Gait analysis explained | understanding it | what is it | Do I need it?

Gait Analysis. You may have heard about it before before but what exactly is it? In it’s simplest form gait Analysis is the study of locomotion. So, in essence, how we walk or run, it’s no more complex than that.

Are there different types of gait analysis out there?

First off there is 2D gait analysis. This is where us as health professionals observe an individual walking or moving. That may be getting them to walk down a corridor away from us and then back towards us. 3D gait analysis looks at using technology, which involves markers that we place on different joints, that might be the hips, the knees, the ankles, and using a camera system that then measures the angles and movement patterns that produces a large set of data that we then interpret for the patient. We effectively build a skeleton of the patient much like you would see in the special effect departments of feature films. A third type of gait analysis is what we call pressure analysis. So you can look at the relationship between the foot and the pressure and the floor, as well.

Each type of analysis has its pro’s and cons but as always very much comes down to the right tool, at the right time for the right person. 2D gait analysis is very quick, you can literally just grab your phone, especially now with modern smart phone technology we’ve all got slow motion capabilities. These days you can use this and there are certain elements that you can reliably and repeatedly look at and analyse on a 2D scale. So if you want to look at cadence, how many steps you take per minute, you can do that with 2D. If you want to look at how your foot strikes the ground, you can do that in in 2D. But if you want to start looking at rotation and angles, then you can only really do that on 3D. Unfortunately, you can’t draw any angles on a 2D, dataset of gait analysis, because you need all three dimensions to complete that.

Kinematics and kinetics in relation to gait analysis

Now they are two, big, horrible “sciency” words. But essentially, kinematics is the measurement of angles and motion. Kinetics is a measurement of forces. Now the reason this is important is because any form of 2D or 3D gait analysis is looking at measuring the angles and the motion that is occurring. However, unfortunately, just to make life really, really complex, because we can’t always correlate the angles and the motion to the force is going through the muscles.

This is why this whole notion around if you’ve got to wear foot orthoses, you would want to make everything straight, it’s just a load of rubbish to put it bluntly. Because we know you can change the forces going through a structure without changing the angles. If something is rolling in, and you think it shouldn’t be doesn’t mean that then the forces are increasing. And this is why it’s really difficult to actually correlate gait analysis, to injury.

When and how do we use gait analysis in clinic?

Here at the NK Active clinic if we’re seeing a patient who has had a series of niggles, so maybe hip, knee, foot or ankle pain that’s come on and off over a period of time, and it seems or appears to be driven by movement and activity, then that’s a good indication that actually we may want to look at the locomotion of that person. We want to then see if there are any small or quick changes that we can make to their walking gait or muscle structures that can help make that process a little easier on their skeletal system. We are very fortunate to have 3D system supplied to us here at the clinic by Run 3D. But not every patient who comes through our doors will receive this analysis because they don’t need it although some people might perceive that they do.

So how do we decide if someone should have an analysis or not?

We have to think about what is the mechanism of injury. What is the likelihood or contributing factors to someone developing pain? Is it due to a training error? Is it due to a trauma or incident or injury? Or is it due to something like overloading over a period of time?

It is very much like a three pronged approach. If you come to see us in clinic and you were to turn around and say, “Right, I’ve got an injury got a niggle in my knee or my ankle. I’ve gone from running five miles a week to 50 miles a week, then that’s a too big increase.” Then that is what we call a training error. And it’s most likely not related to your gait and probably more related to the way you manage your training structure rather than the way you are running. In this case we wouldn’t jump into doing gait analysis on you, we’d sit down and speak to you about how to train and get that loading better. If you come in and said, “I’ve got ankle pain, but I was running along and I sprained my ankle. And this is when the symptoms started after I sprained my ankle..” then we know that injury occurred due to an episode of trauma.

However, if you come in and say, “Well, I’ve had this injury now, my training load hasn’t changed. I haven’t had any trauma. It’s been niggling on for a while. And actually, when I think about it, I’ve had loads of multiple injuries and niggles in the past.” For us in clinic, that’s the perfect time to then look at doing gait analysis.

I am pain free. Should I have a gait analysis?

We get asked this FREQUENTLY in clinic and we we are very much of the opinion that if it is not broken then don’t fix it. Now there is an opportunity to look at this when looking to use gait analysis to improve performance but that is a different matter.

If you are pain free and you are not showing any symptoms then that shows us that your body is coping with what it is doing. If you choose to make a “change” to improve something then it is then that your body may not be able to cope as well with that change. In fact there is more of an increased risk of injury.

In the past when we have conducted an analysis on a pain free client the caveat has always been that we will look at gait and what is happening now but will always combine with some strength testing. Normally the recommendations that come out of this will be around how to improve their strength and conditioning side of things.

We have seen patients at the clinic who have bone on bone osteoarthritis within their big toe or their knee and they can still happily run marathons. So just because it’s there, it doesn’t mean it’s going to cause a problem. And it’s exactly the same with gait analysis. You treat the patient, not the data that the gait analysis brings up. What you start to realise is that there is huge variation. There are lots of ways and running patterns that people can move and it’s appreciating that there’s not one way of moving that’s best. You can move multiple ways in different patterns and variations and still get the same outcome.

To summarise, at NK Active we think that gait analysis has its place and it can be really useful to help patients where movement patterns may be contributing to some of their symptoms. However it has to be used for the right reasons!

You can listen to Nick and Charlie talk on this subject below in our latest episode of the NK Active podcast. If after reading/ listening, you think that you would benefit from a 3D gait analysis then please click here to find out more about the service we offer here at the barn.

Or listen on your chosen podcast platform here: https://kite.link/nk-active

You can also watch this current episode on our YouTube channel.