Is it time you studied your running form? A full body video gait analysis enables experts to see how the whole body is interacting, which can help prevent injury…
Ask a group of runners what the benefit of a video gait analysis is and one of the most common replies will be: ‘To help you choose the right running shoe.’ Recent research shows that the majority of recreational runners still believe that wearing ‘incorrect trainers’ is one of the highest risk factors for injury, despite the fact that there is still no evidence to link any particular type of shoe to injury reduction. You can get injured in any shoe.
‘But I’m an overpronator’, I hear you say. Well, basing shoe selection on how much you ‘pronate’ (a perfectly natural and vital part of foot mechanics) is not actually backed by science. Although some runners wearing an ‘anti-pronation’ shoe may see a benefit such as an end to pain, others do not.
Then we have the runners who ‘overpronate’ but seem to have no issues at all. A quick look at the way in which Haile Gebrselassie’s feet ‘overpronate’ should be enough to seriously challenge any traditional shoe model.
Research has clearly shown that the practice of categorising runners into groups based on arch type (high/normal/low) lacks the specificity required to cater for the immensely varied physiological make-up of each and every runner.
Some shoe shops have fortunately moved with the times and are now focusing on other potentially more significant variants in different running shoes, as well as paying more attention to the runner’s history, their goals, and how comfortable the shoe is. The treadmill is used to allow the runner to judge for themselves how a shoe feels, as opposed to being a tool in the prescription of a particular type of shoe.
So what is gait analysis for?
Running is obviously a process that involves the whole body. What happens at foot level is very often a consequence of what is happening higher up. Full body video gait analysis can help us see how the whole body is interacting, allowing us to evaluate how movements in one area may be contributing to tissue overload in another.
Research shows the importance of considering the mechanics of the hips and trunk of the body, and how they can play a vital role in controlling movement seen distally in the lower limbs. An increasing amount of studies are managing to link movements in the lumbo-pelvic hip complex with overuse injuries in the lower extremity, e.g. foot and ankle injuries, patellofemoral pain syndrome, iliotibial band syndrome and anterior cruciate ligament injury.
While there is no one perfect way of running, we do know that by modifying running form we can change what tissues are having to deal with the load demands. We cannot eliminate the load, but we can redirect it to different parts of the body. This is very significant when it comes to treating running-related injuries. Modifying running form changes load distribution. Here are a few examples.
Research has shown that having straight knees at initial contact can increase the forces experienced by the body and therefore increase injury potential. A common cause of having a straight knee at initial contact is a runner reaching their leg out in front of them before landing, i.e. overstriding.
In order to reduce overstriding, we need a method that will encourage the runner to put their foot down quicker so that it lands closer to the body. This can be achieved by increasing cadence.
Cadence refers to the number of times your feet touch the ground in a minute (measured in spm – steps per minute). Imagine Bob and Ben running next to each other at the same speed. Bob’s running style involves covering ground by taking long steps, his foot landing far out in front of him (overstriding). Bob is taking relatively few steps per minute and has a low cadence. Ben’s running style is different – he manages to cover the same amount of ground as Bob and run at the same speed, but achieves this by taking lots of shorter steps. He has a high cadence.
Which is a better way of running? Well, the number one rule is it depends on the individual runner. As humans we are all very different. However, given that research links overstriding and landing on a straighter knee with increased injury potential, it makes sense that if a runner is experiencing repetitive injury and overstriding, an increase in cadence may be beneficial.
Studies have shown that subtle increases (five to 10 per cent) in cadence can substantially reduce the loading to the joints and may prove beneficial in the prevention and treatment of common running-related injuries.
The important factor here is subtle increases of five to 10 per cent. What we need to do is see what our cadence at a certain speed currently is, and then perform intermittent 20-30 second drills at a cadence five to 10 per cent higher. Personally I prefer five per cent, as increasing by 10 per cent can create too much of an increase in exertion.
The Cadence Calculator
To see what your current cadence is, count how many times your right foot touches the ground at a certain speed in 30 seconds. Multiply it by four to give to total steps per minute. For most recreational runners, the figure will be around 160 spm to 170 spm. Download a cadence app (I use Metronome Beats) and set it at your cadence + five per cent.
During your drills, try to keep up with the beeping of this new this cadence for your 30 second drills, ensuring you are still running at the same speed as before (treadmills can be useful for this).
The relationship between ground reaction forces and injury is anything but clear. It’s not always a case of less stress on the body = less risk of injury. The body is incredible at adapting and we simply don’t know how much load is bad. You could even argue that load is good as it stimulates adaption. However, research does suggest that rate of impact load is related to stress fractures. One of the simplest ways to change the loading rate when running is to try to ‘run softer’. Exactly how you land softer and reduce noise is not important. You will find a way.
Modifying pelvic position
Running requires adequate hip extension (the ability of your weight bearing leg to move backwards and underneath you before your foot leaves the ground). Though the actual amount is not a lot more than that of walking, for some reason many of us drop our pelvis forwards when running in order to achieve the required extension.
Despite the often quoted idea that this drop is due to sitting down all day at work, research also shows that runners who show no restriction during clinical tests sometimes drop their pelvis forwards during running. It may therefore be more of a question of habit rather than an actual physical restriction.
The problem is, running requires optimum use of the posterior chain (glutes and hamstrings) so that each time your foot leaves the ground, you literally fly through the air as far as possible before landing again (flight time). Dropping the pelvis forwards can inhibit optimum propulsion, and the alteration in the mechanics of the swing phase (when your leg leaves the ground and start to travel forwards again) can lead to overuse of one of the thigh muscles and the the muscle at the top of the often mentioned IT Band to achieve hip flexion (the lifting of the knee up in front of you).
Also, the increased lumbar curve caused in the lower back by allowing the pelvis to fall forwards may place more load on the lower back and hold the hamstrings in a potentially more threatening position.
For some runners, the cue of lifting the pelvis upwards slightly may be a useful tool to help take the load off stressed tissues, as part of a rehab programme for injury. Modification should be introduced gradually for intermittent periods of not more than 30 seconds at a time.
Trying to force a running form modification too soon for too long is unlikely to allow the system to make natural changes and could lead to an overload problem elsewhere in the body.
Reducing cross over gait
ITB (Iliotibial band) syndrome is a very common complaint. The good news is that research has shown that increasing your step width during running (i.e. running either side of a midline as opposed to crossing over it each step) can lead to a positive decrease in the symptoms. Greater ITB strain has been shown in runners with a narrower step width, and relatively small decreases in step width have been shown to substantially increase ITB strain.
Running with the feet just 3cm wider can reduce ITB tension by up to 20 per cent. Runners suffering from ITB syndrome who, during a full body gait analysis, exhibit a narrow step width and cross over gait pattern, can be given intermittent 30 second drills in which they run either side of a line, ensuring that the width increase is no more than 3cm.
Modifying foot strike
Despite what you may read about the benefits of midfoot and forefoot strike, research shows that the majority of runners heel strike. Studies have shown that in recreational marathons, nearly 90 per cent of runners run with a heel strike, three per cent with a midfoot strike, and two per cent with a forefoot strike.
Sadly, modifying foot strike is often fast on the heels of wearing the ‘correct’ shoes in advice given out to runners on how to reduce injury. Both are myths. In the majority of cases, sort out up top first and what’s down below at foot level will invariably sort itself out.
Matt Phillips of Stride UK