Running gait- PLEASE HELP ME FIX IT!

Laura Becker

Background:  So I have had issues with knee tracking on and off for a while. I got orthotics made 1 ½ years ago and WOW what a difference! Helped me so much. Fast forward- I was diagnosed with a stress fracture in my tibia in April after training for a 30 mile run…...7 weeks of NO RUNNING. Then run/walk and now I’m building running foundation again.  It’s like learning to run again. 



Went to get new shoes (desperately needed them) and they recorded me run on a treadmill….and replayed slow motion. AND WOAHHHHH my gait has some big issues----I knew it did back in March when I was figuring out what happened with my leg….But even after PT the issue is not fixed. Basically I have a BAD crossover gait and I am a heel striker.


I am reaching out to this incredible team--- HELP ME FIX MY GAIT PLEASE!!! I love running but I want to be more efficient and do it without injury.


Any and all advice would be SO appreciated!!!

John Withrow

1) Buy some Hokas. Particularly good for people with violent foot strikes and stress fracture histories.
2) You NEED to strengthen your Core/Glutes. look at Core section of the Wiki: http://members.endurancenation.us/Resources/Wiki/tabid/91/Default.aspx?topic=Strength+&+Core+Central
3) Go herre and learn: http://members.endurancenation.us/Resources/Wiki/tabid/91/Default.aspx?topic=Running+Technique
4) I would guess that a higher cadence/turnover would also be super important for you to minimize stress and minimize the cross-over. Get a metronome and start using it to increase cadence.

Peter Noyes

John makes a good point about cadence. Do you have a Garmin 920xt? If so and you wear the HR monitor you might already have some collected data.

With good cadence you will end up with your feet landing under your body. This is just more efficient and should reduce the impact on your legs. 180 is a good rule of thumb for running cadence. It doesn't matter if you go fast or slow, should still be high cadence, the only difference is stride length.

Jess Withrow

Do you have a copy of your run gait analysis that you can share?



What was the feedback regarding potential cause of your crossover gait? Is it related to tight adductor/weak glute med? Pelvic rotation?

I'm headed for a gait analysis next week myself, but right before we moved from NJ to MN, I met a PT who did a spectacular job of helping me re-align my pelvis, and my big take home message was how incredibly important it is to address your pelvic floor muscles, regardless of whether you're male, female, have had kids via C-section, haven't had kids at all... Her philosophy was repetitive run and gravitational strain of organs on the pelvic floor stretch those muscles over time and runners are particularly vulnerable to a weak pelvic floor. So core work, YES, super important, but core work that addresses glutes/transverse abs/lats, etc, without addressing the pelvic floor only gets you so far. It was super helpful for me in terms of correcting high hamstring tendinopathy...

I'll be following along and if I learn anything new next week, I'll check back in and let you know!

Laura Becker

First- THANK YOU so much for your responses and advice!!! I truly, TRULY appreciate it. I have to apologize for not commenting back sooner- I am an elementary school teacher and last week was back to school....I seemed to forget how LONG the back to school days are (and exhausting lol).

@ John and Peter- So I have been trying to incorporate glute and core exercises. Any suggestions on how to fit them in to ensure they get DONE. Before run? After run? On ride day? I have been working on cadence over this past week as you suggested and already notice a huge difference! With quick feet there is less time spent on the ground=less pressure on my knees!! Andddd as suggested- been focusing on keeping by legs under my body.  I don't have the 920- just the 910  But I have been trying to do a count every mile or so to see where I am at.

@ JEss- I am SO appreciative of your response and looking forward to hearing what you learn when you go for your analysis! I didn't have an official gait analysis- it was just a brief clip at a specialty running store. But the crossover was EXTREMELY noticeable. So I am really not sure of the cause. I am trying to set up a true analysis to get some more information. At this point I think it will be worth every cent. I am really interested in the pelvic floor muscle exercises!! Do you have any specific recommendations??

Thank you again for your help!!!!

Tom Glynn

My wife did a gait analysis through the University of California, San Francisco about a year ago. I tagged along to listen. It was fascinating. The runners were assessed by a biomechanics expert, a physical therapist, a podiatrist and a diet specialist. After everyone looked at her, they put her slow motion film up on a big screen and they all sat around critiquing her poor running style and then giving ideas on how to improve it. They take all the data back to the research lab and think up ways to proactively keep runners from getting injured. The feed back included a long report of issues and a couple of pages of strength training ideas to really work her hips, glutes, hamstrings and other areas. She did the exercises for three to four months and they made a huge difference on her gait. She is much less tired and is a much improved runner. The slow motion video was incredibly eye opening.

