What happens in a running gait analysis? A physio check vs a shop treadmill test

What is a running gait analysis?

Gait simply means the way you walk or run. A running gait analysis looks at what your body does through each stride: how your foot lands, what your knees, hips and trunk are doing, and how many steps you take per minute (your cadence).

Most running assessments outside a research lab use ordinary video filmed from the side and from behind, rather than full 3D motion capture. A 2023 review of 17 studies found that 2D video gives repeatable measurements of joint angles during running, both between different assessors and between sessions. Its agreement with 3D lab systems was weaker, mostly low to moderate, and the authors advised particular caution with movements seen from the front and with rotation (Leporace et al., 2023).

In practice that means video is good for spotting patterns, comparing one side with the other and checking whether a change has stuck, but it is not a precise laboratory measurement. Any honest gait analysis should be read that way.

Shop treadmill check vs clinical gait analysis

Both are called gait analysis, but they answer different questions.

A shop check can be a helpful way to try a few pairs of shoes on the move. The weak point is the idea that your pronation tells you which shoe will prevent injury. In a Danish study of 927 new runners who all started in a neutral shoe, those with moderately pronated feet were not at higher risk of injury over a year than those with neutral feet. The authors said more work is needed on very pronated feet (Nielsen et al., 2014). A Cochrane review found that choosing footwear based on foot posture probably makes little or no difference to injury rates. That was the strongest finding in the review, although the trials behind it were in military recruits (Relph et al., 2022).

So if a shop check helps you find a pair that feels good, that is useful. Just do not treat the recommendation as injury prevention.

What happens in a running gait analysis with a physio

At The Treatment Table, your running is filmed and assessed by a physiotherapist. The session follows a simple order.

• A conversation first. Current or past injuries, how much and how often you run, what you are training for, and what you want to get out of the session. The footage means much more with this context.
• Filming your running. Bring the shoes you normally run in and kit you can move in, so the footage reflects how you actually run.
• Going through it together. The physio talks you through what they see, including what looks normal for you and does not need changing.
• A plan if one is needed. That might be a change to your training, a strength programme, a simple technique cue to practise, or a recommendation to get an injury properly assessed.

If the filming is done on a treadmill, it is a reasonable stand-in for running outside. A review of crossover studies found treadmill and overground running largely comparable for most measures, with some differences in the angles of the leg at foot strike (Van Hooren et al., 2020).

What does a gait analysis show, and what can it not tell you?

A gait analysis can show things like your cadence, where your foot lands relative to your body, how your knees and hips move as you land, and whether one side behaves differently from the other.

What it cannot do is predict injury from your running form alone. A systematic review of 16 prospective studies concluded that the evidence linking running biomechanics to injury risk is sparse and inconsistent. One of the few patterns with some support was greater inward movement of the hip (hip adduction) being linked with front of knee pain and ITB syndrome in female runners (Ceyssens et al., 2019).

That is why we do not try to correct everything that looks unusual on video. Running form varies a lot between people, and looking different is not the same as being a problem. How much and how quickly you build up your running still matters a great deal, which we cover in our guide to common running injuries.

Can changing how you run help?

Sometimes, for the right person. The best studied change is cadence. In a lab study of 45 recreational runners, taking about 5% more steps per minute at the same speed reduced the energy absorbed at the knee by around 20%, and a 10% increase also reduced load at the hip (Heiderscheit et al., 2011). That was a short treadmill study, and the authors noted it had not been shown to prevent or treat specific injuries.

A review that combined 46 studies with interviews of 16 international experts found plenty of evidence that running retraining changes how people move in the short term, but limited evidence on clinical outcomes. Visual and spoken feedback to reduce hip adduction in women with front of knee pain was one of the few approaches with clinical support, and the authors recommended tailoring retraining to the person and the injury (Barton et al., 2016).

In our experience, technique changes work best as one part of a plan alongside sensible training load and strength work for runners, rather than as a fix on their own.

Is gait analysis worth it?

It is most useful if:

• the same injury keeps coming back when you build your running up
• you are returning after an injury and want to check how you are running (our back to running guide covers the build up)
• you get pain only when you run, and an assessment has not found an obvious cause
• you want to make a deliberate change, such as your cadence, with someone checking it

It is less useful if you are new to running, pain free and mainly want help choosing shoes. Picking a comfortable pair and building up gradually matters more at that stage.

If you are injured now, start with a physio assessment rather than a gait analysis. Filming can come later, once the injury itself has been diagnosed. If you also want your strength measured, we offer VALD strength testing as a separate session.

Frequently asked questions

What does a running gait analysis show?

It shows how you move through each stride, such as your cadence (steps per minute), where your foot lands relative to your body, how your knees and hips move as you land, and differences between your left and right sides. Video is reliable for spotting patterns and tracking change, but it is less precise than 3D lab equipment, and running form alone cannot predict whether you will get injured.

Is gait analysis worth it?

It is most worthwhile if the same injury keeps coming back, you are returning after an injury, you only get pain when running, or you want to make a deliberate change such as your cadence with someone checking it. If you are new to running, pain free and mainly choosing shoes, a comfortable pair and a gradual build up matter more. If you are injured now, get the injury assessed first.

What is the difference between a shop gait analysis and a physio gait analysis?

A shop treadmill check is mainly used to suggest a shoe, often based on how much your foot rolls in. A physio-led gait analysis looks at your whole stride alongside your injury history, training and goals, and ends with an explanation and a plan if one is needed. Research suggests choosing shoes by foot posture probably makes little difference to injury risk.

How much does a running gait analysis cost in Liverpool?

At The Treatment Table, a running gait analysis costs £150. Your running is filmed and assessed by a physiotherapist, who talks you through what they see and what, if anything, is worth changing. We have clinics in Seaforth and Speke and you do not need a GP referral. If you are currently injured, a £45 physio assessment may be the better first step.

Should I change my running technique after a gait analysis?

Only if there is a good reason. Taking slightly more steps per minute reduces load at the knee in lab studies, and feedback to reduce inward hip movement has some support for women with front of knee pain. But evidence that technique changes prevent or treat injuries is limited, so they work best as one part of a plan alongside sensible training load and strength work.