Contributed Piece By: Dr. Rebecca Shultz, PhD in Biomechanics
Gait training is the clinical term for learning to walk or run. Gait retraining then is learning to walk or run again. This relearning may need to occur after an injury and after an assessment that found a red flag that may predispose a runner to injury or reduce a runner’s performance.
Gait retraining is often done in partnership with a physical therapist or a form coach. The idea of changing your form before an injury is a hot debate at the moment. Many therapists and coaches believe that “if it isn’t broken, don’t fix it.” However, the interesting thing with this philosophy is that it doesn’t take into consideration that most runners are ticking time bombs. Yes, the athlete might not be injured now but up to 80% of runners get injured during their careers. This is why fixing red flags may be of interest to them. Also, these patterns also often associated with movements that waste energy in rotations that don’t lead to the forward propulsion of the athlete. The red flags that I would encourage an athlete to fix are patterns that produce overstriding, rotation of the lower extremity and arm swing patterns that lead to a lot of excessive body rotations. Changing your foot strike pattern, heel strike to forefoot, before an injury is one movement pattern that runners may want to do some research on before deciding what is best for their bodies. Ideal form may not exist, yet!, but bad form certainly does so runners should aim to fix these patterns before they manifest into an injury or prevent a runner from running a PR.
There are a few ways to help you with this. As mentioned above, seeking out the help of a professional can be very beneficial. There are also gait assessment programs, like RunSafe, that can help you identify your red flags and give you some homework to help you with your form. Lumo Run and other wearables are also able to help you find these patterns and help you through changing your movement patterns to help you be a more efficient runner. The other alternative is to take a slow motion video of yourself and look for some of the more obvious red flags on your own. Here are 4 things to look out for when reviewing your video:
1. Where does your foot contact the ground with respect to your belly button (pelvis)?
If your draw a line from your foot at contact straight up, it should hit the edge of your pelvis. At the very least your lower leg should be perpendicular to the ground. (there are software to help you do this – ubersense, coache’s eye). If this is not happening, think about pulling your leg in closer to the your body when you land. You can also increase your cadence, steps per minute, by 5-10% (see our blog on preventing over striding to help with this).
2. Is there a 2 inch window between your knees throughout your run cycle?
From the time your foot contacts the ground until the time it hits the ground again, can you see through the “window” at your knees?
If not, think about trying to maintain this window during your run. A study by none other than the “running form” guru Dr. Irene Davis, demonstrate that runners reduced their risk of injury by running in front of a mirror and focusing on maintaining the window between their knees. This forces you to contract your glute muscles and minimize the inward rotation of your legs that is often associated with common running injuries.
3. Are your arms swinging in front of your body and crossing your midline?
Your arms and legs are paired in this plane of motion (bird’s eye view). They are working to counter balance the twisting coming up and across your body. If you upper body is weak and drives your arms forward and across your body, your legs can follow. This can lead to your feet crossing over the midline and cause increased rotation in your legs, such as excessive pronation of the foot. On the opposite side, your legs may be the culprit and your arms may be the victim. In either scenario, make sure that your arms are moving forward and backwards with limit motion across your body. Roll your shoulder down and pack and envision crushing something between your shoulder blades. Pretend you are elbowing someone directly behind you as your run. If you think the issue may be stemming more from your legs, focus on landing with your feet on either side of an imaginary line on the road, or even better run along an actual line on the road (just keep the music off and your head up looking for traffic!). Land with your feet on either side of the line to widen your steps.
4. Do you look relaxed and confident?
This has to do with your posture. Ensure that you are running tall, with your abs engaged, your shoulders down and back, and your chin up and pulled in. You should feel relaxed but confident. If you run by a window or a bus stop, have a look at your reflexion. Do you look like those awful race photos (see a horrible example below!) from the last few miles or do you look like mile 1?
Caution when changing your Form
Any time you change your form you are going to affect which muscles you are recruiting and how much you want them to work. By not taking it slow and allowing your soft tissue to adapt to your new movement patterns you can increasing your risk of injury and decreasing your performance. This was seen recently in a population of runners who decided to transition to quickly to forefoot running and ended up with pain in their Achilles tendon. Forefoot running requires more work by the calf muscle therefore putting more load through the tendon, PTs, such as Irene Davis, recommend doing some strength exercises for the muscles in the lower leg and the bottom of the feet before beginning with a change in foot strike pattern.
Here are a few examples:
The same is true for many other form changes – engaging your core, increasing your cadence, etc. You need to ease into it decreasing the mileage on your these training runs and then slowly building back up (a good thing to do during recovery or post-race season). If there is soreness in new muscles following a training run where you focused on reduce a red flag, you might want to think about strengthening these muscles before adding more miles. Here is a great quick overall strengthening program from none other than Mark Allen, 6 time Ironman champion, that can help strengthen many of the needed muscles used when you have good form (remember arms strength also helps your running!).
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Rebecca Shultz, PhD Biomechanics
Leveraging her 8 years of experience at the Stanford Gait Lab, Rebecca is leading the Lumo Run product experience for audio coaching and in-run cueing.