Normal walking, or gait, is a highly coordinated, rhythmic movement. It is a complex, continuous cycle where the body propels itself forward while maintaining balance and stability with minimal energy expenditure. This process requires the precise function of bones, joints, muscles, and the entire nervous system. When walking becomes difficult or unusual, it is a symptom of an underlying issue, not a diagnosis, indicating a disruption in one or more of the systems responsible for locomotion. Understanding why you cannot walk normally involves examining the structural, neurological, and systemic factors that interfere with this mechanism.
Musculoskeletal and Structural Causes
The most immediate causes of an abnormal gait stem from physical problems within the body’s support structure: the bones, joints, and muscles. Any condition causing pain or restricting movement in the lower limbs forces an alteration in the walking pattern, often resulting in an antalgic gait, a protective limp adopted to minimize weight-bearing.
Acute injuries like a sprained ankle or fracture cause the person to shorten the stance phase—the time the foot is in contact with the ground—on the injured side. This shifts the body’s weight away from the painful area, resulting in an uneven stride. Chronic conditions, such as osteoarthritis or rheumatoid arthritis, create stiffness and degradation in joints, limiting the range of motion and stride length needed for a fluid walk.
Issues affecting the feet and ankles also directly change how weight is distributed. Structural problems, including bunions or ill-fitting footwear, force compensatory movements higher up the leg. Muscle weakness (myopathy) can lead to a waddling gait due to instability and insufficient strength in the hip abductor muscles.
Neurological System Impairments
Walking depends on the central and peripheral nervous systems coordinating motor commands and sensory feedback. When walking is impaired due to signal failure, the problem originates in the control system. Damage within the Central Nervous System (CNS)—the brain and spinal cord—can lead to distinct gait patterns.
A stroke can cause hemiparesis (weakness on one side), resulting in a hemiplegic gait where the affected leg is stiff and swings out in a semi-circle. Parkinson’s Disease leads to a parkinsonian gait involving a stooped posture, reduced arm swing, and small, shuffling steps. Patients often have difficulty initiating movement or tend to accelerate forward (festination).
Multiple Sclerosis (MS) can cause spasticity (muscle stiffness) or ataxia (lack of coordination), disrupting the smooth walking pattern. Spinal cord injury interrupts communication between the brain and the legs.
In the Peripheral Nervous System, conditions like peripheral neuropathy damage the nerves carrying signals to the feet. This loss of control results in a steppage gait, where the foot drops and the person must lift the leg high to prevent dragging the toes.
Systemic and Balance-Related Factors
Walking difficulties can stem from global body factors or issues with balance, not just localized injury. The vestibular system in the inner ear maintains balance by sensing head position. Inner ear disorders, such as vertigo or Meniere’s disease, cause severe dizziness and unsteadiness, leading to an ataxic gait characterized by a wide-based, staggering walk.
Certain medications can temporarily impair walking ability. Drugs like sedatives, muscle relaxants, and some blood pressure medications can cause orthostatic hypotension (a drop in blood pressure upon standing) or generalized dizziness. These side effects compromise stability and coordination, increasing the risk of falls.
Systemic illness or profound fatigue can also manifest as an abnormal gait. Conditions causing high fever or generalized weakness, such as a severe infection, reduce the strength and endurance needed for a normal stride. The gait abnormality is often transient, resolving once the body recovers.
Seeking Professional Diagnosis
Given the vast range of causes, an abnormal gait requires professional evaluation to pinpoint the source. Seek urgent medical attention if the change is sudden, accompanied by severe pain, numbness, unexplained weakness, or loss of consciousness. Gradual changes also warrant a medical consultation, especially if they are progressive or cause repeated falls.
The diagnostic process begins with a thorough physical and neurological examination, where a doctor observes the specific characteristics of your gait and reviews your medical history. Testing may include blood tests for systemic causes, or imaging (MRI or CT scan) for issues in the brain or spine. Specialized tests, such as nerve conduction studies, may evaluate peripheral nerve and muscle function. Accurate diagnosis determines the appropriate path forward.