With many more people taking up running and access to increasing amounts of information via the internet gait analysis has become a bit of hot topic. There has been much reported concerning what is the best running style with different information on which bit of foot to contact the floor first for example with regard to injury prevention or just running better. A comprehensive gait analysis should provide you with information regarding to you personally and not just a one size fits all approach.
Here at Holywell Healthcare we look at your anatomical make up before you start running and then combine this with video analysis of you running. Understanding how you move as you do can provide very useful information to help with your running. The gait analysis we offer in clinic is very different to a shop gait analysis in many ways. The whole process will take around an hour although we do offer different services, and these may take up to 2 hours. We look at all of you from the back and from the side so we can see all of your body and how each segment is working together. We should use all of our body when we run, it not just about feet and legs.
Running is one of those rare sports where how you actually do it is very really thought about or investigated. Most sports or activities usually involve some sort of coaching or advice on how to go about it, with running pretty much all of us just sort out some shoes and go and get on with it. This is one of the good things about running. But sometimes we come unstuck, recurrent injuries of the same thing or different injuries moving around our bodies, not being able to go faster or longer without putting in a disproportionate amount of extra effort, or sometimes we just lose the love of running along easily. All of these things may indicate that you are not using your body as efficiently as you could do. Sometimes we get a bit stuck in a certain movement pattern and this puts strain on a bit of our body, out body then compensates to relieve the pressure which puts a strain somewhere else, which the body then compensates for. We then can find ourselves running out of options but we have developed poor posture and running technique through not fault of our own, just letting the body do what it is good – sorting out the problems we throw at it.
So my job is to try and sort out why you are running as you do and see what can be done about it. This will involve having a chat about all those little niggles that seemed to be no trouble and the bigger issues. Often where you are getting most pain is not the main issue but we need to find where it all started from. The most painful point is where the body has not been able to compensate from and usually not the cause of the problem. So we look at all the painful bits, see how all your foot and leg joints are working, have a look at muscles flexibility and strength in both lying and standing. I’ll have a look at you barefoot walking and then running with your usual running shoes on.
Your running is captured on video and then we have a look at this together. I then try and work out what is going on and discuss this all with you. Remember running injuries are most often repetitive strain injuries (unless you have just sprained an ankle or fallen over) caused by repetitively loading tissues that are not able to take the loads you are placing on them. Therefore, we need to reduce the damaging load that is being places on the tissues and make the tissues stronger so they can take the increased load. We can do this in a number of ways both in the short term and to make longer term changes.
Treatments and interventions can include any of the following and often we will introduce a few things at a time:
- Mobilisations of joints and soft tissues
- Walking posture changes
- Running form changes
- Referral on for further investigations and treatments
- Home treatment advice
This is used to help off-load damaged / painful tissues and can be either in the form of rigid tape that does not move, or flexible sports take that helps reduce tension in tissues. Strapping is usually applied after other treatments to help with their effectiveness.
Mobilisation of joints and soft tissues
This involves gentle movements of the joints in the feet and ankles. Often these little joints can get ‘stuck’ and this can create a whole variety of problems. If we are going to off-load tissues with new movements we need to make sure all the joints are moving as they should. This can be a stand alone treatment or can be part of helping you change the way you move. We also mobilise soft tissues in the feet and lower leg.
We use products that are both premade and custom made. These are prescribed insoles that have a role to play with altering how forces impact on your feet and rest of the body. They will alter how force from your impact with the ground is transmitted into your body and alter how body weight is moved along your foot during the time you are in contact with the ground. If we think you will benefit from orthoses we shall explain why this is so and what we expect the orthoses will do for you.
The debate always rages to and fro about the benefits of stretching. We use certain stretches to help reduce tension in tissues an help the body when you are trying to make changes to the way you move. These are movement specific stretches so help the body learn to function in a new way.
Same as with stretching, the exercises are movement specific and should help your body with making changes to a new way of moving. These could be in a static position or more dynamic. They will often try to isolate a certain movement we are trying to introduce into how you move and teach the muscles to work at a certain time of your gait cycle.
Walking / Running posture changes
This is really important. If you want to reduce a certain load on a tissue then you have to move in a different way. This can be hard work but we work with all your body and so this makes things easier. It is not just about changing one thing as you body is moving in a certain way for specific reasons. If we take away a certain movement we have to replace it with something else. This is where video analysis can really help. Also the explanation of what is the problem and how to go about changing it is much easier if you can visualise this. For running we use certain drills to show your body how to move in a new way. So drills will often focus on making sure you are doing that one movement correctly and then when you start to run again you have borrowed some of the drill to take with you into your new running postion. We look at what you need to change and then try to address this with working on new movement patterns.
Footwear choice is so important. Old worn shoes can be a real problem but so can the wrong shoes for your foot. Some feet do well in flat shoes, some feet do better in shoes with a heel. Sports shoes, especially running shoes, can make a huge difference to your function. Our gait analysis will help show you which type of shoe will be better for you and why.
• Can play an important part in the process
• Often too much support
• Need to allow the body to move in ‘preferred movement pathway’
• Shoes can block ‘preferred movements’
Often the gait analysis is going to highlight other areas that need to be worked on. This means that we can provide other therapists who you may be seeing, with more specific information for them to work with you. We have a good network of people in our clinics but also may need outside help. All of this can be discussed at the time.
For all of this to work well we will need you to take a leading role in your rehabilitation. We show you what needs doing and why and what you can expect but it is down to you to put the hard work in. We will work with you on this and provide as much help as you need but we cannot do the work for you. Your time commitments and level of input that you can do will all be taken into account when we come up with an ongoing plan. This will include review sessions to monitor progress.