Gait Deviations at the Hip

• Trunk leans back at initial contact and loading response

• Weak hip extensors

• Lean back when leg hits the GRF lies posterior to hip- keeps GRF post to hip joint and eliminates the use of hip ext (prevents jack knifing)

Posterior trunk lean during the loading response

• Forward trunk lean

• Hip flex contracture

• Alternative is excessive lordosis; leads to early heel rise and dec step length on opp leg

Forward trunk bend during mid and terminal stance

• Excessive lordosis

• Hip flex contracture

• Lead to early heel rise and dec step length on opp leg

Excessive lordosis during mid and terminal stance

• Trunk lurch is used to passively bring the leg forward

• Hip flexor weakness

• Backward trunk lean but early and late in stance; check PF, hip flex strength

Trunk lurch to advance leg

• Semicircle movement of the hip during swing 

• Hip flexor weakness

• Movement is achieved with a combination of hip flex, hip abd and forward rotation of the pelvis

Hip circumduction (as primary impairment)

• Forward trunk lean early after heel contact

• Weak quads, knee flex contracture

• Anterior trunk lean serves the purpose to bring the GRF ant to the knee, makes knee want to extend

Forward bending of the trunk during loading response (secondary)

• Forward trunk lean later during stance

• Fixed PF ankle, lack of DF

• Serves to maintain the forward progression of the body despite the lack of tibial advancement

Forward bending of the trunk during mid and terminal stance (secondary)

• Excessive hip and knee flex

• Lack of DF on IL side

• Functionally short leg stance leg; opp limb needs to be evaluated

Steppage gait- foot drag

• Hip circumduction

• Lack of ankle DF and or lack of knee flex on that side

• Short stance leg or long swing

Circumduction as a compensation

• Elevation of IL pelvis

• Lack of ankle DF and or lack of knee flex on that side

• Short stance leg or long swing

Hip hiking as a compensation

• Compensated: Shifting the trunk over the stance limb

• Uncompensated: Excessive drop of the CL pelvis during stance

• Weakness of hip abductors of stance leg; hip pain

• Uncompensated may result in other gait abnormalities to compensate for long leg

Trendelenburg Gait

• Shorter step length of CL leg; shorter stance time on painful leg; may include CL trunk lean

• Painful stance LE

• Weight avoidance strategy

Antalgic Gait