Many of us have seen older people shuffle when they walk and may have even wondered why they do this. Family caregivers may find it frustrating when their elderly loved ones shuffle their feet instead of picking them up and taking normal steps.
There are actually a few reasons why seniors shuffle when they walk.
One reason is that shuffling can help seniors stay balanced. When we walk, we transfer weight from one foot to the other.
This can be difficult for an older person who may have trouble lifting their feet or keeping their balance. Shuffling helps them keep their balance by moving both feet at the same time.
Shuffling also allows seniors to move more slowly and take short steps. This can be helpful if they are feeling dizzy or unsteady on their feet. Moving slowly can help them avoid falling.
This is especially true if they are walking on uneven surfaces or a rocky type of pavement.
Some seniors shuffle because they have arthritis or other conditions that make it painful to lift their feet. Shuffling is a way to walk without having to lift their feet very high.
Finally, some seniors simply find a shuffling walk to be more comfortable than walking with a normal gait. They may have had hip or knee surgery, or they may be carrying extra weight, which makes it difficult to walk normally.
Shuffling allows them to move without pain or discomfort.
But, the biggest risk factor with any type of altered gait, including shuffling is that it can contribute to more frequent falls. Which of course decreases their quality of life.
Shuffling is a common cause of falls in affected people because sliding feet can more easily trip on rugs, door thresholds or even slightly uneven surfaces.
theadvocate.com
If you are a family member who is concerned about your elderly loved one’s shuffling gait or walking pattern, talk to their doctor. There may be underlying medical conditions that need to be treated.
In some cases, physical therapy can help seniors with an unsteady gait to improve their balance and reduce their risk of falls.
What Is A Shuffling Gait A Symptom Of?
So what is feet shuffling a symptom of?
The most common cause is Parkinson’s disease which is a progressive, neurological condition. But there are other causes as well as I’ll discuss later on.
You may think that a shuffling gait is just a natural part of old age, but that isn’t necessarily true. In fact, a shuffling gait can be a symptom of several different health conditions, some of which are more serious than others.
There are many possible causes of a shuffling gait (and other gait problems), but one of the most common are problems with motor control. The cause of motor control problems can be any of the following:
Foot Problems: Seniors may shuffle when they walk due to bunions, hammertoes, neuropathy, or other foot problems. These issues can make it difficult to walk normally
Arthritis: Arthritis is a very common condition that affects many elderly people. It causes pain and inflammation in the joints, which can make it difficult to walk. Oftentimes, seniors with arthritis will shuffle their feet in order to avoid putting too much pressure on their joints.
Parkinson’s Disease: Parkinson’s disease is a neurological disorder that can cause tremors and muscle rigidity (An impaired basal ganglia in the brain). This can make it difficult for seniors to walk normally, and many will develop a shuffling gait as a result.
Read our tips on caring for a spouse with Parkinson’s.
Neurological Disorders: Besides Parkinson’s other neurological disorders such as bradykinesia, dementia, Alzheimer’s disease and more can cause a shuffling gait.
Peripheral Neuropathy: This is a condition that affects the nerves. It can cause numbness, tingling, and pain in the extremities. This can make it difficult for seniors to walk properly, and many will shuffle their feet as a result.
Poor Balance: As we age, our balance can start to decline. This can make it difficult to walk without shuffling your feet. Often times, seniors will shuffle their feet in order to avoid falling.
Poor Vision: Having problems seeing and/or poor depth perception can also lead to a shuffling gait. When seniors can’t see where they’re going, they often shuffle their feet in order to prevent tripping or falling.
It could also be a residual symptom of a stroke. If someone has had a stroke, it is not uncommon for them to shuffle their feet when they walk. This is often due to weakness or paralysis on one side of the body.
If you notice that you or someone you know has started to shuffle when they walk, the first step is to see a doctor to rule out any underlying medical conditions. Treatment will vary depending on the cause of the shuffling gait, but may include physical therapy, medications, or surgery.
What Part Of The Brain Controls Gait Stability?
The part of the brain that is “in charge” of balance is called the cerebellum.
