Gait analysis for runners: what I'm looking for, and why it's not what YouTube says

If you’ve watched any running content online in the last five years, you’ve probably been told that you should be a midfoot striker, that your cadence should be 180 steps per minute, and that overpronation is why your knees hurt. Each of those claims is either oversimplified, wrong, or both — and chasing them has caused more injuries than they’ve prevented.

Here’s what I actually look for in a gait analysis.

What I don’t watch for

Foot strike pattern isn’t the point. Rear-foot, mid-foot, or forefoot striking each have tradeoffs, and the literature doesn’t support one being universally better for injury prevention. What matters more is where your foot lands relative to your center of mass — if it’s landing too far in front of you (overstriding), that’s a problem regardless of which part of your foot touches first.

Cadence isn’t a magic number. 180 steps per minute was an observation from elite distance runners, not a prescription. Most recreational runners fall between 160 and 175 and run fine at their preferred cadence. What’s useful is knowing your natural cadence and whether a 5% increase might reduce impact loading if you’re injury-prone — not hitting an arbitrary target.

Pronation isn’t a villain. Your foot pronates as part of normal shock absorption. “Overpronation” as a clinical concept has been largely debunked as a cause of running injuries. The shoe industry built itself around stability shoes that haven’t been shown to prevent injury in most cases.

What I actually watch for

Overstriding and braking. The foot landing too far ahead of the center of mass creates a braking force on every step and loads the knee and shin much harder than a more vertical landing. This is one of the most common findings in runners with shin splints and knee pain, and it’s very fixable — usually with a small cadence increase and cueing to run “tall.”

Asymmetry. Does one leg push off longer? Does one arm swing more? Is hip drop worse on one side? Asymmetries compound over thousands of strides per run and show up as repetitive strain on whichever side is overloading.

Pelvic drop (contralateral). When you’re on your right leg, does your left hip drop down? That’s a hip stability failure at the glute medius, and it’s strongly associated with IT band syndrome, runner’s knee, and low back pain.

Arm swing and trunk rotation. Arms that cross the midline force compensatory rotation at the pelvis — your legs aren’t running straight, they’re working to cancel out your upper body’s rotation. Small upper-body changes often fix stubborn lower-body symptoms.

Cadence under fatigue. I care less about cadence at mile one than cadence at mile five. Mechanics fall apart under fatigue; what does yours look like in the last third of a run?

Why video and slow-motion matter

You cannot assess gait reliably from watching a runner in real time. Human eyes can’t register what’s happening in a 300-millisecond foot contact. I film from the side, from the front, and from behind — at high frame rate — and review the footage frame-by-frame. Small details show up in video that don’t at full speed.

What to do with the analysis

The output is usually two or three specific things to work on — a slight cadence shift, a hip stability exercise, a cue for posture — and then we run again and compare. The shifts that matter are ones the runner can actually execute and sustain. Anything that takes conscious effort every step for weeks is not a sustainable fix. We want changes that become automatic within a few runs.

If you’ve been dealing with a recurring running injury and you’ve been following generic gait advice from the internet, a specific video-based analysis often finds the thing that’s actually wrong — and it’s almost never what you thought.