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  • Writer's pictureRobin R Varghese, PT.

Trendelenberg gait is just another gait abnormality which can be rectified. Let us do it together!!!

Trendelenberg gait


It is caused by a unilateral weakness of the hip abductors, mostly the gluteal musculature.

This weakness could be due to superior gluteal nerve damage or in 5th lumbar spine lesion.



What exactly happens with this gait?



  • During normal gait, both lower limbs bear half of the body weight in some part of stance phase. When one lower limb is lifted in swing phase, the other takes the entire weight.

  • During the stance phase of gait, the pelvis tilts downwards on the weight-bearing extremity and hikes up on the non-weight bearing extremity.

  • When there is a hip abductor weakness, the pelvis tilts downwards instead of upwards on the non-weight bearing extremity.

  • In an attempt to lessen this effect, the person compensates by lateral tilt of the trunk away from the affected hip, thus center of gravity is mostly on the stance limb causing a reduction of the pelvic drop.

The gluteus medius and gluteus minimus are the two main hip abductors. They support the opposition of the pelvis and prevents the pelvis from dropping.

They are supplied by the superior gluteal nerve, which arises from L4- S1 nerve roots.


Causes


Presentation

  • Ttrunk shift over the affected hip during stance and away during the swing phase of gait


Assessment

  • The modified McKay criteria is useful to assess if a patient has Trendelenburg gait. These criteria measure pain symptoms, gait pattern, Trendelenburg sign status, and the range of hip joint movement.

Surgical management

  • Surgical correction of hip dysplasia

  • Pelvic support osteotomies

  • Osteopathic Manipulative Treatment (OMT)

Physical therapy management

The main purpose of physical therapy with regards to this impairment is to strengthen the abductors of the hip. PT includes:


  • Strengthening exercises

  • Resisted Strengthening exercises

  • Closed-chain exercises,

  • Lateral step-ups and

  • Functional balance exercises.

  • Electromyogram (EMG) biofeedback

  • Visual feedback to facilitate proper gait re-education.

At Valley Healing Hands, we provide the best Physical Therapy treatment for Trendelenburg gait. We have highly skilled therapists who will assess your complaints and provide you with the best exercises to help you with your concerns. Our patients are completely satisfied with our services and you may learn about what they have to say about us here. You may also get connected to us here. Our patients love us, you too will.


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