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At the end of the day, gait analysis is not about chasing a perfect running style. It’s about understanding how you move, how you load different tissues, and whether those patterns match what your body can currently tolerate.
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Gait analysis 101
As a running podiatrist I believe the most important part of a running assessment is the running itself. Every runner has their own unique biomechanics, and it is important to get an idea of how those movement patterns make up running so that we can potentially adjust in the presence of injury or dysfunction, or potentially look at ways to enhance performance through running gait analysis.
Below are my basic considerations when it comes to gait analysis.
Phases of gait
Running gait is commonly described in three interconnected phases: flight, absorption and propulsion.
The flight phase occurs when neither foot is in contact with the ground. This allows the body to move forward through the air and reposition the limbs for the next step during the running cycle.
This is followed by the absorption phase, which begins at foot strike. This is where the body decelerates and attenuates impact forces through coordinated flexion at the ankle, knee and hip, while muscles and tendons store elastic energy.
The final propulsion phase uses this stored energy, mostly within tendons along with active muscle contraction, to push the body forward and upward. This happens primarily through ankle plantarflexion and hip extension, generating the force necessary to initiate the next flight phase and continue the running cycle.
Frontal and sagittal planes
The two angles I assess of runners are in the frontal plane (a view taken from behind the runner that shows movement patterns left to right, as well as up and down), and the sagittal plane (a view taken from side on that shows movement patterns front and behind them, as well as also up and down patterns).
The frontal plane is very useful for identifying what have traditionally been deemed “alignment” patterns, such as how much a runner at the ankle pronates or supinates, or how much knee varus or valgus they have. It is also useful for identifying hip drop from left to right, as well as checking spinal shape, shoulder drop and arm swing with running posture considerations.
The sagittal plane is useful for looking at how an athlete cushions impact loads and propels themselves forward. The side on view highlights moment of impact, peak knee flexion, tibial (shin) angle, as well as angles of propulsion.
The basics of my assessment process and considerations
Before getting into the finer details of movement, I want to understand the context of the runner and their current load.
What shoes are they in? A higher stack or softer shoe will often give more overstride than a lower stack.
Are they currently injured or sore?
People will naturally offload themselves to minimise pain even without realising. This sometimes even occurs with previous injuries that have already healed.
Are we testing at race or goal pace? Movements often vary uniquely as we run at different paces. We need to know the different paces athletes are going to be running so we can check all relevant patterns.
How I work through a runner's mechanics
I like to start from the ground up and go from front to side.
Frontal plane checks
I start with the frontal plane and check alignment angle at midstance, then propulsion angle at toe off. I then check if the knees are rolling in (valgus) or being pushed outwards (varus). Next, I check if there is any hip drop and, if so, how much, from either the left or right.
From there I look at the upper body rotation. I check if the spine moves from left to right or if it twists through the shoulders. Staying with the shoulders, I see if one drops at all. Finally, to conclude the frontal plane assessment, I check if arm swing is coming across from a wide angle that may affect balance through the lower body.
I then move onto the sagittal plane.
Sagittal plane checks
I check the front side mechanics first. Where does the foot land, how much knee bend is present at contact, and what are the arm and head positions doing.
I then check midstance. What is peak tibial angle at the ankle, what is the hip position, and is there any curve through the lower back?
Following this, I move onto backside mechanics. I check toe off position, how much ankle plantar flexion they can generate, knee extension at toe off and hip extension at toe off. I also check how the arms are balancing the counter movements at the legs.
Finally, I check the flight phase. The main movements I check here are whether the athlete overloads any structures due to poor swing mechanics. For example, are they pulling their heels up enough, or swinging low frequently.
What are good or bad patterns?
There is no perfect movement pattern, and there are no patterns that are all totally bad either. From a loading point of view, movement patterns have equal and opposite effects at different sites. If you load up one structure, the laws of physics mean you will have to unload something else as a part of injury prevention.
However, individual tissue tolerance does not mean all of a runner's structures are equally resilient. For example, forefoot strike or heel striking are neither “all or none”.
A runner that suffers from ongoing lower leg propulsive injuries, such as Achilles tendinopathy, metatarsal stress injuries or plantar plate issues, may benefit from offloading those structures with a shift to a more midfoot strike if they are forefoot biased.
Even patterns such as an overstride have positives and negatives. There are downsides, such as higher global loading at many sites to cushion larger impact moments and then overcome them with higher propulsion.
But an overstride can also keep the foot planted for longer, so for runners that struggle with balance and stability for a variety of reasons, they may find that higher foot contact time helps minimise acute injuries such as rolled ankles.
Which movement patterns warrant intervening?
In the presence of injury, intervening is quite straightforward. We want to remove direct load on the injured site whilst running. We can achieve this through orthomechanics, footwear, gait retraining, and even changing an athlete's running pace or terrain.
The grey area starts when we change movement patterns for performance or injury prevention.
When we adjust movement patterns for injury prevention or performance, there are some changes that will have immediate and likely positive effects (such as using super shoes for road aerobic efforts). However, changing someone's gait pattern through retraining usually involves a backwards step before we go forwards.
This varies by distance. In power sprinting, a gait cue can sometimes have a positive initial change. But as we work up in distance, this immediate positive shift becomes less so until it becomes a likely negative one.
Often, running can adjust to the new movement pattern over time and that new pattern can supersede the previous one.
A common movement pattern here is overstriding. Adjusting to minimise this when jogging can use more “untrained” structures at first, but eventually these structures become more trained. Over time, this can help a runner increase their running ability back to what it once was, or improve beyond it.
At the end of the day, gait analysis is not about chasing a perfect running style. It's about understanding how you move, how you load different tissues, and whether those patterns match what your body can currently tolerate.
When you're running well and pain-free, an assessment can be useful for reassurance and small performance refinements. When you're injured or stuck in a cycle of recurring niggles, it helps identify what's driving overload so we can make targeted changes through footwear, strength, retraining, pace or terrain.
The goal is always the same: keep you running with less risk, better efficiency and confidence in what your body is doing each stride.
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Runner completing treadmill running assessment designed to analyse gait mechanics, foot movement, and overall running performance