Adventures in Physical Therapy Week 1: Gait Analysis Results

Last week I had a running gait analysis done at the MedStar Harbor Hospital Sports Medicine Clinic. I have been to this clinic several times in the past- once after hip surgery, and then again 3 years ago when I was having problems with my piriformis. In 2012 I had a gait analysis done and worked with a PT for several months to addess imbalances. I got stronger but my symptoms persisted. I ended up stopping PT and began working with a chiro, and eventually got relief with dry needling. 

This time around I started with a chiro and had lots of ART and a few dry needling sessions, and was doing my own strengthening. Considering that it had been 2 months since my marathon and I had taken some time off and kept my mileage low, I wasn’t feeling as good as I would have liked. Even though I saw some improvements they were inconsistent. I would feel good for a few days, then something would bother me, then something different would bother me, and it felt like a never ending cycle. I felt like I couldn’t start training again without being back to 100%. 

physical therapy week 1

So, I decided some PT wouldn’t hurt and I figured I was due for another gait analysis which is included if I’m a PT patient. However, I needed a prescription from an ortho to go to PT, so that’s where I started. I got an X-ray of my hips which looked fine and I think the Dr. was actually a little confused as to why I was there with such mild symptoms (and the day I went I felt fine). He agreed that PT and another gait analysis was a good option, and saw no reason why I couldn’t continue running but suggested I avoid hills until I build up my glute strength. He also thought I might have a mild adductor strain, but nothing too concerning (basically, don’t do anything that makes it hurt, which running doesn’t. I notice it if I do boat pose in yoga or something like that). 

I was able to get in to PT the next day and saw the same guy I worked with the last time so it was nice that he knew my history already. He had me do squats and then checked my ankle range of motion- he said both looked good. I did side planks and lifted my top leg to push into his hand- he said that it seemed like I had good hip strength. I got on the treadmill for the video analysis, and that’s when everything fell apart. 

Despite all the strength and mobility work I do, my form still suffered- and it wasn’t like I had run a ton; I was only on the treadmill for 5 minutes or so.

hip dropMost noticeable was my  lateral hip drop. My PT thinks that even though I have the strength in my hips, for some reason its not carrying over to my running. Those muscles aren’t firing when they’re supposed to. 

My right arm swings out to the side, which may be a compensation for my hip drop. 

overstriding

I’m heel striking/overstriding again, which I hadn’t been since switching to the Pure line 2 years ago. 

heel whip

I also have this weird heel whip going on, which I noticed in recent race photos and may be due to my tight external rotators (piriformis in particular). Those tight muscles could also be preventing my other hip muscles from working properly. 

Next week I will talk more about what I’m working on in PT. So far a lot of my time there was spent getting manual work on my external rotators. I’ve also had the opportunity to run on the Alter-G treadmill, which was another reason why I felt like it was worth it to go back to PT for a bit. It’s nice to get some of my weekly mileage in on there where there is less impact. Right now I’ve been doing 3 miles at 80% body weight. (I’ve still been running outside of PT, just keeping my mileage in the same 20-25 mpw range that I’ve been in for the past month). 

altergWhew, that was alot of info! Any questions about anything? If you are in the Baltimore area this is a great place to go for physical therapy with alot of great technology. 

Have you ever run on an Alter-G treadmill?

If you have had a gait analysis in the past, what did you learn from it?

 PS: Don’t forget to enter my PRO Compression giveaway!

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I’ll be adding this post to Jill’s Fitness Friday link-up!

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61 thoughts on “Adventures in Physical Therapy Week 1: Gait Analysis Results

  1. I would love to have a gait analysis done. I feel like I pass all the strength tests too, so there must be something going n when I run. Thanks so much for sharing your results. I have wondered what results look/sound like.

    I did get to try an AlterG last summer to write a review about. Such a great concept, but sadly there is only one in my state over an hour away.

    Good luck!
    AmyC recently posted…Fitness Friday: The 4 Minute MileMy Profile

    • It seems like the alter-g is becoming a little more popular, so maybe there will eventually be one closer to you!
      Its crazy how we can have so much strength and it still doesn’t carry over to our running. Pretty frustrating!

    • Thanks! I liked that in this analysis I was filmed and then I could look at the still shots to see exactly what was going on. Hopefully addressing some of these problems will help prevent future injuries!

