Training out a crossover gait?
This gal came to see us with right-sided hamstring insertional pain. During gait analysis we noted that she has a crossover gait as seen in the first two sections of this video. In addition to making other changes both biomechanically (manipulation, gluteus medius exercises) and in her running style (“Rounding out her gait” and making her gait more “circular”, running with less impact on foot strike, extending her toes slightly in her shoes) she was told to run with her arms at her sides rather than across her body. You can see the results and the third part of this.
Because of her bilateral gluteus medius weakness that is seen with the dipping and lateral shift of the pelvis on the footstrike side, she moves her arms across her body to move her center of gravity over her feet.
Yes, there is much more work that needs to be done. This is one simple step in the entire process.
Can you see it?
Here we are again. We have looked at this picture before; once about head tilt, and another about flip flops and form.
Take a good look at this picture and what is different about the child in blue all the way to the right and all the others with the exception of the boy in pink, that we really cannot see?
Can you see it? No, we don’t mean the flip flops (but if you caught that all the boys were in sneakers and all the girls are in flip flops, you are good!)
How about looking at arm swing? Remember this post on arm swing and crossover gait, with the simple cue for correction? All of the children EXCEPT the boy in blue, are drawing their arms ACROSS their body (ie: flexion, internal rotation and adduction). Take a look at their legs. Yep, crossover gait (flexion, internal rotation and adduction). Little boy blues arms are going relatively straight and going in the saggital plane, where the others are going in the coronal plane.
We are not saying that blue does not have some gait challenges, like his torso shift to the left (or pelvic drift to the right), most likely do to gluteus medius weakness or inappropriate firing of the gluteus medius on the left stance phase leg; or his head tilt to the right, which most likely represents a compensation for the right pelvic drift and left body lean.
Arm swing. A very important clue to the puzzle we call gait and compensation. It is more prevalent than you think, and, in some cases, easily corrected with a simple cue.
The Gait Guys. Making it real and pertinent, in each and every post.
Correcting a cross over gait with arm swing? Is it really THAT easy? Sometimes, yes!
We noticed this patient had a cross over gait while running (1st few seconds of video. need to know more about crossover gait? click here). We noted she was crossing her arms over her body as well. We than had her run her hands and arms straight out. See the crossover disappear? Need to know more about arm swing? click here
We the had her do the same while walking. Easier to see, eh? That’s because it is often easier to “fudge” things when you are moving faster (ie: the basal ganglia of nervous system can interpolate where the body part is supposed to be, and because of momentum, there is less need for precision). When we do things slowly (like the 3 second Test), more precision is needed. Watch this short video clip a few more times.
The arms are essentially adducting when the arms cross over. The arms are reciprocally paired with the contralateral lower extremity. When you make a change in one, you often will make a change in the other.
Subtle. Yes. Easier to see when the task becomes more difficult. Yes. Pay attention, the answer is often right there if you look closely enough.
Providing the clues to help you be smarter, better, faster, stronger; we are The Gait Guys
special thanks to “Q” for allowing us to publish this video : )
Take a look at this gal.
Why does she have a cross over gait?
- note how much tibial varum she has (curvature of the tibial in the coronal plane)
- how much adduction of the right foot there is, potentially indicating a tight posterior compartment, or perhaps a loss of internal rotation of the right thigh
- the excessive posterior rotation of the left shoulder and upper body
- the subtle abduction of the right arm compared to the left
- the slight torso lean to the left
The correct answer is we don’t know until we examine her. Maybe is is there out of necessity or perhaps it is a more efficient running style for her. Here are some points:
Technical Issues with the crossover gait
The cross over gait may be:
- a more efficient running style
- a potential pathologic musculoskeletal motor pattern
- better for long distance runners
- a challenge to balance because of a narrower base of support
It may also be related to:
- a weak gluteus medius
- weak adductors
- excessive foot pronation
- lower extremity morpholgy (like tibial varum, forefoot varus)
- a weak vastus medialis
- a weak tibialis posterior
- and the list goes on
Join us, tomorrow, Wednesday evening, 8pm EST, 7 CST, 6 MST, 5PCT for an hour of crossover gait on chirocredit.com or onlinece.com for Biomechanics 316. We look forward to seeing you there..
The Gait Guys: Shawn and Ivo