What Is a High Steppage Gait Pattern?

Walking Difficulty Due to Anterior Tibialis Weakness

A high steppage gait pattern is a manner of walking that occurs if you have foot drop. Foot drop is caused by weakness or paralysis of the anterior tibialis muscle, which is in front of your shin bone.

The anterior tibialis muscle contracts to help flex your foot and ankle up while walking. This ensures that your foot clears the floor and you don't catch your toes on the ground.

If you have anterior tibialis weakness or paralysis, you may have a high steppage gait. This means you excessively bend your hip and knee while stepping forward. You lift your leg high off the floor so you'll clear your foot over the ground and avoid tripping.

Your physical therapist can help if you have a high steppage gait pattern after illness or injury. This article discusses the conditions that can cause a high steppage gait and how it can be treated.

Photo or a PT gaining training with a man.
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Causes of a High Steppage Gait

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

  • Sciatica: Pain caused by pressure on the sciatic nerve, starting in the lower back and running down the back of the leg
  • Peroneal nerve injury: Damage to the peroneal nerve, which branches from the sciatic nerve and helps move the lower leg and foot
  • Stroke: Interruption of blood flow to part of the brain that can cause disability
  • Multiple sclerosis: An autoimmune disease that damages the nerve cells in the brain and spinal cord

Call your healthcare provider if you have any of these conditions and trouble catching your toes on the floor as you walk. They may refer you to a physical therapist to help correct this high steppage gait pattern.

Treatment for a High Steppage Gait

Treatment for a high steppage gait pattern involves physical therapy focusing on the anterior tibialis muscle. Specific ankle exercises can help strengthen your anterior tibialis. Stretches for your calf can help maintain your ankle range of motion (ROM).

Your physical therapist (PT) may recommend gait training, or exercises to improve your walk. They may prescribe balance exercises to improve your overall proprioception (your sense of your body's position and movement). 

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

For anterior tibialis weakness caused by sciatica, your PT may prescribe back exercises to get pressure off your sciatic nerve. The exercises are designed to allow messages to travel normally up and down the sciatic nerve in your low back.

Recap

Your physical therapist will work with you on exercises to strengthen your anterior tibialis muscle and improve your balance. They may also use neuromuscular electrical stimulation to help improve this muscle's function.

Assistive Devices for Walking

Your physical therapist may suggest you use an assistive device to help you walk properly. This could include a wheeled walker or a quad cane, which has a base with four small feet. Your PT can ensure that you are using your assistive device properly.

Sometimes, paralysis of your anterior tibialis muscle is permanent. If this is the case, you may benefit from a special brace called an ankle-foot orthosis (AFO).

This brace helps to lift your foot and toes off the ground, which reduces the chance that you'll stub your toes. 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. You no longer need a high step to clear your toes from the ground.

Obviously, wearing an elastic band around your leg all day may not be convenient. However, using it as a temporary solution may help you maintain safe mobility.

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

Recap

Your physical therapist may suggest using assistive devices, such as wheeled walkers or quad canes, to provide support as you walk. A brace called an ankle-foot orthosis can help you to lift your foot and toes off the ground.

Summary

A high steppage gait pattern is a way of walking that occurs when you have a foot drop. A foot drop is caused by weakness or paralysis in the anterior tibialis muscle of your lower leg.

The anterior tibialis muscle usually helps you flex your toes up when you walk. When the muscle is weak, your foot hangs down as you step forward. To compensate for the muscle weakness, you lift your leg high to keep from tripping on your toes.

To help correct your gait, a physical therapist can prescribe exercises. This helps to strengthen the anterior tibialis muscle and improve balance. They may also recommend assistive devices or braces to help you walk safely.

A Word From Verywell

If you have a high steppage gait pattern, you may be concerned about losing your balance and falling. Rest assured that there are ways to improve your walk to help you stay safe.

If you're having trouble hitting your toes on the floor while walking, talk with your healthcare provider. They may recommend a physical therapist who can help you with a treatment plan.

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5 Sources
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