High Steppage Gait Pattern

Walking Difficulty Due to Anterior Tibialis Weakness

Photo or a PT gaining training with a man.
If you have a high steppage gait, your PT can help improve your walking. Terry Vine/Getty Images

A high steppage gait pattern is one that occurs if you have foot drop.  Foot drop is a condition that is caused by weakness or paralysis of your anterior tibialis muscle. This muscle contracts to help flex your foot and ankle up while walking. This ensures that your foot clears the floor and you do not catch your toes on the ground. Your physical therapist can help if you have a high steppage gait pattern after illness or injury.

If you have anterior tibialis weakness of paralysis, you may exhibit a high steppage gait. During this gait pattern, you excessively flex your hip and your knee while you are walking. High steppage occurs as you are swinging your leg through the air while stepping forward. The hallmark of this gait pattern is that you lift your leg high off the floor, ensuring that you will clear your foot over the ground and not trip.

Conditions that may cause anterior tibialis weakness or paralysis and, subsequently a high steppage gait pattern, include:

If you have any of these conditions and are finding it difficult to walk because you are catching your toes on the floor, you should visit your doctor immediately to assess your anterior tibialis muscle function. He or she may refer you to a physical therapist to help correct this high steppage gait pattern.

Treatment for a High Steppage Gait Pattern

Treatment for a high steppage gait pattern involves focusing on the anterior tibialis muscle. Specific ankle exercises can help strengthen your anterior tibialis, and stretches for your calf can help ensure that your ankle range of motion (ROM) is well maintained.

Your physical therapist may choose to use neuromuscular electrical stimulation (NMES) to help improve the way your anterior tibialis muscle works. This type of electrical stimulation artificially contracts your muscle, helping it to function properly.

If your anterior tibialis weakness is being caused by sciatica coming from your back, your physical therapist may prescribe back exercises to help get pressure off your sciatic nerve and restore normal function to your leg. The exercises are designed to allow normal messages to travel up and down your sciatic nerve in your low back.

Gait training and balance training may also be necessary if you have a high steppage gait. Your PT may prescribe balance exercises to help improve your overall proprioception. You may require an assistive device like a quad cane or a wheeled walker to walk properly.  Your physical therapist can ensure that you are using your assistive device properly.

Bracing for a High Steppage Gait Pattern

Sometimes, paralysis to your anterior tibialis muscle is permanent.

 If this is the case, you may benefit from a special brace called and ankle foot orthosis (AFO). This brace helps to lift your foot and toes off the ground. This lessens the likelihood of you stubbing your toes on the ground, and your high steppage gait should go away when you are wearing your AFO.

A temporary solution to anterior tibialis weakness is to use an elastic band to help elevate your foot while you are walking. Tie the band around your leg just below your knee and secure it around the ball of your foot.  When you are swinging your leg forward, the elastic band pulls your foot up, and your high steppage gait is no longer needed to clear your toes from the ground.

What's the danger of not treating your high steppage gait? Safety. If you catch your toes on the ground while walking, you may be setting yourself up for a fall, and this can lead to injury or have serious consequences.

A high steppage gait pattern resulting from anterior tibialis weakness or paralysis can make walking difficult. It can increase your chances of losing your balance which may lead to falls. By working with your physical therapist, you can focus in on the cause of your weakness and work to eliminate your high steppage gait.

Continue Reading