Physical Therapy For A Painful Gait Or Tread Lightly On The Path To Physical Therapy

Painful Gait or Tread Lightly

Simply put, your gait is a pattern of how you walk or run. This basic motor function is essentially the same for all bipeds; a step using a heel-to-toe movement with weight balanced on one side, then a shift to the other foot, but, many daily practices change our stride making normal gait irregular, painful and, for some, unbearable. From the size of heels worn to the stresses of pounding the pavement, humans do serious bodily damage without even realizing it!

You probably have never considered this thought but, just standing barefoot versus elevated on any heel one-inch or greater will change the 90-degree angle of your stance; depending on the heel height, a shortening of the muscles and tendons will also occur. A heel as low as one inch can adversely affect your posture, causing you to tilt forward, upset your natural balance and force your body to internally shift the delicate harmony of joints and bones producing discomfort with every step.

How incredible is this structure containing all of our musculature which we use and abuse without really thinking about the consequences!

Have you ever considered what happens as a result of these damaging weight shifts to the neuromuscular systems of your body? For example, check the tread and the wear pattern on the heels and soles of your shoes. Loss of tread and uneven heels can cause instability to your ankles, an inordinate amount of strain to small bones in your foot and shift the body load altering your balance.

Spike-heeled stilettos are just as damaging as incorrect soles to the wearer; the entire body has to realign itself, shifting into an unnatural position. According to William A. Rossi, D.P.M, the normal angle of a woman’s pelvis is twenty-five degrees; standing on three-inch heels, that angle changes to sixty degrees causing the shifting of internal organs. You may not notice it but the shoes you wear have a total body impact, from the inside-out!

Chances are, if your lower back or feet hurt on a daily basis, your attention will be drawn to it and, if the pain becomes debilitating, you might contact a specialist such as a physical therapist to bring you back to health.

Learning about your gait is the first step to relief; a gait analysis points out the weaknesses in your body and helps build strength and gain mobility for those folks starting to feel the effects of time. Data is collected with reference to how your muscles move while walking or running, the force to the joints as the foot strikes the ground – basically, the overall cycle of your gait, so that clinicians can provide physical therapy to help with rehabilitation.

Is Physical Therapy Dangerous? Physical Therapy or PT is another name for rehabilitation so no, as long as it is directed and performed by qualified personnel, physical therapy will enhance mobility, strength and increase fitness.

According to, physical therapy efficacy rates to assist with balance problems and gait training has been perceived as quite effective and with no apparent side effects.

Performing the correct procedures is essential and can help improve years of abuse. Hammertoes and claw toes are two obvious effects from ill-fitting shoes which can be eased with the help of PT’s and an exercise regimen. If a bone has been broken, such as with a Metatarsal Fracture, after ice, realignment restrain and rest, PT’s come to the rescue, recouping movement through strengthening and stretching exercises which can regain strength and range of motion.

Chances are you don’t need surgery for basic aches and pains and that there is nothing in your gait that requires physical therapy. But, if you are among the growing numbers of pain sufferers who are pushing through your day, take heed. Identify your walking patterns, consider damage that you might be doing on a daily basis from inadequate footwear and know that your body is your temple- this is the first step to relief.


Dr. Kalika’s experience comes from working with Prof. Pavel Kolar the renowned Czech School of Rehabilitation as well as Prof. Christopher Powers who is one of the worlds leader in treatment and prevention of running injuries. Another unique approach that Dr.Kalika is certified in is ISM (integrated system model) therapy.This approach is now used by most elite EPL soccer teams (Manchester city and Chelsea) to keep their players away from injuries as well as for in season rehabilitation. Dr. Kalika has knowledge not only in several different types of therapy he also has expertise with diagnostic ultrasound, gait and running analysis, orthopedics, and sports medicine. The combination of all these different experiences helps him correctly diagnose and rehabilitate athletes better than most clinics in NYC. Dr. Kalika has also studied under top leading running authorities like Brian Hidershide and Irene Davis. These experiences and extra training has given Dr. Kalika the unique expertise in running performance.


Despite 10 years of experience with instrumented gait analysis, attending multiple running medicine conferences, certification in clinical biomechanics, and personal experience with Chris Powers, I decided to undertake this additional certification to ensure that no single detail concerning the assessment and treatment of running injuries escapes me.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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