[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Musculoskeletal system](https://durgical.com/en/clinical-exam/#a-musculoskeletal) › Inspection of gait and posture (orthopedic)

[Clinical exam](https://durgical.com/en/clinical-exam/) · [Musculoskeletal system](https://durgical.com/en/clinical-exam/#a-musculoskeletal)

# Inspection of gait and posture (orthopedic)

- Exam technique

Watching a person stand and walk shows a lot: limps from pain, weak muscles, unequal legs or a crooked spine.

Updated 2026-11-01

**See it in 3D:** [Gluteus medius](https://durgical.com/en/anatomy/gluteus-medius-muscle/) · [Tibialis anterior](https://durgical.com/en/anatomy/tibialis-anterior-muscle/) · [Common fibular nerve](https://durgical.com/en/anatomy/common-fibular-nerve/) · [Quadriceps tendon](https://durgical.com/en/anatomy/tendon-of-quadriceps-femoris-muscle/)

## Key points

- Gait has a stance phase (about 60 % of the cycle) and a swing phase (about 40 %).
- Antalgic gait: stance on the painful leg is shortened.
- Trendelenburg gait: the pelvis drops on the swing side from weakness of the stance-side gluteus medius.
- Steppage gait: the knee lifts high and the foot slaps down from foot drop (fibular nerve or L5 root).
- Timed Up and Go: 14 seconds or more is linked to fall risk in older adults.

## What it is

Inspecting gait and posture is the first part of the orthopedic exam and starts as the patient walks into the room. The examiner looks at standing alignment (spine, pelvis and legs) and walking (stance and swing phases, step length, symmetry). It localises the problem, guides the choice of special tests and, in older people, helps estimate fall risk.

## Landmark anatomy

- Standing landmarks: spinous processes, shoulder blades, iliac crests, posterior superior iliac spines, patellae and malleoli.
- In stance, the gluteus medius holds the pelvis and the quadriceps steadies the knee.
- In swing, tibialis anterior (deep fibular nerve) lifts the foot so it clears the floor.
- At push-off, the triceps surae (S1) drives the body forward.

## Technique, step by step

- Watch the patient from the moment they enter: how they rise, walk and sit, and whether they use a cane or lean on furniture.
- Standing posture, barefoot and in underwear or a gown: from the front, the back and the side.
- Front: shoulder and iliac crest height, knee alignment (varus or valgus) and foot shape.
- Back: shoulder blades, sideways spinal curves, gluteal folds and heels; side: lordosis, kyphosis and knee extension.
- Gait: ask the patient to walk several metres, turn and come back; watch stance, swing, step length and symmetry, and arm swing.
- Tests: walking on toes (S1), on heels (L5) and in tandem; in older adults, the Timed Up and Go test.
- If there is a limp, measure leg length and move on to the exam of the suspected joint.

## Abnormal findings

- Antalgic: hip, knee, ankle or foot pain; osteoarthritis and trauma are the usual causes.
- Trendelenburg: abductor weakness (hip osteoarthritis or dysplasia, superior gluteal nerve injury).
- Steppage: foot drop from common fibular nerve injury or L5 radiculopathy.
- Short leg: the pelvis dips on one side and the person walks on the toes of the short leg or bends the other knee.
- Waddling: bilateral weakness of the pelvic girdle (myopathies, bilateral hip dislocation).
- Inability to walk on the toes suggests S1; on the heels, L5; neurological gaits (parkinsonian, ataxic, spastic) are studied separately.

## Common errors

- Watching only a few steps in a short corridor hides asymmetry; several metres and a turn are needed.
- Examining with shoes or long trousers hides the feet, knees and pelvis.
- Forgetting to ask older patients about falls: gait is part of fall-risk assessment.

## Test yourself

Think of the answer, then tap the question to see it.

## What characterises an antalgic gait?

Stance on the painful leg is shortened to load it for as little time as possible.

## What does inability to walk on the heels suggest?

Weakness of the foot dorsiflexors: an L5 root or fibular nerve lesion.

## What is a steppage gait and what causes it?

The knee lifts high and the foot slaps down on the floor; it is due to foot drop from a fibular nerve or L5 root lesion.

## Which Timed Up and Go time is linked to fall risk?

Fourteen seconds or more to stand up, walk 3 metres, turn, walk back and sit down.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/clinical-exam/inspection-of-gait-and-posture/)

## See it in 3D

The structures of Durgical's 3D anatomy where it is found.

- [Gluteus medius](https://durgical.com/en/anatomy/gluteus-medius-muscle/)
- [Tibialis anterior](https://durgical.com/en/anatomy/tibialis-anterior-muscle/)
- [Common fibular nerve](https://durgical.com/en/anatomy/common-fibular-nerve/)
- [Quadriceps tendon](https://durgical.com/en/anatomy/tendon-of-quadriceps-femoris-muscle/)

## Related

- [Trendelenburg sign and gait](https://durgical.com/en/clinical-exam/trendelenburg-sign-and-gait/)
- [Abnormal gaits: hemiparetic, parkinsonian, ataxic, steppage, waddling](https://durgical.com/en/clinical-exam/abnormal-gaits-hemiparetic-parkinsonian-ataxic-steppage-waddling/)
- [General inspection: appearance, posture, gait and consciousness](https://durgical.com/en/clinical-exam/general-inspection-appearance-posture-gait-and-consciousness/)
- [Spine examination: the Adams forward-bend test and Schober test](https://durgical.com/en/clinical-exam/spine-examination-the-adams-forward-bend-test-and-schober-test/)
- [Comprehensive geriatric assessment: function, cognition, falls](https://durgical.com/en/clinical-exam/comprehensive-geriatric-assessment-function-cognition-falls/)
- [Cerebellar tests: finger–nose, heel–shin and rapid alternating movements](https://durgical.com/en/clinical-exam/cerebellar-tests-finger-nose-heel-shin-and-rapid-alternating-movements/)

## Related conditions

- [Hip Osteoarthritis](https://durgical.com/en/conditions/hip-osteoarthritis/)
- [Knee Osteoarthritis](https://durgical.com/en/conditions/knee-osteoarthritis/)
- [Parkinson disease](https://durgical.com/en/conditions/parkinson-disease/)
- [Scoliosis](https://durgical.com/en/conditions/scoliosis/)

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Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.

Sources: [Gait and Balance Disorders in Older Adults](https://www.aafp.org/pubs/afp/issues/2010/0701/p61.html) (American Family Physician (American Academy of Family Physicians), 2010); [Musculo-Skeletal Examination – Hip Exam](https://sites.ucsd.edu/clinicalmedguide/musculo-skeletal-examination-hip-exam/) (UC San Diego School of Medicine, Practical Guide to Clinical Medicine, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/clinical-exam/inspection-of-gait-and-posture/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/inspection-of-gait-and-posture/