  2. The lateral hip drop looks pretty serious. Is that something that can be altered through PT? I’ve always heard about some people having uneven leg length, and there is nothing they can do about that changing. I do know if we compensate certain moves, you can injure something else. Good luck with your PT Lisa. I never heard of an Alter-G treadmill. Looks interesting.

    • So my understanding is that the hip drop is due to weak adductor muscles, or those muscles aren’t firing properly. A functional leg length discrepancy can happens when certain muscles are too tight pulling the hips out of alignment. Both should be able to be addressed with PT, manual therapy, and adjustments. My PT said that my SI joint was a little tilted, but we don’t know if my muscles were tight bc of my SI joint, or if my SI joint was tilted bc of tight muscles:) So we will work on strength and loosing up those muscles and hopefully that helps!

  3. It sounds like going to Pt is going to be a great resource for you! It’s really interesting to see your gait broken down like that. I’m interested to hear what you work on next. I’ve never gotten it done but would love to – I think it would make a huge difference!

    • Its definitely eye-opening! And probably good to know that for whatever reason the strength work I was doing before wasn’t necessarily helping…

    • I know! And the stuff I am dealing with is so hard to explain because its something different like every day and I feel like I sound like I’m crazy when I try to explain it to people!

    • Yes, I hope so! And I think its important to know that what I was going before wasn’t helping/carrying over to my running!

    • I think its really helpful to see exactly what we are doing when we run! I have always noticed little things in race photos but didn’t really know what it meant or how to fix it.

  4. Really interesting stuff! I’ve seen some funky things in race photos for myself and I’m curious what my analysis would look like. Hopefully this give you clear cut things to work on, although, it’s tricky because running form become such habit and such a tough thing to change! And you do so much strength work as it is!
    Michele @ paleorunningmomma recently posted…Chocolate Cashew Heart Candy CupsMy Profile

    • That is kind of what I am worried about and its probably why I am back to overtiring and the hip drop after working on it a few years ago. I think I will just always need to know that these are issues I will have if I’m not always aware/working on them.

  5. I’ve never had a gait analysis at the PT, but I should really do one. I’m almost afraid to hear what would be said about it haha. You got so much great feedback that I know will be useful in moving toward a full recovery!
    I’ve never tried the Alter-G either but after reading this and Charissa’s post the other day I’d love to try it out!
    Salt recently posted…NJ Marathon Training Week 7 RecapMy Profile

    • The Alter-G is really fun! Not sure where else in Baltimore they have it but the one I use also has self-pay options so you can buy time on there even if you’re not in PT. It would be really great if they started making them available in gyms and other places where they are more accessible to all runners!

    • The Alter-G is a nice option to have, but they just aren’t available in many places! I think it would be awesome if they were eventually available in more public places like gyms!

    • I am feeling really confident about getting things sorted out! I just hope my body cooperates quickly:) Its really crazy how much time I have spent at this PT office over the past 4 years, but I am so grateful to have found them and to have access to such great resources!

    • Thanks! I think most runners could benefit from learning more about their gait and what they could do to improve their running. Ya know, since most runners are constantly getting injured:)

    • That’s exactly what I was thinking! I realized I could sit around and wait for things to get better on their own (which they probably wouldn’t) or try to do something about it before things got worse.

    • Well at least it sounds like things are improving! I just think it can be hard to see exactly whats going on while you’re moving…I have filmed myself running and didn’t notice the hip drop until seeing it in still shot photos….but then again your PT was probably trained to notice any problems:)

    • When you say its on your right side do you mean than when you land on your right side that your left side drops? I’m just wondering which side you have pain/issues on…because I found it interesting that my right hip drops more when I land on my left foot and my right piriformis is constantly tight. Why do our bodies need to be so confusing and difficult? I am planning to share an exercise this week that I think could really help you!

  6. I haven’t had a gail analysis in a really long time, I’m probably due. I have run on the Alter-G, such a weird feeling but it’s amazing that I was totally pain free when I ran on it (while dealing with a calf strain)…too bad they are so expensive. Last time I was checked I had the hip drop as well. I’m curious to see if that has changed. At least you know the important areas to focus on now! Have a great weekend!
    Sue @ This Mama Runs for Cupcakes recently posted…Friday Five: 5 Things I’m Loving Lately!My Profile

    • I really thought my hip drop was better because of all the hip exercises I do but I guess not! The Alter-G is really great…I wish it was more readily available to runners!

