While most people know about the cognitive impairments and hyperactivity that come with ADHD, not everyone is aware of the balance and coordination challenges that the disorder can cause. This includes the ADHD walk - an unusual stride or walking style that appears inconsistent, clumsy, and imbalanced which may make everyday tasks more difficult to accomplish alongside other coordination issues.
All About the ADHD Walk
The term “ADHD walk” refers to an abnormal gait or increased postural sway when walking that is indicative of issues with coordination or balance - two things that are more common in those with ADHD. ADHD walking affects both children and adults, but may be more noticeable in children because adults that struggle with coordination may mask their symptoms to avoid standing out.
The ADHD walk can look like strides that are too long when walking or running because of poor spatial awareness or struggling to move in a straight line because of imbalance, and is caused by problems with sensory inputs and brain-muscle coordination that stem from the somatosensory systems.
Why Does ADHD Cause Gait and Postural Sway Issues?
Exaggerated postural sway and longer gaits associated with the ADHD walk are believed to be a result of issues with cerebellar development - the part of your brain most involved in the coordination of muscles due to its connection to the somatosensory systems. These systems include spatial awareness, coordination, and balance regulation that contribute to the amount of postural sway in standing or walking and impact how easy it is for you to maintain your balance automatically.
While everyone has some level of postural sway, the horizontal movement that is used to find your center of gravity and maintain balance, the deficiencies in motor control and balance experienced by those with ADHD can lead to exaggerated movements when standing and uneven strides when walking. This is because standing and walking require massive muscular involvement and precise coordination between your brain and body, such as engaging the core, chest, and leg muscles to stay upright, which may not be possible for some people to do efficiently.
Fortunately, your body autonomously adjusts to changes in the environment that affect balance through the somatosensory systems. But if you suffer from ADHD, your brain is not as good at making these subconscious micro-adjustments. The corrective signals sent out to your muscles may be slower than required due to cognitive impairments and inefficient communication between systems that are associated with ADHD. Or, your brain may overreact to perceived changes because of increased impulsivity and hyperactivity that it can’t compensate for effectively, resulting in abnormal movements like variable stride length or the inability to balance on one foot.
The Role of Proprioception
Proprioception is your brain’s sense of body movement and positioning that allows you to operate your nervous system and muscles automatically based on feedback from the somatosensory systems and other senses. It happens automatically so that you can move without thinking about the action and even in the absence of certain senses, such as balancing on a rocking boat or typing without looking at your keyboard. Without it, most movement would need to be done as a conscious effort and would be entirely dependent on senses like touch and sight for accurate movements and feedback.
Proprioception disorders can cause issues with balancing on a thin object like a roadside curb, poor hand-eye coordination, falling over quickly when trying to stand on one foot, running into walls or objects because you lose track of your body’s positioning, and struggling with tasks like clapping or tying your shoes without looking. When there are issues with proprioception, the other senses are relied on more heavily to provide guidance for movements, leading to delayed responses as feedback is processed and noticeable physical signs of a lack of coordination.
In the case of maintaining balance while walking, normal proprioception means sensing the correct elevation to raise your foot to so that you can climb stairs, leaning slightly to account for inclines or declines, and adjusting the length of your strides when walking or running. You’ll also be able to walk in a straight line due to decreased postural sway. If your proprioception is abnormal, you may stumble or misjudge the height of stairs and the distance from your foot to the ground without looking down, putting you at greater risk of injury.
Anxiety’s Effect on Proprioception and ADHD Walking
Whether you’ve been diagnosed with ADHD or not, you may still exhibit signs of the ADHD walk for other reasons.
Anxiety is one of the most common comorbid conditions that affect those with ADHD. Balance issues caused by ADHD can be made worse by the presence of anxiety while anxiety without ADHD can also cause issues with balance and coordination by impacting the vestibular system and proprioception in addition to affecting visual processing ability. As a result, you take in less visual feedback for your somatosensory systems to use to create a sense of self-positioning and your brain can’t fill in the gaps effectively. Your brain’s ability to process the feedback it receives is also slowed because of a release of cortisol and the flooding of neurotransmitters in response to the anxiety, interfering with effective cognitive processing that is required for these fast-twitch adjustments that proprioception is responsible for.
How to Improve ADHD Walking
If your balance, coordination, gait, and postural sway are affecting your ability to stay upright or affecting your ability to accomplish everyday tasks, it’s important to address these issues to help prevent injuries and improve your quality of life. The ADHD walk may not be harmful, but it’s possible that you can greatly diminish or even get rid of your symptoms altogether with the right treatment plan.
Physical Therapy for ADHD Walk Symptoms
According to a 2021 study, physical therapy - specifically balance training - can help to improve both cognitive functioning and ADHD-related balance issues. During this study, both groups of children were given methylphenidate (MPH), with the experimental group also receiving balance training. The results showed that those who received balance training had improved balance and reduced postural sway when relying solely on their somatosensory systems with their eyes closed, proving that practice may help address coordination and balance issues.
Tasks like standing on one leg, balancing on a balance board, or walking on a thin surface both with eyes open and eyes closed can help to train your proprioception by activating the cerebellum and improving coordination between your brain, body, and somatosensory systems.
Medication Treatment for ADHD Walking
In addition to helping with focus issues and brain fog, both stimulant and non-stimulant ADHD medications can help with balance issues stemming from the disorder. This may be due to improved cognitive performance and attention that results in more efficient feedback processing for the somatosensory systems to use to maintain homeostasis and balance. Alternatively, it could be the effect that medication treatment has on the cerebellum, vestibular system, or proprioception directly in a way that we don’t exactly know yet.
Get Treatment for Your ADHD Walk Today
Whether you’ve noticed yourself or someone you love exhibiting signs of the ADHD walk and other cognitive issues, it’s important to seek out individualized care that addresses your concerns and helps you to live the highest quality life possible.
At Done, we can help you get on the right path to managing your symptoms and achieving the relief that you want. With an easy one-minute assessment, you’ll be able to schedule an appointment with a licensed ADHD clinician and get more information about diagnosing, treatment options, and medication management that can help you become the best you that you can possibly be.
Postural Sway Definition, Alleydog.com
Fine Motor Deficits and Attention Deficit Hyperactivity Disorder
Somatosensory Systems (Section 2, Chapter 2)
Postural Sway and the ADHD Walk, by Jillian Enright, Invisible Illness, Medium.com
Postural Instability in adult ADHD - a pilot study, ScienceDirect.com
Proprioception: What It Is, Disorders, Symptoms and More, WebMD.com