What your walk reveals about your health
Teacher Pauline Yuill was used to being quick on her feet — she was a keen ballroom dancer and even ran the London Marathon at 46. Yet as she hit her mid-Fifties, her fast stride developed into a lop-sided, slow-paced walk.
‘I was beginning to walk like someone in their eighties and had developed a distinctive tilt to the lefthand side,’ says Pauline, 60, who teaches english as a foreign language and lives in Forest hill, London, with husband John, 60, an accountant.
her GP put it down to getting older, but over the following months Pauline’s walking slowed even further; she also noticed she wasn’t swinging her arms as she walked, even when she consciously tried.
In 2012, when a passer-by shouted: ‘Why are you walking like a drunk?’ Pauline decided to see her GP again.
This time she was referred for an MRI scan of the neck and spine to check for arthritis, which picked up some slight deterioration.
Yet it would take a further two years — following an incident when her legs gave way suddenly — before she was referred to a neurologist, who diagnosed Parkinson’s.
‘I’d always associated Parkinson’s with uncontrolled shaking, not problems with walking,’ says Pauline.
In fact Parkinson’s often causes a distinctive slow, shuffling walk with a shortened stride, as in Pauline’s case.
This occurs as brain cells die, leading to a drop in dopamine, which is important for movement and co-ordination — Pauline was diagnosed after a Dopamine Transporter Scan (DAT scan), which measures levels of it.
‘The gait may become lop- sided because Parkinson’s usually starts on one side of the body first, as one side of the brain is affected more than the other in the beginning — so what happens is that your spine changes shape,’ explains Professor Tahir Masud, a consultant physician at Nottingham University hospital, who is a gait expert.
‘as it progresses you may notice a shuffling style of walking and experience problems taking the first steps when getting up from sitting — what we call ignition failure.’
comedian Billy connolly was diagnosed with Parkinson’s after he’d walked across a hotel foyer in Los angeles and a surgeon, noticing his strange gait, urged him to see a doctor.
In fact, the way someone walks can provide major clues about several diseases, from arthritis to dementia, and even their stress levels.
Last month, scientists revealed that stressed people tend to veer to the left when walking.
Writing in the journal cognition, researchers from the University of Kent concluded that this may be because when people feel anxious, the right side of their brain becomes highly active, affecting the direction they walk in.
‘There are quite distinctive walks for some conditions that geriatricians and neurologists can spot as soon as someone walks into a room,’ says Professor Masud, who makes a point of meeting all his patients in the waiting room so he can watch their walk.
Yet he says distinctive walks are often not picked up by doctors.
‘This is a shame because the way someone walks is an easy assessment — it’s noninvasive and free, unlike some expensive investigations.
‘and it can reveal early signs of certain medical conditions, including minor strokes, spinal stenosis (narrowing of the spinal canal which puts pressure on the spinal cord or nerves) and osteoarthritis of the hip and knee,’ he says.
Lynn rochester, a professor of movement science at Newcastle University, says walking is a good barometer of health.
‘It actually requires complex instructions from the brain — it isn’t about just contracting and relaxing muscles,’ she explains.
‘There’s some evidence that changes in walking speed and pattern may be apparent before memory problems in patients who go on to develop dementia, for instance.
‘In patients with Parkinson’s, some of the early changes are very subtle and may not even be detectable by clinical examination. Patients will just say they’re slowing down or not walking as well.’
after diagnosis, Pauline started treatment with the drug sinemet, which increases dopamine levels, and this has helped to control her symptoms.
‘The drugs worked within a few weeks and my walking returned to normal,’ she says. ‘ I’m now back ballroom dancing, have run a 5km race and recently climbed very challenging mountains while visiting my son in australia.’
however, she wishes the cause of her lop-sided walk had been recognised earlier. ‘I’d advise anyone who develops a walking problem not to ignore it.’
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HEALTH SECRETS OF YOUR GAIT
FEET STICK TO FLOOR
‘There is a recognised dementia walk — we call it a magnetic gait — as dementia progresses, your feet appear to stick to the floor as if they were magnetic,’ says Professor Masud.
This is because in dementia the higher brain functions (that govern thought and action) become impaired. This includes lifting the legs in a timely manner to clear the ground.
other clues would be a slower gait, shorter steps and variability in gait — making you more prone to falls.
PENGUIN WADDLE
‘Waddling with your upper body moving from side to side like a penguin can be due to compression of the nerves in the lower back, common in degenerative back disease,’ says Professor Masud.
‘The squashing of the nerves reduces signals to the muscles of the buttocks which are very important for keeping the pelvis straight when you put weight on one leg.
‘Normally if you stand on your right leg the buttock muscles will keep the left side of the pelvis up, but if the nerve supply is damaged this doesn’t happen, so the pelvis drops with each step and you start to waddle.’
KNEES CROSSING OVER
‘Scissor gait’, where the knees cross over in front of each other, can be related to conditions such as multiple sclerosis, which leads to damage to nerves in the brain and spinal cord, or injuries to the spinal cord from sporting or road accidents, says Professor Masud.
‘Damage to the spinal cord may cause weakness and muscle stiffness in the legs. Some muscle groups become stiffer and weaker. This makes the knees cross during walking.’
LIMPING
Walking with a limp — bearing weight on only one side of the body momentarily — can be a sign of arthritis (in the hip, knee, toe or feet). of course, it could also be due to injury to one of the lower limbs on one side.
Someone with joint pain may unconsciously avoid bearing weight on these joints.
SWAYING
‘LURCHING from side to side as if drunk may be a sign of damage to the cerebellum, part of the brain that controls co-ordination,’ says Professor Masud.
‘This may indicate a stroke, a brain tumour or damage from alcohol abuse.’
DRAGGING FOOT
‘THIS is an occupational hazard for workers who constantly press on their knees, as it damages the peroneal nerve at the side of the leg just below the knee joint,’ says Professor Masud.
‘This can cause dorsiflexion, where a person can’t move their toes up, causing their foot to drag. When they walk they tend to lift their knee up more to stop their foot dragging.
‘This can also cause damage to the nerves elsewhere such as the sciatic nerve higher up the leg.
‘Stroke patients often drag the foot on the affected side as damage to the brain causes the leg to become stiff.’
200 The number of muscles used to take one step