G is for Gowers sign

August 1, 2015

Gowers sign is common in conditions that involve a proximal muscles weakness such as Duchenne Muscular Dystrophy. In these conditions in order to stand the child first starts prone and then uses the hand to ‘walk’ up the legs.


Gowers’ sign is a medical sign that is commonly observed in individuals with muscle weakness, particularly in the lower extremities. It is named after Sir William Gowers, a British neurologist who first described it. Gowers’ sign is most frequently associated with certain neuromuscular conditions, such as Duchenne muscular dystrophy.

The characteristic feature of Gowers’ sign is the way a person uses their hands and arms to rise from a sitting or lying position on the floor. When individuals with significant weakness in their hip and thigh muscles attempt to stand up, they typically exhibit the following sequence of movements:

  1. Initially, they are unable to rise directly from the floor due to the weakness in their leg muscles.
  2. They often roll onto their abdomen and then onto their hands and knees, positioning themselves in a crawling-like stance.
  3. They then use their hands to “walk” up their legs, sliding them gradually toward their thighs, until they reach a standing position.

The characteristic “climbing up the legs” movement observed during Gowers’ sign is a compensatory strategy to utilize the stronger upper body muscles to overcome the weakness in the lower body. It is a result of the progressive muscle weakness and loss of functional mobility in the lower extremities.

Gowers’ sign is often indicative of significant muscle weakness, particularly in the pelvic girdle and thigh muscles, which can be seen in conditions such as Duchenne muscular dystrophy, Becker muscular dystrophy, or other forms of muscular dystrophy. However, it is important to note that Gowers’ sign is not specific to a single condition and can be seen in other neuromuscular disorders or severe muscle weakness.

If Gowers’ sign is observed, it is typically a red flag for underlying neuromuscular pathology, and further medical evaluation, including a thorough neurological examination and potentially genetic testing or other diagnostic tests, may be necessary to determine the specific cause of the muscle weakness.


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