thank you for reacting to my post Clarett!

what's the tension like in hamstrings?:
There is a lot of tension in the hamstring as well as in the quadriceps during the swingphase, the quadriceps is so tight it seems to prevent the knee flexion. He therefore has a light circumduction

and why is there no push off? Is it due to lack of gastroc activity?:
There is a little more push off when is steps are bigger (I tried that now). In standing he has enough gastroc activity to lift his heels from the floor, but still not enough selectivity to actively create the push off during walking.

I'm assuming that he is hip hitching to achieve swing through...correct me if I'm wrong:
Only a little bit

Does he achieve heel strike?:
no he does not achieve heel strike because of lack of sufficient active knee extension.

It would be helpful to know what's happening at the hip & pelvis too. Especially active hip flexion in standing. He has a good active hip flexion while standing and while walking

It's difficult to know what might help/be causing it without more information....

What is he like kicking a ball - does he fully extend the knee doing this or does he hold it in the same position?:
I tried this and he keeps the knee in the same position only moving from the hip (and partly the torso)

Sorry - more questions that answers at this stage!


I gave him an AFO to correct the mild spasticity in the gastroc and the varus in the ankle.
I practice selectivity of his leg lying down and standing but his gait pattern is only improving a little bit (a little more knee flexion). When he walks with bigger steps and a little bit of speed it looks a little better as well.

Overall he’s doing a good job in rehab and his stability during walking has improved tremendously (no aid and safe) but this is an obstacle to try to overcome, a challenge, but a hard one.