The document discusses biomechanics of running and gait analysis. It explains that running transfers force from the foot up the kinetic chain through the lower limbs and trunk. Abnormal movement can cause injuries. Gait analysis studies the distribution of forces during walking and running. The stance and swing phases of walking and running gaits are described. Injuries may result from muscle imbalances or inefficient running technique affecting the spine, hips, knees, ankles or feet. Rehabilitation must address flexibility, mobility and strength throughout the kinetic chain.

1. Healthy RunningHealthy Running
The Body in BalanceThe Body in Balance

2. The Biomechanics ofThe Biomechanics of
RunningRunning
 Kinetic ChainKinetic Chain
 Running transfers force ofRunning transfers force of
the foot hitting the groundthe foot hitting the ground
up the kinetic chain to theup the kinetic chain to the
knee, hip, pelvic region,knee, hip, pelvic region,
lower back and to the upperlower back and to the upper
back and cervical regionback and cervical region
 Abnormal and inefficientAbnormal and inefficient
movement can causemovement can cause
injury to joints and softinjury to joints and soft
tissue facilitatingtissue facilitating
adaptation to running andadaptation to running and
loss of performanceloss of performance

3. Gait AnalysisGait Analysis
 Kinetic ChainKinetic Chain
 When the foot hit theWhen the foot hit the
ground force isground force is
transmitted up the leg totransmitted up the leg to
the trunkthe trunk
 Distribution of forces isDistribution of forces is
critical to safe andcritical to safe and
effective runningeffective running
 Abnormal balance to theAbnormal balance to the
forces leads to injuriesforces leads to injuries

4. Walking Gait AnalysisWalking Gait Analysis
 The stance phase is the period where the foot is in contact with the groundThe stance phase is the period where the foot is in contact with the ground
and equates to 60% of the cycle whenand equates to 60% of the cycle when walkingwalking. The swing phases makes. The swing phases makes
up the remaining 40%.up the remaining 40%.
 During walking there is a period called double stance, where both feet are inDuring walking there is a period called double stance, where both feet are in
contact with the ground. The swing and stance phases can be furthercontact with the ground. The swing and stance phases can be further
divided into:divided into:
 StanceStance
 Heel strike - The point when the heel hits the floorHeel strike - The point when the heel hits the floor
 Foot flat - The point where the whole of the foot comes into contact with the floorFoot flat - The point where the whole of the foot comes into contact with the floor
 Mid stance - Where we are transferring weight from the back, to the front of our feetMid stance - Where we are transferring weight from the back, to the front of our feet
 Toe off - Pushing off with the toes to propel us forwardsToe off - Pushing off with the toes to propel us forwards

6. Gait AnalysisGait Analysis
 SwingSwing
 Acceleration - The period from toe off to maximum knee flexion in order for theAcceleration - The period from toe off to maximum knee flexion in order for the
foot to clear the groundfoot to clear the ground
 Mid-swing - The period between maximum knee flexion and the forwardMid-swing - The period between maximum knee flexion and the forward
movement of the tibia (shin bone) to a vertical positionmovement of the tibia (shin bone) to a vertical position
 Deceleration - The end of the swing phase before heel strikeDeceleration - The end of the swing phase before heel strike
 When running, a higher proportion of the cycle is swing phase as the foot isWhen running, a higher proportion of the cycle is swing phase as the foot is
in contact with the ground for a shorter period.in contact with the ground for a shorter period.
 Because of this there is now no double stance phase, and instead there is aBecause of this there is now no double stance phase, and instead there is a
point where neither feet are in contact with the ground, this is called thepoint where neither feet are in contact with the ground, this is called the
airborne or flight phase. As running speed increases, stance phaseairborne or flight phase. As running speed increases, stance phase
becomes shorter and shorter.becomes shorter and shorter.

7. Running Cycle
 The running cycle is composed of a
 Swing Phase
 Initial Swing: Commences at toe-off and ends at mid-swing
 Terminal Swing: commences at mid-swing and ends at foot strike
 Stance Phase
 Absorption: commences at foot strike and ends mid-stance
 Propulsion: Commences at mid-stance and ends at toe off
 These two phases take up 40-60% of the running cycle
 Airborne period that are when both feet are off the ground occur
at beginning and end of each swing phase

8. Running Cycle
 Hip, Pelvis and Back
 25% to 35% of all running injuries are estimated to be
in this region. That leaves the knee, ankle and foot to
be responsible for 65-75% of the injuries.
 Gait analysis have been shown to be able to pick up
improper of inefficient movement patterns while
running and to allow for the establishment of an
exercise program to correct these abnormalities

