TF Gait Deviations

What are the causes for knee instability?

• knee too anterior

• excessive PF resistance

• weak hip extensors

• increased heel height

• insufficient socket flexion

What are the causes for an abducted gait?

• pressure on pubic ramus

• pain/pressure on distal-lateral femur

• prosthesis too long

• socket too abducted

• abductor contracture/weakness

• no support of lateral wall on femur

What are the causes for a lateral trunk lean on the sound side?

• excessive outset foot

• wide ML of socket

• weak hip abductors

What are the causes for a lateral trunk lean on the prosthetic side?

• short prosthesis

• short residuum

• foot excessively inset

• insufficient socket adduction

• wide ML of socket

• pain @ pubic ramus

• contracted hip abductors

What are the causes for a lateral thrust?

• weak hip abductors

• poor alignment

• balance issues

• patient habit

What are the causes for drop off?

• toe lever too short

• knee too anterior

Why are the causes for excessive lumbar lordosis?

• insufficient socket flexion (lordosis to compensate)

• improperly shaped posterior wall

• weak core/hip extensors (these are posterior pelvic tilt muscles)

• hip flexion contracture

• short residuum

What are the causes for a medial whip?

• knee or foot too externally rotated

• suspension too tight

• weak musculature

What are the causes for a lateral whip?

• knee or foot too internally rotated

• weak musculature

What are the causes for circumduction?

• knee flexion resistance

• prosthesis aligned with too much stability

• extension bias too strong @ knee pressure

• medial brim pressure (varus moment causes pressure medio-proximal/lateral-distal)

• prosthesis too long

• insufficient suspension

• weak hip flexors/lack of confidence

What are the causes for vaulting ?

• prosthesis too long

• excessive resistance to knee flexion

• prosthesis aligned with too much stability

• extension bias too strong

• insufficient suspension

What is terminal impact?

Where there is knee extension too quick in the beginning of swing phase

What are the causes of terminal impact?

• patient forcefully extends hip at end of swing phase

• insufficient knee friction

• knee extension bias too strong

What is uneven step length?

patient is unable to extend on prosthetic sideWhat

What is the cause for an uneven step length (long prosthetic step)?

• insufficient socket flexion (non-accommodated hip flexion contracture)

(patient will flex hip during swing phase and not extend hip during midstance)

What are the causes for an uneven step length (short prosthetic step)

• poor balance

• poor suspension

• weak hip flexors

• painful socket

• unstable knee

• insufficient knee friction

What are the causes for toe drag?

• weak hip abductors on sound side

• poor suspension/socket fit

• poor balance