The vast majority of us have a dominant or stronger side when it comes to writing, kicking a ball or dancing for example (nobody needs to see me dance!). The same can be said for running also. Very rarely will I meet a runner whose form appears symmetrical to the naked eye, let alone the close scrutiny of video analysis.
Possibly linked to the high injury rates experienced by runners, we tend to see a lot of asymmetries in running gait. While some asymmetries are truly down to natural one-sided dominance, many come as a result of previous injury or dysfunction. Put simply, our bodies have an incredible ability of finding a way to ‘get the job done’.
When we pick up an injury and try to run in pain, we have a tendency to subconsciously make slight compensatory adjustments to our movement patterns.
This is our body’s way of trying to offload the injured area and allowing us to run with reduced pain, albeit with a slightly altered technique. These changes in technique often manifest themselves as a noticeable ‘limp’.
When we continue to run in pain, or return from an injury without paying attention to running form, often we find ourselves reinforcing these compensatory movement patterns. This results in us developing a slightly new running form. The main problem comes when the new running technique involves the runner using (or rather not using) key muscle groups in a different way to that desired.
Often such a compensatory running gait will result in the decreased activation of muscles key to good running biomechanics. This ‘pain inhibition‘ has an annoying tendency of hanging around even once the original pain is long-gone… we are left with bad habits. A classic we often see is poor Glute Medius activation.
The usual ‘use it or lose it’ rule applies here. If a compensatory gait pattern dictates that a certain muscle becomes used less, it is likely to become weaker over time, creating somewhat of a vicious cycle. This cycle is only usually broken by proactively changing something for the positive – usually with corrective exercises and attention to form.
Things To Focus On
All things being equal, and barring any significant structural anatomical anomalies, the goal is for us to achieve right-left balance in a runner’s gait cycle.
The question is, what can we do to achieve right-left symmetry in running gait?
Get Pain Free First
Firstly we need to identify if pain is present – if it is, the first step is to reduce the symptoms with assistance of a good physiotherapist or similar sports injury professional. While pain is present, you’ll struggle to make a positive change to this cycle.
After successful treatment, once pain-free running is possible, an important late stage in running rehab is to identify weak links in running form. Where a right-left imbalance is noted, we can investigate further to see whether it is caused by a strength deficit, impaired neuromuscular control, or soft-tissue restriction.
Mobility and Stability
If upon assessment it is noted that movement at a particular joint is restricted on one side when compared to the other (left vs right) through tightness in a certain soft-tissue structure, we need to identify why. Often a muscle can be tight to protect or limit motion at a joint with poor functional stability.
Example: We might see increased activity in Tensor Fascia Lata (TFL) on one side due to poor Glute Medius activation on the same side when in single leg stance. Releasing TFL might give some initial relief to ITB related symptoms, but if Glute Medius is not also activated and strengthened, the hip will be left with less stability than it started – a definite risk for secondary injury, possibly low back in this example. Remember, there is a good reason why TFL was tight in the first place!
Strength and Neuromuscular Control
In reality, I find that asymmetries in running gait are rarely down to strength OR neuromuscular control deficits in isolation, these two factors are intrinsically linked. Before we can build strength in a movement pattern, we need to develop adequate neuromuscular control.
The single leg squat is a great exercise to both assess and develop both of these factors. Focus should first be placed on developing great technique, control and alignment. Inability to maintain good form through the execution of a set of single leg squats identifies neuromuscular control as a weak link. Many athletes will report one leg also feeling physically weaker. Unsurprisingly, this is a simple indicator of functional strength in a unilateral stance.
As a rehab progression towards running, I like to use a series of jumps then hops to work on dynamic control. Especially when hopping, run-specific neuromuscular control, proprioception and strength are all challenged. Using the simple drills in the video below, many runners will note one leg feeling harder to control than the other… Try it!
Careful with these hopping drills, start easy! The video shows an advanced variation.
Again the test becomes the exercise, if a particular leg is harder to control, practice it in short bursts.
Fundamental Running Drills
Once you have set about improving the any strength, neuromuscular control and mobility/stability deficits, it’s important to focus on some of the fundamental movement patterns of good running form.
There are a number of drills you can use to improve your running form. Here are some video examples of classic running drills to try.