And while your balance system engages several parts of your brain, the main part of the brain that controls balance is the cerebellum. Science American explains that the cerebellum – sometimes quaintly known as the “little brain“ – is located at the very back of your skull. The cerebellum controls a number of functions including movement, speech, balance, and posture. But the cerebellum doesn’t work alone. There are several other parts of the brain that also contribute to balance functions, including something known as the vestibular system.
nationaldizzyandbalancecenter.com
Basically speaking, the cerebellum is the command center and it gets it’s “orders” from the vestibular system, which is located in your inner ear. If one of these is impaired, your balance and postural alignment can be affected.
So, what can cause damage to the vestibular system?
- inner ear infections or problems
- calcium debris in inner ear
- certain medications
- stroke
- traumatic brain injury
There are also some new studies showing that there may be a connection with dementia and vestibular damage as well. But more studies are needed.
These findings confirm and extend emerging evidence of an association between vestibular dysfunction and cognitive impairment. Further investigation is needed to determine the causal direction for the link between peripheral vestibular loss and cognitive impairment.
National Library of Medicine
What Is The Most Common Cause Of Gait Disorders?
I am honestly not sure if there is a “common cause” of gait disorders. As an Occupational Therapist I saw many patients with a large variety of neurological and/or physical issues that contributed to an altered gait.
Some of the issues that I helped to treat included:
- arthritis
- heart conditions
- head injury
- stroke
- multiple sclerosis
- obesity
- orthopedic issues
- visual problems
- partial paralysis due to Guillain-Barré syndrome
- general muscle weakness due to inactivity
Gait disorders can be frustrating and difficult to deal with, but there are treatments available that can help improve your symptoms. With the right treatment, you can continue to live an active and fulfilling life.
Now, I have also seen older adults shuffle because the floor they are walking on is very slippery, or they have previously fallen and are now fearful of another fall.
I have also seen seniors shuffling because the shoes they are wearing are the wrong size, or they are worn out or they have no back so no support.
These are issues that can be fixed by adding treads or non-slip paint to a floor. And of course, getting the proper shoewear!
Is Shuffling Part Of Dementia?
One of the early signs of dementia is changes in mobility. This can manifest itself in a number of ways, including shuffling when walking.
Dementia-related gait changes (DRGC) will manifest differently in each person depending on the type of dementia they have and other co-morbid health issues.
This means that someone with dementia could shuffle their feet when walking, but it could also mean that you will see a very slow walk, or a very quick paced walk (aka Festinating gait), usually while they are leaning forward.
You may even see a combination of all three. I remember many patients with dementia who demonstrated all of these types of walking.
Needless to say, all of them could easily contribute to falling.
If your loved one is diagnosed with dementia, there are treatments that can help to improve their symptoms. These treatments can include medication, therapy, and lifestyle changes.
With the right treatment plan, many people with dementia are able to live fulfilling lives while they are in the first stages of this illness.
How Does Dementia Affect Your Balance?
Dementia is a broad term used to describe a decline in cognitive function. This can include memory loss, difficulties with problem solving and decision making, and changes in mood or behavior.
For many people, these changes are subtle at first and may only be noticeable to close family and friends. However, as the condition progresses, they can have a significant impact on a person’s ability to live independently.
One of the most common symptoms of dementia is difficulty with balance and coordination. This can make everyday activities such as walking or getting out of a chair more difficult.
Essentially, dementia is being cause by brain cells dying. This of course begins to affect everything in the person from psychological issues to physical issues.
Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and feelings can be affected.
Alzheimer’s Association
There are several factors that can contribute to balance problems in people with dementia. These include:
Muscle weakness: This can make it difficult to maintain your balance, especially when you get up from a chair or move around.
This can make it difficult to maintain your balance, especially when you get up from a chair or move around.
Poor vision: Dementia can cause changes in your vision, which can make it more difficult to judge distances and avoid obstacles.
Medications: Some medications used to treat dementia can cause side effects that affect balance, such as dizziness or drowsiness.
Inner ear problems: Dementia can cause problems with your inner ear, which can lead to vertigo and balance problems.