  7. You know, I’ve never had a gait analysis and I probably should have gotten that. I don’t know if my PT overlooked it or maybe he doesn’t specifically do gait analysis, but I should probably mention it to see what’s up with that. Your gait analysis was so interesting and I’m glad to see you learned so much from it!
    Charissa recently posted…Bad situations are temporaryMy Profile

    • Not sure if all PTs do that but I definitely found it helpful! I’m not sure if we would have known what to work on otherwise since i appeared to have enough strength during the assessment.

    • That’s interesting! Is that the side where you were having knee pain? But if that is the only flaw in your gait than that is pretty good!!

  8. That is so great you were able to have your gait analyzed (and so quickly!) I have had it done a few times at PT and I have a lot of issues, mainly I have zero ankle mobility in my right ankle due to a surgery and I don’t activate my glutes at all when I run. Fun stuff!! The good news is that you know your issues so you can work on them!!

    I have used the Alter G and loved it–I blogged about it here http://www.lifebetweenthemiles.com/2014/10/15/running-on-the-moon-with-the-alter-g/
    Sara @ lifebetweenthemiles recently posted…4 Q’sMy Profile

    • Loved reading about your experience! I also get so sweaty in there:) Imagine if there were giveaways for Alter-G treadmills?! That would be amazing!
      I have a really hard time with glute activation too (I think that may have to do with the overstriding.) Good to have things to work on I guess!

    • So we are working more on releasing the pifirormis muscle…it had been much better after dry needling but then got back to being tight again. We are thinking it also may be SI joint related because that was slightly off. Its also weird bc my piriformis will be tight like every other day (not consistently).
      Also I’m working on strengthening abductors. I also have tight adductors that are pulling my legs in while we run. I started with pretty basic stuff but will hopefully progress more this week!

    • It seems so common! And I think we get so used to running a certain way that it can be really hard to make changes in form.

  9. This is super interesting stuff! I’ve never had my gait analyzed, but from race pictures, I know I have some hip drop. I have been paying extra attention to hamstring and glute exercises lately. I’m curious to see what some of your PT exercises are, maybe there’s some I can add into my routine :). Thanks for sharing this!
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  10. Wow, what a thorough analysis. I didn’t know that a heel whip was caused by tight hips. I wonder if my heels do that, I bet the right one does since my right hip seems to be stuck in a perpetual state of tightness right now. It will be interesting to hear what your PT has you do/what he does for you!
    Kristina recently posted…Butt Buster!My Profile

    • I don’t really get it either! I think its because my hip is tight in the back so my leg can’t natural swing through or something…not really sure! For that I think we are mostly working on relaxing the muscle and getting the correct muscles to work instead!

    • It can be so frustrating to go to PT and not get better…that has happened to me before!
      Thanks!

  11. This stuff fascinates me! I would love to have a gait analysis done. After having a functional fitness assessment which included a small portion of a gait analysis I started working on the correcting the imbalances and strengthening. Time and miles will tell if it was time well spent.
    jill conyers recently posted…Five Things FridayMy Profile

    • I was really a bit shocked to see how off my form was when I can pass all the functional tests pretty well. I guess i was just so used to running a certain way that doing the same strength exercises wasn’t helping anymore. I hope that your assessment led you on the right path and will help prevent future injuries!

    • Its pretty crazy the ways that flaws in our running can impact different parts of our bodies! Hopefully learning to address the issues will help!

    • So far all I really know for that piece is trying to get the piriformis to relax! And then i think from there working on using the right muscles to keep everything stable will hopefully prevent it from getting tight again…but I will share more as I learn more about what I will be doing!

  12. That is interesting. I bet finding out certain muscles aren’t firing when they are supposed to is frustrating!
    Hopefully, now you are on the right track to a solution!
    I have never run on an Alter G treadmill–sounds supercool. :)
    cheryl recently posted…Digging out…My Profile

    • It is a bit frustrating, especially because I don’t know how to fix it…but hoping that my PT does!:)

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