"Gait Training - Physical Therapy"
by Gerry Van Dyke


Many people believe that since walking is something that they have been doing for most of their lives, no one needs to teach them how to walk again after an injury. Unfortunately, most injuries to the spine and lower extremities do alter walking mechanics and can lead to additional disability if not corrected with physical therapy and fitness training. With or without injury, gait (walking mechanics) frequently deteriorates with age . . . .not necessarily because of age, but most often due to getting weaker.

What is gait? Gait is a manner of walking, stepping or running. More specifically, it is a series of rhythmical, alternating movements of the trunk and limbs which result in the forward progression of the center of gravity (body). Another way to think of gait is as a series of "controlled falls".

How is gait evaluated? We visually observe patients walking on a treadmill or up and down a long hallway. A treadmill allows us to precisely control speed and to observe close-in. If necessary, patients can also be recorded on video while walking/running. The video can then be slowed down, reversed, and repeated as needed during a physical therapy session to perform a more detailed assessment of gait.

Some of the things we look for during a gait evaluation are symmetry of the gait cycle, step and stride length, cadence, and walking base. Symmetry is one of the most important aspects of gait. The movement of one side of the body should mirror the other side of the body. Arm swing, foot placement, step length, foot impact should all be very similar right vs. left.

Injuries and or weakness often lead to heavier impact (usually, but not always) on the opposite side. Since the average human takes 10-15,000 steps each day, increasing the impact of one foot by a force of just 10 lbs (each step) can add up to a lot of extra stress being added to that leg (upwards of 75,000 lbs) every day. No wonder "bad" walking mechanics eventually lead to more injuries.

Another common gait deviation is foot placement. If a patient is having difficulty controlling where the foot is landing (for example: too close to the other leg, turned out/in), they may have significant hip muscle weakness or neurological issues.

The vast majority of gait deviations can be corrected or compensated for with proper physical therapy and fitness training. Most physical therapists are experts in gait evaluation and training. Left untreated, significant gait deviations can lead to injury. Taking that first step, and getting a gait evaluation, could be a step in the right direction for better health.

Contact the Author

PT, SCS, ATC Owner/Director, California Orthopedic and Sports Therapy Rehabilitation Services. Gerry has over 20 years of experience in physical therapy, sports medicine, and fitness training including working with Olympic, professional, and college athletes. http://www.coastrehab.com

Gerry Van Dyke

Site: http://www.coastrehab.com

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