Which gait pattern is described for sacral S1-S2 with plantar flexor weakness?

Which gait pattern is described for sacral S1-S2 with plantar flexor weakness?

• A. Mild crouch gait with weight bearing through calcaneus
• B. High-heeled gait
• C. Trendelenburg gait
• D. Toe-walking pattern

Answer: (A)

When the plantar flexors are weak (as with sacral S1–S2 involvement), push-off and ankle control in late stance are limited. The body compensates by loading the heel during stance and using increased knee flexion to advance the limb, creating a mild crouch pattern. Keeping weight on the calcaneus reduces the demand on the ankle to plantarflex and helps stabilize the leg while forward progression is achieved mainly through the knee and hip rather than ankle plantarflexion. This combination matches a mild crouch gait with heel (calcaneal) weight bearing. Toe-walking relies on strong or spastic plantarflexors, so it doesn’t fit plantarflexor weakness. Trendelenburg gait points to hip abductor weakness, not plantarflexor status. A high-heeled gait isn’t a specific compensatory pattern for plantarflexor weakness.

When the plantar flexors are weak (as with sacral S1–S2 involvement), push-off and ankle control in late stance are limited. The body compensates by loading the heel during stance and using increased knee flexion to advance the limb, creating a mild crouch pattern. Keeping weight on the calcaneus reduces the demand on the ankle to plantarflex and helps stabilize the leg while forward progression is achieved mainly through the knee and hip rather than ankle plantarflexion. This combination matches a mild crouch gait with heel (calcaneal) weight bearing.

Toe-walking relies on strong or spastic plantarflexors, so it doesn’t fit plantarflexor weakness. Trendelenburg gait points to hip abductor weakness, not plantarflexor status. A high-heeled gait isn’t a specific compensatory pattern for plantarflexor weakness.