A Physiotherapist’s Full Framework to Rebuild Your Walking After Stroke
Hey Fam!
Below is the expanded, clinical-level breakdown of walking rehabilitation — but written in a way you can directly apply at home.
This edition covers:
The deeper biomechanics behind what limits your walking
What exercises to prioritise based on your current ability
The safest structure for a home program
Evidence-informed progress cues
A simple weekly roadmap to follow
🔍 1. The Real Reason Walking Feels Difficult After a Stroke
Walking is not one movement; it’s a repeating cycle of two main phases:
Stance Phase — your leg accepts your weight & holds you upright
Weakness here leads to:
Leaning to one side
Knee buckling
Feeling unstable when taking a step
Being unable to shift weight properly
Clinically, most stroke survivors have reduced control in the hip abductors, glutes, and trunk stabilisers. This is why I prioritise stance training in the early stages.
Swing Phase — lifting your leg and bringing it forward
Weakness here leads to:
Dragging the foot
Overusing trunk momentum
Short steps
Lifting the hip (hip hike) to compensate
Swing control depends heavily on hip flexors, lower abdominals, and foot-lifting muscles.
You need both phases.
But stance comes first because you cannot take a good step if you cannot stand confidently.
🧠 2. Determine Which Group You Belong To (Essential for Choosing Exercises)
Group A: Bed-Bound or Unable to Sit Independently
The goal: build the early strength foundation your body needs before sitting or standing becomes safe.
Your focus:
Double Leg Glute Bridge
Strengthens glutes and trunk
Supine Hip Abduction (using a towel or sliding motion)
Builds early hip stability
Inner-Range Quadriceps Activation
Supports future standing and knee control
These movements replicate the essential muscles needed for early stance stability — but done safely in bed.
