Video and Transcript: How to Correct a Limp

Hi everyone! Dr. Orit Hickman here from Pain Science Physical Therapy. 

This short video is going to address one of the most common reasons that patients will come in to see us in the clinic, and that is for a persistent limp. You can start limping after any sort of lower body injury but also if you’re having low back pain. That’s a common reason. Sometimes patients will have low back pain that radiates down to one leg. And, the pain will go away, but the limp will continue. If you’ve had any sort of lower body pain, ankle sprain, knee arthritis, hip pain, any of these are the reasons that patients will limp. 

Learning how to correct a limp: Most commonly, patients will come into physical therapy, but, to be perfectly honest, there’s a lot that you can do on your own. So, the very first thing that you want to do is, if you haven’t already addressed the reason that you’re having pain, is, of course, go to see your physical therapist and/or your physician to come into PT and get treated for the pain. But what if the pain is gone and you continue to have a limp. Well, this can happen because your brain has learned a new way to move and it has forgotten how you moved without pain. So, your brain starts protecting the body part, and then it forgets that it can put weight on it again. So, I’m going to help you try and retrain your brain.

The first thing that you would want to do is you want to practice standing. The best thing to do is in front of a mirror so that you can see whether or not your weight is evenly distributed. So, you can see I’ve got my feet positioned just below my hips, and what you’re going to do is you’re going to shift your weight a little bit side to side. Now, when we have a limp, the tendency is to keep our weight, I’m going to-if I had a-if I had pain on my right side for example, the tendency would be to keep my weight off of that leg. So, as I shift, my shoulders might shift away. So then what that actually means is that I’m not fully taking all of my body weight onto that leg. So, you want to imagine that you’re holding a tray of glasses, and then, as you shift your weight side to side, you’re balancing that tray of glasses. And, you can see how my shoulders are now tracking over my hips. 

As I do this, you might notice that my heels are coming up a little bit. And, that’s because, once you shift your weight fully over onto one leg, you’re ready to take a step forward. That’s your body getting prepared for that. So, just shift the weight side to side, and practice doing this first. 

If you notice that you can’t do this without a hip shift, then you might need a little bit more assistance. You might need somebody to actually be there with you to prevent that hip from going where it wants to go. Again, that’s where going into PT might be really helpful. 

But, practice doing this first. Really start shifting your weight side to side. And, maybe you start with just putting, you know, 25% weight. Then, you go to 50%. Then, you go to 75%. And then, you get all of your body weight over onto that leg. Once you feel comfortable doing this, and this might take-it might take a few days. It might take a few weeks. But, once you feel comfortable practicing and getting your weight fully shifted onto the side that you’re-you’ve been avoiding or protecting, then you want to practice getting that weight fully over there and lifting the opposite leg. So, I’m bringing my weight over to the side, and I’m lifting. So, it’s just a little bit of a-almost like a march. Right? But, not quite a march. So, your foot is not up off the ground for too long. But, again, you’re trying to shift that weight. I’m trying to shift my shoulders so that they’re going up and over and staying over the top of the hip. Shoulders are tracking over the hips. 

Once you feel comfortable doing this, you can then practice bringing the weight over, and bringing one foot forward, and then bringing one foot back. So, walking is a lot of repetition. There’s a lot of repeating of movement. Right? So, I’m shifting my weight over to the right and bringing my left foot forward. All the while, my shoulders are staying over the top of my hips. So, I’m not doing any kind of trunk side to side shifting. I’m just trying to keep my weight distributed. My shoulders are staying, and they’re tracking with my hips right now or tracking with my pelvis. 

Once you feel comfortable repeating this motion, then you can start to shift side to side. So, I bring my weight over. I try to bring my right foot forward. Remember this is the side that I’m protecting. Right? [This is the side] that I’ve had an injury on. So, it is important to get used to bringing that leg forward and bringing the weight over onto that affected side. 

So, you’re doing it side to side. Then, you’re going more weight onto that leg. Then, you’re bringing the opposite leg forward. And then, you’re practicing one leg at a time. Once you get comfortable with this, you should be able to then bring that leg forward and continue the stepping process. Right? And forwards and backwards is really important. You don’t think about going backwards. But, practice in a space that you feel is safe and that there is lots of room. 

Now, I’m doing this without holding onto anything. For patients that have been guarding a leg for a long period of time, I’ll actually have them stand in front of a barre at the clinic in front of a mirror and holding onto the barre and getting comfortable putting the weight over onto the side that they have protected for a long time. So, at home, you can use a countertop. You can use the back of a sofa. [Go] someplace that you feel really secure as you practice this. And, again, if there’s a mirror nearby, that’s really helpful because you can see how much your hips are shifting and if you’re kind of trying to keep your weight off of the leg that you’ve been protecting.

I hope this helps. This is just a really quick video, and it obviously distills down something that we spend a lot of time working on with patients doing some pretty complex retraining to help your brain know that it’s safe to use that leg again. If you thought this was a great video, I’d love a thumbs up. And, please subscribe so that you can hang out and see more videos. And, for those of you who don’t know, this is Murphy, my dog, and he was very unhappy that I was in here while he was outside. I hope you guys have a great day!