Gait Deviations

Lateral Trunk Bending (Prosthetic Causes)

Short prosthesis

Inadequate lateral wall adduction

High or sharp medial wall

Prosthesis aligned in abduction

Lateral Trunk Bending (Anatomical Causes)

Poor balance/ instability

Abduction contracture

Poor gait training

Short residual limb

Weak hip abductors on prosthetic side

Hypersensitive and/or painful residual limb

Abducted Gait (Anatomical Causes)

Abduction contracture

Weak hip flexors and adductors

Pain over lateral residual limb

Adductor roll/ adductor redundancy instability

Abducted Gait (Prosthetic Causes)

Prosthesis too long

High medial wall

Poorly shaped lateral wall (not enough adduction)

Prosthesis positioned in abduction

Inadequate suspension

Excessive knee friction

Circumducted Gait (Prosthetic Causes)

Prosthesis too long

Socket too small

Loose socket

Loose friction (O’S – rapid extension) vs. Too much friction (Giles)

Excessive plantar flexion of prosthetic foot

Inadequate suspension

Locked knee

Circumducted Gait (Anatomical Causes)

Abduction contracture

Improper training

Weak hip flexors

Poor knee control

Lack of confidence to flex the knee

Inability to initiate knee flexion

Painful anterior distal residual limb

Excessive Knee Flexion During Stance (Prosthetic Causes)

High shoe heel

Insufficient plantarflexion

Stiff heel cushion

Socket too far anterior

Socket excessively flexed

Cuff tabs too posterior

Excessive Knee Flexion During Stance (Anatomical Causes)

Knee flexion contracture

Weak quadriceps

Hip flexion contracture

Pain anteriorly in residual limb

Poor balance

Vaulting (Prosthetic Causes)

Prosthesis too long

Inadequate socket suspension

Excessive alignment stability

Foot in excessive plantarflexion

Vaulting (Anatomical Causes)

Residual limb discomfort

Improper training

Fear of stubbing toe

Short residual limb

Painful hip on residual limb side

Rotation of Forefoot at Heel Strike (Prosthetic Causes)

Steel heel cushion / Rigid SACH heel cushion

Excessive toe-out built in (malrotated foot)

Loose fitting socket

Inadequate suspension

Rotation of Forefoot at Heel Strike (Anatomical Causes)

Poor muscle control

Improper training

Weak medial rotators

Short residual limb

Forward Trunk Flexion (Prosthetic Causes)

Socket too big

Poor suspension

Knee instability

Short walker or crutches

Forward Trunk Flexion (Anatomical Causes)

Hip flexion contracture

Weak hip extensors

Pain with ischial weight bearing

Inability to initiate prosthetic knee flexion

Medial or Lateral Whip (Prosthetic Causes)

Excessive rotation of the knee

Tight socket fit

Valgus in the prosthetic knee

Improper alignment

Faulty socket contour

Medial or Lateral Whip (Anatomical Causes)

Improper training

Weak hip rotators

Knee irritability