During gait evaluation, a patient demonstrates a shorter left step length and excessive left knee flexion during left midstance. Which problem is the most likely cause?

During gait evaluation, a patient demonstrates a shorter left step length and excessive left knee flexion during left midstance. Which problem is the most likely cause?

• A. Left hamstrings contracture
• B. Right iliopsoas weakness
• C. Left hip flexion contracture
• D. Right quadriceps weakness

Answer: (A)

Tightness in the knee flexors, such as a left hamstrings contracture, limits how far the knee can straighten during weight-bearing. In left midstance, the knee staying more flexed than normal because the hamstrings resist extension leads to an excessive knee flexion posture. That limited extension also reduces forward progression of the left leg, producing a shorter left step length. The other options don’t align as directly with a knee flexion issue during left stance: weakness of the right iliopsoas or right quadriceps would affect the opposite leg or knee control on the right, and a left hip flexion contracture would more likely present with a different pattern than isolated excessive knee flexion during left midstance.

Tightness in the knee flexors, such as a left hamstrings contracture, limits how far the knee can straighten during weight-bearing. In left midstance, the knee staying more flexed than normal because the hamstrings resist extension leads to an excessive knee flexion posture. That limited extension also reduces forward progression of the left leg, producing a shorter left step length. The other options don’t align as directly with a knee flexion issue during left stance: weakness of the right iliopsoas or right quadriceps would affect the opposite leg or knee control on the right, and a left hip flexion contracture would more likely present with a different pattern than isolated excessive knee flexion during left midstance.