Friday, May 25, 2012

Running Gait Analysis, my experience

Long overdue... here a (hopefully useful for someone) kind of review of my visit to StrideUK

So... early September of 2011, having a spare afternoon to spend before the flight back to HK, I fixed an appointment for a gait analysis with StrideUK, based in Hove (which is basically a suburb of Brighton).
The most challenging part was reaching Hove from 50km away... surviving the appalling conditions of the British roads/traffic... with countless traffic lights, intersections, small villages etc... to arrive on time. I guess that cycling there would have taken less. Anyway...

In line with my "engineer" style, I will try to keep it short and in bullet forms
DISCLAIMER: I did not receive anything from StrideUK for this review. I paid for the analysis on my own (which was a non negligible 160 GBP).
These notes are  only my personal experience which can guide the reader to have a similar analysis done somewhere else.

  • How it works
    • Well, basically I was left in shorts and I got markers on all joints, etc. Then we proceed to:
      • some static analysis of the posture
      • flexibility test of different segments (calves, hips, etc).
      • warm-up on the treadmill
      • cranking up the pace up to Marathon speed (so I was running at 10mph...) and I had to run first 10-15 minutes to get into a "tired" stride and thereafter start video capturing:
        • barefoot
        • with shoes without orthotics
        • with show with my own orthotics
        • frontal, back and side shots of the postures
      • getting dressed
      • discuss the results with the analyst
      • receive and discuss prescriptions (with demonstrations) about specific strength and/or flexibility exercises, etc
      • Also receive a recommendation for the type of shoe which could fit best the running style
      • I eventually got a nice report with also a CD with all the video of my analysis
  • Level of the equipment: I would score it 4 out of 5
    • In a scale up to 5, I would give 5 to the equipment of the lab profiled in this issue of RunningTimes... obviously that is "space lab" level. So we are somehow below that level but with all the right equipments. I particularly remarked the special treadmill used for the analysis (from Sprintex):  a German product and the motor is actually at the back of the treadmill, so in a sense the runner is actually "pushing back" the belt (more similar to the reality of running) rather than the standard treadmills where the belt is "pulling your feet back". Also the belt is not actually a belt, but a succession of wooden plates similar to the tracks of a tank (slat-belt). The feeling is really good and very near normal running. Plus a proper set-up of video-cameras and related rigs.. So it was a solid set-up (I saw some labs trying to do running gait analysis using "home fitness" treadmills with max speed of 12kmh...)

  • Attitude of the analystt, score 5 on 5
    • Mitchell, the owner, really stands out in the crowd of the all the gait analyst which I met until now. Why ? because he took a "white sheet of paper" approach, without any pre-assumption on the needs of orthotics or this or that kind of shoes. Different from many labs, where  a way to get extra income is pushing the envelope for this or that insole, he is not connected to any insole/orthotics manufacturer. I was incredulous when he told me that maybe I could even run without orthotics because my feet (despite hitting the ground at an angle), do not actually roll at all during the pushing stance. So we went through the whole process checking my static posture, barefoot running, running with shoes, etc and later discussing the images together so that I could also give my own opinion and understand the "why" of each image. We spent almost 2 hours together and he really made me understand the how and why of each step.

  • Outcome:
I really would like to avoid to make a self-centered report of the working of each of my joints, so just take my personal case as a lead of the type of output which you could get from a similar analyst:
  • Flexibility test: poor result. My squat is really limited because of poor flexibility of calves and hip/glutes muscles. In retrospection, this poor flexibility has been a major driver of my injuries until now because stiff calves obviously lead to more strain to achilles tendons and the hip mobility seriously affect my stride cycle in the right leg. So the prescription was for Stretching and Foam Roller daily (!!)...
  • Posture: like most of "office workers", the pelvis is tilted, with tight hip flexors and tight quads. Prescription: either change the type of job (unlikely) or stretching the muscles...
  • Leg length difference: a certain difference was measured. We verified that putting 2-3mm under the right leg made the body feel more balanced. So the suggestion was to add a heel lift of 3mm (NOTE: the outcome of this action has been mixed...I am at present very dubious about the overall benefit of adding a heel lift, because it affect my pelvis tilt.. )

