Gait Deviations Associated with Pelvis and Knee Pain Syndromes: Difference between revisions
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!Deviant Movement Pattern | !Deviant Movement Pattern | ||
!Secondary Signs Associated with Deviant Movement | !Secondary Signs Associated with Deviant Movement | ||
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|Increased vertical oscillation of centre of mass | |Increased vertical oscillation of centre of mass | ||
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* Extra vibration during treadmill running | * Extra vibration during treadmill running | ||
* Early heel off | * Early heel off | ||
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|Decreased vertical oscillation of centre of mass | |Decreased vertical oscillation of centre of mass | ||
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* Delayed or late heel off | * Delayed or late heel off | ||
* Fall risk | * Fall risk | ||
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|Contralateral pelvic drop | |Contralateral pelvic drop | ||
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* Excessive medial femoral internal rotation | * Excessive medial femoral internal rotation | ||
* Excessive pronation | * Excessive pronation | ||
|- | |- | ||
|Contralateral pelvic elevation | |Contralateral pelvic elevation | ||
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* Listing of trunk to the ipsilateral side | * Listing of trunk to the ipsilateral side | ||
* Cicumduction of contralateral lower extremity during swing phase | * Cicumduction of contralateral lower extremity during swing phase | ||
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|Lack of knee separation | |Lack of knee separation | ||
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* Genu valgus | * Genu valgus | ||
* Excessive pronation | * Excessive pronation | ||
|- | |- | ||
|Foot crossing the midline | |Foot crossing the midline | ||
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* Asymmetry of arm swing | * Asymmetry of arm swing | ||
* Asymmetry of trunk rotation | * Asymmetry of trunk rotation | ||
|- | |- | ||
|Popliteal skin crease | |Popliteal skin crease | ||
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* Heel whip | * Heel whip | ||
* Excessive pronation | * Excessive pronation | ||
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|Varus thrust | |||
|During stance phase, when viewed from front or behind, there should be little to no lateral/medial deviation or translation of the knee | |||
|During stance phase, when viewed from front or behind, there is a high-velocity small-amplitude lateral deviation of the knee with a rapid return to neutral alignment. | |||
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* Excessive lateral lean of the trunk | |||
* Unequal stance time | |||
* Asymmetrical arm swing | |||
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== Pain Syndromes Associated with Gait Deviations == | |||
{| class="wikitable" | |||
|+ | |||
!Gait Deviation | |||
!Associated Pain | |||
and Pain Syndromes | |||
|- | |||
|Increased vertical oscillation of centre of mass | |||
* "Too much up and down motion" | |||
| | |||
* Back pain | |||
* Knee pain | |||
* Medial tibial stress syndrome | |||
* Achilles pain in runners | |||
* Plantar heel pain syndrome | |||
|- | |||
|Decreased vertical oscillation of centre of mass | |||
| | |||
|- | |||
|Contralateral pelvic drop | |||
| | |||
* Back pain | |||
* Hip labral injuries | |||
* Gluteal tendinopathy | |||
* Piriformis syndrome | |||
* Anterior and or lateral knee pain | |||
* Patellofemoral arthralgia | |||
* Iliotibial band pain | |||
* Medial tibial stress syndrome | |||
* Ankle pain | |||
* Achilles tendon pain | |||
* Plantar heel pain | |||
|- | |||
|Contralateral pelvic elevation | |||
(Hip or pelvic hiking) | |||
| | |||
* Back pain | |||
* Hip pain | |||
* Knee pain | |||
* Leg length discrepancy | |||
|- | |||
|Lack of knee separation | |||
* "absence of daylight" between thighs or knees | |||
| | |||
* Gluteal tendinopathy | |||
* Lateral knee pain | |||
* IT band syndrome | |||
* Knee osteoarthritis | |||
* Medial tibial stress syndrome | |||
* Posterior tibial tendon pain | |||
* Achilles pain | |||
* Plantar heel pain | |||
|- | |||
|Foot crossing the midline | |||
| | |||
* Gluteal tendinopathy | |||
* Hip osteoarthritis | |||
* Anterior and or lateral knee pain | |||
* Patellofemoral arthritis | |||
* Medial tibial stress syndrome | |||
* Achilles pain | |||
* Plantar heel pain | |||
|- | |||
|Popliteal skin crease | |||
* Excessive femoral medial rotation | |||
| | | | ||
* Gluteal tendinopathy | * Gluteal tendinopathy | ||
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|- | |- | ||
|Varus thrust | |Varus thrust | ||
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|} | |} |
Revision as of 03:39, 27 May 2022
Top Contributors - Stacy Schiurring, Kim Jackson, Lucinda hampton and Jess Bell
Introduction[edit | edit source]
This article discusses gait deviations associated with pain syndromes in the pelvis and knee. While this information focuses on certain regions of the body, remember that the human body functions within a kinetic chain. No one movement is ever completely isolated and is without effect on another.
