Foto: BB.LV / Женщина на прогулке
Professor Oksana Drapkina explained which walking characteristics may indicate dangerous diseases and when it is necessary to urgently consult a doctor. We rarely think about how we walk. For most people, it is such a habitual action that it is performed almost automatically. Meanwhile, ordinary walking is a complex process that simultaneously involves the brain and spinal cord, peripheral nerves, muscles, joints, and balance organs. To take one confident step, the body must coordinate the work of many systems. And if even one of them starts to function improperly, the gait may change. As reported by the publication *"Doctor Peter"*, the director of the National Medical Research Center for Therapy and Preventive Medicine, academician of the Russian Academy of Sciences, Professor Oksana Drapkina noted characteristic gait disturbances that help doctors suspect various diseases. According to the specialist, changes in gait are particularly often associated with neurological problems. However, sometimes the cause lies in circulatory disorders, joint diseases, or muscle weakness. ## A Person Starts Shuffling: A Possible Sign of Parkinson's Disease One of the most characteristic changes is the so-called shuffling gait. A person begins to move with short, small steps, hardly lifting their feet off the ground. At the same time, the torso may be slightly bent forward, the arms move less while walking, and the movements become stiff. Sometimes a characteristic shuffling occurs: the steps gradually become more frequent but remain very short. Particularly noticeable difficulties may arise when turning or trying to start moving. In some cases, a person seems to freeze in place, even though they want to continue walking. Such disturbances are characteristic of Parkinson's disease and other conditions accompanied by parkinsonism. However, a shuffling gait alone does not necessarily indicate the presence of this disease. Similar changes can occur for other reasons. ## Gait Like a Drunk Person: The Problem May Be in the Cerebellum If a person starts walking unsteadily, widely spreading their legs and swaying from side to side, doctors may suspect cerebellar ataxia. The cerebellum is a part of the brain that plays an important role in coordinating movements and maintaining balance. When its function is impaired, movements lose precision. Steps become uneven: one may be too short, while another is excessively long. A person may suddenly change speed, lean to one side, and experience difficulties when trying to walk in a straight line. From the outside, such a gait sometimes resembles the movements of a person under the influence of alcohol. But the cause may lie in a neurological disease. Ataxia occurs in various lesions of the cerebellum and associated nerve pathways, including strokes, inflammatory, hereditary, and other diseases. **It is especially dangerous if coordination impairment arose suddenly.** In such cases, it is necessary to rule out acute cerebrovascular accident. ## A Person Raises Their Legs High and Hits Their Heels on the Floor Another characteristic disturbance is sensory ataxia. It occurs when the nervous system stops receiving normal information about the position of body parts in space. In everyday life, a person hardly thinks about where their legs are and how bent their knees are. The brain constantly receives corresponding signals from nerve endings. If this system is disrupted, it becomes more difficult for a person to control movements without the help of vision. They may widely spread their legs, excessively raise them while walking, and forcefully drop their heels on the floor. Thus, the body tries to gain additional sensations from contact with the surface. The balance disturbance is especially noticeable with closed eyes or in the dark. Such symptoms may occur in lesions of peripheral nerves, the spinal cord, and some other neurological diseases. ## The Leg Describes a Semicircle: Possible Consequences of a Stroke Doctors distinguish the so-called hemiparetic gait, also known as the Wernicke-Mann gait. It arises from impaired motor functions on one side of the body. This picture is most often observed after a stroke, although other causes of nervous system damage are also possible. When walking, a person does not bend the affected leg enough at the knee and is forced to carry it forward in an arc, as if describing a semicircle. The arm on the same side of the body may remain bent and pressed against the torso. Neurologists even have a figurative expression: "The arm asks, the leg scythes." Such a disturbance is associated with changes in muscle tone and weakening of voluntary movements. If such asymmetry appeared suddenly, especially in combination with weakness of the arm or leg, it is necessary to call an ambulance immediately. ## Legs Cross While Walking Sometimes the gait becomes tense, and the legs seem to cross during movement. Doctors call this spastic paraparesis or "scissor" gait. It arises due to pathological increases in muscle tone, primarily in the muscles that adduct the thighs. As a result, it becomes difficult for a person to freely spread their legs and take normal steps. Movements become stiff, short, and require significant effort. Such a gait may be observed in some forms of cerebral palsy, as well as in other diseases of the brain and spinal cord. ## A Person Raises Their Leg Too High: "Rooster Gait" Another unusual variant of gait disturbance is called steppage. It is sometimes referred to as "rooster gait." The reason lies in the weakness of the muscles that lift the front part of the foot. As a result, the foot hangs down, and the toe may catch on the floor surface. To avoid stumbling, a person is forced to lift their knee unusually high with each step. Such a gait may arise from damage to the peroneal nerve, some polyneuropathies, and other neurological disorders. It is important to understand that a hanging foot is not just a feature of movement but a possible sign of nerve or muscle dysfunction. If this symptom appears for the first time, a