Running Gait Analysis

Detailed assessment of your running movement and mechanics

Running gait analysis looks closely at how your body moves while you run.

It can help identify movement patterns that may be relevant to pain, recurring injuries, reduced efficiency or difficulty progressing your running. The assessment considers the way your feet, ankles, knees, hips and trunk work together rather than focusing on one body part in isolation.

Running gait analysis can be useful for recreational runners, competitive runners, people returning after injury and athletes whose sport involves regular running.

The aim is not to create one “perfect” running style. Instead, the goal is to understand how you currently run and whether any specific changes may help with your symptoms or running goals.

What is running gait analysis?

Running gait refers to the movement pattern used during running.

A gait analysis may examine areas such as:

• Foot position
• Ankle movement
• Knee movement
• Hip movement
• Pelvic control
• Trunk position
• Arm movement
• Stride length
• Step rate
• Foot strike
• Differences between the left and right sides

Video analysis may be used to slow the movement down so that particular parts of the running cycle can be reviewed more closely.

Your running pattern is then considered alongside your injury history, strength, mobility and training.

Who may benefit from running gait analysis?

Running gait analysis may be useful if you:

• Experience pain while running
• Have recurring running injuries
• Are returning to running after injury
• Notice one side feels different from the other
• Want to understand your running technique
• Struggle to increase running distance
• Develop symptoms at faster speeds
• Notice pain only after a certain distance
• Are returning to running after surgery
• Want to prepare for a race
• Are returning to running after pregnancy
• Want additional information alongside a physiotherapy assessment

You do not need to be injured to have your running analysed.

What happens during the assessment?

The session normally begins with a discussion about your running.

You may be asked about:

• Your current weekly mileage
• How often you run
• Typical running distance
• Running pace
• Recent changes in training
• Upcoming races
• Previous injuries
• Current symptoms
• Running surfaces
• Hills
• Speed sessions
• Footwear
• Strength training
• Other sports

This information is important because running technique should not be considered separately from training demands.

Physical assessment

A physical assessment may be completed before or alongside the running analysis.

Depending on your symptoms, this may include:

• Hip strength
• Knee strength
• Calf strength
• Ankle mobility
• Foot and ankle control
• Trunk strength
• Balance
• Squatting
• Single-leg movements
• Hopping
• Jumping

The purpose is to identify whether strength or movement limitations may be contributing to what is seen during running.

Video running analysis

You may be recorded running on a treadmill or suitable running area.

Video allows the physiotherapist to slow down sections of the running cycle and review movement more carefully.

The analysis may consider:

• Foot placement
• Step width
• Stride length
• Cadence
• Knee position
• Hip position
• Pelvic movement
• Trunk position
• Arm swing
• Symmetry
• Changes with speed

The video can also be used to explain findings and compare movement after a technique adjustment.

Looking at the whole running cycle

Running involves repeated phases of:

• Landing
• Loading
• Pushing away
• Swinging the leg forwards

Each stage places different demands on the muscles and joints.

Rather than concentrating only on where your foot lands, gait analysis considers how the body manages the entire movement.

For example, knee symptoms may be influenced by hip strength, running volume or movement higher up the body rather than the knee alone.

There is no single correct running gait

Runners naturally have different movement patterns.

Differences may be influenced by:

• Height
• Leg length
• Running speed
• Training history
• Strength
• Mobility
• Previous injuries

A movement difference on video does not automatically mean that something is wrong.

Changes are usually considered when a movement appears relevant to symptoms, performance or rehabilitation.

The goal is not to make every runner move identically.

Foot strike

Foot strike describes which part of the foot initially contacts the ground.

Runners may naturally land:

• Towards the heel
• Through the midfoot
• Towards the forefoot

No single foot-strike pattern is automatically suitable for every runner.

Changing foot strike can shift demand between different tissues.

For example, moving towards a more forefoot-based running style may increase demand on the calf and Achilles tendon.

Any change should therefore have a clear purpose and be introduced gradually.

Cadence

Cadence refers to how many steps you take during running.

A small cadence adjustment may sometimes be considered if it appears useful for managing a particular symptom or running pattern.

Increasing cadence slightly may change:

• Step length
• Landing position
• Forces through certain joints

However, there is no universal target cadence that every runner needs to achieve.

Your natural running speed, height and experience all influence step rate.

Stride length

Stride length is the distance covered between steps.

Longer strides are not automatically better or worse.

Stride naturally changes as running speed increases.

If your foot consistently lands a long way ahead of your body and this appears relevant to symptoms, a small change may sometimes be explored.

