Want to be healthy and strong? Total body power begins with the feet! The best runners exemplify perfect form—feet facing straight ahead, rolling from the heel through a strong arch, loading the ball of the foot and big toe, and pushing straight off the forefoot. The term for this action is “elite feet,” and it’s something we should all aspire to if we want to stay mobile and pain-free.
Foot function is too often ignored in the sports medicine field. Often, doctors address foot function only when a patient has a problem such as plantar fasciitis or tendinitis. But how the foot is loaded, aligned, and strikes the ground matters. A balanced, loaded foot leads to proper hip-muscle engagement, pelvic stability, stride power, speed, and agility. We routinely check runners at our gait analysis center to see how the body is performing, and to predict—with startling accuracy—where problems may arise.
In this article, our White Plains podiatrists discuss how to tell if you have elite feet, what exercises can strengthen foot strength and form, and what role a podiatrist may play in helping you improve foot stability.
Alabama newspaper The Dothan Eaglerecently explored the profound impact gait analysis had on a local college football team. The paper reports that the Trojan’s football program is “one of the first few U.S. college units to utilize DorsaVi, a ‘cutting edge’ movement analysis system.'” Video systems and gamer gear like Connect have been around for a long time, but wearable sensor technology and impact sensor technology has gotten a whole lot better within the last decade.
We’ve all seen funny YouTube videos of trips, falls, and face-plants from hapless victims texting while walking. While it’s funny to watch, texting while walking is such a serious problem you could possibly go to jail for it in New Jersey. Legal repercussions aren’t the only reason it’s dangerous – it poses an even greater risk of physical injury.
Patients come to our NYC gait analysis center, wondering, “Do I walk funny?” or “Do I walk weird?” Often, we meet with competitive runners looking to improve their stride or prevent injury. Indeed, our trained eyes can tell a lot about you based on your gait, stride, posture, and pace. Our computerized gait analysis technology can tell even more.
The equipment doesn’t come cheap: Southern Connecticut State University (SCSU) reportedly just spent $95,000 to acquire the high-quality treadmill, and another $20,000 for the three-dimensional cameras necessary to update their human performance lab. That is why you may be hard-pressed to find a fully loaded gait analysis center–even in a large metro area like New York City. The Center for Podiatric Care and Sports Medicine is one place you can find state-of-the-art biomechanical analysis equipment geared toward runners and other athletes looking to improve performance and prevent injuries.
Is running a dangerous sport? Are overuse injuries inevitable? The experts say, “no.” While injury rates among runners have been cited as high as 50 or 90 percent, it doesn’t have to be that way, says Dr. Josef Geldwert from The Center for Podiatric Care & Sports Medicine in NYC. As the old saying goes, an ounce of prevention is worth a pound of cure. Gait analysis is the best injury prevention tool in the sports medicine field.
“Over the past six years, the foot doctors at The Center for Podiatric Care and Sports Medicine have measured motion using a treadmill with 5,000 pressure-force sensors and a video camera hooked to a computer,” Dr. Geldwert explains. “The treadmill captures, tracks and analyzes the pressure and force of each step. This identifies where a person’s structural imperfections originate so that a specific treatment plan can be devised.”
Most of the running shoes you’ll find today feature a cushioned heel “for greater comfort.” However, it was recently discovered that these shoes may alter a runner’s biomechanics and actually diminish performance. This new report comes to us from the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
Having an abnormal gait could be the cause of your chronic back pain, reports CBS News. Many people go through physical therapy and even spinal manipulation from a chiropractor before discovering that an abnormality in walking pattern was the culprit all along. The newspaper cites a February 2009 study published in the Journal of the American Podiatric Medical Association that found corrective shoe inserts to be an effective way to treat abnormal gait and low back pain. After being fitted for custom shoe inserts to correct their imbalanced gait, 84 percent of the test subjects experienced improvement. More than a year later, the follow-up found that pain relief lasted more than twice as long as with previous treatments.
Gait analysis has become an important part of identifying the root cause of physical problems. Sports injury clinics find gait analysis to be a helpful guide in suggesting treatment options. In addition to a basic physical exam, this technology shows doctors precisely how many many aches, pains and injuries can start from the ground up. Patient history and other medical conditions are still an important part of treating an injury, but the computerized process has become an invaluable part of rehabilitation now as well.
Our ability to run seems as natural as our ability to walk. We simply put one foot before the other and speed it up a little. Yet some medical professionals say the thoughtlessness of running could yield big problems down the line.
