Gait retraining for runners

Tom Goom ‘the running physio’ discusses the role of retraining gait patterns in reducing running injuries on a recent ‘Physio Edge’ podcast. 

Here we’ve summarised some of the key themes from the podcast for your information. 

Why is it worthwhile trying to make changes to your gait? 

If you have a recurring injury, the purpose of retraining your gait is to try to reduce the load you are putting on the painful tissues, therefore reducing symptoms. However, it’s not always possible to make an immediate change if it’s too much effort or too fatiguing for the patient. Your physio will be able to guide you through a process of small changes until you are able to achieve the final goal.  

What are the key concepts in a successful running training programme? 

  1. Get the training load at the right level 

  1. Getting the right recovery and sleep to manage that training load 

  1. Strength and conditioning 

With this in mind, gait retraining comes in below all of these factors, and therefore it isn’t the biggest priority in managing running injuries. It is really important that you do address the factors above before you start to spend hours working on gait re-education! 

Can changing my running gait help my knee pain? 

It is always important to say that there is no ‘one rule fits all’ when it comes to gait training. Your physio will take you through a number of tests during your assessment to identify the causes of your pain and then advise you with a rehabilitative programme. This may eventually include gait re-education in order to reduce some of the load you are placing on painful tissues.  

Patello-femoral pain (anterior knee pain) is a common complaint in runners. With gait training in mind, as we land and load the leg during the mid-stance phase of running, before moving into the propulsion phase – if the knee is very bent, then the ankle is required to flex further (a position called dorsiflexion) and a greater load or force is put through the knee. In order to reduce the depth of flexion on the knee and therefore reduce the load, we can increase the step rate while running, causing less time to be spent in the ‘mid-stance’ position. If this is recommended, a runner will often need to gradually increase their step rate, perhaps with short bursts of effort at intervals during a run, before it becomes a natural step pattern for them.  Eventually, if this can be achieved it can reduce knee pain or injury. 

Should I change my current running pattern if I don’t have an injury? 

If you are running pain free, it would not be recommended to try to change your running gait. At the moment there is little evidence to suggest that changing your gait pattern can prevent injuries, and there are other factors which should be addressed as preventative strategies first.  

Emma Bradley