  • Running (either barefoot or with shoes), back view

As you can see from the photo at the left, my foot hit the ground with quite an angle from the vertical. There is nothing I can do about it, it is related to my bow legs (see previous post on the matter). 
The major drawback is the added strain on the Achilles and also that all the impact load goes to the inside of the shoe.
So I have been always naturally attracted to use shoes with "anti pronation" devices, not really because I felt the the need to control the movement of the foot, but rather because being of more solid material in the inside they could remain in "good shape" a bit longer. Neutral shoes would get all tilted inwards after few miles of use...
I also have some custom made orthotics designed in a way to try to align the leg and the ankle during the run. 
Now, the interesting bit is that looking at the same stride a bit later in the movement, just before the tow-off:
you can notice how the feet did not actually tilt inward more or with the ankles rolling-in like it happens to real "pronators" (of which Mitch showed me an example). 
So system foot/ankle/leg remain "aligned" (well.. in a broken line) during all the contact with the ground.
The same back view wearing shoes (with and without orthotics) confirmed the pattern.
Hence, the analyst did come out with the suggestion that I might not really need orthotics at all.

(in retrospection, looking again to these images after few month, I did come to a personal conclusion:
the tilt of the legs while hitting the ground put anyway a lot of load in the inner part of the foot. I suspect that my problems with the sesamoidis are related...
So I feel that probably the best set-up for me is:
- running with "support" shoes (Mizuno Nirvana, Asics Kayano, etc) without insoles for easy / short runs (definitely support shoes with orthotics is a kind of overkill)
- running with neutral light-weight show (aka marathon shoes or lightweight trainers) PLUS orthotics for hard workout, long runs, serious training, races, etc... that should make a good balance between efficiency of the stride and the need to contain the "inward" forces during the landing phase (forces which either quickly destroy the shoe or my foot (or both)).

this is what happen to a pair of neutral lightweight trainers under my "care"...

  • Running (either barefoot or with shoes), side view

that was quite interesting: despite believing all my life to be a "heel striker" (see evidence from a race in 2008), things evolved a bit and my "running stride" improved after years of training...

 Actually now my leg lands on the ground with the foot in almost ideal "full foot" strike. The foot can dorsiflex at the very last moment for an almost ideal landing !!
The gait pattern seen from the side is much better of what I had expected.
Also the analyst remarked that I do run "almost" in proper form.

The main remarks:
- the pelvis is tilted anterior
- the right glute is not activating fully, so the movement of the right leg is not as fluid as the left one.
- Not enough strength in the glutes / hips, etc so you can notice  how much the upper part of the body "collapse" during the stride

- interesting to see how while running barefoot the landing is completely "flat footed", with no sign of heel striking as in the "with shoes" version...
This is another demonstration on how the best  way to improve the stride and eliminate "heel striking" is to get rid of those heavily cushioned trainers and run in lightweight racing shoes !! (while the barefoot running movement has reasonable conceptual fundamentals, it personally think it is a bit too far for most people and for sure not suited if you must run on concrete !)

Running (either barefoot or with shoes), upper body

 It is evident from the pics that my hips/glute strength is not enough and the other part of the body is "collapsing" during the stride.

So... at the end I got a good dose of feed-back on areas of improvement: stretching, flexibility, strength training, etc calibrated to my particular issues...
it is clear that some fundamental "weaknesses" (the bow legs, the inward pressure on the feet, etc) are not going to be solved with any exercise or therapy, but this is also why we are not all running fast like Bekele.. "Choosing the parents" is always the main driver...

Overall I felt that I was satisfied of the visit... for me, it was money well worth.
I would have like to have even more time to try all the possible configuration of shoes/orthotics that I have, but 2 hours is already a solid chunk of time.
In particular, if you are near Brighton, I would endorse StrideUK as a very good gait analysis lab...
It is clear that for similar gait analysis, the #1 success factor is related to the experience and the attitude of the analyst... if you end up in the wrong hands, there is no level of equipment which can alone generate a good analysis

Now, if you are running without injuries and you are satisfied of your running, most likely you can save yourself the hassle and the money and keep on going like you are already doing.
But for all those runners, like me, which might have something not working properly and are afflicted by injuries and poor running, it is probably worthy to open the wallet for a gait analysis and find a long-term sustainable solution, rather than ending up spending the same on physiotherapists, unsuitable pairs of shoes and most of all, being out of action...
Myself, I have now very clear what I should do... the only problem is finding the time to keep up with all the recommendations.
It will be nice to have reports from other people who had similar experiences with gait analysis, I will try to add them at the bottom of the post !

Happy Running!!

1 comment:

Ewen said...

Thanks for the report. I've never had gait analysis done but would now if there was a recommended place here.

Interesting about the different foot-strikes with shoes and barefoot - to be expected. Using a heel lift on one leg? Not sure about that - perhaps if it could be done gradually, millimetres at a time. I know Bill Rodgers had a quite substansial lift on one shoe.