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Abnormal gait caused by weakness of the gluteus muscles

Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal human gait. It is caused by weakness or ineffective action of the gluteus medius muscle and the gluteus minimus muscle. Gandbhir and Rayi point out that the biomechanical action involved comprises a class 3 lever, where the lower limb's weight is the load, the hip joint is the fulcrum, and the lateral glutei, which attach to the antero lateral surface of the greater trochanter of the femur, provide the effort. The causes can thus be categorized systematically as failures of this lever system at various points.

During the stance phase, or when standing on one leg, the weakened abductor muscles allow the pelvis to tilt down on the opposite side. To compensate, the trunk lurches to the weakened side to attempt to maintain a level pelvis throughout the gait cycle. When the hip abductor muscles (gluteus medius and minimus) are weak or ineffective, the stabilizing effect of these muscles during gait is lost. When standing on the right leg, if the left hip drops, it is a positive right Trendelenburg sign (the opposite side drops because the hip abductors on the right side do not stabilize the pelvis to prevent the droop). When the patient walks, if he swings his body to the right to compensate for left hip drop, he will present with a compensated Trendelenburg gait.

Treatment is directed at the underlying cause. In addition, biofeedback and physical therapy are used to strengthen the muscles.

Trendelenburg gait was first described by Friedrich Trendelenburg in 1895.