Gait Training – What is it and why is it relevant to me?

To move freely and pain-free well into old age, we need to be able to move in the way nature intended. In principle, this is all pretty simple and it is the way you walk and run that is the base for the way your body is constructed to move.

Don’t walk and run in the way you should, and your joints will suffer the consequences, leading to chronic pain or even contributing to acute injuries such as sprains and strains, and even making you more prone to loss of balance and falls that lead to major injuries.

Basic Biomechanics

How should you walk and run? The bare bones of it is that your legs should move forward and back and up and down and your arms do the same, but work contra-laterally to your legs (i.e. your right arm comes forward as your left leg comes forward, the opposite on the other side) and also ipso-laterally (you right arm comes forward as your right leg goes back). However, your upper body differs in the way it facilitates arm movement to lower body leg movement. Your legs are closer together than your arms, so to work efficiently with your lower body, your upper body has developed a slinging mechanism. This is especially noticeable when throwing a ball, a punch, a kick, swinging a golf club or tennis racket (look at almost any sport and how the athlete generates power and you will always see upper body rotation), but is also at play during running and walking.

Arms and legs go forward and back and the connection with the trunk rotating propel you forward in your stride. I could go much deeper, but we will leave it there for now.

Note and a warning: How much upper body rotation do you do in the gym? Not much right? Done improperly weighted rotational exercises are some of the most hazardous exercises for most people. Most trainers and physios will steer clear of prescribing them for this reason. There is a process to learning such exercises, and there is great benefit in doing them properly, but don’t be quick to copy them if you don’t know what you’re doing!

We have evolved to walk and run very long distances

Ever wondered why people seem to enjoy a long walk or even marathons and ultramarathons? Well, the latest theories about our evolutionary history might explain it. Humans are thought to have evolved as foragers and persistence hunters. There are still hunter-gatherer tribes in the world today that live this way. Persistence hunting basically involves working as a group to track a prey animal and chasing it all day until it gets too tired or overheats. Most animals don’t sweat, so to cool-off they need a watering hole, shade, or to sit still and pant; they can’t cool down on the run like we can, so eventually they will stop and at this point it is easy to kill them (if you have ever walked or ran with your dog on a hot day, you might notice that they will refuse to move if you work them to the point of overheating). The unique human ability to track and work in teams also means we can plan water stops, take food with us, and other key aspects to keep going. Humans are the best long-distance athletes (land-based) in the animal kingdom. Every year there are several, “Horse vs Man”, marathons held in different parts of the world and even over a the relatively short distance of a marathon, men can and do beat the horses, usually when the weather is warmer.

The Problem

Why then, if we have evolved to run and walk all day does everyone seem to get injured if they do any amount of serious running or any other form of exercise for that matter? And for those that have no intention of running a marathon anytime soon, why is this at all relevant?

Firstly, for most of our evolutionary history we weren’t living well into our 70s and 80s. If you lived to 40, you’d be one of the lucky ones, so the aches and pains of old age would never have had the chance to kick in. Then also think about how recent our current way of life really is; a conservative estimate ages our species at about 150 000 – 250 000 years old. Just how much of our history have we been sitting at a desk, bent-over stressing about deadlines? Or sat in front of the TV or hunched over our smartphones? We’ve gone from hundreds of thousands of years being on our feet, all day (without comfortable, cushioned shoes on, I might add) to largely sedentary beings in the space of maybe a hundred years, and many of our current daily habits are even more recent than that.

Humans need to move to stay healthy, so a sedentary lifestyle is just not in-sync with our evolution. Nor is the combination of a highly stressful job with sitting all day, which causes probably the most common postural problem of kyphosis (rounded shoulders) coupled with a lordosis (hyperextension) of the lower back. The root cause is tight hip flexors from too much sitting. There is an array of other postural issues people have which vary widely and can relate tsomeone's lifestyle and genetics.

That simple motion of moving the legs and arms gets complicated with bad posture. The physics of your movement is compromised, so your body adapts. It utilizes muscles it shouldn’t, it rotates where it shouldn’t, and the joints go through ranges that they are able to do but aren’t meant to on a regular basis and smaller muscle groups take more of the load. All sorts of kinks to this simple movement start occurring and, over the years these kinks put pressure on different areas, slowly pulling your joints out of optimal alignment and leading to injury.

This is where things start to get more complicated, but essentially gait training helps you pull everything back to the way it should be, so that your joints are aligned and moving in ways that are efficient, i.e. dissipating all the force from your movements through the whole body, not localizing on certain areas.

I know people don’t come to the gym for a physics lesson, but it isn’t rocket science to notice that, for example, if your hips, knees, and ankles aren’t all aligned as your foot hits the ground or pushes off for a stride, your going to pay for it eventually. Unfortunately, it isn’t quite as simple as looking in the mirror and correcting it because your body loves to compensate and fixing one problem area might lead to unwanted changes elsewhere. You also may not know how to adjust your posture properly or even be able to do it.

How do you do it?

To begin with gait training involves no movement at all. You start with massage; you can do this yourself using a variety of massage tools or you can go to a massage therapist. A combination of both is quite a good idea as to be effective, massage needs to be done quite often. Then static postural exercises are practiced with a view to teaching the best neutral posture position, because without this you can’t even begin to move in the right way and do it safely. Many people may not get past this stage and won’t even need to in order to feel the benefits.

The next stage involves moving whilst maintaining a good neutral posture. This will involve full-body exercises with subtle upper body rotation integrated into core and leg movements. Huge emphasis is made on engaging the glutes and core even when exercising the arms, for example. No exercises are in isolation. It will look quite different from traditional gym exercises and usually involves using a lot less weight/resistance. Eventually, once all the basics are mastered, large, multi-planar, 3 dimensional movements, with a high degree of coordination and body control can be done. This stage is ONLY for those that have mastered the basics and is generally in the realm of high-level athletes, although not exclusively. These movements are dangerous without both the knowledge and practice of maintaining good posture and core control. Most people can expect to be able to master first stage movement exercises, which are no more risky than traditional weight training and will do.

Good news and bad news

Correcting your posture and improving your gait can be done, but it does require some dedication. Years and years of getting yourself into a problem is not going to be cured by the odd hour in the gym every now and then. Like anything worth doing in life, it requires hard work to see big results and there is no such thing as a quick fix to a complex problem. However, the good news is that even minor changes and a little practice can see relief in areas of tension, helping pain reduction, and slow further deterioration. With a good amount of application, you can literally feel yourself moving better and see noticeable changes in your posture.