What is biomechanical gait analysis?
Biomechanical gait analysis looks at how we move, and the mechanics of this, and therefore considers the forces placed on the body and its structures. It draws on principles of Physics to assess what is happening, combined with other clinical assessments that can help us piece together why it is happening. Biomechanical analysis also considers the functioning within us (alignment, flexibility, coordination and balance, and strength) and factors outside of us (footwear, training surface, training intensity, and training volume).
How can analysis of biomechanics help with physical performance including sports, and how does it help to avoid injuries?
Biomechanical analysis can assist in developing a running technique that is efficient, with minimal displacement of the centre of mass, which will in turn enhance performance as more energy will be conserved. The higher an individual goes when running, the more energy is used, and the more force is absorbed in contact with the ground.
In running specifically, looking at biomechanics and making small changes may reduce injuries and enhance performance. Factors such as an increased stride length can be linked to specific injuries. A narrow width of stride or where there is cross-over, will affect the kinematic angles at the hip and pelvis, increasing the load through the tibia.
Overstride may contribute to tibial strain/’Medial Tibial Stress Syndrome’ and stress on the patellofemoral joint. To reduce stressors, you may wish to try increasing the cadence (steps per minute) to reduce overstride and running with a larger stride width by means of re-education.
Orthotics can be considered as a treatment option to help modify how structures within your body are being placed under stress. This can, in turn, reduce symptoms as an adjunct to Physiotherapy exercises. One example is a heel raise that lifts the heel within the shoe. A tight Achilles tendon or calf muscle will restrict the upward bending motion of your ankle and the heel raise would offset this. Then when considering the rest of the body, if you are an individual with lower back pain, this may impact reducing the arch in the lower back and changing the load on this part of the body.
To improve sports performance and prevent sports injury, the capacity of the tissues in our bodies must be greater than the load. A slow and steady increase in load will have an increase in the training effect, which may translate into performance. Orthoses are used as a load outside of us, to change the load placed on us when moving and exercising. They may therefore be used to optimise how tissues in the body are loaded.
By this principle, analysis of biomechanics and consideration of orthotics can also be useful to consider when preventing injuries to bones where the stress and strain may lead to a fracture (break) in the bone.
After completing the assessments and considering biomechanics, small changes such as the type of footwear, conditioning, orthotic devices and joint supports may support improvements in pain, injury and therefore quality of life, and/or sporting performance.
What is assessed within biomechanical gait analysis, how, and what are the benefits?
Within clinics, Physiotherapists can complete observational assessments, and if the client consents to it, use slow-motion video to analyse walking and running more easily.
Observational analysis may look at:
– Head position
– Shoulder height
– Arm swing
– Pelvis movement
– Pelvic drop
– Hip extension
– Knee position
– Ankle movement bringing the toes up
– Position off the back of your foot/ankle
– Arch height
– The lift of your heel
– The pushing off through your toes
If a Biomechanical Gait Analysis is completed, it will likely be after a Physiotherapist has completed other clinical assessments and potentially identified a specific structure that has become overloaded. This is likely to guide them to look more specifically for certain things.
One example of this may be when an individual has a Tibialis Posterior Tendinopathy. The Physiotherapist may then look at:
• The structures:
• Leg length differences
• External hip positioning
• Tibial varum (bowed legs)
• Limitation in the toes to shin movement of the foot
• Foot posture
• Function and dynamic assessment:
• Strength in joints higher up (e.g. at the hips)
• Single leg control
• Single-leg heel raise
• Pelvic control
• Dynamic foot function
• Footwear performance
• Aspects of gait technique:
• Step width
• Step length
• Cadence
Other examples may include patellofemoral pain (a form of “anterior knee pain”), where assessments of movements of hip strength (including external rotation and abduction) and knee extension are likely to be beneficial.
Additionally, assessing for a pronated foot posture may be more likely to be present with Medial Tibial Stress Syndrome and Patellofemoral pain. A dynamic assessment in biomechanical gait analysis will provide more insight into biomechanical functioning.
When we think about movement when walking or running, most of this occurs in the plane that involves forward and backward movements. When a Physiotherapist assesses, it can be important to consider restrictions in movement through this plane. For example, if you have difficulty pointing the toes down as you walk, there may be an early bending of your knee and a reduced extension of your hip. As a result, there could be more recruitment of the glutes and quadratus lumborum (muscle of the lower back), and so the load through the lower back and pelvis changes.
Biomechanical gait analysis can have significant benefits in formulating a management plan that will help you, tailored to your injury, mechanics, and sport.
One example of this may be combining exercises to improve the conditioning and capacity of the Tibialis Posterior tendon while offloading the arch of the foot with orthotics. This may help to allow a return to running.
If you are having Physiotherapy with one of our Clinicians or decide to book in, they may include Biomechanical Gait Analysis as part of their assessments if it is relevant to the injury that you may have.