GALS examination GALS: gait, arm, legs, and spine. GSAL may be a more logical order. Screening questions Any pain, swelling, or stiffness in joints/muscles? Any difficulty getting dressed? Any difficulty getting up stairs? Gait Ask them to walk, noting smoothness, heel strike, toe off, arm swing, turn speed (ask them to turn quickly). Normal summary: "Gait was smooth, symmetrical, with a quick turn and good arm swing." Spine With them standing with hands by side, first note if elbows and knees are fully extended. Observe from behind, from back of head down to back of feet, noting any scoliosis, whether iliac crests are equal, muscle wasting including gluteals and calves, Baker's cysts (RA), and feet abnormalities. Gluteal wasting might mean chronic knee problems, and calf wasting might mean chronic ankle problems. Observe from side: any excess kyphosis or lordosis? Check lumbar function: have them touch toes while you have two fingers on lumbar spine; the normal finger sp...