Maintaining balance while walking may seem automatic, but it is one of the most complex things the body does. For people living with Charcot-Marie-Tooth disease (CMT), changes in muscle strength, joint motion, and sensory feedback can make walking feel less stable over time.
Understanding why balance becomes challenging can help people with CMT take practical steps to walk more safely and confidently.
This article explains the three key systems involved in walking stability and offers simple, adaptable strategies that may help support safer gait.
The three systems that keep you stable while walking
Walking stability depends on the coordinated function of three major systems:
- Range of motion
- Muscle strength
- Proprioception (your body’s sense of position and movement)
CMT can affect all three, but each can often be supported in different ways.
Range of motion: why joint flexibility is important
Range of motion refers to how freely a joint can move. During walking, the foot and ankle play an important role. When your foot first contacts the ground, it needs to be flexible enough to absorb shock and adapt to uneven surfaces.
In CMT, muscles that control the foot and ankle may weaken or tighten, leading to:
- Reduced flexibility
- Excessive motion in some joints
- Increased instability during walking
What may help
Some people benefit from custom foot orthotics designed to support proper foot alignment while still allowing natural movement. When ankle-foot orthoses (AFOs) are needed, designs that allow more natural foot motion, such as lightweight carbon composite braces with an open heel, may help preserve function during walking.
Orthotic needs vary widely in CMT, so working with an experienced orthotist or physical therapist is important.
Strength: controlling movement and propulsion
Muscle strength is essential for both stability and forward movement. Muscles don’t just move joints; they also control motion and prevent joints from moving too far or too fast.
In CMT, strength can be affected by:
- Direct nerve-related muscle weakness
- Disuse atrophy when muscles are not used regularly
Tight muscles can also develop, especially when muscle imbalances are present.
What may help
- Gentle, consistent stretching of tight muscles
- Using appropriate orthotics or braces to allow safer, more efficient walking
- Staying as active as possible within individual limits
Even supported walking with mobility aids can help maintain muscle engagement and prevent further weakness.
Proprioception: your internal balance system
Proprioception is the body’s ability to sense where it is in space without looking. This system relies on sensory feedback from muscles, joints, and tendons to automatically activate muscles when needed.
In CMT, sensory loss can reduce proprioceptive input, making balance reactions slower or less reliable. When muscles aren’t properly activated, they may weaken further over time. Challenging the proprioceptive system in safe ways may help keep it more responsive, read on to find out how.
Walking strategies that support stability
Walking is highly habitual. Most of us walk the same way every day without thinking about it. Carefully introducing variation, in a safe environment, can help engage balance systems more fully.
Important: Always prioritize safety. Try new walking strategies with support nearby and consult a physical therapist if you are unsure what is appropriate for you.
Gentle gait variations to try with support
The techniques below are meant to be practiced with support from a trusted partner. Always consult with your health care team before making major changes.
Hip movement awareness
Standing with feet shoulder-width apart, gently shift your hips side to side, left to right. Limited movement may indicate weakness in the pelvic muscles that help stabilize walking.
Head position changes
While walking safely, try slowly moving your head up, down, and side to side. This challenges balance systems and may enhance proprioceptive input.
Visual input changes
In a controlled environment, practice walking while either looking up, down, or sideways rather than directly ahead as you would normally. This encourages the body to rely less on vision and more on internal balance cues.
Speed variation
Walking very slowly can sometimes feel harder than walking at a moderate pace. Within safe limits, experimenting with slightly faster walking may feel more stable for some people.
Step length changes
Practice alternating between shorter and longer steps. This can help the body adapt more quickly to unexpected changes in terrain.
Base of support awareness
A wider stance may feel safer, but it can increase energy use and trunk movement. Practicing different step widths can help improve adaptability.
Posture adjustments
Try walking with a more upright posture versus a slightly forward posture and notice which feels more stable.
Rhythm and music
Walking to a steady beat or music can promote a more symmetrical, consistent gait, which may reduce fall risk.
Making walking work for you
There is no single “right” way to walk with CMT. Stability is influenced by disease type, severity, sensory involvement, strength, fatigue, and orthotic needs. What feels stable for one person may not work for another.
Experimenting with walking strategies, using appropriate supports, and working with knowledgeable clinicians can help:
- Maintain mobility longer
- Reduce fall risk
- Improve confidence during daily activities
Walking may be habitual, but it doesn’t have to be static. With thoughtful adjustments and support, many people with CMT can continue walking more safely and comfortably.
This article is for educational purposes only and is not a substitute for medical or physical therapy advice. Always consult your healthcare provider before starting new exercises or making changes to your mobility supports.
