What Causes a Waddling Gait?

Waddling gaits are commonly seen in pregnant women, especially during the third trimester. Several things can cause this.

During your second trimester, your body starts producing relaxin, a hormone that relaxes the joints and ligaments in your pelvis, allowing it to widen. A wider pelvis makes labor and delivery both easier and safer, but it can also affect the way you walk. In addition to relaxin, downward pressure from the growing fetus can also widen your pelvis.

In the later stages of pregnancy, your stomach starts to jut out significantly, which can throw off your center of gravity and make it harder to balance, especially while walking. Your spine and pelvis may also start to curve in to support your growing stomach, causing you to lean back slightly while standing or walking. Both of these factors can also cause a waddling gait.

Having a waddling gait while pregnant is normal and nothing to be concerned about. In fact, it can even reduce your risk of falling. Waddling gaits tend to go away after you give birth, but you may continue to have one for several months.

Age

Most young children, especially toddlers, don’t walk the way adults do. It takes time to perfect the mechanics of walking and balance. In children aged 2 and under, short steps and waddling gait are normal. However, a waddling gait that doesn’t go away by age 3 may be a sign of an underlying issue, especially if it’s accompanied by:

• tiptoe walking, or walking on the balls of the feet
• a protruding stomach
• falling, or stumbling
• low endurance

A waddling gait in a child over the age of 3 may be a symptom of:

• muscular dystrophy
• cerebral palsy
• congenital hip dysplasia
• lumbar lordosis

Some of these conditions, such as lumbar lordosis, often go away on their own. However, others require treatment, so it’s best to work with your child’s pediatrician to figure out the underyling cause. In some cases, your child may just need to work with a physical therapist.

Muscular dystrophy

Muscular dystrophy (MD) refers to a group of rare diseases that weaken muscles, causing them to break down over time. A waddling gait is a symptom of several types of MD, including:

• Duchenne MD. This disorder occurs almost exclusively in boys and affects the arms, legs, and pelvis. One of the first signs is having difficulty crawling or getting up from the floor. Duchenne MD is diagnosed in early childhood.
• Becker MD. This condition is also most common in boys and is a milder form of Duchenne MD. It affects the muscles of the shoulders, pelvis, hips, and thighs. Becker MD is often diagnosed in late childhood or early adolescence.

While there’s no cure for MD, there are several options for slowing its progression and improving mobility. These include:

• assistive devices
• gait training, a type of physical therapy
• medication
• surgery

Infant hip dysplasia

Some babies’ hip joints don’t develop the way they should. This results in shallow hip sockets that make hip dislocation much more likely. In some cases, the ligaments that hold the hip joint in place may also be loose, leading to instability. Infant hip dysplasia may be present at birth or develop during the first year. In some instances, too-tight swaddling can also cause infant hip dysplasia.

Additional symptoms of infant hip dysplasia include:

• legs of different lengths
• limping or tiptoe walking
• reduced mobility or flexibility in one leg or on one side of the body
• uneven skin folds on the thighs

Pediatricians usually screen for infant hip dysplasia at birth and during regular checkups for the first year. If caught early, it can usually be treated with assistive devices, such as a harness or brace. Older infants may need a body cast or surgery for proper treatment.

Spinal muscular atrophy

Spinal muscular atrophy (SMA) is a hereditary neurological disorder. It causes deterioration of your spinal cord’s motor neurons, resulting in muscle weakness and other symptoms. One form of SMA, called autosomal dominant spinal muscular atrophy with lower extremity predominance, causes muscle weakness and loss of muscle tissue in your thighs. This form of SMA is rare and typically begins in early childhood.

In addition to a waddling gait, autosomal dominant spinal muscular atrophy with lower extremity predominance may also cause:

• foot deformities
• high or low muscle tone
• exaggerated curve in the lower back
• breathing problems
• small head size

There’s no cure for SMA, but medication, physical therapy, and surgery can all help to manage symptoms.

There are several methods for figuring out what’s causing a waddling gait. After checking for any additional symptoms through a physical exam, your doctor might use any of the following:

• genetic testing to look for specific disease markers
• muscle biopsy to check for muscle disorders
• enzyme blood test to check for elevated levels of creatine kinase, a sign of MD
• ultrasound to look for check for hip dysplasia

Waddling gait during pregnancy is a common occurrence, which typically dissipates shortly after the birth of the baby or during the next several months. It’s also common in children under 2 and often goes away on its own. If it doesn’t, it may be a symptom of an underlying condition, such as MD or infant hip dysplasia.