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Chasing Potential - Gait Analysis

 Thursday, March 23, 2017

What is a gait analysis? In essence, it is the observation and analysis of movement patterns of the foot, lower limbs and body during motion. Gait analysis can be qualitative (observation by the eye) or quantitative (recording & measurement by equipment). For the sake of simplicity, I'll refer to a qualitative analysis as "visual" and a quantitative analysis as "video". Those aren't industry terms, but display the general differences. A visual gait analysis is often used to catch major compensations during running, and may be done by a shoe store employee, running coach or personal trainer with training in biomechanics and movement patterns. Since running movements happen at a high speed and the complexities behind them are significant, a visual gait analysis likely won't catch the finer details of what is happening at each joint, but can be useful for finding the right shoes or getting started on some simple form drills. 

At Life Time Run, we don't (yet) have an official gait analysis product. However, some coaches & personal trainers may have the background to include one in a training program, either through a visual assessment or with some simple video tools. In addition, they may incorporate other assessment screens to provide a picture of muscle imbalances to target with corrective exercise. If you're considering this approach, you'll want to seek out a trainer or coach with a background in biomechanics or 'corrective exercise'. In my days as a Personal Trainer at Life Time, I held the NASM - CES (Corrective Exercise Specialist) certification. That gave me enough knowledge on top of my biology & sports-science studies to be able to assist my clients with corrective exercises that could stabilize their core and key joints, and to balance out some postural issues. When I had clients with more significant postural issues or injuries, I'd refer out to a physical therapist or other sports-medicine professional. As an athlete, I'm lucky to have a Life Clinic available in Chanhassen where I can get great chiropractic care & rehab exercises when I need them - just across the parking lot from our corporate office. They were invaluable in getting me to the finish line of the Boston Marathon in 2014 in a 2:59, less than 3 months after my van was totaled in a car accident where I was sandwiched between two other vehicles. 

Back to the gait analysis - for a thorough analysis that can catch subtle flaws in a runner's movement pattern, video tools add the capability to capture data and precise measurements. I recently had a chance to go through the gold-standard, a gait analysis in a true physiology lab. The lab is at the Sweere Clinic at Northwestern Health Sciences Center in Bloomington, MN. (Disclaimer - I was given a free gait analysis so I could see the lab in action. Life Time Run doesn't have an official partnership with the clinic, but I'm always looking for great local resources to help our runners achieve their optimal health & performance. Thanks to Dr. Greg and the Sweere Clinic team for sharing their valuable insights and technology!)

I was amazed by the number of cameras used to capture every detail of my gait, picking out the areas where I needed to focus my strength training. I've never had a stress fracture, but had plenty of soft-tissue injuries (tendinitis, muscle strains, etc) and one surgery on my left ankle to remove a ganglion cyst. I have also struggled with back injuries for over 10 years. My back first 'went out' in the fall of 2005, and I've spent countless hours on core training, with dozens of visits to a physical therapist & chiropractors, all in an attempt to get my strength & stability back. During those 10 years I also had 3 babies, and with the car accident 3 years ago, my body has gone through a lot of challenges! I still wouldn't say my back stability is quite where I want it, but I am generally able to keep it healthy enough that I can complete my training. Unfortunately it still keeps me from doing more intense strength training workouts, though Coach MK put a hold on that while I rebuild my strength after baby #3 anyway. 

In my quest to get to the root of my back problems, the gait analysis by Dr. Greg DeNunzio at the Sweere Clinic did show a number of compensations in my body, and he gave me some corrective exercises to help me fix the problems. These should help to correct the compensations and improve my form. Here are some snapshots from the gait analysis: 

All hooked up (wirelessly) with sensors for the cameras! 

Filtering through the scientific details, I'll post some of the charts provided by the software below, with brief explanations that have less science-y jargon. I was a biology major at Adams State College, but realize many of my readers may not share my passion for science!

The big take-away here is that my left foot is turned in (adducted) while my right foot is more turned out (abducted) through most of each stride.

Good news here - my ground reaction force and power are 'normal'. It's probably good that I waited until a few months after I was done nursing baby #3 to have this done, as my power certainly would have been low during the earlier post-baby stages when the relaxin hormone was flowing more steadily, loosening my joint structure and decreasing power. 

At my knee, my flexion (knee bend) is normal, but again we're seeing more rotation. My left knee in particular is externally (outward) rotated. That's likely part of why my stride feels awkward, as my left knee is turned out while my left foot is compensating and turning in. Oh my!

At the hip, the issues farther down the chain (leg) really come to light. I'm quite aware that my hips aren't in the correct alignment. I wish I could say it's an easy fix, but at least now I have more data to work with! The gait analysis showed decreased hip flexion (lifting of the knee) throughout most of my stride, with increased extension (mostly left) at toe-off. My left hip is more externally rotated as I'd expect with what we saw at my knee, and my right hip is more internally rotated (turned in) to compensate. I wish I'd had this done years ago so I could have corrected the problems earlier!

Looking at my power output, the gait analysis showed "very low power generation in stance". That wasn't a huge surprise, and is something MK had alluded to in one of our earlier discussions. She coaches me remotely from Colorado and hasn't seen me run, but could see that my heart rate, pace & cadence data in weren't matching up. My heart, lungs & metabolism are far ahead of my power output & pace right now, and she suspected biomechanics were the issue. It looks like she was right!

Last graph - and this one caught me by surprise. It shows increased posterior tilt at each stance phase (when my foot is solid on the ground). I expected it would show more anterior (forward) tilting of my pelvis due to my tight hip flexors. Posterior tilt is typically due to tight hamstrings & abdominal muscles, and I'm guessing my hamstrings are to blame, as they have always been so tight! Even in elementary school I couldn't pass a sit & reach test. I stretch regularly, but overcoming genetics is tough, and there is something to be said for the performance benefits of a certain degree of muscle tension. My goal is to find the right balance - enough flexibility & mobility that I'm not in pain or limited in my ideal range of motion, but not so much that power or performance would be decreased.

In my quest to get my post-baby#3 body back, I now have more data to work off, and exercises from Dr. Greg at the clinic to incorporate! This post is already really long, so I'll save those for another day. The focus is on strengthening my glutes to support my pelvis, especially the left glute medius (on the side of the hip/glute area). That should help to balance out the external rotation of my left hip, and the internal rotation of my right hip. 

I hope you enjoyed this overview of a lab-based gait analysis. If you're looking for deep insights to what is going on when you run or are frequently injured, check out a local physiology lab like the Sweere Clinic for a gait analysis. The information is so valuable, and can be incorporated into the rest of your workouts if you're working with a personal trainer, run coach or other health or fitness professional. There are so many pieces that work together to create a healthy runner, and I'll do my best to highlight different tests & technologies that may interest my readers. And in the meantime, I'll continue on my 'experiment of one' to see if all of this can help me take my training & racing to the next level as we enter the race season in Minnesota. It's the first time in nearly a decade that I've been healthy enough (and consistent with time) to train 5 days a week, so that alone is good progress. I'm racing this Saturday at the O'Gara's Irish Run 8K in St. Paul, MN and am excited to kick off the USATF MN Team Circuit season with our Life Time Run team!

Happy Spring!!!

Last blog post: "Indoor Cycling for Runners" 

Read more: Blog Index

Rebekah Mayer, National Run Training Manager at Life Time Fitness. Follow me on Instagram at rebekah800, on Twitter at @rebekah_mayer and our team at @lifetimerun. Find us on Facebook at Facebook.com/lifetimerunclub