Research shows that gait pattern alone gives only limited insight in potential running related dysfunction and must be assessed together with the foot structure to understand the dynamic that can lead to injury.
The foot is a very complex structure and often undertreated in the rehabilitation of many orthopedic conditions including knee pain and low back pain. There are 26 bones, 33 joints and over 100 muscles in a foot. A typical foot is divided into the rear or hind foot, midfoot and forefoot. The rear foot is composed of the talus and calcaneus (largest bone in the foot), mid foot is an assortment of bones: cuneiforms, cuboid and the navicular bones (also known as tarsal bones) while the metatarsal and phalanges form the forefoot.
Our basic foot function is to provide a firm platform for landing and absorbing the impact during initial contact with the ground as well as a flexible lever important during the push off stage for walking and running. Foot structure affects the ability for the foot to pronate correctly (timing and the amount), the foot strike pattern and ability to absorb the ground reaction force.
The first phase of gait during walking is heel strike. At that moment 80% of the body weight is over the calcaneus and proper alignment of the articulating bones such as talus and tibia is critical for proper distribution of vertical forces. Bones turn and move on one another to make walking possible with assistance from our muscles and ligaments. Pronation of the foot is a typical occurrence during gait and plays a critical role in the reduction of forces acting on the foot from the moment the heel strike to toe off (beginning and end of a walk cycle).
Two most basic foot deformities are pes planus (flat feet) and pes cavus (high arches). Pes planus is often acquired in adulthood due to a mismatch between active and passive stabilizers of the longitudinal arch, which is the arch giving the foot the height. The etiology or cause of pes cavus is unknown and can be located in either of the three sites of the foot or in a combination of these sites.
Pes planus and pes cavus are often accompanied by hallux varus (great toe turned inward at a sharp angle), bunions, forefoot varus and hammer toes respectively. Considering that bones in the foot articulate with the tibia, which articulates with the femur that lives in the hip socket, one can see how a dysfunctional foot structure that triggers an atypical gait pattern will have an affect on the body, particularly on the knee and the hip.
Foot and gait analysis are critical in not only treatment of injuries but also for their prevention. Before considering a minimal shoe, zero drop shoe or a cushioned shoe the foot structure should be evaluated and understood so that a proper match is found. Sometimes an orthotic is a great solution. Particularly in cases where passive structures have been chronically lengthened and an alternative correction will likely fail.
A good gait analysis should consist of a form breakdown: head position, elbow position, foot to hip alignment and placement of the foot when landing. Because gait alters at different speeds, an analysis at base pace, medium effort and all out sprint is beneficial to take a closer look at mechanics and how they alter at different speeds. The recommendation would be to look for a professional that is detailed and understands proper gait as well as required body mechanics and alignment.
Remember, running by itself won’t cause arthritis or injury. Altered foot structure and gait pattern will.
Coach Martina knows that most athletes like to concentrate on the aspect of training that they are the most comfortable with, which are often long workouts with low effort (volume emphasis). While volume does play a role, shorter workouts at high effort (intensity emphasis) are also very important. Knowing when to do what type of training is crucial in succeeding and staying injury free. As a coach and a musculoskeletal expert, she creates plans that enhance physiological strengths of an individual and correct his or her weaknesses, which makes training fun, efficient and effective.