Any adjustment should still allow the running movement to feel natural.

Step width

Step width describes the side-to-side distance between the feet while running.

Some runners use a relatively narrow pattern, while others run with a slightly wider base.

If step width appears relevant to knee, hip or lower-limb symptoms, it may be considered as part of the assessment.

It does not need to be changed simply because it looks different from another runner.

Knee movement

The knee repeatedly bends and straightens during running.

Gait analysis may look at:

• Knee position when landing
• Knee movement during loading
• Differences between sides
• How the knee behaves during faster running

Findings are considered alongside strength and symptoms.

A particular knee position on video does not automatically mean that it is causing an injury.

Hip and pelvic control

Running involves repeated single-leg loading.

The hips and pelvis help manage this movement.

The assessment may consider:

• Pelvic movement
• Hip position
• Side-to-side differences
• Hip strength

Where appropriate, rehabilitation may include:

• Gluteal strengthening
• Single-leg exercises
• Running drills
• Movement practice

Improving strength may sometimes be more useful than trying to consciously control every hip movement while running.

Trunk position

The upper body naturally moves while running.

Gait analysis may consider:

• Forward lean
• Side-to-side movement
• Rotation
• Arm position

Some technique changes may be useful if trunk movement appears linked to symptoms.

However, runners do not need to keep the torso rigid.

Natural movement and rotation form part of efficient running.

Arm swing

Arm movement helps balance rotation generated by the legs and trunk.

Differences in arm swing are common and are not necessarily a problem.

The assessment may consider arm movement if:

• There is a large difference between sides
• Upper-body movement appears to affect running
• The runner has a previous shoulder or trunk problem

Otherwise, arm swing may require little or no attention.

Running symmetry

It is common to see small differences between the left and right sides.

Perfect symmetry is not required for pain-free running.

However, greater differences may be relevant when:

• One side has previously been injured
• Symptoms consistently occur on one side
• One leg is significantly weaker
• A movement changes noticeably with fatigue

These findings can guide further strength or rehabilitation work.

Gait analysis for knee pain

Running-related knee pain may be influenced by several factors.

Assessment may consider:

• Hip and knee strength
• Cadence
• Step pattern
• Training volume
• Hill running
• Running speed

Treatment may involve strengthening alongside temporary changes to running.

A video finding alone should not be assumed to explain the entire problem.

Gait analysis for shin pain

Shin pain can develop when the lower leg is repeatedly exposed to more demand than it can currently tolerate.

Running analysis may consider:

• Step pattern
• Foot position
• Cadence
• Calf strength
• Weekly mileage
• Running surface

Very localised or persistent bone pain requires appropriate clinical assessment rather than relying on gait changes alone.

Gait analysis for Achilles pain

The Achilles tendon experiences repeated loading during running.

If Achilles symptoms are present, the assessment may consider:

• Ankle movement
• Calf strength
• Foot strike
• Cadence
• Hill running
• Recent training increases

Technique modification may sometimes form part of treatment, but progressive calf and tendon strengthening is usually also important.

Gait analysis for heel and foot pain

Foot or heel pain may be affected by:

• Running volume
• Footwear
• Calf capacity
• Foot and ankle strength
• Running mechanics

The analysis may help identify whether any aspect of the running pattern appears relevant.

Foot strike should not automatically be changed simply because foot pain is present.

Gait analysis for hip pain

Hip pain during running may become noticeable:

• During longer distances
• At faster speeds
• After hills
• During periods of increased training

Assessment may look at:

• Hip strength
• Pelvic movement
• Single-leg control
• Running pattern
• Training load

Persistent hip pain that also affects walking or everyday activity should receive appropriate clinical assessment.

Gait analysis after an ankle injury

An ankle injury can sometimes affect running even after normal walking has returned.

You may notice:

• Reduced confidence
• Different foot placement
• Reduced push-off
• Uneven running
• Difficulty with faster speeds

Gait analysis can help identify whether further work is needed around:

• Calf strength
• Balance
• Ankle mobility
• Hopping
• Running mechanics

Gait analysis after knee surgery

Returning to running after knee surgery usually involves more than simply waiting for the knee to heal.

The assessment may consider:

• Leg strength
• Single-leg control
• Running symmetry
• Knee loading
• Confidence
• Running tolerance

Any return-to-running programme should also follow guidance from your surgeon and rehabilitation team.

Returning to running after injury

Running gait analysis can form part of the transition back to running.

