3D Walking
and Running
Gait Retraining

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Walking and running are natural human motor skills that we develop in early childhood, before most of us can remember. But age, injuries, bad habits and repetitive use can interfere with efficient movement, creating mechanical errors that reduce performance and increase your risk of injuries. Running gait analysis and retraining can correct motor deficiencies to relieve pain, improve balance and stability, enhance performance and mitigate injury risk.

Compensation Patterns in Gait


Although walking and running seem pretty basic, both require highly coordinated and complex interactions between your muscles, bones, joints and connective tissue, all orchestrated by your Central Nervous System, or CNS. Gravity and other internal and external forces also play a role, governing how we maintain stability while standing, walking and running.

When any of the structures of the musculoskeletal system associated with human movement become injured or otherwise impaired, it dramatically alters how those structures interact, degrading movement quality and causing instability or even disability.

Fortunately, unlike an inanimate machine, the human body has more joints and muscles than it needs for performing basic motor skills, and we are able to recruit alternative strategies to achieve our objectives. But relying on compensatory mechanisms will ultimately result in reduced gait efficiency and its negative consequences.

Goals of Gait Analysis and Retraining

Gait analysis is the careful study of an individual patient’s walking or running mechanics. In the past, it was largely observational, but today’s technologies have provided us with precise tools for measuring the various components of gait and quantifying that information, to provide a baseline against which corrective changes can be measured.

Once we obtain a comprehensive overview of the patient’s gait anomalies, we are able to provide an individualized corrective program to restore optimal gait. For example, a previous running injury is the most common risk factor for future injuries. By identifying compensation patterns and correcting them, the runner’s risk of injury is significantly reduced.

Gait analysis and retraining is beneficial to a broad spectrum of patients:

  • Recreational and competitive runners who want to improve performance and avoid injuries.
  • Athletes in sports that involve running who want to gain a competitive edge.
  • New mothers who developed compensation patterns during pregnancy.
  • Patients who have suffered injuries to the lower extremities.
  • People suffering from chronic back pain.
  • Older adults who want to improve balance and stability, and avoid falls.

It is safe to assume that most adults have developed faulty gait patterns over time, brought on by repetitive daily activities and habits that either underuse or overuse the body’s structures, creating imbalances. Virtually anyone can benefit from gait retraining, which can profoundly impact quality of life.

Measuring Walking and Running Gait

To accurately measure an individual’s gait, we need to consider both movement patterns (kinematics) and force loads (kinetics). When either of those mechanical elements is abnormal or suboptimal, it overloads the musculoskeletal system, causing pain and injury. When forces and movement patterns are both impaired, the risk of injury is even greater.

Cutting edge technologies empower us to analyze and quantify human gait in real time. Data on joint angles, muscle activation patterns, ground reaction forces and compensation patterns can then be used to provide powerful feedback for corrective retraining. Recent innovations have enabled us to get a 3-dimensional view of gait, to analyze rotational movements in the transverse plane, where most running injuries occur.

Gait retraining entails more than simply altering motor patterns. When a motor pattern changes, it inevitably affects the entire musculoskeletal system, altering loads to other components along the kinetic chain. An effective gait retraining program includes exercises to strengthen muscles and optimize joint range of motion.

3D Gait Analysis at NYDNRehab

The sports medicine team at NYDNRehab approaches gait analysis from a data-driven perspective. We believe that if we can measure and quantify individual kinematic and kinetic metrics for walking and running gait, we can successfully use that data to retrain our clients’ gait for optimal performance.

Our state-of-the-art gait lab features some of the most sophisticated equipment for gait analysis in the United States, rarely found in private clinics. In addition, we use innovative treatment methods like DNS, to restore innate motor patterns.

Our technological gait analysis toolkit includes:

  • SEMG (surface electromyography) to assess muscle activation patterns
  • Zebris instrumented treadmill to analyze foot pressure distribution
  • Alter-G anti-gravity treadmill for injury rehabilitation
  • 3D infrared cameras to assess joint angles
  • Dual force plate technology to assess ground reaction forces
  • C.A.R.E.N (computer assisted rehabilitation environment) for real-time virtual feedback
  • High resolution musculoskeletal ultrasound, to view damaged structures in real time.
  • Sophisticated computer software to collect and analyze data
  • KINEO systems for optimizing strength, stability and range of motion

Most importantly, NYDNRehab employs a world-class staff of experienced practitioners, capable of analyzing and interpreting gait analysis data, and using it to develop individualized retraining programs that restore gait and boost performance.


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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