Do I Need a Gait Analysis for My Knee Pain

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I get asked often by people who know that I have a background in physical therapy if they should go get a gait analysis to assess how they move in order to fix their knee pain.


My quick answer is: it depends. I’ll give you an example of someone that should go get a gait analysis and I’ll give an example of someone who may not need one and can actually do a quick check on themselves.


Someone who should get a gait analysis for their knee pain

I like to run, so I’m in a lot of running groups on Facebook. Many of these athletes are very fit. They exercise regularly, they do strength training, stretching and obviously run (they’re part of the running group after all). Sometimes when one of them has been training for years, using a coach and doing everything right they still get some knee pain. They have no obvious gait deviation while walking or running. This is the person who should get a gait analysis to see how they are running. During a gait analysis the person doing the assessment can watch the runner at walking pace, slow running pace, training running pace, race day pace and sprinting pace. They can also use video to record and then slow down the analysis.


For someone who is doing regular strength training, has relatively strong muscles and no obvious deviations to the naked eye when they walk or run should go get a gait analysis.


Other things they can do on their own at home before they have a gait analysis or if they don’t know where to go are to think about these questions:

  1. Did they recently ramp up their training → was it more than 10% of time OR speed per week?

  2. Did they recently get new shoes?

  3. Did they switch from running outside to inside on the treadmill (or vice versa)?

  4. Did they fall, have an accident or injure themselves?


If someone can answer yes to any of these questions that may be why they suddenly have new onset knee pain and may not actually need a gait analysis but need to work with someone to fix the answers to these questions.


Ok how about someone else who doesn’t need a gait analysis for their knee pain?

Someone who I don’t recommend getting a gait analysis for their knee pain is a non-athletic person who has knee pain during their every day activity. They’ve had knee pain ongoing for years, maybe it comes and goes and overall has worsened over the years.


This person can do a few checks themselves, or have a family member check for them.

  1. Standing with feet hip width apart: where are your knees?

    1. Are they knock-kneed?

    2. Are they bow-legged?

  2. Standing on 1 leg without holding on

    1. Can you do that?

    2. Look at the hip of the leg you’re standing on: does it tilt so the opposite hip drops?

  3. When you walk:

    1. Do you “waddle”?

      1. Do your hips sway side to side?

    2. Do you take a shorter step on one side than the other?

      1. Does it seem like you take a quicker step with one leg and the other leg takes a normal length step?


By looking in the mirror, taking a picture or having family members look at you and seeing how you stand and how you walk, these will give you good insights. For someone who is not running often the things someone analyzing gait will see can be seen by you or a family member at home, you just need to know what to look for. So let’s go through these:


  1. Standing with feet hip width apart: where are your knees?

    1. Are they knock-kneed?

      1. Knees that are knocked together put added stress on the inside of the knees, and when they rub together that can create friction and its own source of pain.

    2. Are they bow-legged?

      1. Knees that are bow legged can put added stress on the outside of the knees where the joints come closer together, and can stretch out the inside portion of the knee adding some pain there.

  2. Standing on 1 leg without holding on

    1. Can you do that?

      1. If you can’t stand on one leg for at least 10 seconds you likely need to use a cane. You may be likely to fall and your balance can be contributing to your knee pain.

    2. Look at the hip of the leg you’re standing on: does it tilt so the opposite hip drops?

      1. When you stand on one leg the hip muscles of the leg you're standing on need to hold up your pelvis. If your hip drops it means the hip muscles on the outside of the hip are weak and need strengthening.

      2. Walking sideways helps strengthen these muscles. YouTube Video

      3. Doing sidelying hip abduction exercises help as well. YouTube Video

  3. When you walk:

    1. Do you “waddle”?

      1. Do your hips sway side to side?

        1. This is the same concept as the hip dropping when you stand on one leg at a time. The muscles in the hips that keep the pelvis level are weak if your hips sway from side to side.

        2. Walking sideways and sidelying hip abduction help these muscles.

    2. Do you take a shorter step on one side than the other?

      1. Does it seem like you take a quicker step with one leg and the other leg takes a normal length step?

        1. If it seems like one step is shorter than the other this can contribute to your knee pain because you aren’t taking the same stride length that your body height wants. This can put stress on different parts of your body including your hips, knees and back. And if you’re stepping harder on the short step because it’s quicker and you come down fast that can contribute to knee pain on that side. 

          1. Working on balance can improve your step length.

          2. If you’re stepping short because your knee hurts so much, finding ways to reduce that pain can improve the step length.


Ok let’s recap: You may need a gait analysis if you are a runner who regularly does strength and stretching and recently started having knee pain without having any other reason for why the pain came on. Someone who isn’t an athlete that has longstanding knee pain that has worsened over time can do a few things at home to see how they stand and walk including check if they have knock knees or bow legs, see if they can stand on one leg an dif they can does their hip drop, when they walk do they sway their hips side to side? For more information on how to fix these problems check out the full Youtube Video.


If you’re looking for knee pain relief check out this free guide I created just for you

Ali Marty

Hi! I’m Ali. I’ve been in the health and wellness space since graduating with a Doctor of Physical Therapy degree in 2012. I worked in the typical outpatient clinic with active men and women with orthopedic injuries (shin splints, Achilles tendonitis, muscle and ligament tears, knee pain, IT Band pain, plantar fasciitis, and hip and knee arthritis until 2018 at which point I started Mobile Physical Therapy in Las Vegas, Nevada. Over the past few years I’ve transitioned to helping women running runDisney races after they’ve had an injury and they want to finish strong and enjoy the rest of their runcation.

https://dralipt.com
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