medical examination is necessary. ## Legs Involuntarily Twist In dystonic gait, movements become unusual due to involuntary muscle contractions. The feet may turn inward, the legs may take unnatural positions, and walking becomes difficult. Sometimes the disturbances worsen with certain movements or after prolonged exertion. The cause may be various forms of dystonia — a neurological disorder associated with impaired regulation of muscle contractions. In such cases, it is important not only to assess the gait but also to conduct a comprehensive neurological examination. ## A Person Walks Waddling: The Issue May Be with the Muscles The so-called waddling gait is characterized by swaying of the torso from side to side. A person seems to roll from one leg to another. Such changes may occur due to weakness in the pelvic girdle and thigh muscles. In particular, they are observed in some myopathies — diseases of muscle tissue. However, a similar gait is also possible in other conditions, including orthopedic problems. Therefore, to establish the cause, it is necessary to assess muscle strength, joint condition, and the nervous system. ## Pain Causes Limping Not every unusual gait is associated with nerve damage. Sometimes the body simply tries to reduce pain. In the so-called antalgic limp, a person instinctively reduces the time of support on the painful leg. As a result, the steps become uneven. The cause may be injuries, inflammatory joint diseases, osteoarthritis, and other musculoskeletal problems. Such a change in gait is a protective reaction of the body. But if the pain persists or worsens, it is necessary to determine its cause rather than just rely on painkillers. ## Calves Hurt While Walking: Check the Vessels Professor Drapkina pays special attention to diseases of the lower limb vessels. In atherosclerotic lesions of the leg arteries, blood supply to the muscles worsens. During physical exertion, the muscles require more oxygen, but narrowed arteries cannot provide sufficient blood flow. As a result, characteristic pain arises, most often in the calf muscles. A person is forced to stop, rest a bit, after which they can continue moving. After a certain distance, the pain returns. This condition is called **intermittent claudication**. It is one of the characteristic symptoms of peripheral artery disease. As the disease progresses, pain may even occur at rest, especially at night. Such symptoms require a doctor's consultation, as significant blood supply impairment can lead to serious complications. ## Heavy Legs and Swelling: Possible Problems with Veins In chronic venous insufficiency, normal blood flow from the lower limbs is disrupted. A person may feel heaviness, fullness, and fatigue in their legs. By evening, swelling often appears. Due to unpleasant sensations, the gait may become slower and heavier. However, such symptoms are not specific only to venous diseases. Leg swelling may also occur in heart failure, kidney diseases, and other conditions. Therefore, it is important to evaluate not only the gait but also accompanying complaints. ## A Person Tilts Back Significantly Sometimes changes in gait are associated with an increase in abdominal volume and a shift in the center of gravity. A person begins to noticeably tilt their torso backward to maintain balance. Such a body position may be observed during pregnancy, pronounced ascites — fluid accumulation in the abdominal cavity, as well as with large formations in the abdomen. Of course, such posture alone does not allow for a diagnosis. But if the change in body position is accompanied by abdominal enlargement, shortness of breath, pain, or other unusual symptoms, it is necessary to consult a doctor. ## Even Flat Feet Can Change Gait The condition of the feet also affects the nature of walking. In some forms of flat feet, the distribution of load is disrupted, which can lead to pain, fatigue, and changes in movement mechanics. The gait may sometimes become less smooth, with heavy steps or a feeling that a person is "slapping" their feet. However, flat feet do not always cause symptoms and do not necessarily require treatment on their own. The need for correction depends on the severity of the disturbances, the presence of pain, and other circumstances. ## When to Urgently Seek Medical Help It is especially important to pay attention not only to the nature of the change in gait but also to the speed of symptom onset. Gradually developing disturbances may be associated with chronic diseases. However, a sudden change in gait sometimes indicates a condition requiring emergency assistance. **Call an ambulance immediately if you suddenly experience:** - weakness or numbness in an arm or leg, especially on one side of the body; - speech or understanding disturbances; - sudden vision deterioration; - pronounced coordination and balance disturbances; - sharp dizziness with an inability to stand or walk normally; - sudden instability, especially in combination with other neurological symptoms. Such signs may indicate a stroke or another acute disease. In such situations, one should not wait for the condition to improve on its own. Even if symptoms quickly disappear, urgent medical evaluation is necessary. ## Conclusion: Gait Can Reveal More About Health Than It Seems We tend to consider gait an individual feature of a person — just like voice, facial expressions, or mannerisms. However, for a doctor, it can become an important source of information about the functioning of the nervous system, muscles, joints, and vessels. Shuffling steps, sudden limping, instability, unusual foot positions, or changes in arm movements can indicate a wide range of diseases. At the same time, **it is impossible to make a diagnosis based solely on gait.** A specialist's examination and, if necessary, additional tests are required. But it is still worth noticing changes — especially if a person used to walk quite differently. Sometimes the body warns of health problems not with pain but by suddenly changing the habitual step. And it is important to hear this signal in time.