“So many runners just run. So many people look at a (fitness) magazine and say ‘I can do that.’ Then they get hurt and wonder why,” said Jay Dicharry, a physical therapist and author of Anatomy for Runners. “If we prepare ourselves we’ll do a better job,” he adds.
Whether it’s posture, poor foot control or over-striding, a gait analysis can be a great place to start improving your step. While this type of test is most commonly associated with long-distance runners, it’s not exclusive. Research shows that gait analysis is important in assessing and treating conditions like Alzheimer’s and arthritis too.
Who Needs Gait Analysis?
Gait analysis can provide valuable insight for runners looking to improve their speed and performance. Yet, gait analysis can also reveal abnormalities caused by disease or injury and help people who suffer from pain in their backs, hips, knees, ankles, feet, legs, or neck.
There have been a number of studies in recent times identifying a link between cognitive function and gait. One study of 1,153 Alzheimer’s patients, conducted by researchers at the Basel Mobility Center in Switzerland, found that slower walking speed was linked with cognitive decline. The study’s lead author, Dr. Stephanie Bridenbaugh, issued a statement testifying that: “Gait analysis can simply, quickly and objectively measure walking.” She added, “When problems emerge, this may provide early detection of fall risk and the earliest stages of cognitive impairment in older adults.” A second study conducted by the Mayo Clinic found that patients with lower cadence, speed and stride length were predictive of declines in cognition, executive function, and memory 15 months later.
Many of the people we see here at the NYC Center for Podiatric Care and Sports Medicine are experiencing chronic pain and would like a clearer picture of all the factors which may be contributing to that pain. Gait analysis is an excellent way to see just what is going on.
How To Prepare For Gait Analysis
If you’ve never been to the clinic before, bring relevant medical records and test results from your primary doctor with you.
Wear comfortable shorts and your usual footwear. If you’ve recently changed footwear, bring your old pair too.
Plan to pay about $150 for the gait analysis (which includes a follow-up visit) — which is the same as a good pair of running shoes.
You may also want to consider asking some of the following questions at your appointment:
Would custom orthotics help improve my gait?
Are there any athletic activities that could help me?
Are there any athletic activities I should avoid?
Should I do any particular stretches each day?
Do you think my shoes are contributing to my problem?
What is my condition called, and where can I find more information about it?
How long will it take to see results from my treatment?
What Happens At Gait Analysis?
Our gait analysis procedure usually takes about an hour. First, you’ll be asked some basic questions about your day-to-day activities, such as: What surfaces do you regularly walk or run on? How many miles a week do you run? Do you use or have you ever used orthotics? Have you had any injuries? Where are you feeling pain? We’ll measure your feet and conduct a visual assessment your legs’ bone alignment, just as your general physician might. We can have you stand on a pad to check your arches and balance. We can also see where your weight is placed when you stand.
Next, you will need to take 10 consecutive steps without any assistance to achieve effective results. As you walk, we’ll examine your step length, stride length, cadence and cycle time. Runners in relatively good shape can jog on a treadmill. Through high-tech 3D video motion analysis, we’ll take joint angle measurements at normal and high speeds. Rather than use the naked eye to asses, we use 5,000 sensors on a mat that can calculate your foot step pattern and speed more precisely, as well as check the force and pressure of your steps.
Lastly, you’ll get to see the video played back, as we explain our findings. We’ll discuss all the various treatment options and give you some time to decide what you’d like to do.
“I am so grateful for having had Dr. Geldwert perform bunion surgery on both of my feet. I have complete confidence in him and continue to see him for other sports related injuries. I was cautious about having surgery for the first time, but his knowledge, patience, and skill made me completely comfortable in trusting him. And I couldn’t be any happier with the results!! When anything else feels wrong with my feet, I love that I now know to go immediately to him. He is my top choice for anyone searching for the best foot fixer/surgeon/sports doctor in NYC! Thank you, Dr. Geldwert!!!”
– J. M., Manhattan, NY
Manhattan Office 111 East 88th Street New York, NY 10128 (212) 996-1900 See map here
Westchester Office 10 Mitchell Place Suite 105 White Plains, NY 10601 (914) 328-3400 See map here
Manhattan Orthopedic and Sports Medicine 57 West 57th Street New York, NY 10019 (212) 996-1900 See map here
Dr. Josef J. Geldwert DPM, Dr. Katherine Lai DPM, Dr. Ryan Minara, DPM, and Dr. Mariola Rivera DPM serving Westchester County, White Plains, Ardsley, Bronxville, Harrison NY, Larchmont, Mamaroneck, New Rochelle, Rye, Scarsdale, Rye Brook, Chappaqua, and the surrounding area.
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