Want To Run Better, For Longer and Stronger?

Consider Gait Retraining

Jeremy has been involved in a multi-centre international study in to the role of Gait Re-training in the management of lower limb conditions.

This research has involved discussing the role of modifying a runner’s technique to manage injury, with expert clinicians, researchers and running coaches from Australia, United Kingdom and the United States. The process of “Gait Retraining” involves assessing an individual’s injury and providing a diagnosis. Once a diagnosis of the injury is clear the way in which an individual runs or “Gait pattern” can be assessed. This usually takes place on a treadmill with video assessment. Our Physiotherapists with a comprehensive understanding of injury and running mechanics can fine tune running technique to “offload” and redistribute loading forces or “joint stress” away from the injured site.

Expert opinion is that running is a skill that has desirable technique attributes, much like swimming or hitting a golf ball. Improving or making subtle changes to a technique can allow you to recover from an injury and potentially improve your performance by allowing an unhindered training routine.

Injuries that respond well to Gait Retraining include:

Anterior Compartment Syndrome also known as Biomechanical Overload Syndrome,

Anterior compartment syndrome or Biomechanical Overload Syndrome is characterised by pain that is located at the front of the shin. This Shin pain is usually located on the outside or lateral aspect of the shin, in the muscular region. Pain is usually widespread across this region, rather than a localised spot.

Pain usually increases the longer someone runs. People that suffer from Biomechanical overload usually have pain that builds at the start of running and can at times force them to stop running as the front of their shin aches and produces a strong pressure or aching sensation. Pain from this usually resolves within 2- 15 minutes after ceasing activity. This is a common problem in long distance walkers, recreational runners and sports such as netball, and all codes of football.

Tibial Stress Reaction/Fracture or Shin Pain

The tibia is the large long bone in your lower leg, commonly referred to as the shin. With repeated exposure to load such as running, the tibia may experience excessive loading. Repeated long runs or an abrupt increase in training loads, can lead to the Tibia producing a stress reaction or a stress fracture.

A stress reaction can be a painful region of bone that has been exposed to a higher volume of loading than it can tolerate.

A stress reaction is on the same continuum as a stress fracture, commonly a stress reaction may progress to a stress fracture if it is not managed appropriately. A stress fracture is a small break in the continuity of the bone, and often requires a lengthy period of time on the sidelines resting.

Tibial stress fractures are in the top 10 most common injuries for runners. They typically average 8 – 12 weeks to rehabilitate and have a recurrence rate reportedly between 10 – 36%. Apart from training loads running technique has been identified as a potential contributor to stress reaction and stress fracture in the tibia. Subtle and simple changes to a runners technique can decrease loading rates in the tibia by up to 30%.

This decrease may be enough to settle pain associated from stress reaction to allow runners to continue to run and achieve their goals without pain or further injury.

Patellofemoral Joint Pain Syndrome (PFPS)

PFJP is characterised by pain around the knee cap that is produced with activities such as running, squatting jumping or landing. PFJP is the most common knee pain in runners, and alarmingly has been reported to have a recurrence rate of up to 90% of people suffering the condition.

The development of PFJP can be multi-factorial. One of these factors that is often not adequately addressed by health professionals is running technique. Attributes of running technique that are commonly observed in PFJP include:

  • Overstriding
  • Slow step rate
  • Cross over gait pattern
  • Increased adduction and internal rotation of the hip (scissoring knees).

It is often possible to abolish pain associated with PFJP by changing the running technique alone. Knowledge of both the injury process and running mechanics is crucial. Once an injury such as PFJP is recognised simple and often subtle changes to a runners technique can effectively unload the knee cap and redistribute the impact elsewhere within the lower limb and trunk.

Often gait retraining does not require you to cease running. Unlike some other interventions gait retraining involves the client to continue to keep running.

If you have knee cap pain that returns with running regularly, ensure you have a clinician thoroughly assess your running technique.

Illiotibial Band Friction Syndrome or Runners Knee

This is the second most common injury reported by runners. Pain is felt on the outside aspect of the knee. Much like Patellofemoral joint pain, pain often starts mid run and at times forces runners to stop. The pain can be a sharp, grabbing pain when the runner lands on that leg. Again similar to PFJP runners often have a combination of

  • Overstriding
  • Slow step rate
  • Cross over gait pattern
  • Increased adduction and internal rotation of the hip (scissoring knees).

In much the same fashion of management of PFJP this condition can be managed by impact modulating technique changes and redirecting loads to other regions of the lower limb, that can tolerate greater loading.

Lower limb Tendon Pain

Common sites for tendon pain associated with running include

  • Hamstring insertion, pain is usually felt high up the back of the leg, or the base of the bottom.
  • Achilles Tendon pain at the base of the heel or 2 inches above the heel with thin Achilles tendon.
  • Gluteus Medius tendon, pain on the outside of the “Hip” or lateral thigh.

Tendon pain from running can be produced during running and also 1-2 days after a training session. Often patients with tendon injury report being sore in the morning either a day or two after running. Tendon pain is usually multifactorial and running technique is one factor often missed in the rehabilitation process. Tendon pain is frustrating as it is often recurrent and stops a runner from running, or limits their ability to make progress either with running distance or performance.

These conditions can be managed by impact modulating technique changes and redirecting loads to other regions of the lower limb, that can tolerate greater loading.

Often gait retraining does not require you to cease running. Unlike some other interventions gait retraining involves the client to continue to keep running.

If you have pain that returns with running regularly, ensure you have a clinician thoroughly assess your running technique.

So if you have lower limb or back pain with running book an appointment for a thorough assessment of your injury and running form, to ensure you get Back On Track and Stay On Track, why settle for second best?