Prosthetic Gait Deviations

• Excessive knee flexion at heel strike

• Insufficient knee flexion at heel strike

• Forward bending

• Lateral thrust

• Early knee flexion at push off

• Delayed knee flexion at push off

gait deviations of below knee prosthesis during stance.

• Excessive dorsiflexion of prosthetic foot 

• Excessive anterior tilt or displacement of socket over foot 

• Too stiff heel cushion or plantarflexion bumper 

• Knee flexion contracture 

causes of excessive knee flexion at heel strike. 

• Excessive plantarflexion of foot 

• Excessive posterior tilt or displacement of socket over foot 

• Too soft heel cushion or plantarflexion bumper 

causes of insufficient knee flexion at heel strike. 

• Pain at the end of residual limb

cause of forward bending (midstance).

• Too much inset 

• Abducted socket 

causes of lateral thrust during midstance.

• Excessive dorsiflexion of foot

• Excessive anterior tilt or displacment of socket over the prosthetic foot

• Too soft dorsiflexion bumper

causes of early knee flexion at push off.

• Excessive plantarflexion of foot

• Excessive posterior tilt or displacement of socket over the prosthetic foot

• Too stiff/hard dorsiflexion bumper

causes of delayed knee flexion at push off. 

• Foot rotation at heel stroke 

• Foot slap 

• Lateral trunk bending 

• Wide walking base

• Uneven step length

• Swing phase whips 

• Exaggerated lordosis 

gait deviations of above knee prosthesis during stance. 

• Too stiff heel cushion or plantarflexion bumper 

cause of foot rotation (usually ER) at heel strike. 

• Too soft plantarflexion bumper 

cause of foot slap.

• Prosthesis is too short (ipsilateral)

• Hip abduction contracture

• Hip abductor weakness

• Abducted socket

causes of lateral trunk bending during midstance.

• Prosthesis is too long 

• Hip abduction contracture 

• Abducted socket 

• Higher medial wall

causes of wide walking base gait.

• Hip flexion contracture (longer)

• Insufficient knee friction (longer) 

• Fear or insecurity (shorter) 

causes of uneven step length.

• Excessive ER of prosthetic knee 

cause of medial whip.

• Excessive IR of prosthetic knee 

cause of lateral whip 

• Hip flexion contracture 

• Weakness of abdominals 

• Weakness of hip extensors 

• Insufficient support from anterior wall

• Improperly shaped posterior wall

causes of exaggerated lordosis during midstance. 

• Vaulting

• Circumduction gait

• Hip hiking

• Uneven heel rise

• Terminal impact

gait deviations of above knee prosthesis during swing phase. 

• Prosthesis too long

• Insufficient knee friction

causes of vaulting (seen in non-affected side).

• Prosthesis too long 

cause of circumduction gait.

Prosthesis too long

cause of hip hiking gait.

• Forceful hip flexion 

• Insufficient knee friction 

• Too loose an extension aid 

causes of excessive heel rise.

• Excessive knee friction 

• Too tight an extension aid 

• Manual lock 

causes of insufficient heel rise.

• Insufficient knee friction 

• Too tight an extension aid 

• Worn out extensino stop 

• Fear of buckling 

causes of terminal impact.