How We Do Gait Analysis
For many of us the uncertainty of not knowing what’s causing our pain is what prevents us from moving forward. A major part of our job is not only treating pain but identifying its underlying cause. If you suffer from unexplained or unsuccessfully treated foot pain, hip pain, knee pain or low back pain the answer could be in your feet.
The gait analysis process involves a brief history and then you will be asked to walk across a plate with 4000 sensors which is attached to a computer. The plate takes a very detailed moving image of what the feet do during your walking cycle. The entire gait analysis process takes around 30 minutes.
What We Look For On Your Scan
Gait Scan is a ‘functional movement’ scan of how you bear weight through your feet when you walk and run. It reveals a huge amount of information about the most common sources of pain in feet, ankles, knees, hips and lower spine. Gait Analysis reveals the source of stubborn lower body pains and recurrent injuries in the overwhelming majority of instances. It is so intuitive that our patients can usually spot the reason for their pain once they look at it themselves.
What we look at extremely closely on your gaitscan are the parts of each foot that take the most pressure when you heel strike, when you bear your full weight on your foot and when you propel yourself forward. In addition to direct pressure readings, gaitscan tracks your centre of gravity with minute precision during each of these phases. The location of your body weight in each of the 3 phases reveals a great deal of information about the behaviour of your ankle, knee, hip and spine.
If there is an unusual twist in your right knee as you load your weight onto your right foot for example, it will come through on the scan as a sudden inward shift of your body weight on the scan.
If your arches are collapsing on you when you walk, your centre of gravity will take a very distinctive path up the inner margin of your foot.
If you have an old unrehabilitated ankle injury on your left side its weakness will be revealed by the fact of how little weight you bear on that side, people are often amazed to see the ‘signature’ of old injuries on their scan.
In keeping with that age old observation about knowledge being power. Knowing in great detail what your feet and lower limbs are doing while they bear your weight (3 million times a year on average) empowers us to work together on the weaknesses and imbalances we find. One of the things we really love about Gait Analysis is how intuitive the findings are, most of our customers are really blown away by the clarity and understanding that they have about their pain once we have talked them through their scan.
Why We Do Gait Analysis
Gait analysis is a tool for those who are interested in long term prevention of pain. Gait analysis is a stepping stone to tailored forms of rehabilitation that target your specific issues. When the root cause of your pain has been uncovered it takes all the guess-work out of treatment and rehabilitation of your lower body pain.
We believe that all pains have a story to tell and that there are genuine underlying physical issues behind all stubborn pain, even the stress related kinds. The truth is, stubborn pains are preceded either by a significant injury or by deep and persistent patterns of weakness, misalignment, or scar tissue within the body. In other words, you don’t get sore overnight, and you certainly don’t get chronic pain overnight, unless you have had a major injury.
The weaknesses and misalignments that precede our pains can occur as quietly and invisibly as the creeping damage to arteries does in heart disease, or the microscopic erosion of tooth enamel at the hands of sugar addicted bacteria.
Slow, silent, microscopic, degeneration and irritation of tissues caused by weaknesses and stubborn mis-alignments, that is pain in its dormant form. Eventually though of course the pain does come, first often as a ‘minor injury or a niggle that either doesn’t settle or tends to reoccur.
We love using Gait Analysis to demystify the genuine underlying reasons for our client’s pain, it’s something we get really nerdy about and that’s no bad thing. The deeper reason for our enthusiasm, however, is that we know this kind of information can completely transform people’s quality of life.
The ability to stand and move freely in a state of comfort is absolutely essential for our health, wellbeing, and for our enjoyment of life. Even for those of us who don’t reside at the sporty end of the spectrum, the freedom to move comfortably is a basic part of leading a normal healthy existence.
As important as all this is, we live in a culture full of people suffering unnecessarily with pain and limitation. Pain that could be easily avoided with extremely simple measures. We have all heard horror stories about what people’s teeth were like before dentistry came of age, going by the data we are potentially every bit as terrible at preventing joint, muscle, and back pain right now!
One of the many leaps of understanding we will need to make (as a culture) in order to start doing a better job of managing and preventing pain is to quit trying to diagnose pain as if it is a ‘disease’. In more specific terms this means acknowledging that we can’t see weak hip stabilising muscles on an x-ray, there is no blood test for flat feet and an MRI scan can’t tell you if your core is weak.
Virtually all muscle, joint and soft tissue pain relates to movement, therefore it is movement that must be scanned, measured, and assessed.. that’s where gait analysis comes in. If the basis of pain is patterns of movement and weakness and then it is primarily movement and weakness that we must assess.
*X Ray’s scans and blood tests are of course extremely important diagnosic tools in a relatively small percentage of pain cases, we use them ourselves frequently. People are often quite surprised to learn that leading pain experts agree with us, about the fact that they are only relevant and useful to a minority of pain sufferers.
Not so long ago, all dentistry involved was waiting until you couldn’t handle the pain anymore and then pulling your tooth out. This is the exact same approach most doctors and surgeons take with arthritic hips to this very day. We are lead to believe that there is nothing that can be done to manage or prevent wear and tear in our joints other than surgical replacement.
These days we consume more sugar than we have ever done and yet we have less tooth decay than we have ever had, and we have fewer tooth extractions than ever also. All thanks to what we know about ‘dental care’. We believe that achieving the same feat could easily be achieved with all the back pain, foot pain, plantar fasciitis, ankle sprains, knee pain, ACL tears, osteoarthritis, hip pain and back pain etc. that we suffer with.
On average we take around 3 million steps per year. When you decide to come down out of your tree and start walking upright the stakes become quite high for your feet, ankles, knees, hips, and spine. A clue to this is the fact that your knees are more than twice the size of any 4 legged animal with the same body mass as you.
