Running Gait analysis as part of a rehab progam
Did you know that upwards of 60% of runners experience a running-related injury every year? In fact, many runners will tell you they are rarely “pain-free”, but rather, deal regularly with nagging aches and pains, thankfully most of which go away on their own. If you have a running injury that doesn't go away? You typically find yourself seeking outside help in the form of YouTube videos, physical therapy or chiropractic care. But have you ever considered a running gait analysis as part of your injury rehab program?
Running gait analysis, or assessment of a runner’s form on a treadmill through video analysis, gives insight into how a runner’s form may be contributing to their running-related injury by identifying form breakdowns and/or form characteristics that increase risk for injury. A running gait analysis can, and should, also influence how we, as professionals, rehab that specific runner and approach their individual injury or performance goals based on their preferred running patterns. No two runners have the same running form and even amongst elite runners, there is great variation in foot strike and running technique that allows each of them to run with optimal efficiency in relation to their individual anatomy. Therefore, when it comes to consideration of current or past injuries along with the goal of optimizing running efficiency, what strategies work for one runner may or may not work well for another. It is important to identify those preferred strategies in an injured runner and consider which ones could be changed to help them better manage the repetitive high-impact loads of running and make them a more efficient runner.
As a physical therapist who specializes in the treatment of running-related injuries, I believe that the running gait analysis is a necessary piece of the rehab puzzle and should be completed at some point in the rehab plan of care. When the running gait analysis is considered along with the other findings of the examination (a musculoskeletal screen, a running-specific assessment and a runner’s history related to past injuries and current training program) THEN you have the information needed to paint the complete picture and to produce the most optimal treatment outcomes.
Let’s look at an example of a runner in the Home Team Physical Therapy rehab setting. A runner with shin splints, for example. Since most running-related injuries are multifactorial (a combination of training errors, strength deficits, running form/technique), at Home Team, we consider all of them.
Training errors— a client comes in for an appointment with Home Team Physical Therapy. She used to run frequently but life got busy and she just recently returned to running last month. Her goal is to a run a half marathon in another 6 weeks. Her training error was that she applied more load to the body than what it was prepared to handle at this point in time. In other words, too much too fast.
Strength deficits— a musculoskeletal exam and running strength screen performed at Home Team reveals that she has below average strength in the foot/ankle/leg complex compared to other females in their mid-30s.
Form/technique errors— A running gait analysis reveals an aggressive over-stride with a large heel-to-ground contact angle (red lines in Figure 1) and we hear a loud “foot slap” with every step on the treadmill. We know that both of these things, a large heel-to-ground contact angle and “foot slap” (or lack of ability to control the foot back to the ground after initial contact) can put a runner at greater risk of obtaining shin splints.
Figure 1: tibial angle (yellow line) and heel-to-ground contact angle (red lines) demonstrate a large over-stride.
When you consider all of the above findings, it is not surprising that this particular client is struggling with shin splints. And just as important as it is to consider all of the above findings in regards to WHY she has shin splints, it is just as important to address all of the above in the TREATMENT of her shin splints. Our Home Team rehab program for the client above might look something like this:
Referring the client to a trusted running coach for proper training program build-out
Discussion of nutrition, sleep and recovery
Using results from the running-specific screen to work on any deficits in strength, balance and/or tendon efficiency (the ability of the tendons to store and release energy)
Consideration of running shoes
Recommendation and implementation of changes to running form as it relates specifically to that individual runner’s pain or performance
In conclusion, the running gait analysis is a useful tool in identifying a runner’s specific form preferences as well as identifying breakdowns in form that could be contributing to injury. It should be strongly considered as part of a runner’s assessment and rehab training plan. Recommendations for changes in running form should not be uniform across all runners, but rather be specific to an individual runner’s injury and/or performance goals.
Our primary goal at Home Team Physical Therapy is to help people in pain find a way confidently back into the activities they love without limitations or restrictions. If you or someone you know would like to book an appointment with us, contact us here. You can also follow us on Facebook and Instagram @hometeamwr to stay up to date on events and happenings!