An incredible amount of movement, throughout the entire body, happens as we walk. During a time of injury, many of those details get lost in the shuffle (pun intended), and compensation methods begin. A functional gait assessment helps to gauge postural stability and/or joint dysfunction after an injury resulting in gait impairment. The walking pattern (aka the gait cycle) can be broken down into different phases to see what each body region is doing at various stages. One complete cycle is from the heel strike of one leg to the next heel strike of the same leg, which includes both the stance phase and the swing phase.

Let’s run through an example of what happens to the right leg through one complete cycle.

Stance Phase

  • Heel Strike: Also known as the initial contact, this is when the lateral (outer) edge of the heel contacts the floor/ground. At this stage, the foot locks itself to prepare to take the body’s weight for the single-leg stance portion to begin.
  • Foot Flat: The foot begins to unlock itself to absorb the ground, and your proprioceptors start to let you know where you are in space so you can make balance corrections as needed. This helps you with navigating uneven ground, like grass, sand, or soft dirt, so you do not roll your ankle.
  • Midstance: The tibia (shin bone) has translated forward. Hence, it is upright and perpendicular to the ground. Your weight is shifting, so there is some pressure on your first ray (big toe) in preparation for pushing you forward.
    *Putting pressure on the big toe is a critical component that is often forgotten after an injury to the foot.
  • Heel Off: The foot has re-locked itself to become a secure platform to propel you forward from the ball of the foot.
    ***Heel-toe-push is a mantra that all my patients know and love!***

Swing Phase

  • Toe Off: The foot comes entirely off the floor, the shin muscles pull the toes up to aid in clearing the floor, and the knee begins to bend with the initial swing phase of the leg.
  • Mid Swing: The hip flexes, the hamstrings (back of thigh) continue to concentrically bend the knee as the leg comes through to prepare for the heel strike.
  • Heel Strike: There is a deceleration of the leg via the eccentric control of the hamstrings with the concentric contraction of the quads (front of thigh) to straighten the leg for the initial contact of the lateral heel.

The gait cycle is considerably more complicated than the above descriptions, but this at least gives you an idea of why relearning to walk is so important and why a functional gait assessment is necessary in rehabilitation. This will help you to understand the crucial “why” of the exercises we give you to improve your proprioception and the activities that break down the gait cycle for you to practice. Each phase is vital for overall healing.

After surgery, a new injury, or an old chronic, nagging injury, it is imperative to retrain your muscles and joints with the correct gait cycle to minimize compensation methods and to avoid risk of further injury. You can count on your PT at Endurance to give you a functional gait assessment and to teach you the right way to walk! Contact us today to get started.