A waddling gait happens because of weakness in your hip girdle and upper thigh muscles. To make up for the weakness, you sway from side to side and your hip drops with each step. It’s also called myopathic gait and can be caused by several conditions.
Waddling Gait in Pregnancy
Pregnancy is one of the most common causes of a waddling gait. Your body goes through several changes during pregnancy that affect the way you walk. One of the ways it prepares to deliver a baby is by boosting the production of the hormone relaxin. This relaxes the muscles and joints in your pelvis to make it easier for a baby to pass through.
You also gain weight when you’re pregnant. Because most of it is in your belly, it changes your center of gravity so you have to lean back a little. Your gait should go back to its pre-pregnancy position after you give birth.
Waddling Gait in Muscular Dystrophy
Duchenne muscular dystrophy (DMD) is a genetic condition that causes muscle weakness that becomes more severe over time. It's one of four conditions caused by a change in a protein called dystrophin, which helps keep muscle cells together. Children with DMD walk with a waddling gait by the time they are school age.
Becker muscular dystrophy (BMD) is a milder form of DMD that can also cause a waddling gait. It's often diagnosed later in life than DMD. The course is usually slower and not as predictable. Both DMD and BMD mostly affect boys.
Children with DMD usually have to use a wheelchair by around the age of 12. Mobility aids can help with walking before then. These include:
- Braces to support the ankle and foot
- Braces at night to stretch the Achilles tendon
- A standing walker
- Wheelchairs that lift to a standing position
Waddling Gait in Toddlers
A waddling gait is normal in children under the age of 3. When your child is just learning to walk, they walk with their feet wide apart and turned out. This helps them keep their balance as they take a lot of short steps. If your child is older than 3 and still has a waddling gait, talk to their pediatrician about it.
A waddling gait in children over 3 can be a symptom of disorders including:
- Developmental dysplasia of the hip
- A muscle disease, such as DMD
- Cerebral palsy, a disorder that affects movement and balance
- Lumbar lordosis, an exaggerated inward curve of the lower back. This often goes away without treatment in children.
Waddling Gait in Spinal Muscular Atrophy
Spinal muscular atrophy (SMA) is a genetic disorder that involves the loss of nerve cells in the spinal cord. It affects the central nervous system, the peripheral nervous system, and voluntary muscle movements. SMA symptoms can range from mild to severe. Generally, the earlier symptoms appear, the more severe the condition is.
One type of SMA is autosomal dominant spinal muscular atrophy, lower extremity-predominant 2 (SMALED2). With this condition, symptoms appear in early childhood and mostly affect the thigh muscles. Other symptoms include:
- Delayed walking
- Difficulty walking
- Foot deformities
- Loss of some reflexes
How Is Waddling Gait Diagnosed?
Your doctor will do a physical exam and talk to you about your symptoms. They may also check:
- Muscle strength, tone, and coordination
- Your neck and spine for deformities
- To see if you're at risk for falling
- Your blood pressure when you're lying and standing
- Your vision
- For neurologic disorders such as muscular dystrophy
- For arthritis
Depending on the results, you may need further tests or imaging studies.
How Is Waddling Gait Treated?
The treatment for waddling gait will depend on the cause. Some conditions may resolve on their own. Other treatment options are:
- Canes and walkers for balance
- Physical therapy to help with strength, balance, and flexibility
- Fall prevention measures
- Leg braces or splints to help with foot alignment
- Medicine
- Surgery or prostheses