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Get successful with gait retraining


• Written by philip cortvriendt

Introduction

Covid has created a running boom. Since 2020, there are a significant number of novice runners out there. Despite all the benefits of running, health practitioners see a lot of running related injuries each year. Approximately 80% of runners suffer from an injury (Van der Worp et al. 2015). We prescribe exercises to improve the load capacity of the tissue, and to improve the runner's technique to distribute the load better over the body. In this way we hope to get and keep runners injury free. However, we don't always get the expected transfer of motor control training to running technique improvements. There is still a gap between the exercises and the specificity of running itself. Running gait retraining can be a great solution for a lot of recreational and professional runners that have difficulties to get back to their running.

What is gait retraining?

The goal of gait retraining is to optimize the running mechanics of an athlete through a motor learning process. With specific cues we try to change load and load distribution of the stress from one joint to another. 

Benefits of gait retraining

Gait retraining can especially help injured athletes. For example, modifying foot strike pattern from rearfoot to forefoot reduced pain scores in people with patellofemoral pain during running (Roper et al. 2016). In addition, increasing step rate and a forward trunk lean can be also used as a strategy in reducing patellofemoral pain (Dos Santos et al. 2019). In novice runners, Chan et al. (2017) showed that 8 weeks of gait retraining can lower vertical impact loading by approximately 20%, and reduce running related injuries by 62% in the following year. Despite the great prospective results of gait retraining in running related injuries, there was a slight increase in injuries of the calf and Achilles tendon compared to the control group. Gait retraining is a great strategy to use, but should be carefully applied in the individual context of the athlete's history of musculoskeletal injuries.

Gait retraining can lower impact by 20% and reduce running related injuries by 62% - Chan et al. (2017)

Running technique is not only important from an injury perspective. It explains a substantial proportion of the variance in running economy (39%) and performance (31%) (Folland et al. 2017). Increasing step rate in well trained female runners showed to improve their running economy (Quinn et al. 2019). Gait retraining does not only get your patient back to running, it also can improve their performance. Helping athletes achieve a better running technique is something worth attempting, but how can you successfully change someone's running technique?

How to get successful with gait retraining? 

1. Optimize the motor learning process 

To optimize the running technique of your athlete, you have to induce the required motor learning process by providing real-time feedback during gait retraining. This process should include at least 3 important parts (Wulf et al. 2016)

  • Competence: Give you runner constructive and positive feedback. They have to experience the positive effects of the feedback towards their running technique.  
  • Autonomy: Try out multiple cues. Work together to find the best solution for the runner.
  • External focus: Use cues and feedback that doesn't lay focus on the body. It promotes greater multi-segmental coordination and automatic process (Wulf et al. 2002).

2. Don't generalize, individualize 

Before you start your gait retraining program with your athlete, shouldn't you know which cue works and which cue won't work? You have two important criteria. First, How does the athlete feel with the cue? Via this way you promote the competence and autonomy of the runner in the motor learning process. Secondly, you need objective data that provides you with valuable information. Wearable technology can provide valuable components for real-time feedback training. A wearable should be reliable and scientifically validated in order to use in gait retraining.

"Components are suitable for real-time feedback if they have a strong relation with injuries or running economy, can be measured accurately during various conditions, and are modifiable." - Van Hooren et al. (2020)

Increasing step rate is commonly used to improve running technique. On the one hand, it can be used to improve several kinematic and kinetic parameters of running (Heiderscheit et al. 2011). On the other hand, increasing step rate in "low impact runners"  increases the number of steps and therefore increases the cumulative impact, described as the total impact over time (Baggaley et al. 2017, Willy et al. 2018). Therefore, you should always test if your strategy works for the individual. 

3. Make your cue work

We don't want to overwhelm the athlete with data.  Real-time feedback is only effective when the information is intuitive and interpreted correctly. Otherwise it can hinder results by loss of motivation, distraction and misinterpretation. Providing continuous feedback with every step can be annoying to a runner. The athlete can become dependent on the feedback which also hinders the motor learning process. Therefore 1) faded feedback (i.e., by reducing feedback over time); and 2) bandwidth feedback (i.e., where you only provide feedback once you have exceeded a given threshold), can be a great way to improve your gait retraining skillset. Both visual and auditive feedback can be used as an effective way in gait retraining (Agresta et al. 2015).

Runeasi as a gait retraining tool

Runeasi integrates biofeedback training to optimize the technique of every runner. The technology provides the necessary validated information to induce adaptations to the runner's mechanics by:

  • creating external focus during training
  • providing reliable and validated metrics 
  • using relevant metrics towards injury perspective and running economy
  • focusing on individualization and improving what we measure
  • utilizing strong visual feedback 

 

Get in touch

Get access to the most comprehensive biomechanics sensor analytics available. Are you a practitioner looking to move your practice forward with gait retraining? Are you a runner wanting to retrain your running gait to reduce your injury risk and improve economy? Get in touch below: 

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