The progression may involve:

• Walking
• Walk-run intervals
• Continuous jogging
• Longer running
• Faster running
• Hills
• Sprinting where required

Gait can be reassessed as running demands increase.

A movement pattern that looks comfortable at an easy jogging pace may change considerably at faster speeds.

Running at different speeds

Running mechanics naturally change with speed.

For some runners, symptoms only appear during:

• Faster intervals
• Sprinting
• Race pace
• Slow longer runs

Where appropriate, the assessment may therefore include more than one running speed.

This can provide a better picture of how your body responds to the type of running that normally causes symptoms.

Gait changes with fatigue

Some movement patterns become more noticeable later in a run.

A runner may look comfortable during the first few minutes but develop symptoms or noticeable changes after:

• 20 minutes
• Several kilometres
• Repeated faster efforts

If symptoms are linked to fatigue, the assessment may consider muscular endurance and training capacity rather than technique alone.

Running gait and strength

A gait analysis often leads to exercise recommendations.

Strength may be particularly relevant through the:

• Calves
• Quadriceps
• Hamstrings
• Gluteal muscles
• Hips
• Trunk

Exercises may include:

• Squats
• Split squats
• Lunges
• Step-ups
• Calf raises
• Deadlift variations
• Single-leg exercises

The programme can be progressed according to your running goals.

Single-leg control

Each running step involves supporting the body on one leg.

Rehabilitation may therefore include exercises that challenge:

• Strength
• Balance
• Coordination
• Stability under load

Later exercises may progress towards:

• Hopping
• Landing
• Running drills
• Faster movements

The aim is to develop capacity rather than trying to hold the body in one fixed position.

Running gait and mobility

Some runners have restricted movement around the:

• Ankle
• Hip
• Knee

If this appears to influence running, mobility work may form part of rehabilitation.

However, increased flexibility is not automatically required for every runner.

Some runners already have more than enough movement and would benefit more from strength and control.

Running gait and footwear

Footwear may influence how running feels, but gait analysis should not be used simply to prescribe a particular type of shoe based on how the foot appears on video.

Suitable footwear should generally:

• Feel comfortable
• Fit well
• Be appropriate for your running
• Allow you to train without creating new symptoms

A recent major footwear change may be considered if symptoms developed around the same time.

Minimalist and highly cushioned shoes

Different shoe designs can alter how running feels and where load is distributed.

Switching suddenly to a very different shoe may place unfamiliar demand on the legs and feet.

If you want to change footwear significantly, gradually introducing the new shoe may allow the body time to adapt.

There is no single shoe style that is appropriate for every runner.

Treadmill gait analysis

Treadmill running provides a controlled environment for observation.

It allows:

• Consistent speed
• Repeated viewing
• Video recording from different angles
• Small technique changes to be tested

Some runners may initially feel slightly different on a treadmill.

Usually a short period of comfortable running is allowed before the main analysis begins.

Outdoor running

Outdoor running includes demands that cannot always be reproduced on a treadmill.

These may include:

• Hills
• Uneven surfaces
• Corners
• Wind
• Different speeds

If your symptoms only occur outdoors, these factors should be discussed during the assessment.

Recommendations can then be based on your normal running environment.

Trail running

Trail running often requires:

• Greater balance
• Variable step length
• Uneven foot placement
• Changes in elevation

A treadmill gait assessment may still provide useful information, but the wider demands of trail running need to be considered when developing rehabilitation.

Strength, balance and terrain tolerance may be particularly important.

Running downhill

Downhill running changes the forces placed through the lower limbs.

Some runners experience symptoms mainly during descents.

Assessment may consider:

• Knee strength
• Running technique
• Hill volume
• Training history

Rather than avoiding downhill running permanently, rehabilitation may gradually increase tolerance where appropriate.

Running uphill

Uphill running increases demand on areas such as the calves, hips and cardiovascular system.

Symptoms during hills may be influenced by:

• Calf strength
• Hip strength
• Training volume
• Sudden introduction of hill sessions

Hill running can be temporarily modified and gradually reintroduced during rehabilitation.

Gait analysis for beginners

Beginners can also benefit from running gait analysis.

The assessment may help with:

• Starting running gradually
• Understanding basic technique
• Selecting appropriate strength exercises
• Managing early discomfort
• Building confidence

New runners do not need to focus on making every part of their running technically perfect.

Building a consistent and manageable running routine is often more important.

Gait analysis for experienced runners

Experienced runners may seek analysis because of:

• Recurring injuries
• Increasing mileage
• Preparing for a race
• Returning after injury
• Symptoms at faster speeds

Changes should generally be made cautiously when someone has been running successfully with the same technique for many years.

