Our Aims
The aim of our practice is to provide a painless, stable
and normal gait cycle.
A ‘normal’ gait cycle reduces direct impact over weight
bearing joints, such as the lower spine, hip, knee, ankle
and foot.
If one or more of these areas are painful or stiff, the gait
cycle will change to minimise use of these areas, leading
to overloading of otherwise healthy joints.
The ‘normal’ gait cycle is explained below in more detail.
All our treatments are aimed at returning the gait cycle to
as close to normal as possible, through surgical
techniques such as joint replacement, restoring
anatomical structure, rather than joint fusion and
conservative treatment such as orthoses and gait re
training or Physiotherapy.
The gait cycle is a series of movements made by the lower limbs when walking. Observation of human gait has led to the development of the diagram above, which shows one step of the right leg.
Stance Phase
This is when the right limb in the diagram is in contact with the ground. It is broken into different sections:
Contact When the heel hits the ground, it is necessary for the body to absorb shock. It does this by bending and internally rotating (twisting inwards) the hip and knee, slowing the movement of the foot to the floor (so it doesn’t slap) and pronating (rolling inwards) the foot.
Mid-Stance This is when weight is taken onto the right limb and the left limb is swinging through to take the next step.
As midstance progresses, only the right limb is in contact with the ground (as the left limb is swinging through the air to
take the next step). Initially, the lower limb is in a similar position to the contact phase, but, as the left leg swings
through the air and weight is taken onto the right limb, the opposite starts to happen, with the hip and knee beginning to
straighten and stop rotating inwards. The ankle joint bends more and the foot should stop rolling inwards.
Push-Off At this point, the right leg, instead of absorbing shock, needs to become rigid and springy to push-off onto
the next step. The hip and knee are externally rotating and extending, the ankle begins to flex again, after bending to
100 degrees at the end of mid-stance, load is taken onto the forefoot and pressure is directed between the 1st and 2nd
toes, allowing the big toe joint to bend.
Balance Assist Load is then transferred to the tips of the toes, as the left heel hits the ground and both legs are
momentarily in contact with the ground at the same time. The big toe is the last to leave the ground as pressure is
taken on the other foot.
Swing Phase This is when the right limb in the diagram is swinging through to take the next step and is broken down into 2 phases:
Early Swing The primary function in early swing is to clear the limb from the ground, as it passes the other leg. The
hip, knee, ankle and big toe joint all flex to shorten the limb and enable its passage past the weight-bearing leg.
Late Swing Once past the standing leg and as the centre of gravity of the body moves forwards, the hip continues to
flex, but the knee begins to straighten again to throw the leg forwards in order to take the next step.
The lower spine and pelvis
As weight is transferred from one leg to the other in gait, the rest of the body is also moving. Movement of one leg can
never be seen as truly independent when walking, as any movement of the lower limb, via the hip, pelvis and lower
spine, alters the position of the opposing side of the pelvis and, therefore, hip and lower limb position, as can be seen in
the diagrams below.
Altered gait cycle
If a joint involved in the gait cycle is stiff, painful or dysfunctional, it will not work properly when walking. This can also
happen if the body compensates to avoid using a stiff or painful joint. These changes then put pressure elsewhere in
the lower limbs or lower spine and pelvis, causing pain or dysfunction.
Our treatments are aimed at normalising gait, allowing a return to a normal gait cycle.