For a review of the gait cycle, please review this article. For an overview of gait deviations, please review this article. To review common gait terminology and definitions, please review this article.
Pain Syndromes and Gait Deviation[edit | edit source]
Gait deviations are likely related to the development and or associated with musculoskeletal pain syndromes. It is often the complaint of pain that will lead a patient to physiotherapy. It is the role of the physiotherapist to educate the patient on the etiology of their pain while treating and correcting the noted gait deviation.
Gait Deviation Definition HERE
The most commonly noted gait deviations for pain syndromes include:
- Decreased gait velocity (most frequent gait deviation for patients with neurological deficits)
- Decreased vertical oscillation of centre of mass
- Delayed heel off
ADD INFORMATION re: Fritz 2009 article about gait speed
Gait Deviations[edit | edit source]
Gait Deviation | Expected Movement Pattern | Deviant Movement Pattern | Secondary Signs Associated with Deviant Movement |
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Increased vertical oscillation of centre of mass
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Choose a fixed location such as the top of the head, sacrum, or belt line. Compare the highest point during swing phase to the lowest point during stance phase.
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Decreased vertical oscillation of centre of mass | (Same as above) |
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Contralateral pelvic drop | During stance phase, a line drawn between the posterior superior iliac spines (PSIS's) should deviate no more than four degrees inferiorly. | During stance phase, the line between the PSIS's will deviate inferiorly greater than four degrees.
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|
Contralateral pelvic elevation
(Hip or pelvic hiking) |
During stance phase, a line drawn between the posterior superior iliac spines (PSIS's) should deviate no more than four degrees superiorly. | During stance phase, the line between the PSIS's will deviate superiorly greater than four degrees.
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Lack of knee separation
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Unless morbidly obese, when walking and viewed from front or behind, there should be a space or "daylight" between the knees and thighs. | When walking and viewed from front or behind, there is an absence of space or "daylight" between the knees or thighs.
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Foot crossing the midline | When walking and viewed from front or behind, the opposite foot strike should be visible and not cross a vertical line which travels from the belly button to the ground.
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When walking and viewed from behind, the opposite foot strike is not visible because the foot crosses the vertical line.
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Popliteal skin crease
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When viewed from behind during stance phase, the skin crease on the back of the knee should be horizontal. | When viewed from behind, the skin crease will be oblique from superiolateral to inferiomedial (inferring there is excessive movement of the femur into medial rotation).
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Varus thrust | During stance phase, when viewed from front or behind, there should be little to no lateral/medial deviation or translation of the knee | During stance phase, when viewed from front or behind, there is a high-velocity small-amplitude lateral deviation of the knee with a rapid return to neutral alignment. |
|
Pain Syndromes Associated with Gait Deviations[edit | edit source]
Gait Deviation | Associated Pain
and Pain Syndromes |
---|---|
Increased vertical oscillation of centre of mass
|
|
Decreased vertical oscillation of centre of mass | |
Contralateral pelvic drop |
|
Contralateral pelvic elevation
(Hip or pelvic hiking) |
|
Lack of knee separation
|
|
Foot crossing the midline |
|
Popliteal skin crease
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|
Varus thrust |
Resources[edit | edit source]
- bulleted list
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or
- numbered list
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