Getting this in depth, ‘functional’ view of what the feet are doing forms the basis of our custom orthotic prescription. We believe in correct ‘movement’ of the foot as opposed to the shape of the foot because we believe that most pain comes from the way in which we move.
Who Needs Gait Analysis
It is not always easy knowing where you should go to ask for help if you have a specific complaint. Obviously, not all practitioners are interested in all complaints. We pride ourselves on being transparent about the specific pain complaints that he have a strong track record of success with. There are a significant number of pain conditions that we can help you to manage, this is because we use a wide range of tools and approaches.
A percentage of all back pain cases are caused by movement and alignment problems in the feet and their connections to the knee and hip joints. On average we take over 3 million steps a year, and we do so mostly on unnaturally hard flat surfaces like paving concrete and tarmac. The jarring forces caused in our leg bones transfer directly through the pelvis into the delicate spinal tissues and can easily become a source of pain. Many of us get away with this form of stress in our lives without it turning into back pain because we have correct alignment through our lower bodies. Those of us with alignment and movement issues in our feet, knees, and hips are however susceptible to developing this kind of back pain.
Gait Analysis is an effective way of identifying whether your feet are causing your back pain. Knowing exactly what is happening when you walk in this way takes all the guess work out of creating longer term solutions to your back pain.
Your hips do an incredible amount of work during your lifetime, they are the major hinges that connect your upper body to your lower body and they bear the weight off your entire upper body every time your heel strokes the ground. The hip is the most common joint in the human body to be replaced for good reason. Correct alignment through the hip during walking and running is absolutely essential for a lifetime of healthy pain free function of your hips. Gait Analysis can often reveal the underlying reasons for hip pain and even osteoarthritis to develop. Accurately identifying faulty movement patterns in the hip is an essential step if you wish to work towards consistently pain free hips in the long term.
The fossil record shows that the human knee doubled in size very fast once we started walking upright, this should offer a glimpse of how much extra strain there is in a knee when you decide to walk upright. Correct and healthy function of the knee is intimately connected to movement and correct weight bearing of the feet.
If for example you have an arch that collapses when you walk this creates an awkward inward rotation of the knee with every step, an issue like this is more than enough to cause damage to the soft tissues of there knee over time. These kind of mechanical issues in the feet can even help predispose you to major knee injuries like ACL tears. Using Gait Analysis to identify weight bearing issues within the knee and foot connection is an excellent way to inform rehab decisions for knee pain sufferers.
Ankle Pain and Ankle Sprains
The ankle may be the joint that performs the biggest party trick of all weight-bearing joints. The ankle bears more weight than any other major joint, and yet it has less immediate muscle support than even a small non-weight-bearing joint. The secret to the ankle’s success is in its design, but it is a design that has its limits.
If you have alignment issues when you bear weight through your foot and ankle it weakens the soft tissues that hold the ankle together during all that work. In a percentage of us, this can predispose us to ankle pain and ankle sprains. Gait Analysis is a reliable way of identifying the underlying causes of ankle pain and the residual weaknesses left behind by many ankle sprains.
Foot Pain, Heel Pain, Arch Pain & Plantar Fasciitis
The soft tissues in the sole of the human foot spend their lives sandwiched between the heel bone and the hard flat surfaces that make up our urban environments. Being compressed like this with every footfall (over 3 million of them each year) means that pressure needs to be evenly distributed or damage cam occur to the connective tissues.
If for example you don’t heel strike evenly pressure can build up in certain areas, this can lead to damage of collagen fibres and scar tissue build up in the heel. If your arch collapses it cam become over-stretched with time and similarly cam develop scar tissue. Gait Analysis can easily identify the cause of heel pain, arch pain and plantar fasciitis in almost every instance. Knowledge is power and great plans of management become possible when you know the root cause of your pain.
IT Band Syndrome
The most common cause of IT Band Syndrome is repetitive strain. If your arch collapses when you take a step and bear weight it causes internal rotation of the hip and thigh. This kind of internal rotation of the hip and thigh puts stress through the IT Band and over time it reacts by tightening.
You can foam roll all you want but if you don’t identify and work on the underlying cause of your IT Band issues you’ll be rolling for a long time. The alignment of the foot and the strength of the glutes usually need to be addressed in order to make real progress with IT Band issues. Performing in depth Gait Analysis to identify exactly what is happening is the first step towards tailored solutions.
People who suffer from shin splints generally either have major alignment issues or major muscle recruitment issues in the lower limbs. The kind of pain and pressure that come with shin splints doesn’t just show up out of the blue. Gait Analysis is an excellent way of digging into the possible underlying causes of shin splints with a view to putting preventative measures in place. Some might say this is a good thing to try out before you let someone cut a 6 inch hole in your shin in an attempt to reduce your pain.
When it comes to explaining the connection between Gait Analysis and osteoarthritis in the hip and the knee we generally like to let logic and facts do the talking. More than 90% of all hip replacements are single replacements. This means that it is extremely common for 1 joint to wear out and the opposite hip joint to remain largely intact.
In every instance of 1 hip joint wearing out (and the other not) both hips have the exact same mileage, genetics, footwear, lifestyle, hobbies, diet, and environment. The only 3 remaining factors possible in generating osteoarthritis are birth defects, old injuries and movement patterns… hip injuries and birth defects are pretty rare. Have you ever heard of someone having a sprained hip? This leaves movement patterns being the only probable common explanation for all those millions of hips wearing out while their neighboring hip survives. Gait Analysis diagnoses faulty movement patterns.. we believe it offers essential insight into options for supportive and rehabilitation care for people with osteoarthritis in their lower body.