10. Gait Analysis and hip, pelvis and
back injuries Review
 Slocum and Bowerman first to
document that the position of the
pelvis is the key to postural
control. Gait Analysis was used in
their studies
 Gracovetsky and colleagues also
moved the biomechanical study of
hip, pelvis and low back injuries
while running to the forefront
 Improper alignment and or
movement of the hip, pelvis and
lower back can lead to debilitating
injuries that can include:
 Groin Injuries
 Hamstring Injuries
 Piriformis Injuries
 Back Spasms/hip flexor spasms
 Runners Hip injuries

11. Gait Analysis and the hip, pelvis
and low back
 Pelvic Movement and
running
 The Anterior and
Posterior tilting of the
pelvis when running is
noted to increase as the
speed of running
increases
 To improve efficiency and
endurance the amount of
tilting is to be minimized

12. Gait Analysis and the hip, pelvis
and low back
 Hip movement and running
 As speed increases a reduction in
hip extension is seen and an
increase in hip flexion is noted.
This occurs at the toe off period of
the cycle
 Increase hip flex will increase
stride length and increase overall
speed
 Hip extension is limited by the hip
joint capsule
 Noting an increase in hip flexion at
time of foot strike at slower
speeds allows for improved
absorption at this point of the gait
pattern
 The maximum values of hip
extension during running
approaches the limits of passive
hip extension.

13. Gait Analysis and the hip, pelvis
and low back
 Trunk Position
 It is thought that the lumbar spine
is the pivotal point of the lower
extremity lever system during
running
 Movement of the lower limb
backwards during stance phase is
thought to commence with
extension of the lumbar spine.
 This anterior tilts the pelvis which
effectively increase the working
range of extension and
contributes to the extension thrust
mechanism of the lower extremity.
 These finding support that the
trunk should be in an erect
position in early phases of stance

14. Pelvic Obliquity and trunk
movement
 At time of foot strike the pelvis
obliquity is aligned being
slightly higher on the stance
side and lower on the swing
side.
 Pelvic Obliquity is thought to
play a role in shock absorption
and in smooth ascent and
decent of the bodies center of
gravity at this time
 In stance phase the hip
adducts (absorption) and into
abduction during (propulsion)

16. Pathologies and Running
 Muscle Imbalance, ineffective and
inefficient running technique can lead to
injuries to any aspect of the kinetic chain
 Spine
 Hips
 Knees
 Ankles
 Foot

17. Healing CycleHealing Cycle
 Inflammation (4-6 Days)Inflammation (4-6 Days)
 Therapy most effective to decrease inflammatory cycle and toTherapy most effective to decrease inflammatory cycle and to
facilitate next stage of healingfacilitate next stage of healing
 Remodeling (5-21 Days)Remodeling (5-21 Days)
 Therapy applied here allows for the injured area to be stressedTherapy applied here allows for the injured area to be stressed
in a slow and graded fashion (slow progression of appropriatein a slow and graded fashion (slow progression of appropriate
stress)stress)
 Maturation (20+ Days)Maturation (20+ Days)
 Critical area to develop injured tissues (apply appropriate stress)Critical area to develop injured tissues (apply appropriate stress)
and proper balance to avoid further injuriesand proper balance to avoid further injuries
 Key is to avoid the Chronic Inflammatory CycleKey is to avoid the Chronic Inflammatory Cycle

18. When to get help?When to get help?
 Not always clearNot always clear
 If pain reappears timeIf pain reappears time
and time again rest isand time again rest is
not the solutionnot the solution
 Balance ofBalance of
musculaturemusculature
 FlexibilityFlexibility

19. Rehabilitation of theRehabilitation of the
Ankle-Foot ComplexAnkle-Foot Complex
 Forces at the footForces at the foot
 Therapist must firstTherapist must first
address the position ofaddress the position of
the foot and providethe foot and provide
the proper:the proper:
 FlexibilityFlexibility
 MobilityMobility
 StrengthStrength
 Strength and control toStrength and control to
the upper leg and trunkthe upper leg and trunk

20. Pronation of the FootPronation of the Foot

21. How mal-alignment affect theHow mal-alignment affect the
entire bodyentire body

23. Rehabilitation of the KneeRehabilitation of the Knee
 Knee JointKnee Joint
 Middle joint of the kineticMiddle joint of the kinetic
chainchain
 High level of threeHigh level of three
dimensional forcesdimensional forces
 Requires high level ofRequires high level of
ligaments and muscularligaments and muscular
supportsupport
 Patella position and smoothPatella position and smooth
movement is critical tomovement is critical to
proper functionproper function

25. Rehabilitation of PelvicRehabilitation of Pelvic
InjuriesInjuries
 Force transmitted to theForce transmitted to the
Sacral Joint and lumbarSacral Joint and lumbar
regionregion
 Three dimension forces onThree dimension forces on
jointjoint
 Key Stone of lower trunkKey Stone of lower trunk
core stabilitycore stability
 Low back imbalance canLow back imbalance can
present radiculopathy thatpresent radiculopathy that
can mask true problemcan mask true problem

