How to Fix Circumduction and Walk Better

Why Your Leg Swings Out: Causes and Exercises to Improve Gait

Circumduction is a common issue after a stroke, where your leg swings out to the side instead of moving straight forward as you walk. This abnormal gait pattern can be frustrating and challenging, but with the right understanding and exercises, you can work towards improving your walking pattern.

What Causes Circumduction?

Circumduction can happen for several reasons after a stroke. Understanding the root causes is key to addressing it effectively.

Weak Hip Muscles:

If the muscles that help lift your leg are too weak, your leg may swing out when walking.

Spasticity:

This is an involuntary muscle contraction that is a result of a neurologic injury, making it hard to control your movements and causing your leg to swing to the side.

Abnormal Movement Patterns:

After a stroke, your body may move in fixed patterns. For example, when your hip moves, your knee might move at the same time, making walking harder.

Legs Not Working Separately/Inability to Dissociate:

Your legs may not move independently of each other, causing them to move together in an awkward way.

Incorrect AFO (Brace):

If your brace isn’t fitted properly, it can make your leg feel longer or harder to move, causing circumduction. An improperly fitted AFO, such as a Floor Reaction AFO, can cause issues with your walking. If the brace pushes your shin backward and prevents your knee from bending. The best AFO for correcting circumduction is one with a plantarflexor stop, which helps push your leg forward as you walk. Make sure to work with your orthotist to ensure your AFO is properly adjusted to fit your specific needs.

Exercises to Help Improve Circumduction Gait

Now that we’ve explored the causes of circumduction, let’s look at some exercises that can help correct it:

Weakness/Inability to Bend Hip:

• Lie on your back with your good leg bent and place your bad leg on a gym ball.
• Roll the ball with your bad leg, lifting it and moving your knee toward the opposite chest.

Modified Version: If you can’t use the gym ball, lie on your side with your bad leg on top and gently roll your body to allow your leg to fall down.

Spasticity (Quadriceps):

• • Lie on a mat or bed with your involved leg hanging off the edge.
  • Place a weight on your leg to help bend your knee.
  • Lift the leg straight, then relax it.
  • Repeat to help your muscles go from tight to relaxed.

Tight Calf Muscles (Spastic Ankle):

• • Stand with your involved foot on a foam wedge.
  • Step your uninvolved leg forward.
  • Feel the stretch in your calf and hold to release tightness.

Breaking Extensor Synergy Pattern:  

• Stand with your bad leg on a step, knee bent.
• Put weight on your strong leg and relax your bad leg.
• Hold the position until your leg no longer wants to straighten.

Progression: Use a higher step to increase the challenge.

Learning to Dissociate, Address Weakness and Spasticity:

• • Stand next to something sturdy (like a step stool with a handle).
  • Place your involved leg on a mini skateboard or furniture slider.
  • Keep your leg slightly bent and move it forward slowly, trying to control it if weakness is an issue.
  • Hold the leg in a bent position and relax for a few seconds to address spasticity.

Conclusion

Circumduction is common after a stroke but can be improved with the right exercises. By understanding the root causes—whether it’s weakness, spasticity, abnormal synergy patterns, or an improperly adjusted AFO—you can target the right exercises to improve your walking pattern. Consistent practice, along with proper guidance from your healthcare provider or physical therapist, can help you regain mobility and walk more efficiently. Keep working on your recovery—small steps lead to big progress!

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