Brian Schiff’s Blog

One of the most common PT clients I see is an injured runner.  There can be a umber of different reasons or factors involved leading up to a running injury, but I wanted to focus on this idea of gait retraining that is taking place today.  With the advent of Born to Run and minimalist footwear, people have begun to question and debate what the best way to run is.

Is this suited for everyone?

Let me just say right away that I do not believe there is a simple answer here.  Human beings are all unique and have different genetic and biomechanical makeups.  What this means in effect is that they have their own set of “issues” if you will that I classify into common categories such as:

• Static alignment problems (arch, knee, hip, etc)
• Static and dynamic balance deficits
• Inefficient gait mechanics
• Muscle imbalances
• Soft tissue tightness
• Recurring pain patterns

The list could go on and on, but you get the point.  The idea of “re-teaching” someone how to run differently than their natural motor pattern dictates in not easy and is a decision that should be well thought out and based on sound decision making.  We are pre-programmed at birth with certain native motor patterns and running is one of those patterns.  Generally, your brain finds the most efficient way for you to run in your own body.

Now granted, some run much better than others.  Perhaps we can say athleticism plays a role in this, but as we grow and reach skeletal maturity our body type, training experience, strength and environment are also major factors .  With that said, I know that runners with recurrent and/or chronic pain are looking for a finite solution to their problem.  They grow frustrated when they are unable to log all their miles or finish a race.

If traditional PT or relative rest fails to alleviate the pain, we must delve deeper and look more closely at their gait.  I think video analysis is a great tool for doing this.  We use Dartfish at my clinic, and this is very useful for breaking down gait mechanics and detecting things like heel versus forefoot striking, overpronation, asymmetry side-to-side, trunk inclination, etc.  Once we find things on video we must also correlate these findings to our clinical screening to uncover a cause and effect relationship.

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