Running Gait Analysis: What to Expect

As a runner, you’ve likely thought a lot about your “form”.  You’ve likely read in Runner’s World or Running Times about how certain adjustments to form might improve your efficiency or delay fatigue…ultimately improving your performance and/or reducing your risk of injury.

I like to think of performance and injury as one big continuum.  Improving economy and efficiency – two things that are typically spoken of only in conjunction with performance – can also reduce risk of injury.  And if you have the misfortune of being injured, well….suffice to say you are not performing well in your running!

Whether you are injured or injury-prone and wanting a ladder to climb out of that hole, or you’re looking for that last little tweak to boost performance, you MAY be interested in having your running gait analyzed.  If you’ve got the money, you can go to a local-ish run lab (such as the RUN LAB at Virginia Commonwealth University or the SPEED Clinic at University of Virgina, or the K-Lab at Duke University) and have a 3-D gait analysis done. As many of these labs are based out of teaching hospitals, you’ll likely be able to get a full physical therapy evaluation here as well if you’re injured or looking to reduce risk.

However, the research shows that simple “2-D” gait analysis – aka, the clinician using their eyes and maybe an iphone camera – is  EVERY BIT AS VALID AND RELIABLE (aka just as good!) as 3D gait analysis. It’s also a lot cheaper, and you’re much more likely to have a physical therapist who is trained to analyze running gait near you (it’s not really that hard tbh) than you are to have a fancy run lab nearby.

Adjustments to your form and your gait can, for some individuals, be hugely beneficial for:

-Reducing pain during running

-Reducing the risk of certain running injuries, most notably patellofemoral pain

-Reducing fatigue and improving economy

-Improving performance (via economy and efficiency)

However, if you’re not trained, it’s hard to know what to look for and how to actually go about correcting it, which is why I think it’s best to see a professional! And if you are in pain or looking to prevent injuries down the road, it’s best to see a physical therapist who has experience working with runners.  Here’s what to expect!

  1. Your Physical Therapist MIGHT NOT analyze your running gait at your first visit, depending on your current level of pain and running.

This is part of a PT’s clinical decision making.  If you are in so much pain that you currently cannot run, you just had a surgery or already have a diagnosis like a stress fracture that prevents you from bearing weight, or you haven’t run in a long time, it’s probably best to wait a bit before doing a gait analysis.  Before running, you will need to tolerate standing, walking (for up to an hour), and hopping without pain during, and 24 hours after.  If you are already able to do these things, and/or you are currently maintaining some running mileage, your PT should do a gait analysis on day one.  If not, your PT should wait until these criteria are met before putting you on a treadmill.

2. Your PT will most likely have you run on a treadmill…but not always

The research shows that there is no difference between gait pattern and effort levels when running on a treadmill as compared to running on the roads.  Thus, if you are comfortable on a treadmill, the PT will likely do the analysis there – to put it bluntly, it’s just plain easier for us.  Your PT should give you a few minutes (at least 3, but 5-6 is better) to warm up and get accustomed to the treadmill before analyzing.  If you’re super uncomfortable with treadmills, no worries! gait analysis can be done just as easily in the clinic parking lot.

3.  Your PT will likely take some video from two angles.

Your PT (using your phone, probably, because HIPPA) will likely film you from behind (to look at your frontal plane mechanics) and from the side (to look at your sagittal plane mechanics).  She may film from the front as well, but most experienced clinicians find that this view isn’t as useful as the back view.

The purpose of video is  ultimately to look at your mechanics in slow motion.  It also allows the PT to show you what she is seeing and explain how your mechanics could be contributing to your pain or performance deficits.

4. Your PT will give you some cues with the goal of changing ONE THING about your gait

There are likely a million things that could be found “wrong” with your gait.  This is why it’s best not to try to analyze your own gait – how would you know where to start?  And how could you possibly manage all those changes over the course of one run? Trying to think about all that will just take the fun out of running.  Your PT should pick one major thing to work on and give you no more than three cues to try to work on it.  It may take some trial and error to find a cue that works for you.  For example, if  you are trying to increase your cadence, your PT may 1) have you run to a metronome or 2) ask you to “run quietly”.   If you are trying to keep your knees from collapsing inward, your PT may ask you to “push your knees out toward the wall”, or may put a mirror in front of you.

5.  How you implement any gait changes depends on your current running status.

If you are just coming back to running after a long hiatus,  it’s best to follow a run/walk protocol (one minute of running, one of walking, etc, and gradually building up).  Here, it’s easier to implement those gait changes during every running interval so that you are building these good habits from the ground up.  HOwever, if you’re still currently putting in a decent amount of miles, your PT may have you try to think about your gait change cues for the first 15 minutes of your run, and then for the remainder you can relax and run as usual.  This helps keep the joy present in running and over time, that change will carry over!

6.  Gait changes are rarely, if ever, a magic bullet fix!

You can expect that your PT will offer some suggestions for strength exercises, warmup, cooldown, nutrition, recovery strategies, and training schedule alterations in order to help you heal an injury, avoid future injuries, and maximize performance.  All of these things are important for building the healthy, fit, speedy runner you know you can be!



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