Nerve damage: Dementia can damage the nerves that help you maintain your balance, leading to imbalance and unsteadiness.
Fear and anxiety: People with dementia may become anxious or scared in new or unfamiliar surroundings. This can lead to them feeling unsteady on their feet and cause falls.
Tips On What You Can Do If Caring For Someone With Dementia
If you are caring for someone with dementia, there are a few things you can do to help them maintain their balance and prevent falls:
Make sure their home is safe: Remove any trip hazards such as rugs or cords. Add grab bars in the bathroom and make sure there is good lighting throughout the house.
Encourage exercise: Exercise can help improve muscle strength and balance. Go for a walk with your loved one, do some gentle stretching exercises together or join a local senior’s exercise class.
Monitor medications: Some medications can cause dizziness or drowsiness, which can lead to falls. Be sure to talk to your loved one’s doctor about any medications they are taking and if there are any potential side effects that could affect balance.
If you are concerned about your loved one’s balance or ability to walk, talk to their doctor. There are many different causes of balance problems and some can be treated.
What Other Neurological Conditions Affect Gait?
There are many other neurological conditions that can affect a person’s ability to walk. Some of these include:
- Parkinson’s disease: This condition affects the nerve cells in the brain that control muscle movement. Symptoms can include tremors, stiffness, and slow movement.
- Multiple sclerosis: This condition attacks the nervous system, causing problems with muscle control, balance, and coordination.
- Cerebral palsy: This is a condition that is caused by damage to the brain during development. It can lead to muscle weakness and problems with movement and coordination.
- Muscular dystrophy: This is a group of conditions that cause progressive muscle weakness and loss of function.
- Traumatic Brain Injury: A traumatic brain injury can cause damage to the brain that leads to problems with movement and coordination.
- Hydrocephalus: This condition occurs when there is too much fluid in the brain. It can cause problems with balance and coordination.
- Brain Tumor: A brain tumor can cause problems with movement, balance, and coordination.
- Stroke: A stroke is basically a heart attack in the brain and with most any condition that affects the brain, gait can be altered (including shuffling).
There are many different types of gait impairments that can occur as a result of a neurological condition or injury.
Some common types of gait impairments include:
1. Spasticity – this is when your muscles are very tight and stiff, making it difficult to move them. This can happen as a result of damage to the spinal cord or brain.
2. Ataxia – this is when you have trouble coordinating your movements. This can be caused by damage to the cerebellum, which is the part of the brain that controls movement.
3. Weakness – this can make it difficult to walk because your muscles are not able to generate enough force. This can be caused by damage to the motor cortex, which is the part of the brain that controls muscle movement.
4. Balance problems – this can make it difficult to walk because you have trouble keeping your balance. This can be caused by damage to the vestibular system, which is responsible for maintaining balance.
5. Sensory problems – this can make it difficult to walk because you have trouble processing information from your senses. This can be caused by damage to the somatosensory system, which is responsible for processing information from the body’s sense organs.
If you experience any of these problems, it is important to see a doctor so that they can determine the cause and recommend treatment.
Treatment options will vary depending on the underlying cause but may include physical therapy, medications, or surgery.
Why Do Older Adults Have Poor Balance?
There are a number of reasons why older adults may have poor balance. One reason is that the muscles and joints tend to become less flexible as we age. This can make it more difficult to keep our balance and make sudden movements.
Another reason why older adults may have poor balance is that the nerves and brain function decline with age. This can make it more difficult for the brain to process information about where the body is in space, which can lead to balance problems.
There are also many medical conditions that can cause balance problems in older adults, such as the ones we mentioned above. Stroke, Parkinson’s disease, inner ear conditions, certain medicines, etc.
I suffer from low blood pressure (orthostatic hypotension). What that means for me is that I get dizzy for about a minute or so when I stand up from either bending down or squatting down.
Of course, high blood pressure can cause this sensation as well!
This just means that I have to make sure that there is something that I can hold onto when I stand up. Safety first!
Other issues that could affect poor balance are low iron, low blood sugar, vertigo and poor circulation.
