Gait Deviations Associated with Lower Leg and Foot Pain Syndromes
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 |
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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.
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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.
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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. |
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Toe out | During walking when viewed from front or behind, the foot is 5-10 degrees out form the line of progression.
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Greater than 10 degrees of toe out relative to the line of progression.
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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.
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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. |
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Heel whip | This is the one gait deviation that occurs between the transition from stance to swing phase.
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If the heel whip angle of rotation is greater than 10 degrees.
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Excessive pronation | A bisected calcaneus or shoe heel counter is perpendicular relative to the ground.
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When viewed from behind:
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Absent windlass effect
ie: increased dorsiflexion of the first MTP joint |
During forefoot contact/terminal stance, there is normally 35-65 degrees of first MTP joint dorsiflexion.
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Decreased dorsiflexion of the first MTP joint | During forefoot contact/terminal stance when viewed from the side, there is normally 35-65 degrees of first MTP joint dorsiflexion. | During forefoot contact/terminal stance, there is less than 35 degrees of first MTP joint dorsiflexion. |
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Pain Syndromes Associated with Gait Deviations[edit | edit source]
Gait Deviation | Associated Pain
and Pain Syndromes |
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Late heel off or prolonged heel contact |
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Early heel off or premature heel rise |
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Stride length too long |
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Toe out |
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Loud foot strike |
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Heel whip |
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Excessive pronation |
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Absent windlass effect |
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Decreased dorsiflexion of the first MTP joint |
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Resources[edit | edit source]
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