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WHAT IS GAIT RE-TRAINING?

Gait retraining is an efficient and effective way to change your running form through real-time visual or auditory feedback. While most people assume that their running form is perfectly suited for their individual body, research shows us that our running mechanics can often get in our own way of being efficient and injury-free runners. Good news is - we can change that!


Knowing how to retrain your gait to reduce injury or increase performance all starts with correctly identifying the areas of your gait pattern that require improvement. This is best determined through a gait analysis performed by a physical therapist who is able to make a connection between the angles measured on your body while running with your strength, flexibility, and functional movement pattern deficits discovered during your assessment. Gait retraining without first establishing causation is similar to replacing a random gadget from under the hood of your car because you started seeing smoke a few miles back. 


Once your gait has been analyzed and your assessment completed, gait retraining can be used to improve your running form. Gait retraining typically falls into two categories: auditory and visual gait retraining.

Image by Malte Wingen

Auditory Gait Retraining

  1. Step rate manipulation is one of the most commonly prescribed gait retraining techniques as it is quite simple to perform and incredibly effective. Step rate manipulation is increasing your cadence (the amount of steps that you take per minute) by 10%. As it is challenging to internally drive a 10% increase in your step rate, runners will often run to the beat of a metronome or songs with the correct beats per minute. This increase in cadence has been shown to improve your running pattern, rid yourself of injury, decrease total load on your joints, and increase your performance.  *For a not-so-quick example, scroll to the bottom of the page to meet Ben, our overstriding runner.

  2. Sound-Intensity feedback can be used to reduce the “pounding” of running as it turns out, the sound of your foot slapping the pavement correlates with the impact of force on your body. If you run more quietly, your bones and joints endure less total pounding. Sound-intensity feedback can be performed through a decibel meter app that will give you real-time feedback on your current level of noise. While you run, your goal is to try to keep an eye on the decibel level to decrease the sound as much as possible. This has been shown to decrease impact force and total force on your body while running

Visual Gait Retraining

  1. Mirror Gait retraining is a technique that can include putting stickers on your body at specific points and making sure to keep the dots aligned as you watch yourself run in the mirror. Although this is often not a fun task, visual gait retraining with mirror feedback can be incredibly helpful for improving faulty gait mechanics that contribute to injury. 

  2. Marking up your treadmill with a line down the center can be another effective way to visually train your running if you have a crossover pattern, meaning you cross center as you land. If you don’t have access to a treadmill but are able to find a stretch of wide sidewalk where you can run on either side of the sidewalk crack, feel free to play the “don’t step on the crack or you’ll break your mother’s back” game to widen your step width. This has been shown to significantly improve mechanics of running pattern at the hip, knee, and ankle. 

Image by Holger Link

The beauty of gait retraining is the simplicity of using cues to help change your pattern without having to think through every step. Each of these techniques, if performed correctly, can very effectively improve your running form. Further improvements can be seen by performing these gait retraining techniques in a clinic with a physical therapist giving you additional cues specified to YOUR gait impairments. 
 

Meet Ben

Ben demonstrates an overstriding gait pattern. Because of this pattern, he is experiencing shin splints on the outside of his shin bone (anterior tibial stress syndrome). He is also at increased risk for stress fracture, knee pain, and hamstring strain due to his running stride.

What Is Gait Retraining?: Text
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As you can see, not only is his knee too straight when his foot hits the ground (anything greater than 160 degrees is considered too straight), his foot is also very flexed (dorsiflexed) when his heel hits the ground. Not only does this put his shin bone at risk for stress fracture, it also means that the tiny muscle on the outside of his shin bone (tibialis anterior) has to control the foot all the way down to the ground. That puts a lot of stress on that muscle and is the reason for his shin splints (anterior tibial stress syndrome).

Based on his exam, he met the criteria for anterior tibial stress syndrome but we needed to dig a little deeper as to why this was occuring in the first place. If you look at his landing form, you’ll see that along with the too-straight knee and the too-flexed foot, he is landing really far in front of his body. This is called overstriding. Overstriders tend to run with under use of their glutes (butt muscles) as their body is too upright to require use of the muscles.

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Upon exam, no surprise, very weak glutes with decreased ability to activate muscles in functional tasks.
 
So what did we do with him? We started him off on an exercise program to strengthen his glutes with careful attention to selecting exercises that would use these muscles in the same way that he needs them to run. This is a great first step, but as we know from Can I lift my way out of injury, this is not enough. While this runner began working on getting his glutes to be stronger and more active, we were able to start him on a step rate manipulation program.
 
His cadence was counted to be 156 steps per minute (spm). The next day he ran, we bumped him up to 171 spm and filmed him again. Already his numbers improved.

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There is obviously some more work that needs to be done, but his shins already feel better with the higher cadence! Stay tuned to watch his recovery as he improves his running form.

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