Gait Deviations Associated with Lower Leg and Foot Pain Syndromes: Difference between revisions
No edit summary |
No edit summary |
||
Line 7: | Line 7: | ||
For a review of the gait cycle, please review [[Gait Cycle|this article]]. For an overview of gait deviations, please review [[Gait Deviations|this article]]. To review common gait terminology and definitions, please review [[Gait Definitions|this article]]. | For a review of the gait cycle, please review [[Gait Cycle|this article]]. For an overview of gait deviations, please review [[Gait Deviations|this article]]. To review common gait terminology and definitions, please review [[Gait Definitions|this article]]. | ||
ADD REVIEW OF ANKLE/FOOT ANATOMY, photo for reference | |||
== Gait Deviations == | == Gait Deviations == | ||
Line 61: | Line 63: | ||
* When viewed from behind during ambulation, more than two of the lateral toes are visible. | * When viewed from behind during ambulation, more than two of the lateral toes are visible. | ||
* There is an asymmetry in the degree of toe out between the person's lower extremities. | * There is an asymmetry in the degree of toe out between the person's lower extremities. | ||
* Will occur with hallux limitus or first MTP joint osteoartirits | |||
* Can occur due to an anatomically short leg | |||
| | | | ||
* Laterally oriented patella | * Laterally oriented patella | ||
* Popliteal skin crease is oblique from superomedial to anterolateral | * Popliteal skin crease is oblique from superomedial to anterolateral | ||
* | * When viewed from behind, the lateral malleolus is visible but the medial malleolus is not | ||
|- | |- | ||
|Toe in | |Toe in | ||
Line 71: | Line 75: | ||
* Or when there is an asymmetry in the degree of toe in between the person's lower extremities. | * Or when there is an asymmetry in the degree of toe in between the person's lower extremities. | ||
* Will occur with hallux limitus or first MTP joint osteoartirits | |||
* Can occur due to an anatomically longer leg | |||
| | | | ||
* Popliteal skin crease is oblique from superolateral to inferomedial | * Popliteal skin crease is oblique from superolateral to inferomedial | ||
* Medially oriented patella | * Medially oriented patella | ||
* When viewed from behind, medial malleolus is visible but the lateral malleolus is not | * When viewed from behind, medial malleolus is visible but the lateral malleolus is not | ||
|- | |||
|Loud foot strike | |||
|It is expected for foot strike to emit a sound. The sound is representative of the ground reaction force. | |||
|If the sound of the foot strike is ''asymmetrical'' between the lower extremities, or between the non-painful and the painful side. | |||
| | |||
* Loud single or double sounds with the same foot strike | |||
* Slow cadence with a long stride length | |||
* Increased angle of foot relative to the ground (increased PF) with a prolonged heel only period during stance | |||
* The heel stays on the ground longer in early stance phase | |||
|- | |||
|Heel whip | |||
|This is the one gait deviation that occurs between the transition from stance to swing phase. | |||
During walking when viewed from behind, it is expected to see a 5-10 degree rotation of the heel and foot in the transverse plane as the foot comes off the ground. | |||
|If the heel whip angle of rotation is greater than 10 degrees. | |||
Also deviant is the heel whip is greater on one side compared to the other side. | |||
* Can occur due to an anatomically long leg | |||
* Likely related to muscle imbalances at the hip | |||
| | |||
* Oblique popliteal skin crease | |||
* No daylight between the knees | |||
* The foot crossing the midline of the body | |||
* Signs of excessive wear on shoe bottom under the metatarsal heads where shear or twisting force occurs | |||
|- | |||
|Excessive pronation | |||
|A bisected calcaneus or shoe heel counter is perpendicular relative to the ground. | |||
When viewed from behind: | |||
* can view two or fewer of the lateral toes | |||
* the navicular bone is not visible | |||
| | |||
| | |||
|} | |} | ||
Line 121: | Line 165: | ||
|Toe out | |Toe out | ||
| | | | ||
* Hip osteoarthritis | |||
* Knee osteoarthritis | |||
* Gait pattern can become habitual status post total joint replacements | |||
* Patellofemoral arthralgia | |||
* Medial tibial stress syndrome | |||
* Tibial stress fracture | |||
* Achilles pain | |||
* Plantar heel pain syndrome | |||
* Metatarsalgia | |||
|- | |||
|Loud foot strike | |||
| | |||
* IT band syndrome | |||
* Medial tibial stress syndrome | |||
* Stress fracture | |||
* Plantar heel pain syndrome | |||
|- | |||
|Heel whip | |||
| | |||
* Gluetal tendinopathy | |||
* Anterior and or lateral knee pain | |||
* Patellofemoral arthralgia | |||
* IT band syndrome | |||
* Medial tibial stress syndrome | |||
* Tibial stress fracture | |||
* Metatarsalgia | |||
* Hallux valgus | |||
|} | |} | ||
Revision as of 16:50, 28 May 2022
Top Contributors - Stacy Schiurring, Jess Bell, Kim Jackson and Lucinda hampton
Introduction[edit | edit source]
This article discusses gait deviations associated with pain syndromes in the lower leg and foot. 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.
ADD REVIEW OF ANKLE/FOOT ANATOMY, photo for reference
Gait Deviations[edit | edit source]
Gait Deviation | Expected Movement Pattern | Deviant Movement Pattern | Secondary Signs Associated with Deviant Movement |
---|---|---|---|
Late heel off or prolonged heel contact | The heel of the trailing foot lifts off the ground just prior to the contact of the leading foot. | The heel of the trailing foot stays on the ground beyond the moment of the leading foot heel strike.
|
|
Early heel off or premature heel rise | (Same as above) | The heel of the trailing foot leaves the ground just prior to the leading foot heel strike.
|
|
Stride length too long | During walking when viewed from the side, the linear distance from the foot strike to the person's centre of mass is relatively short. | During walking when viewed from the side, the linear distance from the foot strike to the person's centre of mass is too long. |
|
Toe out | During walking when viewed from front or behind, the foot is 5-10 degrees out form the line of progression.
|
Greater than 10 degrees of toe out relative to the line of progression.
|
|
Toe in | During walking when viewed from behind, should not be able to view the big toe. | The big toe is visible during walking when viewed from behind.
|
|
Loud foot strike | It is expected for foot strike to emit a sound. The sound is representative of the ground reaction force. | If the sound of the foot strike is asymmetrical between the lower extremities, or between the non-painful and the painful side. |
|
Heel whip | This is the one gait deviation that occurs between the transition from stance to swing phase.
|
If the heel whip angle of rotation is greater than 10 degrees.
|
|
Excessive pronation | A bisected calcaneus or shoe heel counter is perpendicular relative to the ground.
|
Pain Syndromes Associated with Gait Deviations[edit | edit source]
Gait Deviation | Associated Pain
and Pain Syndromes |
---|---|
Late heel off or prolonged heel contact |
|
Early heel off or premature heel rise |
|
Stride length too long |
|
Toe out |
|
Loud foot strike |
|
Heel whip |
|
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x