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Wheeless' Textbook of Orthopaedics
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Stance Phase of Gait



- See:
    - Gait Menu:
    - Orthotics for the Foot

- Discussion:
    - stance phase represents about 60% of the gait cycle, swing 40%;
            - normal gait is symmetric & thus, relationship between swing and stance phases of each leg are consistent;
    - normal gait requires stability in stance phase, a means of progression, and energy conservation;
    - stability requires constant balancing of trunk over base of support;
    - during progression, potential energy is converted into kinetic energy;
    - much of kinetic energy for swinging limb is provided by inertia, which is augmented by the
            plantarflexors (85%) and hip flexors (15%);
    - energy is conserved by minimizing movements of center of gravity of body, by controlling momentum,
            and by transfer of energy between body segments;

- Five Parts of Stance Phase:
    - stance phase has five parts: contact, loading, midstance, terminal stance, and preswing;
    - throughout stance pelvis gradually rotates backward & hip extends (this resists the tendency for the hip to
            flex during early stance phase due to body wt and body inertia);
    - heel strike
            - at initial contact, the knee is extended and the ankle is neutral (or slightly plantarflexed);
            - during loading, knee flexes 15 deg while ankle plantarflexes 15 degrees, which is an energy-conserving mechanism;
            - throughout first phase of stance, hamstrings and ankle dorsiflexors remain active;
            - quadriceps and gluteal muscles act during loading and throughout early midstance to maintain hip and knee stability;
    - midstance:
            - by midstance the knee is extended & ankle is neutral again;
            - in midstance, the triceps surae acts to control tibial advancement (preventing the tendency for the
                  tendency for the ankle to dorsiflex due to body wt and inertia);
            - double support, when both feet are in contact with the ground, lasts about 10% of the whole gait cycle;
    - terminal stance
            - at preswing, knee flexes 35 degrees &ankle plantarflexes 20 degrees;
            - in these last phases of stance, the toes, which have been neutral, dorsiflex at the metatarsophalangeal joints;







Dynamic Loading of the Plantar Aponeurosis in Walking.























Original Text by Clifford R. Wheeless, III, MD.