Tuesday, June 16, 2009

Gait Analysis

I have suffered for years from chronic shin splints.  More specifically, chronic right shin splints.  My right shin first went bad when I was training for the Safaricom Marathon in 2006.  I could not walk without pain (even while medicated) for a month leading up to the marathon.  Mysteriously (& miraculously) my shin stopped hurting 2 days before the race and I was able to complete it with no shin pain and very reduced training.

Ever since then if my mileage increases -- shin pain.  Speed work -- shin pain.  Too many consecutive days running -- shin pain.  When training for Rome 2007 (my first marathon post-Safaricom) the shin pain came back when the mileage started to pile up.  I made an appointment to see a podiatrist.  He fit me with custom orthotics which I have been using ever since.  With the orthotics I usually get a very tender right shin.  Sometimes it will hurt for a few moments when running.  However, since the orthotics things have never escalated to the point they did back in 2006.  I am always searching out new ways to control this shin thing.  Icing, stretches, compression...

Recently I stumbled upon a gait analysis review at Hella Sound.  I have had my gait analyzed in the past for the sake of shoe fitting, but never by physical therapists who could offer solutions other than a change in footwear.  I made an appointment at the Running Clinic and hoped they would offer some new insight about Mr. Right Shin Splint.

When I arrived I ran briefly on two different treadmills.  One had a force plate to measure foot strike.  The other was used to video me running from three different angles.

Here's the front view of my running.  You can also see my signature arm/torso swinging.

Here is some of the information generated by the force plate treadmill:


I then met with a physical therapist who reviewed the videos/information.  She mentioned that I seem to be pushing off from my 2nd toe (vs. the favorable big toe).  We later decided this was due to my very rigid orthotics.  Big toe push-off is more desired but she said the 2nd toe was not too terrible.  She mentioned that the above chart showed relative symmetry between right and left, though I very slightly favored more time on my right foot.  The physical therapist also felt that my left knee dropped in slightly more than my right when I was running (Uh, but I have so many more problems with the RIGHT leg).

She checked the flexibility of my feet and said they were neither too flexible or too stiff.  I then got a little bit of conflicting advice.  First I was told to not subtract any support from my current footwear situation (orthotics + stability shoes).  I questioned the idea that if my orthotics were doing what they were supposed to be doing, shouldn't I now be in a neutral shoe?  She then said that was a good point and that maybe I could try a neutral shoe with the orthotics.  Perhaps that would even get me pushing off with my big toe.  Umm...  I lost a little faith at that point.

I was then asked to hop around on one foot, do some side to side lunge jumps, resist her pushing down on my leg, etc.  The final verdict:  Most likely my issues aren't coming from my feet.  She wanted me to try some hip strengthening/stretching exercises to see if that was causing problems lower down my legs.  She ran me through all the exercises and made a follow-up appointment with me shortly before the marathon.

I have already documented the deleterious after effects these exercises had on me.  The next day I was literally sorer than after running the Big Sur Marathon.  Seriously.  THAT sore.  Who needs to run for 5+ hours for that great post-marathon feeling?  Just do a couple of leg raises and lunges!  She was obviously right about my weak areas to cripple me that easily.  It took about a week before I felt up to trying the exercises again.  But ever since I've faithfully been following all of her instructions.

I was told it takes about 6 weeks for any strengthening effects to be noticed.  So far the shin has not improved and my left foot has been holding steady (she gave me an arch exercise to try for that).  So basically nothing has changed for the better.  At this point I am only cautiously optimistic that this whole endeavor will do away with Mr. Right Shin Splint for good.  I was really hoping she would find some sort of fatal asymmetry between right and left that would explain everything, but she couldn't come up with a reason as to why I have chronic problems with just the right side.

I will withhold final judgment until my follow-up appointment, but as of now cannot give it as glowing a review that Hella Sound passed.  

As a side note, I asked her about my swinging arms and rotating torso.  I've read before about how that type of superfluous movement can cause leg problems from the unnecessary torque.  Plus side-to-side movement is all wasted energy when you're trying to move forward.  She didn't recommend I consciously try to alter my natural running form (no idea if I could actually 100% alter it anyhow).  Any thoughts on that?

11 comments:

RG said...

A couple thoughts ...

You might try runnng for some distance .. maybe 1/2 mile .. now and then ... with your arms hanging straight down and see if that straightens you out a bit.

You might try running where you pump your fists right up almost to the center of your chest .. that might straighten you out too ... that is what I remember from the great Prefontaine pictures.

You don't mention much stretching before and after a run. Quads, hamstrings, calfs, etc ... might loosen up your gait a bit and help the shins.

Or ... whatever feels good!!! Good luck.

d. moll, l.ac. said...

Fascinating.....Dr. Nancy Bergmann in San Jose is excellent for this sort of thing. Let me know if you want her number.

Mica said...

Whoa, that's a super-intense gait analysis! I hope her advice helps you and Mr. Shin.

EndorphinBuzz said...

Fascinating stuff. I hope the exercises strengthen you and the shin splint don't come back...

Anonymous said...

Wow, that's quite the analysis! I hope the exercises help with your shin issues.

ShirleyPerly said...

Interesting analysis. I'm not sure changing how you swing your upper body will make much difference as I've seen all sorts and it seems to be a very individual thing and not necessarily bad.

Are you a heel-toe runner by chance? Can't tell from the front view of you running but I've heard a lot of people have problems with knees, feet, shins, etc. because of that. A gait change to land more mid-foot ala Chi Running may be worth trying if you are. I'm not a Chi Runner myself but do try to land mid-foot and keep my stride turnover quick (180-190) to try to keep the impact at a minimum when running.

Runner Leana said...

Wow, all of the data you get from the gait analysis is really interesting. Hopefully you will feel that the process is worthwhile after you go back for your follow up!

Alisa said...

Wow that's really cool! I'm going to try to scrutinze myself now =).

P.S. Yoga DVD will get to you I promise at some point. We moved and stuff is still in boxes.

P.P.S. Before you say I'm living your dream. Shhhhhh don't tell anyone but there is no shower and I "toweled" off my face and sprayed down with body spray. Certainly not ideal but once in awhile doable.

Aron said...

wow very cool, sounds like there was a lot of interesting info there. too bad she couldnt give you an exact answer but hopefully some of those exercises will help keep the shin happy!

ProGait said...

Gait Analysis is great for runners and I would highly recommend it as it does make a difference to the way you run and walk. Plus a good, fitted pair of running shoes makes running much more comfortable. Great post!

ProGait said...

Gait Analysis is fascinating. The advice you receive from your Podiatrist is invaluable and it does help to improve your technique. Podiatrists can also prescribe orthotics from the results of your Gait Analysis. Orthotics can restore natural foot function to help prevent common sporting injuries and foot conditions. Great Post!