Walking normally can be taken for granted by most people, but for some it can be quite challenging. There are many potential reasons why someone may have difficulty walking normally, ranging from temporary injuries to more serious neurological or muscular conditions. In this article, we’ll explore some of the most common causes of abnormal gait and mobility issues. Understanding the root of the problem is the first step towards finding solutions and treatments to improve your walking ability.
What is normal walking?
Normal walking, also called gait, refers to the pattern of movement when a person walks. It requires a complex sequence of muscle activations and motions to propel the body forward. Key elements of normal gait include:
- Heel strike – Landing on the heel when the foot hits the ground
- Foot flat – The foot flattens onto the ground as weight is transferred
- Midstance – Body weight centered over the grounded foot as the other foot swings forward
- Heel off – The heel lifts as the foot rolls forward
- Toe off – Pushing off the toes to propel the body
- Swing phase – Swinging the leg forward to take the next step
When all these components flow together smoothly, it results in an energy efficient, stable, and balanced walking pattern. Disruptions in any phase of the gait cycle can lead to an abnormal walking style.
Short-term causes of abnormal gait
There are many temporary issues that can alter normal walking for a period of time. These include:
Injuries
Sprains, strains, fractures, and wounds affecting the feet, ankles, legs, hips, or back can change the way you walk. Pain or instability forces the body to compensate until the injury heals. Common examples include:
- Ankle sprains
- Achilles tendonitis
- Runner’s knee
- Hamstring or calf strains
- Low back pain
Walking with crutches or a cane can also contribute to an abnormal gait. With rest, protection, rehabilitation exercises, and physical therapy, most gaits return to normal once the injury has healed.
Surgery
Recent surgeries like joint replacement, bunion removal, or spinal procedures can temporarily change your walking pattern. Swelling, pain, muscle weakness, and joint stiffness need time to resolve. A period of limping or asymmetric steps is common as the body recovers. Physical therapy helps retrain the proper gait pattern after surgery.
Pregnancy
The physical changes and extra weight of pregnancy often lead to altered gait. Hormones loosen ligaments and the center of gravity shifts forward. Waddling, swaying, or wide stances are common as a woman’s body adapts to accommodate the baby bump. These modifications usually resolve within several months after giving birth.
Long-term causes of gait abnormalities
If you’ve had issues with walking for more than a few months or the problem keeps recurring, it may be caused by one of these underlying medical conditions:
Arthritis
Osteoarthritis, rheumatoid arthritis, and other types of joint inflammation can all affect gait. The pain and stiffness leads to limping, slower pace, reduced stride length, and decreased joint mobility. Knee arthritis in particular is a common culprit.
Weakness
Generalized muscle weakness or impaired muscular control reduces the stability and power needed for normal walking. Causes include:
- Sarcopenia – Age-related muscle loss
- Lack of fitness
- Nerve damage
- Wasting – Long periods of immobility
Strengthening exercises often help improve abnormal gaits related to muscle weakness.
Poor balance
Difficulty balancing can necessitate wider stances, shorter steps, and more concentration while walking. Contributing factors include:
- Inner ear disorders like vertigo
- Neurological conditions
- Orthostatic hypotension – Blood pressure drops upon standing
- Impaired vision or depth perception
- Reduced proprioception – Body positional awareness
Balance and gait training activities including tai chi may help improve stability for those with poor balance affecting their gait.
Peripheral neuropathy
Nerve damage in the feet and legs from diabetes, alcoholism, infections, autoimmune disorders, or nutrient deficiencies can alter sensations and foot mechanics. Abnormal walking patterns are common as a way to avoid pain or “numb” feet. Custom orthotics, rocker-bottom shoes, and gait aids like canes can help reduce pressure and enable a more normal gait.
Spinal conditions
Spinal stenosis, herniated discs, scoliosis, and other back problems often manifest as an abnormal gait. The spine is crucial for posture, stability, shock absorption, and power generation during walking. Physical therapy, surgery, injections, and chiropractic care aim to realign and decompress the spine to improve associated gait disturbances.
Parkinson’s disease
Parkinson’s affects the nervous system and movement. Key gait changes include a shuffling walk, difficulty starting motions, reduced arm swing, and imbalance. Medications and exercises may help some people achieve an improved walking pattern.
Stroke
A stroke can lead to foot drop, leg weakness, stiffness, and lack of coordination that impairs normal walking. Rehabilitative therapy is important for regaining strength and function on the affected side. Orthotics, braces, or mobility aids can compensate for any residual deficits.
Cerebral palsy
This disorder stemming from brain damage before, during, or soon after birth can cause spasticity, rigid limbs, and poor balance that affects gait. Physical therapy starting at a young age is beneficial to improve mobility. Assistive devices like walkers or ankle-foot orthoses provide extra support as needed.
