Use of Video Gait Analysis in Running Shoe Stores

Hi Graig – interesting, are you going to take this further?

Do you think the results would differ if you allowed the runners to adjust to their natural cadence with each shoe, rather than sticking to 8kph? I am making this assumption as runners often prefer shoe ‘A’ over shoe ‘B’ because they feel they run more efficiently.

Was there any change in medial/lateral deviation in CoP between shoes?

 

This is very much a work in progress and preliminary ... just testing to see if the parameter we measured was worth pursuing.

 

The "Black Box" is usually provided by a manufacturer to specifically recommend that brand's motion control or neutral runner. They are usually flashy marketing tools, but they should never replace the experience of the practitioner.

For our part, we measure feet, visually observe gait, check for shoe & insole wear and ask if there's anything causing the customer pain. All of this information is collected without the use of flashy marketing tools.

For me, the real value of some of these technologies is that they can serve as an objective witness to data you have manually collected. If you notice significant callusing behind met heads 2-5, the Aetrex iStep machine (and other similar technologies) will light those calluses up like a Christmas tree. Now my visual and manual observation has been confirmed by a neutral witness, and the customer feels more at ease with shoe or insole recommendations for their desired activities.

Video gait analysis and pressure plate systems are not a replacement for knowledge and experience. But they can serve as a helpful communication tool when I am talking to a customer and making a shoe recommendation.

I do not own a running shoe store, but I do sell a few shoes for runners. Most of my customers work on their feet for a living, or they are looking for shoes that make walking and exercise more enjoyable.

 

Let me understand it better - so according to your assumption that the quicker the preassure center moves forward the better - the better is high percentage?

 

That is the basis of the hypothesis

The lower percentage is better - in the abstract above that is the % of the stance phase that load was gone from the heel.

 

Contradiction? Re: Use of Video Gait Analysis in Running Shoe Stores

Craig,
some words from above: "assumptions" , "could" , "presumably". Does this not indicate that even scientific resarchers aren't sure about what they find? That is not a problem of course, that's the reason for research.

The two studies above are a good example of studies, which learn us nothing about the way running-shoes should be advised; it's all known. I find them quite worthless, because it's wrong to put all flat feet in e.g. a Brooks Beast. Because of the dual density the people who won't need it, will get problems. Flat feet or not. The harder the medial posting, the more problems probably. Most serious running-shops will not work with this ridiculous way of advising runningshoes. Yes, you will find this still in RunnersWorl Magazine, or on some sites of runningshoe brands, and I'm detesting this as much as you do.

You all speak about "kinetics" and "kinematics" and how important the diffeference between these terms is, but on the other hand you easily do research on assumptions based on static information as foot type or kneebending while standing. And in the meanwhile you are capable of giving a good shoe advice based on this static information?

This is very contradictive.

The foot type is NOT an indication of one's running gait. It's so much more complex. You can never predict exactly beforehand, how the interaction between the shoe and the runner is. You should SEE this, and that's why you need video.

I you have some better examples of studies about runningshoes and relations to injuries, I'll love to read them.

Have a nice weekend.

 

This chap has just literally left my clinic and I immediately thought of this thread.

So, we have a young (18 years old) fit healthy guy who has a place in the London Marathon in April. First ever marathon but a very sporty type. Longest run to date = 9 miles. Asymptomatic during all training (and other sports). Advised to go to a running store to get himself a pair of 'proper' running shoes which he did about 3 weeks ago.

I've attached some freeze frames of his dynamic midstance during a 9.0km/h treadmill run. He was sold a pair of Brooks Adrenaline (for his 'overpronation' one assumes? Don't even go there...). Remember he was symptom free up to this point. Arguably there's an alteration in his rearfoot kinematics when you compare the two pictures..

Any takers on why he came to see me today??

 

Probably because he's now developed symptoms, but was that due to his change in footwear or a change in training intensity or some other factor?

 

He tells me that nothing else but the trainers had changed in the last 3 weeks. (Whether thats the case or not who knows but it's all I have to go on). His symptoms came on about 4-5 miles into a run not long after his new trainers were introduced into the equation. Symptoms then gradually worsened with each run attempted until he was driven to see the Physio (late last week) and then me today.

Sweepstake for the symptoms?

