By Luther Chiew (Physiotherapist)
Premier Sports Medicine
A running gait analysis can show how you move at a particular speed and how your movement changes after a cue. It can help a clinician form and test a rehabilitation plan. It cannot identify the single cause of every injury, predict all future injuries or prove that one running style is “correct”.
Need help with recurring running pain? See our Running Injury Clinic assessment and treatment.
Quick takeaways
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Video is one part of a runner-specific assessment.
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The findings need to be interpreted with symptoms, training and physical capacity.
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A visible difference is not automatically a problem.
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Gait cues can change biomechanics, but one cue does not suit every runner.
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The useful question is what change helps your symptoms and goals without creating another load problem.
What happens during a running gait analysis?
A clinician will usually ask about the problem before recording any video. This may include where symptoms occur, when they start, recent changes in training, footwear, previous injury and what you want to return to.
Video may then be recorded from the side and behind while you run on a treadmill. The clinician may review:
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step rate and step length;
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where the foot lands relative to the body;
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trunk and pelvic movement;
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hip, knee and ankle movement;
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left-to-right differences;
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how the pattern changes with speed or fatigue.
Not every measurement is needed for every runner.
Can video diagnose a running injury?
No. A video can describe movement; it does not diagnose tissue damage by itself.
Two runners can show a similar pattern and have different symptoms. Another runner may have an obvious left-to-right difference and no pain. The video has greater value when combined with the symptom pattern, clinical examination, strength or capacity tests and training history.
A good analysis does not label every difference as a fault.
What can gait retraining change?
Running retraining uses cues or feedback to alter a selected part of the running pattern. Examples include a small change in step rate, reducing a marked overstride, changing trunk position or adjusting how quietly a runner lands.
Systematic reviews show that feedback can change step rate, joint movement and loading measures. The evidence is clearer for changing biomechanics than for preventing all injuries.
Some research supports gait retraining for selected runners with patellofemoral pain. Evidence for other injuries is less certain, so changes should be based on individual findings rather than a standard checklist.
Is there a perfect running technique?
No. Healthy runners use different step rates, strike patterns and movement strategies.
Height, speed, experience, terrain, footwear and fatigue all affect running form. A runner does not need to look symmetrical or copy an elite athlete to run well.
The aim is not cosmetic. A change should have a clinical reason, such as reducing a provocative load, improving comfort or supporting the next stage of rehabilitation.
What can gait analysis miss?
A short treadmill recording may not reproduce the conditions that cause symptoms outdoors. A runner may only feel pain after 40 minutes, on hills or at race pace. Fatigue, surface, wind and changes of direction are also different outside.
Treadmill and overground running are broadly comparable across many measures, but research reports some differences in foot-ground angle, contact time and joint movement. The assessment should account for those limits.
Video also does not measure recovery, sleep, total weekly load, nutrition or how the runner responds the following morning. These can matter as much as what appears on screen.
When can gait analysis be useful?
It may add value when:
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pain appears during a repeatable part of running;
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a runner cannot progress despite sensible load and strength work;
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symptoms change with pace, hills or fatigue;
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a clinician wants to test a specific cue;
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the runner needs a measured return-to-running plan.
It may be less useful when pain prevents safe running, the presentation needs urgent medical assessment or the main issue is already clear without video.
What should happen after the analysis?
The runner should leave with a simple explanation and a small number of actions. These may include a temporary running adjustment, strength or capacity work, and a plan for changing training load.
If a gait cue is used, it should be practised in manageable doses. Changing too much too quickly can move load from one area to another.
The change should then be reviewed against symptoms and function. A video that looks different is not enough; the runner’s response matters.
What may Premier’s assessment include?
Premier’s runner-specific assessment may include the running and injury history, symptom assessment, strength and capacity testing, mobility or movement assessment, and treadmill video when clinically useful.
Premier’s Running Injury Clinic:
https://premiersportsmedicine.com.au/classes-programs/running-injury-clinic/
Common questions
Do you need to be injured to have a gait analysis?
No, but the analysis should still answer a clear question. Screening cannot guarantee that an injury will be prevented.
Will you be told to change your foot strike?
Not automatically. Research does not show that one strike pattern suits every runner.
Is treadmill analysis accurate?
It provides useful information about treadmill running. The clinician should interpret it alongside outdoor symptoms and the known differences between running conditions.
How many changes should you make at once?
Usually as few as needed to test the clinical idea. One clear change is easier to practise and assess than several cues at once.
References
Doyle et al. Effectiveness of gait retraining on running biomechanics:
https://pubmed.ncbi.nlm.nih.gov/35128941/
Agresta and Brown. Gait retraining using visual and auditory feedback:
https://pubmed.ncbi.nlm.nih.gov/26158882/
Barton et al. Running retraining for lower-limb injuries:
https://pubmed.ncbi.nlm.nih.gov/26884223/
Van Hooren et al. Treadmill and overground running biomechanics:
https://pubmed.ncbi.nlm.nih.gov/31802395/
If running pain keeps returning or is stopping you from progressing, book a Running Injury Assessment with Premier Sports Medicine:
https://premiersportsmedicine.com.au/classes-programs/running-injury-clinic/
About the author
Luther Chiew is a physiotherapist at Premier Sports Medicine with an interest in running, sports and overuse injuries. His background includes strength and conditioning, and he holds a Bachelor of Applied Science and a Master of Physiotherapy Practice from La Trobe University.
Read Luther’s practitioner profile.
Clinical content reviewed and approved by Luther Chiew, Physiotherapist.
This article provides general education. An individual assessment may lead to different advice.