Multiple sclerosis
MS is a progressive disease causing nerve damage that interferes with signaling between the brain and body. Gait abnormalities like staggering, dragging legs, and foot drop are common. A multidisciplinary approach including medication, exercise therapy, and orthotic devices helps manage symptoms.
When to see a doctor
See your doctor promptly if you experience:
- Sudden change in your walking pattern
- Numbness, tingling, or burning in your feet and legs
- Bowel or bladder dysfunction
- Unexplained falls or inability to walk
- No improvement after a few weeks of self-care
- Pain, swelling, limping, or limited mobility
These can indicate an underlying medical issue requires further evaluation and treatment. Don’t ignore persistent gait problems.
Medical evaluation
During the appointment, your doctor will:
- Ask about your symptoms and medical history
- Check your strength, balance, and sensation
- Examine your spine, joints, feet, legs, nerves
- Assess your walking and observe the gait pattern
- Order testing such as x-rays, MRI, EMG, blood work
This clinical workup helps identify any structural problems or medical conditions contributing to the abnormal gait. Your doctor can then advise appropriate treatment options based on the cause.
Treatments
Treatment depends on the underlying reason but may involve:
Medication
Drugs to reduce inflammation, swelling, muscle spasticity, nerve pain
Physical therapy
Stretching, strengthening exercises, balance and gait retraining
Orthotics
Shoe inserts, braces, splints to support the foot and ankle
Assistive devices
Canes, walkers, crutches to improve stability and reduce pain
Surgery
To repair injuries, decompress nerves, or correct structural problems
Home modification
Install grab bars, railings, ramps to ease mobility around the home
Self-care strategies
Alongside medical treatment, you can incorporate these self-care remedies:
- Perform gentle stretches and lower body strengthening exercises
- Rest and elevate injured limbs
- Use cold or heat therapy for pain and swelling
- Wear supportive shoes with good cushioning
- Modify activity to avoid motions that aggravate symptoms
- Use an assistive device until walking improves
- Focus on posture, balance, and proper gait pattern
- Lose excess weight to avoid stress on lower body joints
Being patient through the recovery process is important. It can take weeks or months to restore normal walking function in many cases.
Coping strategies
Abnormal gait can be physically limiting and socially awkward. Here are tips for coping:
- Join a support group to connect with others facing similar mobility challenges
- Enlist friends and family to help with household tasks during recovery
- Ask your doctor about getting a temporary handicapped parking permit
- Plan outings during less busy times when you can move at your own pace without crowding
- Sit if needed rather than standing in long lines
- Stay positive and be diligent with your treatment program
Focus on the improvements you’re making and don’t get discouraged. There are always ways to adapt activities to accommodate limited mobility.
Prevention
While not all gait problems can be prevented, the following healthy lifestyle measures can help:
- Regular exercise to maintain strength, flexibility, balance, and coordination
- Good nutrition to prevent nutrient deficiencies that can damage nerves
- Manage chronic conditions such as diabetes to prevent neuropathy
- Wear shoes with arch support and cushioned soles
- Use proper lifting mechanics and avoid high-impact activities if prone to injuries
- Remove tripping hazards like clutter, cords, throw rugs at home
- Have vision checked annually and update eyeglass prescriptions
- Review medications with your doctor and adjust any that may cause dizziness
While not a guarantee, these proactive measures can help reduce your risk of developing gait abnormalities.
Outlook
The prognosis for abnormal gait depends greatly on the cause. Short-term issues like sprains and strains typically resolve fully with rest and rehabilitation. Chronic conditions like arthritis tend to progressively worsen, but gait can still be improved through a combination of therapies and adaptive devices. Severe neurological or muscular diseases may lead to irreversible mobility loss without treatment.
Early intervention maximizes the potential for a good outcome. Following prescribed treatment, using gait aids as needed, and staying active within limitations are key to managing gait disorders. Many people are able to regain comfortable walking ability through patience and persistence.
Conclusion
Walking normally requires the proper functioning and coordination of many musculoskeletal and neurological elements. When these become disrupted, it can significantly impact your gait and mobility. Understanding the root cause, whether temporary or long-standing, is important for finding appropriate solutions. With professional treatment guided by a thorough evaluation, most people can achieve noticeable improvement.
While recovery takes time, there are many ways to optimize healing and adapt activities for limited mobility. Focus on celebrating small wins. The more you work to build strength and retrain your gait pattern, the faster you’ll get back to smoothly walking and enjoying life. Mobility aids are available to provide stability and assistance during the process. Don’t give up hope – with the right treatment plan, you can get back to putting your best foot forward.