Not every visible movement difference needs correction.

Gait analysis for marathon runners

Long-distance runners may need the body to tolerate thousands of repeated steps during training and racing.

Assessment may consider:

• Weekly mileage
• Long-run distance
• Running pace
• Strength
• Fatigue
• Previous injuries

If symptoms only appear late in longer runs, endurance may be as important as initial running mechanics.

Gait analysis for sprinters

Sprint mechanics differ considerably from easy-distance running.

If sprinting is the main goal, assessment may need to consider:

• Acceleration
• High-speed mechanics
• Hamstring strength
• Calf strength
• Hip strength

Returning from a sprint-related injury usually requires exposure to progressively higher speeds.

Gait analysis for team-sport athletes

Football, rugby, hockey and other field sports involve much more than straight-line running.

Athletes also need to:

• Accelerate
• Stop
• Sprint
• Turn
• Change direction

Running gait analysis may therefore form only one part of a broader sports assessment.

Later rehabilitation should prepare the athlete for the unpredictable movements required by the sport.

Postnatal running gait analysis

Running may feel different after pregnancy and childbirth.

A postnatal assessment may consider:

• Pelvic floor symptoms
• Abdominal strength
• Hip and leg strength
• Pelvic pain
• General fitness
• Running mechanics

Symptoms such as urinary leakage, pelvic heaviness or pelvic pain may require pelvic health rehabilitation alongside running analysis.

Technique changes should have a reason

Seeing your running in slow motion can make small movements look more significant than they really are.

Not every difference needs to be corrected.

A technique change is generally more useful when there is a clear reason, such as:

• Reducing demand on an irritated area
• Supporting return from injury
• Improving comfort
• Addressing a consistent problem

The recommendation should be practical and directly related to your goals.

Making gait changes gradually

If a technique adjustment is recommended, it should usually be introduced gradually.

This is because changing running mechanics shifts demand around the body.

A new technique may initially feel unfamiliar and place more load on muscles that are not accustomed to it.

Changes may first be practised during:

• Short running intervals
• Easy runs
• Running drills

The duration can then increase as the movement becomes more natural.

More than one change is rarely needed at once

Trying to consciously change:

• Foot strike
• Cadence
• Posture
• Arm swing
• Stride

all at the same time can make running unnecessarily complicated.

Where changes are required, one or two relevant adjustments are usually easier to practise and evaluate.

The aim is for running to eventually feel natural again.

What happens after your gait analysis?

Following the assessment, recommendations may include:

• Strength exercises
• Mobility exercises
• Running drills
• A small technique adjustment
• Changes to weekly running volume
• A return-to-running programme
• Gradual reintroduction of speed
• Hill progression
• Further physiotherapy

You may also be shown the relevant video findings so that you understand why a recommendation has been made.

Follow-up gait analysis

A follow-up assessment may be useful after a period of rehabilitation.

This can help review:

• Changes in strength
• Changes in symptoms
• Running technique
• Running tolerance
• Progress with distance or speed

The purpose is not necessarily to make the video look perfectly symmetrical.

Improved comfort, capacity and confidence may be more important measures of progress.

When running analysis is not enough

Running gait analysis should not replace proper assessment of an injury.

Further medical or physiotherapy assessment may be needed if you experience:

• Severe pain
• Significant swelling
• Inability to put weight through the leg
• Persistent localised bone pain
• Repeated joint instability
• New significant weakness
• New numbness
• Pain that repeatedly wakes you at night
• Symptoms that are rapidly worsening
• Sudden calf swelling, heat or redness
• Chest pain or unexplained breathlessness during exercise

These symptoms require appropriate assessment before focusing on running technique.

Analysis based on your goals

Your gait assessment should reflect what you actually want to achieve.

Your goals may include:

• Running without pain
• Returning after injury
• Increasing weekly mileage
• Running your first 5K
• Preparing for a half marathon or marathon
• Returning to sprinting
• Improving confidence
• Understanding recurring injuries
• Returning to team sport
• Understanding your running movement

The findings can then be used to create practical recommendations around your training and rehabilitation.

How many appointments will I need?

Some runners may only need one gait analysis session.

If an injury, weakness or significant rehabilitation need is identified, additional appointments may be recommended.

Follow-up sessions can be used to:

• Progress strength
• Review running tolerance
• Introduce faster running
• Review technique changes
• Reassess gait

The number of sessions depends on your symptoms and running goals.