Antalgic Gait

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Definition

• Antalgic gait is a painful gait pattern.

• The patient avoids spending time on the affected leg due to pain.

• The goal is to reduce weight-bearing on the painful extremity.

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Normal Gait Cycle

• Stance phase: 60% of the gait cycle

• Swing phase: 40% of the gait cycle

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Gait Pattern in Antalgic Gait

• Shortened stance phase on the affected side.

• Patient spends more time weight-bearing on the normal leg.

• Swing phase is increased on the affected side.

• Swing phase may be shortened on the normal side to quickly return the normal leg to the ground.

• This pattern helps lift the painful extremity off the ground as soon as possible.

In antalgic gait:

• Stance phase may decrease to approximately 40%.

• Swing phase may increase to approximately 60%.

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Causes

Antalgic gait occurs due to pain in any part of the lower extremity.

Common causes include:

• Hip pathology (e.g., arthritis)

• Knee pathology (e.g., arthritis)

• Severe disc herniation symptoms

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Clinical Features

• The patient guards the painful lower extremity.

• Walking increases pain, leading to development of the antalgic gait pattern.

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Use of a Cane

• Pain may be reduced by using a cane.

• The cane should be held on the opposite side of the painful extremity.

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Trunk Lean in Hip Pain

When pain arises from the hip joint:

• The patient leans the trunk toward the painful side during the stance phase.

• The center of gravity shifts toward the painful hip.

• This decreases the moment arm of body weight acting on the hip joint.

• As a result, total force across the hip joint is reduced.

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Important Distinction

• Antalgic gait due to hip pain should not be confused with:

  • Trendelenburg gait

• Trendelenburg gait results from abductor muscle weakness, not pain.

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Summary

• Antalgic gait is a compensatory gait pattern caused by pain.

• Characterized by shortened stance phase on the affected side.

• Most commonly associated with hip, knee, or severe lumbar pathology.

• Trunk lean may be present in hip-related pain.

• Proper cane use can help reduce symptoms.