 

I´ll put a bid on PFS

 

Peroneals if he's getting too much supination moment from the shoe, but given that its a shoe designed to increase supination moment, I'll go plantar fasciitis, post. tib.
Maybe, knee pain? Give me a clue: foot or leg?

 

Ok, clues.

1. Symptoms are in the foot.
2. Plantar aspect of medial columns have had the bejeezus blistered out of them.

 

Peroneal pain and cuboid syndrome

 

Ok, he could have pain from peroneous longus as it tries it's hardest to stabilize the medial column, or tib anterior to avoid the pain from the blisters by supinating away from the painful stimulus, or he might have 1st MTPJ pain as the increased loading on the shaft of the first met might be disrupting biomechanics there. Could have plantar fascial irritation, or problems with the hallucal flexors..... or he could have painful blisters... I give in. I don't do diagnosis by telephone, and I don't do it via t'interweb either.

 

1st MPJ pain

 

I'll put a bid on lateral ankle problems
JB

 

Sorry didn' the realise Simon had already said that. In that case, I am going for intermetarsal pain. To be honest, Simon hasn't left much to choose from

 

Is it possible that he is just doing too much too soon? His longest previous run was only 9 miles. Did he build a solid base foundation of miles before deciding to start training for a marathon?

I've learned from the barefoot thread that we shouldn't just blame the shoes for what could be a result of training.

 

You're allowed to pick the same as me Robin. What this thread shows is the need for a good history and physical. Diagnosis via internet and a couple of stills is not possible.

 

Damn. There goes my next business model

 

Obviously it's possible. He has been gradually increasing his mileage since November. His 9 mile run was in early January. His first run in his new shoes (mid Jan) elicited symptoms 4-5 miles in. Pain in them ever since. My gut feeling (rightly or wrongly) is that it's the shoes.

Too true. But thanks for playing.

Quite intense pain on palpation of 5th metatarsal (mid-shaft level).
Peroneal discomfort.

 

I was right first time, so maybe there is a business model in there.....

It does raise an interesting theoretical though; how does peroneal activity impact on 5th metatarsal bending moment?

 

Foreign body in the apex of his left 5th?

 

I'd try to keep foreign body's away from the apex of any of my toes, which is why I don't run barefoot, but then I'd just get accused of being xenophobic.

 

This runner is completely "blocked" in his normal movement, I agree. If you look at the still of his bare foot, I must say, I see nothing special. The adrenaline is a very corrective shoe. You will cause problems, if you put a "neutral"runner on this shoes.
A nice example of an incompetent "shoe-advisor".

 

Clearly, a xenophobe you are not. Glad you had a great time in Porto

 

Awesome game.
So lets just say if it is the shoes and not any other external factor, what is the explanation for mechanism of injury?
Ian do you know what shoes he was wearing before he was told to get "proper" running shoes?

 

Sorry I thought someone mentioned the word sweepstake. Not that I am easily sucked in by the mention of gambling....... no no no.!

 

While I love teaching overseas, the great thing about going away from home, is the coming back to all that you can't leave behind.

 

simon, did you feel like a stranger in a strange land?
i think you should try and get a U2 reference into all of your posts from now on. can be as obvious or subtle as you like. first to spot it gets a prize of a pair of barefoot running shoes. thats RobinP sucked in again!

JB

 

As an unknown caller JB, you'll first have to spot and decipher the hidden message on the aforementioned album cover... without using google (took me a couple of years). Robert or Dave Smith might see it.

 

Not me, no way. No way jose....... did you say U2?

 

Ah now I remember this vaguely. Is it not some kind of biblical reference in the background? Like the John 13:16 ( or whatever it is exactly) that you see folk holding up at sporting events. Can't mind what it means or represents though and cd is up the loft. There is a fair chance the wife will go mental if I go up just now, start scratching about and wake up the weans.
Will check tomorrow
Cheers
JB

 

Yep, the numbers are falling off the clock face, time for bed...

 

For starters I don't think you can really assess someone from the original info...

