg
Inadequate Hip Flexion

  • Hip flexor weakness

  • Hip joint arthrodesis

Inadequate hip flexion tsw l.jpg
Inadequate Hip Flexion - TSw

Rapid hip /

Rapid hip 

Compensation for weak quadriceps that

cannot extend the knee (flaccid knee)

Compensations for inadequate hip flexion psw isw l.jpg
Compensations for Inadequate Hip Flexion – PSw/ISw

Compensatory posterior

pelvic tilt

Compensations for inadequate hip flexion psw isw27 l.jpg
Compensations for Inadequate Hip Flexion – PSw/ISw

Voluntary excessive (magnitude &

velocity) knee flexion

Excessive hip adduction l.jpg
Excessive Hip Adduction


  • Ipsilateral abductor weakness

  • Adduction contracture or spasticity

  • Using adductors as hip flexors

  • Contralateral hip abduction contracture

Deviations l.jpg

Swing  “Scissor Gait”

Combined hip  & IR

Deviations30 l.jpg

20 adductor contracture

or spasticity

20 adductors used as hip flexors

20 glute med weakness

Excessive hip abduction l.jpg
Excessive Hip Abduction


  • Ipsilateral abduction contracture

  • Contralateral adduction contracture

  • Scoliosis w/ pelvic obliquity

Deviations32 l.jpg

Compensation for

inadequate knee flexion

20 contralateral

abduction or ipsilateral

adduction contracture

Excessive hip external rotation l.jpg
Excessive Hip External Rotation


  • Gluteus maximus overactivity

  • Excessive ankle plantarflexion

Excessive hip internal rotation l.jpg
Excessive Hip Internal Rotation


  • Medial hamstring overactivity

  • Adductor overactivity

  • Anterior abductor overactivity

  • Quadriceps weakness