26. Rehabilitation of Hip InjuriesRehabilitation of Hip Injuries
 Hip jointHip joint
 Ball and socket jointBall and socket joint
 High level of stabilityHigh level of stability
 Limited mobilityLimited mobility
 Critical for straight hipCritical for straight hip
controlcontrol
 Balance ofBalance of
musculature flexibilitymusculature flexibility
and strength isand strength is
essentialessential

29. Strengthening RequiresStrengthening Requires
BalanceBalance
 Note the complexity ofNote the complexity of
the musculaturethe musculature
alignmentalignment
 Note muscles are notNote muscles are not
aligned in a linearaligned in a linear
fashion but morefashion but more
obliqueoblique
 Design promotesDesign promotes
rotational componentrotational component
of movementof movement

30. Rehabilitation of the Thigh and hipRehabilitation of the Thigh and hip
straight Hip Controlstraight Hip Control
 Injury to the lowerInjury to the lower
extremityextremity
 Pain to an area is notPain to an area is not
always the true source ofalways the true source of
the problemthe problem
 Rest not always the cureRest not always the cure
to the problemto the problem
 Assessment essential toAssessment essential to
find source and avoidfind source and avoid
further injuryfurther injury

31. Upper BodyUpper Body
involvement in Runninginvolvement in Running
 BalanceBalance
 Coiling movement ofCoiling movement of
the bodythe body
 Efficiency ofEfficiency of
MovementMovement
 Propulsive forcePropulsive force
 Breaking forceBreaking force

32. StretchesStretches

33. If you have a running injury,If you have a running injury,
The Do's and Don'tsThe Do's and Don'ts
DODO Rest, ice, and elevate the leg (if that's what you injured!)Rest, ice, and elevate the leg (if that's what you injured!)
DODO Reduce your mileage to a pain free amount, even though it may be a blow to your ego.Reduce your mileage to a pain free amount, even though it may be a blow to your ego.
DODO Cross-train to maintain your overall fitness level with exercise such as biking, or swimming orCross-train to maintain your overall fitness level with exercise such as biking, or swimming or
perhaps stair climbing.perhaps stair climbing.
DODO Trust and listen to yourself. Irritability, fatigue, insomnia, severe muscle soreness, and gettingTrust and listen to yourself. Irritability, fatigue, insomnia, severe muscle soreness, and getting
colds and flu easily may me signs that you are overtraining.colds and flu easily may me signs that you are overtraining.
DODO Progress at a naturally comfortable rate.Progress at a naturally comfortable rate.
DODO See a doctor, physical therapist, or other health professional who you trust. If they can't help you,See a doctor, physical therapist, or other health professional who you trust. If they can't help you,
they probably know someone who can.they probably know someone who can.
DODO Warm up by walking or jogging slowly for at least five minutes.Warm up by walking or jogging slowly for at least five minutes.
DODO Cool down slowly at the end of your run by walking at least five minutes.Cool down slowly at the end of your run by walking at least five minutes.
DODO Stretch before and after every run, especially the Achilles tendon, hamstrings, and quadriceps.Stretch before and after every run, especially the Achilles tendon, hamstrings, and quadriceps.
Remember the best time to stretch is after you run when the muscles are pliable.Remember the best time to stretch is after you run when the muscles are pliable.
DODO Get on a weight training program to strengthen muscles around the hip, knee, ankle, andGet on a weight training program to strengthen muscles around the hip, knee, ankle, and
abdominal area. This may take some of the shock away from the knee and hips.abdominal area. This may take some of the shock away from the knee and hips.

34. If you have a runningIf you have a running
injury, The Do's andinjury, The Do's and
Don'tsDon'tsDON'TDON'T
Run though the pain. Your body is trying to tell youRun though the pain. Your body is trying to tell you
something–listen to it.something–listen to it.
DON'TDON'T
Think you have to give up running. There's help out there!Think you have to give up running. There's help out there!
DON'TDON'T
Ignore the problem. If you do, it is more likely to come back.Ignore the problem. If you do, it is more likely to come back.
Or get worse.Or get worse.
DON'TDON'T
Think that someone else can fix your problem. PhysicalThink that someone else can fix your problem. Physical
therapists and others can help a great deal, buttherapists and others can help a great deal, but the ultimatethe ultimate
responsibility for being injury free is yours!responsibility for being injury free is yours!

35. Contact InformationContact Information
 Dr. Charles CurtisDr. Charles Curtis
 Dr Charles Curtis MS, PT, DPT, Cert MDT,Dr Charles Curtis MS, PT, DPT, Cert MDT,
 Vestibular Rehab SpecialistVestibular Rehab Specialist
 ccurtis33@verizon.netccurtis33@verizon.net
 732 320 0768732 320 0768