I haven't seen the latest adrenalines as they are not sold here, however I do remember them being a shoe where I found the density of the lateral aspect of the midsole to be very soft, and the medial posting very firm. I guess this would be along the lines on Corne's comment that it is a very corrective shoe... The gradient between the different densities of the lateral and medial midsole is too great.
This is an issue in many 'stability/ motion control' shoes which can lead to lateral instability overload and lends weight to the argument that many shoes are 'over engineered'

I would be interested in seeing a video rather than the stills- I would be expecting that he has a increased varus lateral midfoot strike and, this leads to increased lateral column loading through the initial load phase- a slight shift out before the natural pronation motion occurs.
Peroneals will be worked overtime- this is the discomfort, and he is likely to have increased peroneal nerve tension.
5th met will also have increased loading through propulsion- this may be the reason for the pain on palpation. Often I also see increased tightness through the ITB and sometimes PFJ and hamstring tightness in these cases.
If this is the case, then it will get worse as the shoe wears and the midsole compresses further.
Does he have an older pair of shoes where you can see the wear pattern?
Always good to see some clinical examples...

 

Stress #?

 

How do you define a 'neutral runner' Corne?

To paraphrase: "Just normal trainers". He didn't know the make or model, just that they were definitely not 'running' shoes.

Agreed - it was just a bit of fun though...

Sorry, the vids were far too big to attach (I even had to resize the pics before they'd upload). He has no other symptoms at all (at the moment). No other shoes were available to inspect at time of consult. Neural tests all negative.

I'm of the thought that the sudden introduction of a stiffer midsole medially has changed the temporal loading pattern of his lateral column, and probably increased the peroneal work load (by introducing an increased subtalar joint supination moment).

We currrently have a high index of suspicion for a 5th metatarsal stress reaction

 

Hi Craig,

The use of video gait analysis in a footwear retail setting has become a common technique which has grown over the last few years. There are many stores around that do this type of assessment in the UK, US and AUS.

I can understand why people may think of it as a marketing ploy. I can't speak for the ones in the US and UK but being a past employee of one of the Melbourne based retailers, I definitely did not see it as a marketing ploy or scheme.

We would use video gait analysis to assess the patient's barefoot movement and then make a decision on the best shoe for that customer based on their size, weight, level and type of activity etc. The shoe selected would then be assessed on the treadmill to ensure the customer was not over or under corrected. Unless an improvement in rear foot to lower limb alignment was visible the shoe would not be sold.

As you said, the Asics Kayano, Brooks Beast, the Nike Equalon etc are all good shoes. But how is a podiatrist able to recommend a shoe to a patient and suggest they spend $200+ on a shoe without knowing whether it will provide the support and stability they require??? I definitely don't want my patients running around in a shoe that is inappropriate for their foot type. ie. if you have a person that is a supinator with recurring anlke sprains your not going to sell them an Adrenaline or Beast - specifically designed to prevent moderate to significant overpronation.

Unfortunately you can't rely on everything the shoe reps says. The mild changes to the structure or design of the shoe can often impact in function and if it has a negative impact they aren't about to tell us about it.

I don't know what the other stores are like but the one I worked at for almost 2 and 1/2 years was owned by podiatrists and had qualified pods or final year students working for them. That is where I send all my patients to buy footwear....

 

One must ask WHY? Is it because shoe retailers think that diagnostically they can manage lower limb issues? Or is it because "bells and whistles" sells shoes?

Well you might not, but it most certainly is - ask athletes foot in Australia what there profit margins rose to after the introduction of the foot fit system - and what exactly does that system tell you diagnostically?

But what exactly are you looking at to assess them? This question intrigues me - if you are looking at "position" arguably you are looking at the wrong thing. How do you assess "force" via a treadmill video gait analysis? For example would a 65kg female with pes plano valgus do better in a Brooks Ariel or Adrenaline GTS or an ASICS 2160?

How does a shoe store do this with a video treadmill? If we cannot ascertain that what we are looking at even correlates to force, how can you recommend a shoe based on "bells and whistles"?

The whole "diagnostics" in a shoe store worries me - especially when Podiatrists are NOT involved. It simply does not help if what you think you are assessing is not really what you are assessing at all!

So - lets throw the gauntlet down - in a posterior facing video of a patient walking on a treadmill what exactly should I be assessing? Any takers?

 

"..lets throw the gauntlet down.."

Please add to your Gauntlet toss.

Does the client walk the same on a treadmill as they do on the ground?

Go back to link of the young boy walking on a treadmill for the ACA channel 9 TV cameras and tell me thats how he walks normally