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Do You Need a Running Gait Analysis?

Picture of Dr. Mike Brown, PT, DPT

A running gait analysis can be a really useful tool for runners, but probably not for the reasons that you think. The three most common reasons I hear when runners ask about a running gait analysis are to reduce their risk of injury, decrease pain from a current injury, and/or optimize running performance. I want to break down each of these factors so you can understand the true benefits of a running gait analysis. 

Injury Risk Reduction

Unfortunately, decades of research has not found one running gait variable, nor combination of variables, that is predictive of injury. Just look at the graphic below. There are so many different things we can look at, but only 5 of them have even moderate evidence supporting their relation to specific injuries.1 Therefore, we cannot look at the way a person runs and confidently say they are going to be injured because of how they run, or that they won’t be injured if we change this one thing about how they run. 

Is a gait analysis helpful at all for decreasing injury risk? Yes, but not because it leads to changing your running gait. The greatest benefit of a gait analysis when we are healthy is to tell us which structures we tend to load more. For example, a forefoot strike places more load on the Achilles tendon and calf muscles.2 Knowing this, we can check the strength, endurance, and power of the calf muscles and Achilles tendon to make sure they can tolerate the loads that we are placing on them. Then, we can use targeted exercises to improve the areas we need most. This is what makes us more resistant to injury. We don’t need to change our running form if we exercise to support the structures that are being loaded the most! 

Decrease Pain While Running

A running gait analysis is useful to do in the presence of an injury, but first, we want to make sure you can run enough without increasing your symptoms from the gait analysis. In general, if you cannot run 10 minutes without significantly increasing your pain/symptoms, then a running gait analysis is probably not appropriate. If you can run for 10 minutes with mild pain, then a great benefit of a gait analysis is to assess your current running form and determine if we can find any cues or form changes that decrease your symptoms in real time. However, these are only temporary solutions. They give you back control of your pain so you can continue to run despite pain. As you improve and progress through an appropriate running-related rehabilitation program, you should not need to rely on these gait changes as frequently and return to your regular running form.

Optimize Running Performance

Elite runners often make running look effortless, and it is natural to compare our running form to theirs. Then we think, “if my running gait was as smooth as theirs I could run even a little faster.” While yes this is true - there are gait parameters that are more associated with higher running efficiency3 - optimizing running form may not be as important as we think it is for performance improvement. There are multiple reasons for this, but most importantly, our body is most efficient at running the way we normally do, especially if we have been running that way for a long time. Running actually feels harder after we change your form away from what is natural to you!4 

Most of the gait parameters that are correlated with improved running efficiency have only small correlations, so for the average runner the impact of emphasizing these variables is going to be minimal.3 While it may be worth the time for professional runners, who are looking for any small improvements they can make, it is likely not relevant to the average runner. For the recreational runner, the best way to improve running performance is by dialing into training, not our gait. Distance running performance is primarily dictated by metabolic efficiency: how well our body uses oxygen and fuel sources, like glucose and lactate. For example, even a race as relatively short as 3000 meters requires us to use our aerobic system roughly 85-95% of the time we are running.5 If we can improve our aerobic efficiency through our training, we are going to see much larger progress in performance than by “optimizing” our running form.

Earlier I talked about how a running gait analysis tells us which structures we are loading more, and we can take this principle and apply it to optimized performance as well. If our muscles and tendons are used to being loaded in a certain way with our current running form, any changes could load tissues that are not used to being loaded as much. At best this decreases efficiency in the short term and improves performance slightly in the long term. At worst, this could lead to an injury that could have been avoided. 

 

References

  1. Willwacher S, Kurz M, Robbin J, et al. Running-related biomechanical risk factors for overuse injuries in distance runners: a systematic review considering injury specificity and the potentials for future research. Sport Med. 2022;52(8): 1863-1877. doi. 10.1007/s40279-022-01666-3
  2. Almeida MO, Davis IS, Lopes AD. Biomechanical differences of foot-strike patterns during running: a systematic review with meta-analysis. J Orthop Sport Phys Ther. 2015;45(10): 738-755. doi. 10.2519/jospt.2015.6019
  3. Van Hooren B, Jukic I, Cox M, Frenken KG, Bautista I, Moore IS. The relationship between running biomechanics and running economy: a systematic review and meta-analysis of observational studies. Sports Med. 2024;54: 1269-1316. doi. https://doi.org/10.1007/s40279-024-01997-3
  4. Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43(2): 296-302. doi. 10.1249/MSS.0b013e3181ebedf4
  5. Duffield R, Dawson B, Goodman C. Energy system contribution to 1500- and 3000- meter track running. J Sport Sci. 2005;23(10): 993-1002. doi: 10.1080/02640410400021963
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