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Is Arm Swing A Vital Part Of Pain-Free Gait?

When we walk or run, swinging our arms is a vital activity. We need it to free up our hips and the lower extremities. For instance, as the left arm swings forward, the right hip and leg also move forward, and vice versa. Putting it another way, the left shoulder moves in the same direction as the right hip and leg. This contralateral rhythm dissipates forces and allows for smooth gait. 

What can upset this delicate balance for smooth gait? A simple reason I see day after day is that patients do not move their arms. 

When people do not move their arms, stress builds up in the lower extremities. Their hips and knees can start to hurt.  In my clinical experience, getting patients to swing their arms when walking can help alleviate lower extremity pain. With less motion to dissipate stresses, the patient will experience shock absorption problems like metatarsal stress fractures.

Sometimes, the lack of arm motion is totally due to habitually carrying too much stuff. Backpacks may not be appealing to every generation but they free up the arms, which in turn can free up the lower extremities. A recent patient with heel pain from heel bruising exhibited no arm swing during gait observation when leaving the office. The situation greatly improved by using a backpack for carrying heavy objects and focusing on arm swing.

I perform gait evaluation on 100 percent of my patients so I commonly pick up on asymmetries in arm motion. It behooves us podiatrists to include arm and shoulder position in our biomechanical evaluations. These asymmetries may be due to pain in the upper extremity or neck pain that affects one side. Alternately, this asymmetry can also result from uneven foot or leg motion, or compensation from a limb length discrepancy.

The moral of this story is simple. If patients have lower extremity pain, assess their arm swing during gait and see if that is a contributing factor. 

Dr. Blake is in practice at the Center for Sports Medicine, which is affiliated with St. Francis Memorial Hospital in San Francisco. He is a past president of the American Academy of Podiatric Sports Medicine. Dr. Blake is the author of the recently published book, “The Inverted Orthotic Technique: A Process Of Foot Stabilization For Pronated Feet,” which is available at

Editor’s note: This blog originally appeared at It is adapted with permission from the author.

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