Lower extremity movement in the developing gait pattern

Hip joint:

• internal rotation ROM changes little after birth, but the hip external rotation which is initially much greater than internal rotation (70 degrees ER vs 55 degrees IR) at one year, decreases by 2 1/2 years of age to become equal.
• hip abduction decreases from 55 degrees to 45 degrees by seven years of age, as the hip adductors and hamstring muscles shorten.
• gradual tightening of hamstrings causes SLR to decrease from a mean of 100 degrees at one year of age to 80 degrees at age five.

Ankle and foot

• Ankle DF decreases from 25 degrees to 15 degrees by age of 4, owing to decreased plantar flexor flexibility.

  Development of torsional relationships:

  • External tibial torsion, less than 5 deg at one year, increases rapidly to 6 degrees by 1 1/2 year, then more gradually to 10 deg by age 5.

  • In the frontal plane, the knees are slightly varus to neutral at one year, and develop a genu valgus up to 2 1/2 years. This valgus actually reverses, until the mature alignment of 7 degrees valgus is stable by age 7.

---

Last updated 3-19-02 ©Dave Thompson PT