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Gait Retraining in Runner

Running is a great form of exercise and stress reliever. If you are a runner you probably do it for the health benefits, the social comradery, or you just want to crush the person next to you. All are good reasons. Unfortunately, you are also aware that running can lead to injuries. Recent studies show that 75% of runners experience some form of injury while running. The benefits of running far exceed the risk of injury so understanding the mechanism and risk factors of injury is important to keep us doing what we love. Injury occurs when the load(stress) exceeds the load capacity of the structure. Once the load exceeds the load capacity and we get an injury it is common practice to prescribe rest for runners. The issue with complete rest is that we are lowering the injured tissues load capacity so when that athlete returns to running they are in a de-conditioned state. Gait retraining is a great tool we use at PhysioFit to change the load on the injured tissue to allow the runner to continue running while recovering and rehabilitating the injured tissue. Gait retraining utilizes many different techniques to modify a runners mechanics in order to change the load/stress on the specific injury and allow the runner to continue with diminished pain. Gait retraining is important as evidenced by Willy RW, JOSPT 2011 in which they showed hip strengthening and squat retraining alone do not change running mechanics. Therefore, as physical therapists we must be incorporating gait retraining with our patients when appropriate. One technique we utilize at PhysioFit is called cadence manipulation. Low cadence is common with injured runners and has been shown to lead to overstriding. Overstriding leads to greater impact shock. Heiderscheidt BC et al, 2011 showed that increasing cadence 10% increased knee flexion at contact, decreased hip addiction, and reduced impact at hip and knee. This is a great technique to reduce pain at hip and knee and allow runners with hip or knee pain to continue running while they address the specific impairments causing their injury. Another technique we utilize at PhysioFit is biofeedback. Biofeedback is performed using mirrors, verbal/tactile cueing, and other modalities to provide corrections to a runners mechanics. Willy RW et al, 2012 showed that following 8 sessions of biofeedback in subjects with patellofemoral (knee). pain there was significant reduction in pain and change in mechanics. Cadence manipulation and biofeedback are just 2 of the gait retraining techniques we use at PhysioFit to keep our runners running. With this said there are some injuries such as bone stress injuries where gait retraining isn’t appropriate so a thorough evaluation is important. If you or anybody you know has a running injury, contact us at PhysioFit we would love to work with you!

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