Shuffling Gait

A shuffling gait is a walking pattern that occurs when a person drags their feet while walking. The length of each step is typically shorter than normal. While most people occasionally shuffle—perhaps while catching their balance after tripping or trying to run when their leg muscles are tired—a consistent shuffling gait pattern can signify an underlying health condition.

This article discusses shuffling gait, including its causes, treatment, and diagnosis of conditions associated with this symptom.

What Causes Shuffling Gait?

Shuffling gait can occur in people who have health conditions affecting the nervous system, joints, or muscles.

Neurological Conditions

Neurological conditions can cause uncoordinated gait, called ataxia. Shuffling gait is a type of ataxia. The most common cause of shuffling is Parkinson's disease. This progressive neurological condition develops when cells in the brain no longer produce dopamine—a chemical involved in controlling the body's movements.

Gait that occurs with Parkinson's disease is often called festinating gait, propulsive gait, or Parkinsonian gait. In addition to shuffling, people with Parkinson's disease develop a significant forward-leaning posture. The combination of these two things causes a person to gain momentum as they walk (sometimes leading to jogging) to help prevent them from falling.

Shuffling can also occur with a condition called foot drop. This condition causes difficulty or an inability to lift the front of the foot while taking a step. It can affect one or both sides of the body, depending on the underlying cause.

Foot drop can occur with conditions such as:

• Multiple sclerosis (MS) (an autoimmune disease that attacks the nerve covering called myelin of nerves in the neck and spine)
• Spinal muscle atrophy (AMS) (a neurological condition characterized by muscle weakness)
• Amyotrophic lateral sclerosis (ALS) (a progressive disease that attacks the nerves)
• Stroke (interrupted blood supply to the brain)
• Cerebral palsy (motor disability)
• Charcot-Marie-Tooth disease (a genetic disorder causing nerve damage)
• Peripheral neuropathy (nerve damage often caused by diabetes)
• Polio (a virus causing paralysis)

Joint Tightness

Joint tightness in the legs can contribute to a shuffling gait. Tightness leads to decreased range of motion, preventing a person from taking normal-sized steps.

Range of motion that contributes specifically to shuffling includes decreased:

• Hip extension (straightening)
• Knee extension (straightening)
• Ankle dorsiflexion (lifting the front of the foot upward)

Joint tightness can develop after injuries, as part of health conditions (such as arthritis), or from long periods of bed rest.

Muscle Weakness

Shuffling gait can be caused by muscle weakness, as can foot drop in the muscles that lift the front of the foot (dorsiflexion).

Shuffling can also occur from weakness in other muscles that help get the leg ready to advance (the initial swing phase of gait), such as the hip flexors that lift the thigh and hamstrings that bend the knee.

Treatment for Shuffling Gait

Shuffling gait can improve with treatment of the underlying cause—such as taking medications to treat Parkinson's disease or getting blood sugar levels under control if you have diabetes.

Treatment for shuffling gait often includes physical therapy, regardless of the underlying cause. Physical therapy professionals use a variety of interventions to improve function in people with a shuffling gait. These include:

• Strengthening exercises
• Stretching/range of motion exercises
• Balance activities
• Proprioceptive training (orienting your body within the environment)
• Joint mobilization techniques
• Gait training (which can include the use of parallel bars)
• Prescription of assistive devices (such as a walker or cane)

Orthotics, such as a device that keeps the ankle joint in a neutral position called an ankle-foot orthosis (AFO) are also used to reduce foot drop and improve your ability to clear your feet while walking.

Diagnosis of Shuffling Gait

Shuffling gait is diagnosed by a healthcare provider through observation of a person's walking and a neurological exam. However, additional testing is required to determine the underlying cause of the abnormal gait.

Diagnosis of conditions that can affect gait often requires imaging of the brain, spinal cord, or joints.

Imaging tests can include:

• Magnetic resonance imaging (MRI): This test uses strong magnets to produce images of structures in the nervous system. MRI is commonly used to diagnose brain damage, stroke, brain/spinal cord tumors, neurodegenerative disorders, multiple sclerosis, inflammation, and traumatic brain injury.
• Computed tomography (CT scan): This test uses computerized X-ray images to produce two-dimensional pictures of body structures. CT scans often diagnose conditions such as brain bleeds, brain tumors, brain damage, encephalitis (inflammation of the brain), and hydrocephalus (fluid build-up in the brain).
• Positron-emission tomography (PET scan): This type of imaging uses radioactive isotopes injected into the blood to produce two- and three-dimensional images. PET scans are often used after areas of concern are identified on MRIs or CT scans to provide additional information.

Other neurological tests that might be performed include:

• Electromyography: This test records electrical activity in the muscles to help diagnose conditions affecting the muscles and the nerves that control them (motor neurons).
• Nerve conduction studies: This test (also called nerve conduction velocity test) measures the speed of electrical impulses in your nerves. It can help diagnose conditions such as Charcot-Marie-Tooth disease and peripheral neuropathy.
  

Summary

Shuffling gait is characterized by short steps and feet that slide along the ground rather than fully clear the floor. This gait commonly occurs with Parkinson's disease and conditions that affect nerves and muscles in the legs.

Shuffling gait is primarily treated with physical therapy and specific treatments based on the underlying cause. This symptom is diagnosed with a physical and neurological exam.

A Word From Verywell

If you notice changes in your gait—even if they seem minor—talk to your healthcare provider. Early diagnosis of conditions that cause a shuffling gait can significantly improve recovery or slow the decline in function with progressive conditions. Addressing a shuffling gait can also help prevent further injuries from falls (a common result of gait abnormalities).