10/22/15. Walking vs Running. Normal Running Mechanics. Treadmill vs. Overground Are they the same? Importance of Gait Analysis.

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1 2 angle (deg) 1/22/1 Normal Running Mechanics Walking vs Running Irene Davis, PhD, PT, FACSM, FAPTA, FASB Director, Spaulding National Running Center Walking Periods of DOUBLE SUPPORT Running Periods of FLOAT Importance of Gait Analysis Important Component of Overall Clinical Assessment Each Person has their own fingerprint of gait Abnormal Gait patterns carry over into all functional activities Treadmill vs. Overground Are they the same? Kinematics 2 Kinematics 3 FLEX 1 angle (deg) angle (deg) angle (deg) -1 FLEX angle (deg) angle (deg) TM OG TM OG

2 1/22/1 Foot Kinematics Rearfoot angle (deg) TM OG DF - -1 Rearfoot angle (deg) Rearfoot angle (deg) Treadmill vs. Overground FORCES Summary of TM Running Vertical Ant-post Mediolateral Kinematics Slightly shorter stride Tend to land with a flatter foot (less dorsiflexed) Otherwise, very little difference Ground Reaction Forces Increased ML forces Otherwise, very little difference (Fellin et al., 28, Willy et al, 29) TM OG Evaluation of TM running provides a valid assessment of their gait Ankle Joint Complex Sagittal Plane Ankle Joint Complex Sagittal Plane o DF Peak DF 2 o DF Heelstrike PF exes Loading 1 o DF Propulsion 3 o PF Ankle Sagittal Plane 2 DF sd -2 PF +sd -2 2

3 1/22/1 Ankle Joint Complex plane Ankle Joint Complex Plane -1 o Peak EV -1 o EV Loading 1-1 o EV Propulsion 1-1 o Rearfoot Plane sd EVER +sd Rearfoot-Shank Coupling Rearfoot-Shank Coupling 1 1 Tibia Rearfoot Plane Tibia EVER Tibia ER AS the rearfoot everts, the tibia int. rot (2:1). EV/T Ratio related to foot structure Medial Longitudinal Arch FS Raised Loading Lowers Propulsion Raises STJ! axis STJ > 4 o T > EV! EV/T < 1. STJ <4 o EV > T! EV/T > 1. stance! STJ angle = 3-3 o - greater EV than T! 3

4 1/22/1 Sagittal Sagittal FL 1 o Peak FL 4-4 o Loading FL 2-2 o Propulsion EXT 2-2 o Sagittal Plane EXT FLEX sd +sd o Peak Add 3- o Loading 3 o Propulsion ABD 3- o Plane 1 8 -sd +sd ABD -8 ER 1-12 o Peak - o Loading 1-1 o Propulsion ER o Plane sd ER +sd -2 4

5 1/22/1 Sagittal Sagittal FL 3 o Peak FL 3-3 o Loading FL -1 o Propulsion EXT o Sagittal Plane 4 FLEX -sd 3 +sd EXT -3 1 o Peak 1-18 o Plane -sd +sd Loading -8 Propulsion ABD 1-2 o ABD -1 o Peak -1 o Loading - o Propulsion ER -1 o Plane 1 -sd +sd ER -1

6 1/22/1 Pelvis Pelvis - o Peak CPD -1 o 1 1 CPE Pelvis Plane Loading DN -1 o Propulsion UP 1-1 o CPD -sd +sd LOADING SUMMARY PROPULSIVE SUMMARY ANKLE KNEE HIP ANKLE KNEE HIP Sag DF FL FL Sag PF EXT EXT EV ABD ABD Trans ER ( Tibia) Trans (ER Tibia) ER ER Normal Gender Differences Adduction Internal Rotation Degrees * * TRANSVERSE ABD ER Female Male Males.6 (4.2) Females 9.2 (6.6) Males 7. (.1) Females 11.2 (4.1) Ferber et al, 23 2 males, 2 females 6

7 1/22/1 Ground Reaction Forces GRF Measurements 1.-2 bw 2.-3 bw.2-.3 bw Peak Vertical (2.-3. bw s) Vertical Impact Peak (1. bw s) Vertical Load Rate Average (6-7 bw/s) ALR Vertical Ant/Post Med/Lat Instantaneous (7-8 bw/s) 2-8% ILR Anterior-Posterior Anterior-Posterior.4 POST(+).4 POST(+) BW's BW's ANT(- ) -.4 ANT(- ) Medial-Lateral GRF STJ Pronation LEFT med Moment Arm Lat(+) Medial-Lateral GRF Between subject variability subject1 subject2 subject3 subject4 subject Lateral GRF BW's Lat(+) -. BW's Med(+) Med(+) 7

8 1/22/1 Shod Running Mechanics RFS 89% Landing patterns Rearfoot and forefoot strike patterns are associated with different Vertical GRF s MFS 1% FFS 1% AVLR Rearfoot strike AVLR Forefoot strike Larson et al., 211 Reduced initial load rates in FFS/MFS Landing Patterns Landing patterns RF angle at FS FFS greater: PF Peak angles are similar! FFS greater PF moment (gastroc force) More negative work performed during loading Summary - FFS Higher EV and DF vel. may place greater strain on posterior tibialis and achilles tendon Lower vertical LR perhaps placing them at reduced risk of stress related injury Greater muscular work done at the rearfoot and less done at the knee Common Abnormal Mechanics / Contralateral Pelvic Drop Genu Valgus Genu Varus Excessive/Prolonged Foot Pronation Excessive/Prolonged Foot Supination Toe In/Out Excessive Stride Length Excessive Impact Forces 8

9 1/22/1 Thank You Spaulding Na3onal Running Center 9