Which gait abnormality is typically seen with gluteus medius weakness?

• A. Antalgic gait
• B. Hemiplegic gait
• C. Trendelenburg sign (pelvis drops on the contralateral side during single-leg stance)
• D. High-stepping gait

Answer: (C)

Stability of the pelvis during single-leg stance depends on the hip abductors, especially the gluteus medius, pulling the pelvis level as the opposite leg swings forward. When gluteus medius is weak, the pelvis can’t stay level, so it drops toward the swing leg side. In gait this manifests as a Trendelenburg sign, where the pelvis drops on the contralateral side during single-leg stance, and many people compensate by leaning the torso toward the stance leg to maintain balance. This is the classic presentation of gluteus medius weakness.

Other gait patterns relate to different issues: antalgic gait is driven by pain and shortened stance time on the affected side; hemiplegic gait stems from a unilateral brain lesion with muscle weakness and spastic patterns; a high-stepping gait occurs with dorsiflexor weakness causing foot drop and exaggerated knee and hip lifting.