If you have any of these conditions just be extra cautious. Make sure to always be near something that you can grab on to in case you feel like you are losing your balance.
How Do You Stop Shuffling When Walking?
It takes a conscious effort to stop shuffling. The first thing you need to do is notice that you are doing it.
Once you are aware of the problem, correct your posture and try to keep your shoulders back and your chin up. I list some exercises below that may be helpful.
But before you begin any exercise, please consult with your doctor and perform the exercises with a physical therapist, initially. This way you can make sure that you are doing them correctly.
If you have chronic pain or another condition that makes shuffling difficult to stop, talk to your doctor about ways to treat the underlying condition.
Exercises To Help Prevent Shuffling
If you are someone who tends to shuffle your feet when you walk, it’s a good idea to do some specific exercises that can help retrain your muscles and prevent the shuffling.
Again: before you begin any of these exercises I caution you to speak to your doctor first and perform these with a Physical Therapist.
Another recommendation I can make is that if you or a senior loved one has balance problems and they are starting to exercise, be there with them and use a gait belt similar to this one to help them in case they lose their balance.
Heel Walks
Walking on your heels forces you to use the muscles in your calves and back of your legs, which helps to stabilize your body and prevents shuffling.
Start by walking 20 steps on your heels, then rest for 30 seconds. Repeat 3-5 times.
Toe Walks
This exercise is the opposite of heel walks, and works the muscles in the front of your legs. Start by walking 20 steps on your toes, then rest for 30 seconds. Repeat 3-5 times.
Walk In Place
While holding on to a sturdy object (like a chair or grab bar) walk in place in an exaggerated motion without lifting your feet off the floor.
Raise heel of one foot while raising the toes of the other foot. Then alternate.
Side Leg Raises
This exercise helps to strengthen the muscles in your hips and thighs, which can help prevent shuffling. Start by standing with your feet hip-width apart.
Raise your leg out to the side, keeping your thigh parallel to the ground. Hold for 2 seconds, then lower back down. Repeat 10 times on each side.
Hamstring Curls
Strong hamstrings are important for stabilizing the knee joint, which can help prevent shuffling. Start by lying on your back with your legs straight.
Place a small towel under your right foot. Using your hamstring, curl your leg up towards your butt, then slowly lower it back down. Repeat 10 times on each side.
Calf Raises
Strong calves can help improve your balance, which can in turn help prevent shuffling. Start by standing with your feet hip-width apart.
Raise up onto your toes, then slowly lower back down. Repeat 10 times.
Ankle Circles
This exercise helps to improve the range of motion in your ankles, which can help prevent shuffling.
Start by sitting on the ground with your legs straight out in front of you. Place a small towel under your right foot.
Using your ankle, make small circles in both directions for 30 seconds. Repeat with your left foot. This will also help to increase your step length.
Leg Lifts
This exercise helps to stretch and strengthen the hamstring muscles, which can help prevent shuffling. Start by lying on your back on the ground with your legs straight out in front of you.
Slowly lift your right leg up into the air, keeping it straight, and hold for a few seconds. Lower your leg back down to the ground and repeat with your left leg.
Walking speed
This is an important factor in preventing shuffling gait in seniors. By increasing your walking speed, you can help to increase your step length and prevent your feet from dragging.
To increase your walking speed, start by practicing walking heel-to-toe. Place your heel directly in front of your toe, and then roll through your foot to push off with your toes.
You can also try using a metronome to keep a consistent pace while you walk.
Arm swing
It may take a little work, and conscious effort but it’s important to incorporate naturally swinging your arms while walking. This is especially true for seniors who are affected by Parkinson’s disease.
Some of these can be simple exercises for you, and some can be difficult.
Either way, do them initially with some supervision to not only ensure that you are doing them correctly, but that you are capable of doing them without injuring yourself.
Final Thoughts
If you or a senior loved one is shuffling when they walk and have been for some time, there may not be anything that you can do to correct it.
If this is the case, I recommend that you encourage them to use a walking aid (if they are able to), to seek therapy from a physical therapist and to make modifications in the home to reduce the risk of falling.
