The video clips that follow are designed to illustrate the common neuromuscular deficits that impact the normal gait (locomotion) cycle. Abnormal patterns are analyzed to review synergistic muscle groups and innervation and to visually simulate the compensatory movements routinely observed during patient ambulation. Cutaneous nerve deficits are included when relevant to aid in the differential diagnosis of neuromuscular impairments that impact locomotion.

Normal gait in humans is bipedal and subdivided into four phases (see illustrations above), i.e., stance, push-off, swing, and heel strike; push-off requiring predominantly the big toe. It involves the actions of synergistic skeletal muscles that are grouped into compartments innervated by terminal (named) branches of the lumbosacral plexus. These peripheral nerves contain two or more segmental spinal nerves (L2-S3). Synergistic group action permits ambulation in patients with neuromuscular deficits. Prescribing physical therapy strengthens innervated synergistic muscle groups to improve patient mobility during locomotion.

The buttocks and thigh are organized into four compartments that act at the knee or with the iliopsoas at the hip. The leg in turn contains three compartments that function at the ankle or with the intrinsic muscles of the foot. During heel strike the foot is inverted and dorsiflexed at the ankle joint. As the limb moves from heel strike into stance, the foot rotates from inversion into an everted position. This movement facilitates plantar flexion of the ankle and toes at push-off and initiates the swing phase of the gait cycle.  During stance, inversion and eversion occur at the subtalar and transverse tarsal joints of the foot. Flexion of the toes is a complex act employing the remaining joints of the foot. 


Normal Gait

Created by the Neurobiology and Anatomy Department:
F. Reilly, Ph.D., B. Palmer, P. Klinkhachorn, Ph.D., H. Ressetar, Ph.D.




Heel Strike

Gait - referenced to the right foot

Lower Limb