Out of the Gait: A Sock Doc Review of Running Gait

The interest in minimalist and barefoot running shoes has shifted runners’ attention from banging out long training runs or speed work to something more fundamental: how to naturally improve one’s form. This is not as easy as it sounds, since it involves more than knowing where your foot lands. To help shed light here, Zero Drop asked  Sock Doc to look at the key aspects of gait. In the first of a two-part series, I examine injury and its relationship to gait.

The gait of any person, especially a serious runner, is also sign of health. A lot can be understood by looking at a person’s form to see what is working well and what is functioning sub-optimally. Take for example, a runner trying to run through muscle tightness in the hip. You would most likely see him or her running or walking with the affected leg swinging out to the side, trying to compensate for the injury through a shift in weight.

Many runners are chronic compensators even though they might not even realize it. The athlete goes from one injury to the next, never really completely healing the previous injury, only altering their individual style and gait, (body mechanics), until the pain is subdued or eliminated. Soon, that old injury is no longer felt, but a new one pops up, and the compensations begin again. Eventually, the body is unable to keep up with all the altered gait mechanics and the individual is stuck with that chronic nagging injury that “comes and goes” or even worse, just stays.

Even before an injury occurs, a change in gait mechanics can be seen. Sometimes it is such a small biomechanical difference that it can only be noticed if the athlete is videotaped while running. Other times it is obviously noticed from the other side of the track or running beside the person. But it is always there if the athlete’s health or fitness is suffering; it just sometimes takes a trained eye to know what to look for.

One common gait imbalance many people have is a longer stride on one side than the other. The side of the shorter stride is usually the problem, or soon to be injured side. The short stride could be due to a tight hamstring or tight calf muscle on that same side; or it could be due a low back problem or foot dysfunction on either side. The person may feel fine at this point, but he or she is not performing optimally, evident by the imbalance. But why is that injury there? Why does it just all of a sudden show up as a muscle pain or joint ache or even worse – a pulled muscle?  There are many reasons for this.

One common reason is past injuries. Gait and body mechanics are highly influenced by past injuries. Some estimate that up to 80 percent of all injuries ever incurred by a person result in body compensations and altered gait mechanics, almost as if the body has a muscle memory of the injury. This is the person who has just “never been the same” since a long-ago twisted ankle or pulled groin muscle. Perhaps that sprained right ankle finally better, but the gait has now compensated to shift more to the left, soon resulting in some left hip pain or lower back problem.

Another common reason for injuries is stress, due to emotional, nutritional, thermal, or physical stressors. Muscle function is impaired when influenced by stress. The stress may be physical such as an improper pair of shoes causing the foot to land incorrectly and thereby putting stress on the foot, knee, and hip. It may be a thermal stress from running in the cold winter or hot and humid summer weather resulting in muscles contracting and relaxing in an unaccustomed manner. The stress may be from a nutritional imbalance such as dehydration, glycogen depletion, or even a nutrient deficiency. And muscle function can even be altered by emotional problems and mental stress. Have you ever had a bad day at work that just mentally drained your legs feel heavy? That’s emotional stress causing physical problems. Some muscles will become over-facilitated which means they will work harder than what they normally would, while other muscles, usually the antagonist (the opposite side), will become fatigued. This imbalance often results in a gait disturbance.

You may have seen a runner who “shuffles” as  he or she runs, barely lifting the  legs off the ground. Some start their run with a normal gait, but end up shuffling as they miles go by as their hip flexors have fatigued and have lost optimum function. Basically, the muscles are not working as well as they should. The muscles are impaired, and power is lost, and along with that, the gait is disrupted. Now other flexor muscles on the front of the body are going to have to work harder to help them swing their leg forward. One common muscle that will do this is the abdominal muscles. Sometimes a side stitch or cramp can result.

Conversely, there are those people who have that really pronounced kick when they run, so they almost hit their behinds with their heels. These individuals have hamstrings muscles that are working too hard and a hamstring pull is just waiting to happen. The individual usually complains of tight or aching hamstrings, even though the problem, the true cause, often initiates in the quadriceps muscles, the antagonist muscle on the opposite side. The runner will want to stretch the tight hamstrings but it will not help because the problem is on the other side of where the tightness is felt. Plus, stretching never has helped an injured muscle or even prevent an injury, though it’s a ritual for many. Many studies such as the recent one by USA Track & Field involving 1,400 runners showed no injury reduction in those who stretched compared to those who didn’t. Stretching does absolutely nothing to facilitate or “turn-on” a muscle and nothing to inhibit (relax) the muscle and actually elongating an injured muscle by stretching further inhibits the muscle, leading to delayed healing.

A runner’s upper body can also tell a story about muscle imbalances and impaired gait mechanics. One example is the person who runs with their head tilted to one side. This is often because of an imbalance in the psoas muscles, which are the big hip and lower back flexors. The head will tilt away from the side that is fatigued. This is also known to cause breathing problems as the connective tissue from the psoas muscles joins with the diaphragm – the major breathing muscle. Other runners run with one arm swinging way out to the side and the other one tucked close in, aiming straight ahead. This is due to some shoulder or upper arm muscle imbalance, perhaps from a foot, ankle, or knee problem on the opposite lower limb as described above. Their training partners know what side this is, they run other the other side!  Upper limb issues can be a local muscle imbalance problem but they many times tie-in with a gait dysfunction. Due to normal gait mechanics, the upper limb on the right side and the lower limb on the left side work together in harmony in a normal gait pattern. The same is true for the left upper limb and the right lower limb. So an upper arm problem could be due to a hip, knee, ankle or foot problem on the opposite side, perhaps from a poor fitting pair of shoes, or possibly from some injury in the leg. The upper are on the opposite side is a reflection of this problem as the runner tries to once again, compensate and adapt for the injury.

Ultimately, there are many factors that can and will influence gait. A gait imbalance must be investigated entirely throughout the body, as a muscle dysfunction or imbalance anywhere in the body can affect the gait. Gait can also be influenced by nutritional factors as much as it is affected by physical imbalance and improper footwear. In part two, I will discuss nutrition and gait.

Part Two can be read here.

This article was originally written for Zero-Drop.

Dr. Stephen Gangemi "Sock Doc"

I'm a board-certified chiropractic physician and clinical nutritionist with a passion for true natural health care. I implement dietary & nutritional therapies, exercise & movement practices, and lifestyle changes along with manual therapy techniques to help the body heal and prevent illness and injuries.