Gait Analysis with Function360

Monday, September 18, 2017

You probably have heard lately how I am struggling with my running.  My Achilles are angry with me, developing pain during and after runs.   When I stand up to walk, I usually waddle for a few minutes until I loosen up a bit.  I usually blame it on my age, but as a scientist, I am always willing to learn more.

The guys from Function360 invited me in for a gait analysis to look more closely at how my body moves.  I was really interested to see what they observed as I had a gait analysis done in Berlin 2016 at the marathon expo, which said I was a 'perfect runner'.  Then in the spring, I visited the Saucony Stride Lab and they made some suggestions on which shoes I would run well in.  These two sessions monitored my movement on a treadmill.  Function360 has a different trick up its sleeve.

Their office is conveniently located within walking distance of Moorgate and Liverpool Street Stations in Central London.  I brought a sporty set of clothes with me and my running shoes as I assumed my gait assessment would involve some running on a treadmill, as I had mentioned above.  Imagine my surprise when I learned my analysis  would involve standing still and then on one foot with my eyes closed.  There was some walking too (about 50 laps of the exam room) but I didn't even break a sweat.  Their gait analysis can fit in to anyone's day in the office without needing a shower afterwards.

I met with Mike, an ex-rugby player turned personal trainer who is working towards a masters degree in physiotherapy (he is also Irish and really tall).  He was very friendly during our meeting and made me feel at home in the exam room by explaining to me what I had to do while also asking me about my training and injury history. My measurements were taken on a Sensor Medic mat which feeds into Free Step program.  All the raw data is captured in real time, so Mike was able to explain a few things about my readings as we went along, such as where I put the most of my body weight when I stand (interestingly, my left heel which was where most of my Achilles pain was that day).  The entire appointment took less than an hour.

After I left, Mike went away to create a report for me within which he summarized the major points of my strengths and weaknesses based on the data collected.  The report also recommended what could be done to correct imbalances, such as custom insoles to help with my posture and pain.

The insoles are definitely an investment (starting at £200+) but will last for 10 years.  These are made from the scans so no further appointments are needed for a fitting.  Their custom design takes into account injury history and which sports they will be used for. The material used and the type of insoles (full length or 3/4 length) are chosen based on customer preference and intended use.

My dynamic results after pacing back and forth a million times

The report was sent to me by email and it fairly technical in the summary.  The highlights were:
  • Static:  The centre of pressure of the left (L) and right (R) leg are not on the same line. The L leg's centre of gravity is backwards and the R leg centre of gravity is forwards with respect to the body centre of gravity
  • Stability:  Postural sway is almost double the normal value in a double leg stance (eyes open and closed), indicating pelvic instability and weak hip stabilisers
  • Dynamic:  There is reverse gait on the R foot (I go back on myself after the toe off phase, increasing chance of overloading and further wear and tear).  There are elements of uneven gait which needs to be corrected to enhance my performance and reduce risk of injury. The structural imbalance in the rear of the R foot and the collapsing of the arch in the L foot need to be corrected/supported with the use of insoles. 
My suggested rehabilitation plan includes:
  • Glute activation in closed chain, bilateral and unilateral exercises, gradually progressing and increasing loading
  • Balance/proprioception to increase stability at ankle, knees and hips
  • Opening up the hip flexors and adductors to allow glutes to activate more.

Sway test results with eyes opened and closed

You might want to know what happens after the analysis is done.  Me too, so I talked to Mike about what the results meant and what I need to do next.  His answers are in italics.

How 'normal' are my results?  Do most people have an imbalance or just the clientele you attract?

Yes, most people have imbalances and can live with them with no problem. The importance of addressing these imbalances is heightened in active people (athletes etc). Many people live with imbalances and are totally fine, but when you are impacting the joints on unstable joints or muscles with imbalances this is where the problem lies because damage will occur.

Your results are not abnormal, they are normal imbalances, but your activity levels and injury presentation suggest that addressing these imbalances is important.

Trying to stand on one foot with eyes shut
In terms of correcting problems, do clients come in once a week for an hour?  Do they have 'homework' to do?  How long does 'rehab' usually take?

Correcting the ‘problems’ depends solely on the patient. What we do is identify where the work is required, we then give you the option of working with us weekly or every other week on your specialised rehabilitation, constantly progressing the program, or you may choose to come in every few weeks for a reassessment and update of the program whilst carrying out the prescribed program alone at home. It is usually quicker when the exercises are carried out with a therapists present, because they are monitoring form/technique and also progressing the movements more frequently. 

The duration of rehabilitation varies. We can help you to progress as much as you like, and performance progression is endless. Our initial goal would be to target the obvious imbalances, reduce your injury risk and optimise your performance at the basic level. Moving forward we can do more sports specific rehab with you, and this can be progressed as much as you would like it to be.

In my case, what will happen to my gait and body pains if I decide not to take on board your recommendation?  Or just do insoles or rehab, not both?

I am not very good at it
This is difficult to answer. Running and impacting the body with imbalances causes pain/injury/damage, but the presentation is different with everybody. To us, the rehab is the most important phase of the process because building strength to support your sport is greatly important.

The insoles will provide foundations for your strength to be built on, and provide stability to the structural imbalances that rehab does not address (arch collapse, ankle rolling etc).

Why don't you have runners run during the gait analysis?  Does their gait not change?

The gait pattern with walking provides enough information for us. The imbalances found on the analysis would be heightened in the running cycle.

Does 'reverse gait' on right foot mean I am a heel-striker?

No, reverse gait means that you are going back on yourself (usually due to joint instability), so after your toe off phase you go back onto your foot, essentially slowing you down.

Will the rehab exercises make me any faster?  I don't think genetically/anatomically my body is designed to be springy.

The rehab will definitely make you faster. Your muscles drive your running, if you have imbalances in the muscles that are propelling you forward, you are not running at your maximum potential. If you fine tune those muscles to propel yourself forward without hindrance you will run faster. The insoles will also help with this.

If you stabilise the pelvis through rehab, work on single leg stability and balance to increase ankle stability and then reinforce these progressions with a solid landing through insoles you will definitely run faster and be at less risk of injury.

Well, what am I going to do next?  With my life goal to qualify for the Boston Marathon in 2019, it makes sense that I start to work on my balancing my imbalances.  I will try anything that will get me faster.  Track was making a difference to my speed but I know that strength training will help too.  Having knowledgeable coaching will make a big difference too.  My next step will be to get back in touch with Function360 and see how we can move forward.  I will keep you posted on what actions we decide to take.  #BQorBust

Thank you to Function360 for the complimentary gait analysis.  All opinions and imbalances are honest and my own.

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