Her run assessment obviously applies to her, but if you wanted a copy, just send an email request and I'd be happy to share it with you. Lots of great ideas to improve.

Jess Withrow

Ahhhh! JW and I were wondering what had happened to you! Makes total sense now - you must be swamped!!!

Tom hit the nail on the head regarding his wife's gait analysis - I've had the "In-Store-Treadmill-Salesperson-Selling-Shoes-'Analysis'" (and I use the term "analysis" very loosely in that context), the "Tri-Coach-Video-Analysis" (not referring to RnP here), and the "Health-Care-Professional-Who's-Taken-a-Weekend-Course-on-Run-Gait-Analysis-Analysis." I only reference the latter as a non-practicing health care professional who repeatedly receives pamphlets and brochures for these courses - they've become VERY popular, and I could easily take one and claim I've had "specialized training" in gait analysis, when in fact, 10-12 Continuing Ed credits certainly doesn't make me an expert in the finer points of breaking down someone's run and identifying where they're weak and what muscles they're using to compensate. My in-store analysis resulted in a new pair of shoes that would "fix" my gait, my coach analysis (~3yrs ago) left me with fairly standard glute and core strengthening exercises, and my most recent evaluation (we haven't gotten to the gait analysis part yet... ) has been the most insightful yet. The difference is the level of training and experience - I specifically set out to find a PT who truly specialized in hip, pelvic, SI disorders, and gait analysis. She works primarily with runners and treats many of the pro athletes in the Twin Cities.... so I felt confident going into to my evaluation with her.

What I learned was the glute work I've been doing for the past few years has REALLY helped - she was shocked at how much glute strength I had for a runner. The bad news is that - because I wasn't "re-activating" my glutes with the guided help of someone who knew what they were doing (ie, I was previously handed my exercises, walked out the door and that was more or less it), I was using a lot accessory muscles (like those adductors!) to help my glutes fire. Now I need to teach my body to shut off my psoas and adductors and primarily fire my glutes. Once I can inhibit those muscles, THEN we'll do a treadmill analysis.  *EDIT* - I feel the need to edit to add that simply stretching tight hip flexors, piriformis, etc, is NOT an adequate substitution for teaching your body to rely less on them and more on glutes during running.  These accessory muscles are tight BECAUSE they're being overused, and they're going to continue to be tight and create imbalance until the glutes are re-trained to fire without so much assistance from them.  I used to think all I needed to do was address my weak glute max/med and stretch, stretch, stretch the psoas and piriformis and I'd be alright.  Not the case at all...  which is why I'm starting from scratch AGAIN!    

Gait analysis is just SO individual, and SO worthwhile when it's done right - I'd really encourage you to have one done to address your specific issues. It looks like you're in Connecticut - if that's the case, NYU Langone has a Run Lab that's similar to what Tom's wife did and might be convenient for you to visit: http://nyulangone.org/locations/sports-performance-center/the-running-lab



PS - I am at my boys' Literacy Assessments right now and I have to tell you - teachers ROCK!!! I'm going to send you a PM when I get home and can use a real computer (because typing on an iPad does NOT rock... ??).

rlh2000

Jess makes really good points both about the "expert" label from a quick pretty subpar for profit course (near license renewal time I will get dozens of pamphlets a day, amazing what hands on skills people claim they can teach in an online course...) but more importantly about the difference between having glute strength and actually using it! I always tell people that if their PT doesn't have their hands on you when you are doing exercises and cueing you about the muscles, find a new PT. one very simple "exercise" I like is to stand up, place your hands so you can feel your glute max and glute med turn on, activate those muscles, and then shift your weight to one side and lift one leg just slightly off the ground. Your glutes should stay on on the stance (leg that is on the ground) side. If you have the MIA glutes that I do, you'll find it turns off. Very basic, but very important. Let me know if that didn't make sense.

Laura Becker

@ Tom- Thank you so much for sharing your experience! If you and your wife wouldn’t mind I would LOVE to see her analysis!! What is your email address?

@ Jess- Back to school is crazy time for teachers (and kids and parents!! LOL). Hope your boy’s literacy assessments went well!! Beginning of the year- LOTS OF ASSESSMENTS- but they do help with instruction so I am all for the useful ones   It sounds like I need the PT, knowledgeable, specialized gait analysis…and if I am going to spend the money I want to do it right! I’m sure I am not firing my glutes but have no idea how to fix that. I also sent you an email about this stuff! THANKS AGAIN!

