Fatigue matters. Why a quick treadmill analysis of someone's gait will lie to you.

This is why i think gait analysis, on a treadmill with all the sensors, the visual captures , there are so many lies and fake outs.

Driving to work today and I saw this 40 something lady running. It just might have been the most tortured running i have seen in ages. It made me wonder, when we see our clients at the office and we ask them to run, they are typically in a fresh state, they're going to give us their best running, they are naturally going to put out their best for us, even if we ask them to "just run".

The truth is, they haven't been out there for 10-15 miles slogging it out in the heat and the pain and in the dysfunction. They haven't been out in the elements slowly fatiguing stabilizers, slowly layering neuro-protective tightness and strategies to offset the fatiguing structures. Even if that lady came in to see me tomorrow, i am not going to see what i saw in here on the side of the road. The clues i might see will be the muscular inhibition, the neuro-protective tightness, the compensations, the things on the hands on examination. This is why gait analysis has to have a hands on examination. And if i put her through a screening method, i am going to see her strategies in the screen to get around all that i mentioned above.

This is why i think gait analysis, on a treadmill with all the sensors, the visual captures , there are so many lies and fake outs. That process has significant limitations. Do not get me wrong, everything has value, but do we know what that value is, and what the lies are?

I think my question for my clients needs to be, be honest with me how ugly does your run get in the later miles when you're in pain? But then again, that is an impossible question isn't it !? Self awareness has its limitations. After all, we are human.

When asked to run at my doctors office, i am still gonna put on my best run for them. I will hide my flaws, my weaknesses, my tightness, my soreness, and give them the best run i have. The game is on them. Lets see how good they are.

Good luck today comrades, see what you can find and solve in all those who come begging for help, yet doing their best to hide their worst.

Doing video gait analysis ? Really? Are you ?

Thought for the day. Are you doing video gait analysis ?
How do you justify that the data you are getting is almost purely based on your client’s “reactive postural and movement adjustments” to their compensation patterns ? Much of the research driven data today is also mensuration on just this reactionary data. This data is not what is wrong with your client, it merely represents their strategies to react and subsequently anticipate the next motor strategy. This all goes back to one of our favorite sayings, “what you see is someone’s gait is not their problem, it is their strategy around (or to cope) with the problem(s)”. One best not recommend exercises and therapy based on what you “see” in your client. They should be based on what your clinical evaluation can determine.
If your solution for your client with the turned out foot is to tell them to start turning the foot in, you are asking them to consciously add a compensation strategy to their unconscious compensation strategy. You are getting even further away from their solution.

"Action Expresses Priorities"- Gandhi

“Action expresses priorities.” -Mahatma Gandhi

So much truth to this statement.  It pertains to gait analysis perfectly.  

For years now you have heard us say, “What you see is NOT what is wrong with someones gait, rather you see their COMPENSATION STRATEGY around what IS wrong." 

The body is always strategizing to negotiate around pain, instability (functional or anatomic) or immobility.  What you see in gait are those strategies. You may not see their immobility for example, you see how they move when increasing mobility in one or multiple areas to cope with immobility in another. 

*Translation= The gait action strategy you see expresses the body’s compensation priority to make gait possible around the underlying problems that are preventing the clean, optimal and primary gait motor pattern from surfacing.

Thanks to Gray Cook for unearthing this Gandhi quote on his twitter.