Why You Don’t Need a Gait Analysis
My very first experience with gait evaluations was as an engineering student in the UW Neuromuscular Biomechanics Lab. Over a semester, I’d go to lab once a week. We’d place dozens of reflective markers on a runner, then record them running on a force-plate treadmill - a high-tech setup that measures exactly how much force you apply with each step, how your foot strikes the ground, and how that force travels through your body - all captured by a ring of high-speed motion-capture cameras for 3D biomechanical analysis. Fancy. Later, in PT school, I learned how to analyze gait in your usual clinic: using an iPad mounted on a tripod to take ~30 seconds of video to look for flaws like “overpronation", hip drop, or overstriding.
Most sports medicine or PT clinics offer a running gait analysis service - claiming it will help improve your performance or injury risk. My Garmin watch also informs me of my step rate and vertical oscillation, providing me with a nice, color-coded reminder that my vertical oscillation isn’t apparently as good as the elites.
Before you decide to worry about your Garmin metrics or book an appointment with your nearest clinic, here’s what you should know.
How Do We Measure Running Performance?
In running literature, performance is linked to a person’s running economy (RE) and VO₂max. VO₂max is the maximum amount of oxygen your body can use during intense exercise; while running economy refers to how efficiently a runner uses their oxygen at a given speed. If you take two runners with the same VO₂max, the one who is more economical will likely win the race because they use less energy to maintain the same pace.
Because running economy is so closely tied to performance, scientists have long been trying to determine what influences running economy and how to improve it. While the literature has determined several contributing factors such as tendon stiffness and shoe weight, the easiest variable to manipulate in the short-term is a person’s running biomechanics.
Which Biomechanics Influence Running Economy?
A 2024 systematic review in Sports Medicine analyzed 51 studies to determine which aspects of running form actually influence running economy. Here’s what they found:
Biomechanics not strongly associated with better economy:
Ground contact time (how much time your foot is on the ground)
Flight time (how long both feet are off the ground)
Joint angles throughout the gait cycle (e.g. how much knee bend your knee goes through while running)
Peak vertical ground reaction forces (how hard the ground pushes back on you when you strike)
Biomechanics with some positive association:
Higher step rate (cadence)
Lower vertical oscillation (less up-and-down movement)
Greater leg stiffness (the ability to store and return elastic energy efficiently)
These findings suggest that while some biomechanics can influence efficiency, many commonly scrutinized gait variables don’t seem to matter as much.
Do Biomechanics Influence Running Injury?
Naturally, scientists are also interested in determining if certain biomechanics can predict injury and, unfortunately, they have been unable to determine factors that are truly “risky.” For example, a 2022 article in Sports Medicine delved into 66 studies to identify biomechanical risk factors for common overuse injuries such as runner’s knee, Achilles tendon pain, and shin splints. They found that the data was too inconsistent or limited to create any meaningful risk profiles for injury. They concluded that running injuries result from a complex mix of mechanical stress, training load, and personal factors like sleep, nutrition, and prior injury — not how someone runs. These results were replicated by a separate group of authors in 2022, who also concluded that biomechanical measures could not be used as risk factors for running-related injuries.
Gait Retraining ≠ Improved Running Economy or Reduced Injury Risk
Knowing that higher step rates and a less bouncy running form are associated with improved running economy, many runners might still be tempted to flock to their nearest clinic to learn if their step rate is too low and how to be less bouncy. Recent research is also showing that probably isn’t helpful.
Gait retraining research is interested in determining if runners can actually change their running form; and furthermore, if those changes result in any changes in economy or injury risk. A 2022 systematic review and meta-analysis in The Journal of Orthopaedic and Sports Physical Therapy found that gait retraining did allow participants to:
Increase their step rate
Reduce their vertical loading rate by increasing step rate or focusing on landing lightly
Increase knee flexion angle at initial contact by training non-rearfoot striking
Shift runners away from heel striking
Interestingly, even though increased step rate is associated with improved running economy, runners who increased their step rate or foot strike pattern did not improve their running economy. In fact, a study done at the University of Cardiff in 2012 found that beginner runners improved their running economy simply by running more consistently over a period of 10 weeks. And another study found that healthy runners who were retrained to land with a forefoot strike actually experienced more injuries.
Is It Ever Worth Getting Your Gait Evaluated?
Does that mean gait evaluations are worthless? Not necessarily. When you're injured, temporary form changes can reduce stress on sensitive tissues and help you keep running.
For example, if you have knee pain and a very low step rate, your PT might suggest increasing cadence as a short-term strategy to reduce joint loading. That can be helpful, but it’s different from claiming gait retraining prevents injury or improves your race times.
The bottom line is that gait analysis and retraining won’t make you faster or prevent injury. If you want better performance, focus your time into what has been shown to work: consistent training and strategic strength training and plyometrics.
REFERENCES
Van Hooren B, Jukic I, Cox M, Frenken KG, Bautista I, Moore IS. The Relationship Between Running Biomechanics and Running Economy: A Systematic Review and Meta-Analysis of Observational Studies. Sports Med. 2024 May;54(5):1269-1316. doi: 10.1007/s40279-024-01997-3. Epub 2024 Mar 6. Erratum in: Sports Med. 2025 Mar;55(3):779-780. doi: 10.1007/s40279-024-02157-3. PMID: 38446400; PMCID: PMC11127892.
Willwacher S, Kurz M, Robbin J, Thelen M, Hamill J, Kelly L, Mai P. Running-Related Biomechanical Risk Factors for Overuse Injuries in Distance Runners: A Systematic Review Considering Injury Specificity and the Potentials for Future Research. Sports Med. 2022 Aug;52(8):1863-1877. doi: 10.1007/s40279-022-01666-3. Epub 2022 Mar 5. PMID: 35247202; PMCID: PMC9325808.
Peterson B, Hawke F, Spink M, Sadler S, Hawes M, Callister R, Chuter V. Biomechanical and Musculoskeletal Measurements as Risk Factors for Running-Related Injury in Non-elite Runners: A Systematic Review and Meta-analysis of Prospective Studies. Sports Med Open. 2022 Mar 7;8(1):38. doi: 10.1186/s40798-022-00416-z. PMID: 35254562; PMCID: PMC8901814.
Doyle E, Doyle TLA, Bonacci J, Fuller JT. The Effectiveness of Gait Retraining on Running Kinematics, Kinetics, Performance, Pain, and Injury in Distance Runners: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2022 Apr;52(4):192-A5. doi: 10.2519/jospt.2022.10585. Epub 2022 Feb 5. PMID: 35128941.
Moore IS, Jones AM, Dixon SJ. Mechanisms for improved running economy in beginner runners. Med Sci Sports Exerc. 2012 Sep;44(9):1756-63. doi: 10.1249/MSS.0b013e318255a727. PMID: 22525760.