@ Rachel- I need to do that test- but got slightly lost in the process of doing that…just to confirm- activate glutes then once you lift your leg- see what the glute does?

THANKS EVERYONE!!!

Tom Glynn

@Laura, I just sent you a PM with my details.

Trish Marshall

Hi all...I have a couple options for run gait analysis here in Metro Detroit. One is through Henry Ford Health System, "A filming appointment with a DVD or Mediabook handouts, including a written description of analysis under the video clips, will be provided for all participants. A follow-up appointment to educate the individual on the video analysis with demonstration of appropriate exercise, along with a handout of these exercises, will be conducted. Additionally, included in Package 3 is a follow-up filming appointment 6-8 weeks from the initial video session. A second set of film, in the form of an additional DVD or Mediabook handouts, will compare the first film session to the second"They use Dartfish for the video and it is done through their sports medicine department.

The other is through Easter Michigan University

"Biomechanical Assessment

3D Gait Analysis with Vicon 8 Camera Motion Capture System ($300)

Performance Assessment

Clinical Assessment

Both Performance and Clinical Assessments are provided with one test session and the single 3D gait analysis fee

Biomechanical and VO2max Assessments combined ($400)"

The guy who developed Run tss and Swim tss for Training peaks Stephen McGregor runs that lab at EMU. It is about twice as much money as HFHS. I doubt he would be the person dealing with a 50 something adult onset runner/triathlete though.   

I really want to work on my gait (I wear out shoes very quickly with my pronation and have a few reoccurring issues I hope to shore up) but am needing to follow a budget for the first time in my tri career!!! UGH! What would you chose???

I did have a Dartfish evaluation done after my first IM in 2010 by local pt/distance runner Clint Verran. He basically told me I'd be a great hurdler. LOL. Not very helpful for a newer runner who wants to be injury free and get faster!

Any input would be great!

Jess Withrow

Wow Trish, that's a tough one. The opportunity to work with Dr. McGregor would be super cool. All I know of him (other than rTSS) is that he co-authored The Runner's Edge with Matt Fitzgerald, and it's pretty clear he relies heavily on technology and data gathered from technology... so my question with his analysis would be, who's doing the Clinical and Performance Assessment? Is this person hands on, putting you through range of motion testing, checking for joint instability, looking at alignment and any compensatory movements you might have? Will they be giving you an exercise program and following up in 4 - 6 weeks as well?

The HFHS evaluation sounds more likely to be done by Physical Therapists and related rehab professionals, and with your pronation issues you might actually need the orthotic option they provide... it really looks like a great value from what I saw on their website, but it could definitely also be a lot more generic than what you'd be getting with Dr. McGregor.

I'm not helpful at all, am I??? :-) Keep us posted either way!!! I'd love to know what you end up doing and how it goes!

rlh2000

My honest opinion- neither. I think these analyses are overdone and often tell you no more than your own observations, a standard PT eval, or just having a friend video you with no fancy technology. I'm sure you can find a lot of people who will tell you that a fancy analysis saved them, and that is great! But for you, especially if you are on a budget, it definitely wouldn't be my first step. You say you know you overpronate, likely linked to injuries, and without evaluating you, I'd guess we should strengthen your posterior tibias, lengthen your gastroc/soleous and hip flexors, and majorly strengthen glutes and work on neuromuscular recruitment. Orthotics may also be a good option from a good podiatrist. Now if you have gone through a full (8-12 weeks of PT and then home exercises) rehab program with a good PT and really done your exercises and STILL have issues, then maybe further analysis is necessary.

Trish Marshall

Rachel,  

I spoke with the Henry Ford program and the fellow who runs the "run faster" program is a PT.  He does the evaluations, videotapes walking, running, some of the evaluation (not the dartfish tech...).  IF he feels you don't need PT he will give you a program to follow, then a follow up in 6-8 weeks.  I think for the $ this is a very good place to start.  He knows runners and triathletes, is a PT and it is less money than me going through my hmo crappy insurance channel. 8-12 weeks of PT through my insurance would be very expensive I'm afraid. I had quite a bit of $ in my last year of tri spending go to art providers and chiro adjustments, all out of pocket of course since none of this is covered for me until a HUGE deductable is met.  

Hopefully he can address my gait issues, muscle imbalances, help with shoe selection and give me the tools to get strong and durable.  I have a friend who worked with him and thought he was a good place to start.  

robin sarner

Can you post here a simple video of you on the road?

Note Brett Sutton's recent comments on heel strikers. The kona winners are heel strikers.