Hip Pathological Gait

Question 1

Muscles that Influence

Answer 1

Weakness:
extensors
flexors
abductors

Question 2

Limited Hip mobility

Answer 2

Flexion contracture- 30-60 lowest pressure

Elastic common over time elongated from sitting to much

Question 3

Inadequate Flexion
CAUSE

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Answer 3

Quad weakness
Inad knee flexion=inad hip flexion
Hip exten weakness
Decreased heel rocker

Question 4

Inadeqate Flexion
PENALTY

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Answer 4

Decreased shock absorption at knee- increased bone/cartilage loading
(hip maintains 20F so cant absorb shock since no arc of motion, all rely on knee flexion)

Question 5

Inadequate Flexion
CAUSE

Preswing-Midswing

Answer 5

Hip Flexor Weakness (rec fem, add long, illopsoas)

Muscle/joint pain or avoidance

Question 6

Inadequate Flexion
PENALTY/COMPS

Pre-Midswing

Answer 6

Pen:
Decreased limb advancement
Decreased stride length
Decreased foot clearance
Inad knee flexion- hip flex drives knee flex 

COMPS:
Excessive knee flexion compensates to generate hip flexion- early and excessive bicep fem short
Circumduction- pelv rotates back but can’t generate knee flexion/doesnt set you up

Circumduction

Question 7

Excessive Hip Flexion
CAUSE

Preswing-Midswing

Answer 7

Compensetory to clear foot- excessive PF/inad knee flexion

looks like they’re marching

Question 8

Excessive Hip Flexion
PENALY/COMPS

Preswing-Midswing

Answer 8

PEN:
Increased energy expenditure from hip flexor overuse

COMPS:
Past-retract mech: extends knee in terminal swing (looks like kicking leg forward)
Excessive hip flex accels tibia fowrad so drive knee back to decelerate and lock in for initial contact

Question 9

Inadequate Hip Extension
CAUSE

Mid-Termstance

Answer 9

Hip Flexor tightness

• Hip flex contracture (increased lumbar lordosis causes mass flexion motments/more energy used)
• Knee flexion contracture (can’t extend hip w/ knee flexed)

MOST COMMON GAIT DEV CAUSE TIGHT HIP FLEXORS

Question 10

Inadequte Hip Extension
PENALTY

Mid-termstance

Answer 10

Reduced stride length
COM beyond BOS
-Quad overuse (knee doesn’t extend via hip extension)

Question 11

Inadequate Hip Extension
COMPS

Mid-Termstance

Answer 11

Excessive ant tilt/Back rotation:

swings hip side to side; see on front facing video view

Question 12

Excessive Hip Adduction
CAUSE

Stance phases

Answer 12

Hip Abductor weakness- from thigh collapse/pelv drop

Question 13

Excessive Hip Adduction
PENALTY

Stance phases

Answer 13

Joint tissue straing- ITB lengthened, lateral hip pain, medial knee strain (add contribs to knee valgus)

Question 14

Excessive Pelvic Drop
CAUSE

Stance phases

Answer 14

Hip Abductor weakness

moves GRF close to joint to reduce lever arm= reduced abd demand
Uncompensated (no lateral trunk lean) pelvic drop= trandelenburg sign

Question 15

Excessive Pelvic Drop
PENALTY/COMPS

Stance Phases

Answer 15

Increased knee stress- varus moment
Increased spine stress- facet joint compress
Muscle overuse- paraspinals/QL (LBP opposite side)

COMPS:
lateral trunk lean away from dropped side=compensated

Question 16

Excessive Hip Rotation
CAUSE

Stance phases

Answer 16

Excessive pronation

Weakness hip ERs

Question 17

Excessive Hip Rotation
PENALTY

Stance phases

Answer 17

Knee joint stress- MCL, Pes ans, ITB

Patellofem joint stress